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.
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.
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.
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.