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.

Oats can now make gluten-free claim in Canada

By Sue Newell, CCA

Oat flakes on white background

Health Canada announced regulatory changes that will allow a gluten-free claim for specially produced or processed oats that are free from wheat, rye, barley, or their hybridized strains, and for foods containing these oats. Details about these changes, an updated position paper and other important information can be found on Health Canada’s Website.

The Canadian Celiac Association supports this decision to allow gluten-free claims for specially produced gluten-free oats and products containing such oats. The Canadian Celiac Association Professional Advisory Council Position Statement on Consumption of Oats by Individuals with Celiac Disease is available on www.celiac.ca.

Health Canada’s Marketing Authorization permits the gluten-free claim for oats if they meet the following criteria:

  1. The food contains no oats other than specially produced “gluten-free oats”;
  2. The finished product does not contain greater than 20 ppm of gluten from wheat, rye, barley or their hybridized strains;
  3. The food contains no intentionally added gluten from wheat, rye, barley, or their hybridized strains; and
  4. The “gluten-free oats” are clearly identified as such in all cases where ‘oats’ are referenced, including in the list of ingredients.

Manufacturers who want to make a gluten-free claim on pure oats or products made with pure oats are responsible for ensuring those oats meet the criteria outlined in the Marketing Authorization. If a product is marketed as gluten-free and contains oats that do not meet the criteria, it will be subject to enforcement actions by the Canadian Food Inspection Agency (CFIA).

Celiac expert, Shelley Case, to speak at Choices

Shelley Case will be speaking at Kelowna’s Choices Market on Wednesday September 8th at 7 pm.

This is a great opportunity to hear one of the most knowledgable speakers on Celiac Disease. There is a charge of $5.00. Contact Choice’s at (250) 862-4864 to reserve a space, maximum 50 people.

Who is Shelly Case?  Read below for the bio from her web site.

A registered dietitian, Shelley Case is a leading international nutrition expert on celiac disease and the gluten-free diet. She is a member of the Medical Advisory Boards of the Celiac Disease Foundation and Gluten Intolerance Group in the United States and the Professional Advisory Board of the Canadian Celiac Association.

Shelley is a frequent guest on television and radio, including the NBC Today Show and CBC Newsworld. A popular speaker, she has delivered numerous lectures and workshops at national and regional medical, dietetic, Celiac and food industry conferences throughout the USA and Canada, including the National Institutes of Health Consensus Development Conference on Celiac Disease, American Dietetic Association and Dietitians of Canada annual conferences and Natural Products Food Expo conferences.

She is the author of many articles on celiac disease and the gluten-free diet in leading publications such as Gastroenterology,Digestive Disease Sciences, Pediatrics, Journal of Human Nutrition and Dietetics, Topics in Clinical Nutrition, and Today’s Dietitian. In addition, she co-authored the celiac section in the Manual of Clinical Dietetics (6th edition) by the American Dietetic Association and Dietitians of Canada, and has contributed to many other publications including textbooks, magazines, and other patient education resources. Shelley writes “Ask the Celiac Expert” column for Allergic Living Magazine; “Good for You” column at www.glutenfreeda.com and “Ask Shelley Case” at www.befreeforme.com.

In recognition of Shelley’s major contributions to the celiac community and dedication to educating health professionals and individuals with celiac disease in Canada and the United States, she was awarded the Queen Elizabeth Golden Jubilee Medal. Shelley also recently received the Canadian Celiac Association’s Honourary Life Member Award.

Shelley earned a Bachelor of Science Degree in Nutrition and Dietetics from the University of Saskatchewan and completed her Dietetic Internship at the Health Sciences Center in Winnipeg, Manitoba. Over the past 27 years, Shelley has helped thousands of people improve their eating habits and manage a variety of disease conditions through good nutrition. Currently, she has her own nutrition consulting company specializing in celiac disease and the gluten-free diet that offers a variety of services to individuals, health organizations and the food industry.

Professionally, Shelley is a member of the Dietitians of Canada, Saskatchewan Dietitians Association and American Dietetic Association, as well as the Nutrition Entrepreneurs, Dietitians in Business and Communications and the Medical Nutrition Practice Groups of the American Dietetic Association. She also serves on the Advisory Board of Living Without magazine.

Very active in her community and church, she has chaired many conferences and special events. Shelley is an accomplished musician who enjoys playing piano and electric keyboard. She lives with her husband and two children in Regina, Saskatchewan, Canada.