Kelowna Celiac Kids Day Camp July 8-12, 2019.

Courtesy The Celiac Scene


Register Your Child Now – First Come, First Served

Celiac Kids Camp 2019 – July 8-12, 2019. Join BC’s first celiac kids camp in Kelowna!

– Subsidized by the Canadian Celiac Association – Kelowna Chapter
– Day camp, 10 – 4 pm, Monday to Friday
-Physical activity, healthy eating activities, and age appropriate cooking and baking activities everyday!
– Led by celiac dietitian, Selena Devries RD, and volunteers
– For kids 6-12 years

Sign up to be kept in the loop!

From Selena!

First and foremost, I want you all to know that I, myself, am celiac. Further to that, I am a registered dietitian, that specializes in the dietary management of celiac disease in my practice. I am also on the Canadian Celiac Association (CCA) national board of directors, and host the CCA virtual office hours, “ask the dietitian,” for the CCA FB group page for over 10,000 group members. You can trust that your child will be in safe hands with me at the day camp. Food and kitchen details below

Sponsorship:

Are you or do you know of a GF company or organization? Camp celiac is looking for sponsors to get camp celiac off the ground and running! If you are interested in helping in any way, please connect with [email protected]

Pricing:

Registration for the camp should go live in about 1-2 weeks. We are just trying to finalize a few things for pricing, depending if we can get some additional sponsorship, but you can expect it to be in 200-300 dollar ballpark range.

Kitchen and food details:

Lunch and one snack per day will be provided for the kids.

The kitchen:

• The kitchen is not a certified gluten free kitchen. However, it will be sanitized top to bottom before the camp starts and it will remain gluten free for the entire week of the camp.
• The camp is run at a church
• Dedicated GF equipment will be used: cutting boards, wooden spoons, baking pans, baking/cooking utensils, baking equipment (ie-mixers), food processor, blender, pasta strainer, toaster.
• Cloths, tea towels, and sponges: clean/new ones will be provided
• Questions? Happy to answer them, please contact me.

Food:

• The food menu has not been finalized but I am happy to share when it is and answer any questions on ingredient sourcing
• All nuts and seeds, GF grains/cereals (and products made from these) will be purchased with a “GF claim” or certification logo
• Food donations are only accepted from dedicated bakeries, or GF companies that state GF on packaging, are certified by CCA or other organization, or have been vetted by me.
• Questions? Happy to answer them, please contact me.

Additional medical diagnosis:

At this time, no additional medical diagnosis can be accommodated. If camp celiac is a success, we do hope that we will be able to manage type 1 diabetes in the future when we have a larger budget to accommodate additional health professionals.

Additional food sensitivities and allergies:

Dairy free will be accommodated for dairy sensitivities. If there are dairy allergies, please note that there will be dairy in the facility and there will be no guarantee of preventing cross contamination of dairy in the kitchen.

No other food sensitivity or any allergies can be accommodated at this time. Staff will note additional sensitivities upon registration, but the offending food/s may or may not be used in the kitchen. If they are in the kitchen, staff will direct your child way from the food. Therefore, if it is a life threatening allergy or anaphylactic response, it is recommended that your child does not participate in the camp this summer.

Schedule:

The schedule will be worked out closer to the date. But, you can expect that your child will participate in one age appropriate cooking or baking activity per day and engage in physical activity, and arts and crafts daily as well!

If you have not already applied for the celiac camp, please do so by clicking here as I will be emailing everyone once the registration link goes live.

Canada’s Food Guide: What does this mean if you’re gluten-free?

New Canada’s Food Guide: What does this mean if you’re gluten-free?
January 23, 2019 – Mississauga, ON. Health Canada released its new Food Guide recently with some key updates. The content was created using the most up to date and evidence-based research. In this food guide, there is a renewed focus on plant-based foods, lower intakes of processed foods which contain higher levels of sugar, saturated fat and sodium with a less direct emphasis on dairy products as the dairy and meat categories were combined into one group labeled protein. The Food Guide also has a guiding statement that if Canadians have a specific health condition, such as celiac disease then they should consult further with a dietitian for their specific nutritional requirements.

So, what does this mean for Canadians required to eat a gluten-free diet?

Folate

One of the first considerations includes the differences in folate fortification of gluten-free grains and processed grains which can result in lower folate intakes of children and adults with CD (1).  While folate fortification of gluten-containing flours is mandatory in Canada, folate fortification of gluten-free flours and processed grains is voluntary in Canada.  This places Canadians consuming the GFD at risk for suboptimal folate intake(1).  While the increasing emphasis of plant sources of protein (such as lentils, beans) and fruits and vegetable may be potentially beneficial to increasing folate intake in Canadians on the GFD, it will be challenging for children and woman of child-bearing potential with CD to eat sufficient quantities of these foods to meet their folate needs.  Suboptimal folate status has important growth and developmental implications for both the child and woman of child-bearing potential and hence needs to be addressed when developing nutrition guidelines for Canadians with CD.  Consultation with a registered dietitian regarding the need for routine folate supplementation is an important consideration for Canadians with CD and highlights the need for consideration of a folate fortification policy for gluten-free grains in Canada.  Development of evidenced-based nutrition guidelines for Canadians with CD will also be important in this process.

Vitamin D

Another nutrient of concern for children with CD is vitamin D, which is predominantly found in fatty fish, vitamin D fortified cow’s milk and fortified margarine.  Vitamin D is an important nutrient for bone health, particularly at time of CD diagnosis due to the potential for malabsorption of vitamin D related to gastrointestinal damage caused by gluten exposure.  This is particularly important for children and youth as peak bone mass is achieved in adolescence and early adulthood. Vitamin D can also be obtained by exposure to sunlight as the sun stimulates the skin to produce and synthesize vitamin D.  However, as Canadians have reduced sunlight exposure due to our long winters, suboptimal vitamin D status can occur throughout the year if Canadians do not consume sufficient quantities of vitamin D-fortified foods. As a Canadian with CD, it will be important to eat and drink sufficient quantities of vitamin D-rich foods and to consider the need for routine supplementation during the long winter months.  Choosing lower fat, dairy choices that are fortified with vitamin D will also be important for Canadians with CD to ensure they meet their vitamin D needs.

Lowering saturated fat and added sugars

Lastly, the final consideration of the new guidelines regarding lowering your intakes of saturated fat and added sugars is an important message for Canadians.  It is noteworthy to highlight that Health Canada is placing a stronger and more direct message regarding this point.  Increasing intakes of fruits and vegetables and lower fat dairy and meat and alternatives (protein choices) as a healthy way to accomplish this is being emphasized in the new guide.  However, for the child and adult with CD this can be challenging since many of the processed GF-grain products are a lot higher in saturated fat and added sugars. A recent Canadian study by Elliot et al(2), has shown that gluten-free foods marketed to children were higher in added fats and sugars. This is particularly concerning for children and adults with CD as this may increase the risk for obesity and chronic diseases and thus highlights the need for nutrition guidelines to emphasize ways for Canadians with CD on the gluten-free diet to address this concern.

Meeting nutritional needs on a GF diet

One of the ways is for specific evidenced-based nutrition guidelines focused on the GFD to be developed.  This is currently being done by a team led by Dr. Diana Mager Ph.D. RD at the University of Alberta.    Currently, Dr. Mager and her team are developing a GF food guide for children and youth with CD and hope to extend this work in the future by developing a GF food guide for adults.   This endeavor is important because specific consideration of the nutritional challenges associated with eating a gluten-free diet is being addressed in these guidelines.   This work has been supported by a Canadian Celiac Association J.A Campbell Research Award and with help from the Edmonton and Calgary Chapters of the Canadian Celiac Association.

For more information regarding the folate, vitamin D content of foods and other nutritent concerns, go to: https://www.celiac.ca/living-gluten-free/diet-nutrition/get-nutrients-into-your-gf-diet/


For more on Canada’s updated food guide: Click here

1. Alzaben AS, Turner J, Shirton L, Samuel TM, Persad R, Mager D. Assessing Nutritional Quality and Adherence to the Gluten-free Diet in Children and Adolescents with Celiac Disease. Can J Diet Pract Res. 2015 Jun;76(2):56-63.
2. Elliott C. The Nutritional Quality of Gluten-Free Products for Children. Pediatrics. 2018 Aug;142(2).

Cannabis Beer Will Be Gluten-Free

Courtesy of Mark Johnson, President CCA Ottawa Chapter

According to numerous sources, scientists in Canada are working on marijuana beer. Canadian company Province Brands, out of Toronto, has filed a provisional patent for “the world’s first beers brewed from the cannabis plant”. And they will be gluten-free!

While there are already beers and wine out there that are laced with cannabis, this will be a first in that it will be entirely brewed from cannabis. The company says its product will be “alcohol-free, yet highly intoxicating”, and low in sugar and calories. And no gluten – instead of barley, the beer is brewed from the stalks, stem, and roots of the cannabis plant – which offers the added benefit of using what is essentially a waste product for the industry.

According to company spokesperson Dooma Wendschuh, “The flavor is dry, savory, less sweet than a typical beer flavor. The beer hits you very quickly, which is not common for a marijuana edible.” After various “horrible … rotten broccoli” taste-test rounds, the flavor was perfected with the help of a chemist. They eventually hit on the right combination of hops, water, yeast – and cannabis. The aim is to create a product that, when consumed, will be roughly equivalent to a single dose of alcohol.

In the early 2000s, Canada became the first country to legalize medical marijuana and, as you likely know, the government is very close to legalizing cannabis, including edibles and beverages. By sometime in 2019, all the above should be legal. While pot is already legal in several US states, the situation is tenuous, with the federal government strongly opposed, whereas in Canada, the consensus seems to be that this is the right way forward.

And it won’t just be beer! The company wants to also spin-off, according to a wine business report, “to make alcohol-free cannabis drinks like sodas, coffees and fruit-based drinks.” At Canopy Growth, North America’s first publicly traded cannabis company, researchers are already developing a line of cannabis-infused cocktails.

The cannabis industry in the US alone was worth almost $7 billion in 2016, with industry experts projecting it to rise to $50 billion by 2026.

Sources:
https://www.forbes.com/sites/thomaspellechia/2018/02/08/cannabis-beer-soon-to-be-available-in-canada/#1c240ce73f6c
https://www.highsnobiety.com/p/cannabis-beer-canada/
https://www.theguardian.com/world/2018/jul/22/it-hits-you-very-quickly-canada-brews-first-cannabisbeer

Professional Advisory Council “Meet and Greet” Notes

From the 2018 National Conference – Ottawa – June 8th

The 2018 National Conference started with a panel discussion including members of the CCA Professional Advisory Council answering questions from the CCA Chapter executives. Members of the panel included:

  • Dr. Don Duerksen
  • Shelley Case RD
  • Dr. Jenny Zelin

Discussion regarding gluten-free flours
There are many myths about flours and a lot of discussion regarding arsenic in flour. The glutenfreewatchdog.org provides credible information regarding this. The bottom line is that you should not base your diet on rice, especially brown rice which has more arsenic. Alternate your grains so that you get a variety of grains in your diet.

Soy – There is a theoretical concern regarding hormones and soy. Again variety is important so you do not overload on any one grain. Soy in itself is not harmful.

Oats – Newly diagnosed should wait up to 18 months when the tTG normalizes to include gluten-free oats in the diet. The gluten-free certified oats should be introduced slowly due to the increase in fibre in the diet. The Health Canada website provides good information on gluten-free oats.

Nima Gluten Detection
The Nima device is used to detect gluten in food. Third party validation data is lacking on the Nima device, therefore it is suggested that “buyer beware”. This type of technology is where this industry is heading, however, testing must be done by experts to ensure it does what it
says it will do.

What information should I give my doctor when first diagnosed?
Direct the doctor to www.celiac.ca and give them handouts of position papers that are available there. tTG follow-up is helpful but not 100% accurate as to what is going on. The Celiac Follow Up Care Resource brochure will assist the doctor in what testing should be done on an on-going basis to manage celiac disease. Panel members stated that dietitians and dentists are very helpful in diagnosing celiac disease (CD).

What percentage of the general population are affected by celiac disease?
Canada borrows the data from the US which indicates approximately 1% of the population has CD. Test for CD before testing for anything else Canada is developing a registry for Registered Dietitians for CD. Training for undergrads is also a priority. Handouts are on the national website that Dietitians can download.

How long does one have to eat gluten before testing?
There are many different answers quoted to patients. Generally, 4-6 weeks of a slice of bread per day is adequate. If a patient has been gluten-free for a long time, more time on gluten may be required.

What symptoms affect the brain/body when eating gluten?
Symptoms vary from person to person. You must always beware that the cause “might be something else”. The longer an individual is off of gluten, usually the more sensitive they are to gluten exposure.

Please comment on tTG remaining high for an abnormally long time?

It takes different people different times to come within the normal tTG range. The number one reason for not normalizing is they are unaware of gluten exposure. Refractory celiac disease is rare. This is when the individual does not respond to a gluten-free diet.

Travel
Best to do your research before you go. Find out what the food safety standards are in the country that you are going to and it is often useful to contact the local Celiac Association and check out their website.

Wheat Starch
The inclusion of wheat starch in food is allowed in Europe. In Canada, today, this does not meet our standards. Additional processing is required to remove the gluten. Canadian law requires that anything that contains a gluten source is not allowed.

Pregnancy
If a mother is celiac, there are no known adverse effects to the baby, however, the fertility of the mother may be an issue in those with undiagnosed celiac disease. Current research indicates that gluten should be introduced to babies’ diets at approximately 6 months of age.

Is it possible to have elevated tTG and not be celiac?
Yes, there are other conditions that may cause an elevation. It is important that the biopsy provides 4-5 samples to ensure proper diagnosis.

How long does gluten stay in your system?
Gluten is found in the stool for approximately 24 hours and in the urine for 6 hours.

Celiac Disease in the News – December 2018

by Val Vaartnou

The following are summaries of research in progress or completed from credible medical journals and medical sites. Links are provided where further information can be found.

Celiac disease and eosinophilic esophagitis linked A large analysis of more than 35 million patients found an intriguing connection between celiac disease and eosinophilic esophagitis (EoE). Out of the 15,000 patients in a database pulled from 360 U.S. hospitals who had been diagnosed with EoE, 2 percent also had celiac disease.

The numbers translate into a likelihood nine times larger of finding celiac disease in a patient with EoE compared to a patient in the normal population.

For more information: https://www.allergicliving.com/2018/06/07/whats-the-link-betweeneoe-and-celiac-disease/


Prebiotics can help celiac symptoms Research published in the Journal of Clinical Gastroenterology found that a 6-week probiotic treatment is effective in improving the severity of IBS-type symptoms in celiac disease patients on strict GFD, and is associated
with a modification of gut microbiota, characterized by an increase of bifidobacteria.

For more information: https://www.ncbi.nlm.nih.gov/pubmed/29688915


Viruses can lead to activated celiac disease A growing body of research suggests that viral DNA or proteins introduced into the body can contribute toward the development of serious diseases long after the initial viral infection has passed. And now, research by a team from
the Cincinnati Children’s Hospital shows that exposure to the Epstein-Barr virus (EBV), best known for causing mononucleosis, appears to boost the risk of developing seven other diseases in individuals who inherited predisposing gene variants – including celiac disease.

For more information: http://www.iflscience.com/healthand-medicine/the-virus-that-causes-mono-linked-to-sevenautoimmune-diseases/


Questioning the link between antibiotics and celiac In contrast with existing research, a recent study published in the journal Jama Pediatrics found that antibiotics taken during a child’s first four years of life were not associated with the development of celiac disease or type 1 diabetes, even if the child was genetically predisposed to the development of either condition.

For more information: https://mykidsfoodallergies.com/isthere-a-link-between-childhood-antibiotic-use-and-celiacdisease/


Celiac disease can indeed strike anytime in life From childhood to late life, diagnosis of celiac disease is critical and should not be ignored. That’s the message for patients and healthcare providers from two recent studies.

In the first, researchers from Italy concluded that the number of patients with celiac disease worldwide is increasing, “thanks to better environmental conditions that allow children with celiac disease to survive longer.” In the second, scientists from Finland and the United Kingdom found that one in four celiac disease diagnoses is made in people 60 years or older. Still, 60 percent of patients remain undiagnosed because their symptoms, including tiredness, indigestion and reduced appetite, are blamed on older age itself.

For more information: https://www.beyondceliac.org/research-news/ViewResearch-News/1394/postid–106300/


Gluten-free food not so gluten free in Melbourne

A first of its kind study led by Institute researchers and City of Melbourne environmental health officers has detected potentially harmful levels of gluten in foods sold and served as ‘gluten-free’ across Melbourne, Australia. The undercover study revealed one in 11 samples of ‘gluten free’ food tested were contaminated with gluten at levels that could prove harmful to people with celiac disease.

For more information: https://www.wehi.edu.au/news/illuminate-newsletter/june-2018/melbourne-gluten-freestudy


US study finds restaurant gluten-free food not always gluten-free

Based on more than 5,600 gluten tests over 18 months, the investigators determined that 27 percent of gluten-free breakfast meals contained gluten. At dinner time, this figure hit 34 percent. The rise could reflect a steady increase in gluten contamination risk as the day unfolds, the researchers said.

For more information: https://www.webmd.com/digestivedisorders/celiac-disease/news/20181008/study-somegluten-free-restaurants-fall-short#1


Ensuring dietary compliance among children and teenagers

New research on children and adolescents with celiac disease examined their dietary habits to determine the factors responsible for non-adherence to a gluten-free diet.

Compliance with the diet is difficult at all ages but particularly for teenagers due to social, cultural, economic, and practical pressures.

For more information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5775619/

CCA Survey On Long-Term Care Facilities

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The Canadian Celiac Association (CCA) is conducting a survey of the Canadian celiac community to gain perspective on positive experiences or challenges facing people with celiac disease currently living in a long-term care facility or those feeling anxious about moving themselves or family into one.

  • The survey takes approximately 6 minutes to complete
  • Information provided on the survey will be anonymous and confidential
  • Findings will be used by CCA to identify gaps, suggest recommendations and/or tools to improve the quality of care for community members living or heading into a long-term care facility.

To complete the survey, click on the following linkhttps://www.surveymonkey.com/r/LTDCeliac

For more information or if you have any questions about the survey, please contact Zaynab Al-Nuaimi at [email protected].

Gluten Concerns in Home Renovation Projects

By Jo Anne Murray

There have been a number of concerns expressed by members of the CCA Facebook page about the presence of gluten in drywall joint compound. Because I was having a few repairs done in my own home, I decided to research some of the industry standard products to determine their safety from the gluten perspective.

I’ll talk about the restoration products first. The major suppliers of many of the products currently on the market claim that there are no gluten-containing ingredients in any of their products. I included standard products marketed by Home Depot, Lowe’s, Rona and spoke to and/or exchanged emails with sales reps and other company spokespeople. Some of the products available are produced in Canada exclusively, others share some cross-border exchange. DAP was the only company that indicated that wheat starch is still used in a couple of their USA plants and that the wheat starch is actually tested for gluten content and the gluten content measures at a level well below 20 ppm. It is likely safe to say that the current drywall joint compounds should pose little to no concern to members of the celiac community.

Most of the information that I received from these spokespeople also encouraged that the products they have available that have the reduced dust properties are likely more desirable for projects where any health issues are of concern as the remnants from sanding these particular joint compounds fall directly to the floor with very little circulating in the air.

Now I’ll cover a few concerns for the demolition phases of any renovation projects. There is little information available about products that were used in previous decades and the potential for gluten content in these products. The only way to be certain of their safety would be to  have samples tested for gluten content before any major demolition took place. However, a more significant concern is that of asbestos in the drywall joint compound and the plaster used in lath and plaster finishing as well as texturing paint and stippling products.

Because of the insidious nature of lung injury from asbestos particles, it is recommended that existing materials be tested before any demolition takes place and if asbestos is present that abatement should be undertaken by companies qualified in the safe removal of
the asbestos-contaminated materials.

Needless to say, proper management of asbestos removal would assure that any potential gluten content would also be safely removed.

So what construction years are of greatest concern for asbestos? Asbestos has been extensively used in the construction industry for more than a century. It was banned for use in Canada in textured paint and drywall joint compound in 1979 – but – it still made its way into many of these products until the early 1990s.

If you are inclined to disregard the asbestos concerns and undertake the DIY projects anyway, there are a number of steps you can take to limit exposure to asbestos and gluten if it is present. There is personal safety equipment available to protect your health.

There are also many ways to limit the dust exposure escaping to areas outside the actual renovation area.

  • Seal off the renovation area, including sealing off the hot and cold air returns to your furnace.
  • Choose a time of year when the furnace is not likely to be running.
  • Cleanup must be managed to prevent contamination of equipment and the remainder of the building.
  • Talk to the renovation professionals so you fully understand the methods to prevent asbestos contamination. By managing the risks for asbestos exposure, you automatically manage the risks for any potential gluten exposure.

Another consideration for gluten lurking about in a renovation project is wallpaper. The commercial glues used in most pre-pasted modern wall coverings are developed from the same types of glues that are used on envelopes. However, prior to ~1970, wallpaper was applied using wallpaper paste that was made at home from wheat flour.

There are still many homes that have layers upon layers of wallpaper, and many of those layers will have wheat based wallpaper paste holding them in place. Care must be taken in their removal to contain the dust from these projects to the area of restoration and minimize the potential for its being circulated through the furnace ducts and other air movement equipment (fans, dryers, dehumidifiers).

Gluten might be a consideration in any renovation project but will be overshadowed by the asbestos concerns in most renovations. When asbestos is addressed in your project, any gluten exposure would be included in the prevention of general contamination concerns.

Please protect your health when you undertake your DIY projects.