2012 #FNCE Celiac Disease Session Recap and G-Free Pavillion

I had a lot of fun walking through the gluten free section at the expo at #FNCE and saw a lot of great g-free products – some old and some I hadn’t seen before. Then later, I got to sit in on a really interesting session called “Celiac Disease: It’s Not Just the Digestive Tract” with Alessio Fasano, MD and Carren Sellers, MMSc, RD, LD, CDE.

By now, most people have at least heard of Celiac Disease, or might even know of someone who has it. It’s become much more commonly diagnosed over the years, mostly due to new diagnostic developments.

I wrote a session summary below and included links to some of the exhibit hall gluten-free products.

My key “take-aways” from the session were that people with Celiac need to be very careful with cross-contamination issues. There is no mandatory labeling for gluten-free so there is a chance products marketed as “gluten free” have traces and can cause a reaction.

Although this was not brought up in the session, I am aware of the gluten-free certification organization — “Products carrying the GF logo represents unmatched reliability and for meeting strict gluten-free standards. GFCO is the leading gluten-free certification program in the world.” You can look for the seal below on products to know they are truly gluten-free.

The other key “take away” was that people could have Celiac disease without GI symptoms that most people expect to feel. For example, iron deficiency anemia or fatigue could be the only symptom. If you aren’t sure you should definitely see a Registered Dietitian who specializes in digestive health.

If you are in the D.C. area, you may want to take a look at my digestive health services. If not, email me anyway and I can help you find a good RD in your area.

Here’s the detailed summary.

What is Celiac?

Celiac disease is an autoimmune disorder that is triggered by gluten, a protein found in wheat, barley and rye. According to the University of Chicago Celiac Disease Center the prevalence in the US is 1 in 133; an estimated 97% of those people living with it are undiagnosed.

What are the Symptoms?

If a person with celiac disease eats foods with those ingredients they might experience GI issues like chronic diarrhea. But one thing the panelists discussed was that many people don’t, and that makes nailing down a diagnosis potentially very difficult. Many people don’t experience any physical symptoms, but instead feel fatigue, and also very commonly anemia. It’s also found to be a co morbidity of Hashimoto Thyroiditis, another autoimmune disorder. Many times family history can also be a factor.

Gluten in Hiding

Many times foods that wouldn’t normally contain gluten can become cross contaminated through processing. Always read labels because many times you’ll see it will say somewhere on the label that it’s processed in a facility that also produces wheat. Labeling requirements are still being sorted out, but some products do carry a seal of approval. Here a few other hidden gluten sources mentioned in the session:

  • Coffee flavorings
  • Lipstick – the long-lasting kinds
  • Imitation seafood – the real stuff is g-free, but not the fake stuff
  • Fries – if they’re fried in the same oil as anything battered
  • Any contaminated cooking surface
  • Oats can potentially be if they’re produced in a plant that also processes wheat products
  • “flavorings”, “seasonings” and “smoke flavoring” all can contain barley
  • Basically, “when in doubt, leave it out”!

I’m Celiac – Now What?

The good news is, it’s completely treatable. The bad news is that you will need to avoid gluten for the rest of your life, which most likely means a big change to your eating habits.

Walking through the FNCE exhibit hall I found a lot of great products that can be a part of a well balanced gluten free diet. Here are some of the ones I really liked:

  • Gluten Free Living Magazine – great articles, tips, recipes and resources for people living with celiac.
  • Bob’s Red Mill has a over 70 products that are gluten free including baking mixes and flours
  • Pamela’s – she’s been making g-free foods since 1988 including a line of baking mixes
  • Udi’s has a really tasty line of g-free breads, tortillas and other baked goods
  • San-J – gluten free soy and tamari sauces that taste delicious
  • Dried cranberries – I was really excited to hear they’re coming out with 50% lower sugar versions next year!
  • Lundberg Rice – they offer a number of rice snack chips for those crunchy cravings as well as pastas, rices, couscous and, of course rice.
  • Sorghum flour – a whole grain alternative to wheat flour that’s great for baking. I tried cookies baked with it and they were amazing

Other Helpful Resources

Here are a few resources I found in the expo that I thought might be useful for folks

  • www.celiacdisease.net – if you’re newly diagnosed you might qualify for a free Gluten Free Care Package
  • www.gluten.net – find local gluten intolerance support groups and educational materials
  • Jump Start Your Gluten-Free Diet: Living with Celiac/Coeliac Disease & Gluten Intolerance – download the free e-book put out by the University of Chicago Celiac Disease Center
  • Shelly Case has a great resource guide
  • Rachel Begun, The Gluten-Free RD
  • InspiredRD blog has great recipes

Does someone you know have Celiac disease and need more information on how to cope?

Compare Your Favorite Foods Using MyFood-A-Pedia

MyFood-A-Pedia is a new nutrition tool designed for users to quickly access a food’s calories and MyPyramid food group information. This application also allows you to compare two different food items.

What makes this tool unique from other online calorie counters is that is calculates the total number of discretionary – or “extra”- calories from alcohol, solid fats, and added sugars in foods. These “extras” contribute to weight gain mainly because they sneak into our diets. Added sugars in “juice” drinks, sodas, and fat-free or light products can sneak up on a dieter without them even being aware. Alcohol contains 7 calories per gram and contains no nutritional benefit. Solid fats – such as saturated and trans fats – are artery-clogging fats that lead to atherosclerosis and other heart issues.

I did a few comparisons on the MyFood-A-Pedia site to give you an idea of how much two foods can vary – or how little they vary – in terms of their discretionary calories and nutritional benefit:

1. Orange Juice vs. Orange (Raw): One raw orange contains 62 calories, in comparison to a cup of sweetened orange juice that contains 130 calories. The orange juice also contains 29 extra calories, most likely from added sugars.

2. French Fries (deep-fried) vs. Baked Potato (plain): The calorie difference between French fries and a baked potato was huge – more than 300 calories! (478 for deep-fried french fries with ketchup compared to 159 for a baked potato). The French fries also contained 238 extra calories from solid fats… more than the total for the baked potato!

source: MyFood-A-Pedia

3. Butter vs. Margarine (and other spreads): I chose butter, stick margarine, and tub margarine. These items contained 36, 35, and 34 calories, respectively. All calories were considered “extras” from the solid fat. I wanted to compare these items because many people mistake margarine as a healthy alternative to butter, when in fact it contains nearly the exact same amount of calories per serving size, as well as the same amount of artery-clogging, bad-f0r-you fat. On the other hand, reduced-calorie margarine spread contained only 17 calories (and zero extras!) and light butter contained 25 calories (a 10 calorie reduction) with only 3 calories from solid fats.

While this online tool is a great way to find the calorie information about certain foods and to compare it to another as a healthier alternative, I did find one issue with MyFood-A-Pedia. I think it would be a much better tool if it provided more information than just how many calories it contained and what food group the item belonged to. It would be interesting to compare foods based on their fiber, vitamin and mineral, and fat contents as well as calories. Another tool that compared foods’ sugar content or grams of carbs might be beneficial for diabetics. However, I think this is a great start and an excellent complement to the MyPyramid tool that allows users to customize meal plans based on their specific MyPyramid plan. For more information or to use the MyFood-A-Pedia, visit http://www.myfoodapedia.gov/

Are You Getting Your “Fill” of Fiber?

If you have found yourself eating what feels like a good amount of food, but struggle with staying “full,” there could be a chance you aren’t getting enough fiber.

Fiber not only functions as a way to fill you up and make you feel fuller for longer, but it also has many amazing health benefits including:

  • improving gastrointestinal health and function
  • improving glucose tolerance and insulin response
  • decreasing LDL and cardiovascular disease risk factors
  • reducing the risk of some cancers.

Two Types of Fiber

Soluble and insoluble fiber are two types of fiber that you can consume, each with different functions in the body. Insoluble fiber helps move bulk through the intestines and promotes better digestive health. It is also linked to reducing the risk of colon cancer. You can find it in the skin of fruits and root vegetables, whole wheat products, nuts and seeds, and vegetables like green beans and spinach.

Soluble fiber is the ‘headline maker’ that can reduce your LDL cholesterol and regulate blood sugar. It does this by binding with fatty acids and decreasing the amount of lipids absorbed in the bloodstream. Sources of soluble fiber include oat bran, dried beans, nuts, flax seed, psyllium husk, apples, and carrots.

How Much Fiber?

Both types of fiber are important for filling you up and suppressing food cravings in a healthy way. Recommendations on fiber consumption vary with age and gender, but men under age fifty should consume 38 grams of fiber per day, while women of the same age should consume 25 grams of fiber per day, coming from a variety of fiber rich foods.

Great sources of fiber include fruits, vegetables, nuts and seeds, cereal and grain products, and beans. Some of the higher sources are: raspberries, carrots, lentils, and brown rice. While grocery shopping, remember that in order for a food to be labeled “high in fiber” it must contain 5 grams of fiber or more.

According to the position paper of the American Dietetic Association regarding dietary fiber, “A fiber-rich meal is processed more slowly, which promotes earlier satiety, and is frequently less calorically dense and lower in fat and added sugars. All of these characteristics are features of a dietary pattern to treat and prevent obesity.” By filling up on more fiber, you will increase satiety (fullness feeling that tells you to stop eating) without a ton of calories, until it is time for another meal or snack, which is somewhere in a 3 to 5 hour window if you are eating enough nourishing food at meal time.

Here are some easy ways to sneak more fiber into your diet: 

  • Add fresh raspberries or blackberries to a high-fiber cereal or raisins to oatmeal in the morning.
  • Bring raw carrots and broccoli with hummus to work instead of going to the vending machine.
  • Snack on an apple with peanut butter for a sweet yet filling snack.
  • Toss in high-fiber add-ons to your favorite salad: almonds, sunflower seeds, dried cranberries, chickpeas, shredded carrots, or pecans.
  • Make a delicious high-fiber snack mix for when you’re on-the-go. Combine your favorite nuts with raisins, a handful of high-fiber cereal, and chocolate covered soy nuts.
  • Replace regular pasta or white rice with whole wheat pasta and brown rice, which are delicious fiber-rich alternatives.

Fruit Juice: Health or Hype?

Every time we turn on the TV, listen to the radio, drive down the road, we are bombarded with advertising from food marketers proclaiming that their product is the secret to weight loss, longevity, and pleasure. With over 200 food choices to make every day it is difficult to sort through claims produced by food manufacturers to make the best choice for your health. Today we’ll tackle the issue of fruit juices: health or hype

As part of its ongoing efforts to uncover over-hyped health claims in food advertising, the Federal Trade Commission has issued an administrative complaint charging the makers of POM Wonderful 100% Pomegranate Juice with making false and unsubstantiated claims that their products will prevent or treat heart disease, prostate cancer, and erectile dysfunction. David Vladeck, Director of the FTC’s Bureau of Consumer Protection, said:

Any consumer who sees POM Wonderful products as a silver bullet against disease has been misled. When a company touts scientific research in its advertising, the research must squarely support the claims made. Contrary to POM Wonderful’s advertising, the available scientific information does not prove that POM Juice or POMx effectively treats or prevents these illnesses.

No one can argue that Pomegranates are a wonderful and healthy food, full of vitamin C, potassium and antioxidants, but a line must be draw as food marketers push their products to the extreme. According to Self Nutrition Data, pomegranates are a good source of dietary fiber (11 grams each), 5 grams of protein, folate (107 micrograms), calcium (28.2 mg), vitamin C (28.8 mg), and vitamin K (46.2 mcg). Since POM is made from 100% pomegranate juice, one would think it would have many of the same great nutrients.

Not so. A $3.99 16-oz bottle has 320 calories, 72 grams of sugar, no fiber, and no vitamin C, calcium, folate or vitamin K. Yes, the only ingredient many be pomegranates, but by stripping away the fiber and nutrients, you just have sugar-water. Nutritionally speaking, these aren’t much different from a soda. This isn’t unique to pomegranate juice. All fruit juice loses much of the original fruit’s nutritional value when the juice is extracted, but POM is going a bit overboard with their health claims. A glass of POM a day is not going to prevent heart disease if the rest of your diet is laden with trans and saturated fat. It is important to look at your diet in its entirety, rather than trying to gain benefits from a single serving of fruit juice.

So let’s get over this hype and get healthy! Swap out the juice and reach for a piece of fruit! Aim for 2-4 servings of fruit per day. If you enjoy fruit juice, try diluting it with sparkling water to make your own spritzer. Next time you are at a grocery store, take a closer look at the health claims the manufacturer proclaims. Turn the package over and take a look at the actual nutrition panel and judge the food for yourself. Knowledge is power, and make sure you are well-armed!

What are your thoughts on this Fruit Juice Debate? Do you have any other health claims that you are confused about?

Fake Dyes Added to Food Might Lead to Cancer

Still looking for that natural ingredient in the dye Red 40?  Yeah, I haven’t found it either.  But I have recently discovered that the Center for Science in the Public Interest has found links of specific dyes to harmful consequences.

Michael Jacobson, executive director at CSPI stated that the addition of these dyes does in no way alter the taste or flavor, but is simply for aesthetics.  So I’m thinking, that’s not that bad, right?  We all deserve something pretty to look at.  But wait, the addition of the dyes might not add flavor, but can create allergic reactions and hyperactivity in children, while causing cancer in all other ages.  Knowing this, I’ll pick something else in my life to be pretty!

The research states the dyes Red 40, Yellow 5 and Yellow 6 are currently contaminated with cancer causing agents.  But still in our food.  Also, Red 3 is classified as a carcinogen by the FDA, but still in our food.  Am I missing something here?  Shouldn’t we try to avoid cancer causing agents?  Statistics show that food manufacturers pump an estimated 15 million pounds of these cancer-colors into commercial products a year!

As far as a solution, the British government is in the works of banning all usage of the majority of dyes.  Also, the European Union is establishing warnings, like they have on cigarettes, of cancer risks and other issues.  The United States?  Not so much work as of yet, but I’m sure with the CSPI pumping out this type of information, it won’t be long until someone gets the ball moving and only the natural rainbow in our meals!

Pepsi’s New Designer Salt: Healthy or Health Hazard?

You may have heard in the news recently that PepsiCo created a salt for its Lay’s potato chips (and other Frito products) that will reduce salt content. At first glance, it seems like a gimmick. You might even think they are trying to make people think that their snack products are healthier. But, there’s actually more to it than that.

I talked with the Director of Public Relations and Marketing, Aurora Gonzalez, about the new salt and got some interesting health-related information.

Frito-Lay cares about making a good product. They were the first company to remove trans fats in favor of sunflower oil. They are thinking about sodium in terms of “if there is something we can do, we should do it.” They know people are concerned about salt intake. They also know that people like seasonings, and products with seasonings tend to have higher salt. So they’ve been looking into sodium and playing with the structure to reduce the total sodium content. They’re doing it because it’s the right thing to do. Frito-Lay realizes consumers struggle with salt intake. Basically, they are trying to make a small dent, while keeping up the integrity of the quality ingredients.

They already have a line with 50 percent less sodium – the “lightly salted” line of Lay’s, Ruffles, Fritos, and the soon-to-come Rold Gold pretzels. These are just made with less salt. Nothing new.

As a dietitian, this is what I would recommend to people who are actively trying to reduce salt, but still want to enjoy chips or pretzels in moderation: It’s up to you to make sure you get your fruits and veggies. And, if you like chips, it’s also up to you to eat and enjoy a small portion. I will often tell chip eaters to avoid eating them alone. Make a sandwich with whole grain bread, lean protein, and veggies. Add a side of crunchy veggies, such as sugar snap peas, and then a handful of chips.

Savor the bites. If you’re the kind who eats chips out of the bag in front of the TV, it’s important to acknowledge that it’s not the chips, it’s how you are choosing to eat them.

The other thing to keep in mind is that the original version of the potato chip actually doesn’t have much salt. If you turn the bag around and read it, the salt is not that high (compare it to a cup of tomato soup, which can have 5 to 10 times the salt). Read the ingredients. Not a lot there. The best thing you can do is control the portion.

As far as the designer salt goes, don’t expect it to make a serious dent in your sodium intake. Instead, cut back on eating out at restaurants. Or, when you go, ask for your meals to be prepared without salt. There are many examples of meals that have 1-2 days worth of salt in one serving. No amount of “low salt” product can reverse those abnormally high numbers.

Next time you go out, start with a garden salad and share an entree of whatever you want with someone else. Eat slowly and mindfully and stop when you feel full, regardless if there is food left. Skip the alcohol, bread, appetizers, and desserts, and even the “worst” meal won’t be a bad. Make that small change and you should see some great results.

Supplement Scandals

By Carlene Helble-Elite Nutrition Intern

More supplement issues in the news? I can’t say I’m surprised. With a lack of the tight restrictions that prescription drugs have, supplements can do things like:

  • make broad health claims as long as they don’t say they are a ‘cure’
  • avoid sending clinical trials to the FDA to prove the safety of a product

This week, a supplement scandal emerged involving an ethical question. Can pharmaceutical executives have personal side ventures in which they sell compound X as a supplement? What about while the pharmaceutical company is still running clinical trials on the same compound as a prescription cancer treatment?

British pharmaceutical company GlaxoSmithKline found itself in the news this past Thursday after telling two employees to ‘distance themselves’ from their side company Healthy Lifespan Institute (HLI).  Glaxo discovered through a business and technology website that HLI was selling supplements containing the compound resveratrol, found in red wine. In 2008 Glaxo spent over $700 million to buy the biotech company that developed the resveratrol formula, with the hope that it would be used in the future as a prescription drug.  They are now testing it for use as cancer and type 2 diabetes treatments ( a potential financial jackpot for the company).

Later news updates divulged that the two employees resigned from HLI and that the side venture no longer sells the supplement after censure demands from Glaxo. But that wasn’t what caught my attention. A scary piece of information also emerged; Glaxo clinical trials with the resveratrol resulted in kidney failure in some patients. While it seems that the supplement was not ‘identical to the drug compound’ and in a less concentrated form, it’s worrisome to think that the same compound appears in an unregulated supplement!

Got (hormone-free) milk?

By: Carlene Helble-Elite Nutrition Intern

There is much more to milk than meets the eye. Not only are there hundreds of different dairies that are producing, but there are also categories like hormone free milk to consider while you’re making your grocery list.

Around 2005, the price of milk spiked, something many of us tend to take in stride question free, but grumble about as we push our carts to the check out line. Between 2005-2006, states like California were eliminating the use of rBGH, a bovine growth hormone, in dairy cattle, making them hormone free, but also less productive (hence the price hike). The majority of milk produced within the United States are now hormone free.

But what’s the big deal? Studies have indicated that rBGH may increase your risk of producing a cancer-causing hormone. Canada and most European nations have already ban the hormone, something that raises red flags. Other studies show that the small amount of rBGH in milk gets destroyed in our GI system, or during pasteurization. More recently, Monsanto, the rBGH producer, and the FDA threatened to sue those who labeled milk rBGH free and state-by-state, the legality of the labeling changes.

Although rBGH is not illegal in the US at this point, it’s definitely something to keep an eye out for in the news. While we are unsure of the long-term outcome of rBGH consumption, we do know that grass fed cows, as opposed to corn fed cows, produce milk that is healthier for your heart. A Harvard study showed that Grass-fed cows deliver milk with more heart healthy benefits (test subjects had up to a 36% lower risk of heart attack), a very cool new finding! Remember, low fat milk and other dairy is a great source of protein and calcium, and now heart healthy.

Fiber from the Farm: Natural Sources Give Extra Health Benefits

A new phase of food marketing has been the fiber health halo. Added to cereals, drinks, and packaged snack bars, companies promote these products as a prime way to get your daily fiber intake. Have you ever seen an ad for fruits, vegetables, or beans promoting their fiber content? Me neither, but these whole foods contain natural sources of fiber plus important vitamins and minerals: an added bonus! Try to use these nutrient dense sources to get your fiber fill. Not only will they keep you full for a longer period of time when eating, but they also lower your risk of heart disease and obestity…something fiber additives aren’t yet proven to do. Here are some of the fiber counts in these healthier foods:

  • Pear: 5 g fiber
  • Medium apple: 4 g
  • (1/2 C ) lentils: 7 g
  • 1 C Raspberreies: 8 g
  • 23 Almonds: 3.5 g
  • Whole wheat bread: 1.5 g
  • 1 C Broccoli: 5.1 g

Soluble fiber, like that from the foods listed above,  is the kind of fiber that dissolves within your digestive tract. It will slow down how quickly the body absorbs sugar and fat. In turn, this can help lower insulin levels, cholesterol, an blood sugar, a benefit that fiber supplements with insoluble fiber can’t match.

To make a great fiber filled dish, experiment with international dishes like Indian dahl which uses lots of veggies and lentils. As a side dish, have a fruit platter or a dish of almonds. Take advantage of the plethora of summer produce: summer squash, tomatoes, berries, and corn and ask your friends for their favorite recipes. For easy snacking, chop veggies and keep them in the fridge for easy access.

By getting your daily fiber from whole foods instead of supplements, you will be more satisfied from a delicious meal and you’ll get the vitamins and minerals that a fiber bar just won’t give you.

An Honest Tea Review: Organic, Fair Trade, and just plain good!

By: Carlene Helble- Elite Nutrition Intern

What better way to celebrate the end of National Iced Tea Month than with a glimpse into an awesome new tea product? Honest Tea Organic: half tea and half lemonade is the perfect refreshing drink with a conscience.

At first I was a little concerned when I decided to try the product since many pre-bottled teas can be sickeningly sweet. Not so with Honest Tea half and half! It was not overly sweet and the lemonade complemented and enhanced the tea rather than covering it. Besides the taste, I loved that the company was environmentally aware as well as globally aware of how they could help people and the planet as a whole. The product is USDA certified organic AND fair trade! The bottle is made from #1 plastic which is the most recyclable of the plastics. They even changed their bottle designs to be 22% lighter to save plastic and reduce their carbon footprint (bottles can be heavy to ship which uses more gas).

From a nutrition standpoint, I appreciated the notation of the number of calories in a single serving, as well as the number of calories in the entire bottle. Some products give only the calories in a single serving, while the package may contain 2.5 servings, leading some to think they are only eating the calories of one serving if they eat the indulge in the whole package. A huge diet breaker if done on a regular basis! Each serving of the tea had 48 kcal and 25 mg of caffeine ( about ¼ of a cup of coffee) while the entire bottle had 100 kcal.

If you’re looking for a refreshing treat, Honest Tea gets my seal of approval for a great taste and good conscience! With one last hurrah for tea month, here are some cool fun facts:

  • Almost 85% of tea served in the US is iced tea.
  • You can brew upwards of 200 cups of tea from a single pound of loose tea leaves.
  • The Tea Association of America says tea is almost 5000 years old!
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