Celiac Disease Learning Activity by Digital Education @ CTLM https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax The purpose of this assignment is to create a space where you can share your thoughts with your classmates and your instructor. While many of us are practicing dietitians, it’s good to be exposed to areas that we may not know a lot about, or get a refresher on a topic. In this case it’s Celiac Disease. By sharing what you learned, or asking about what is not clear is a good way to just exchange information, and remind oneself that there is always more room to grow/learn. If you see a question, that you can answer of your classmates, please do so! Sharing about a product you have tried is another way to share what new foods are out there, that may be appropriate for you to recommend for your patients. Patients with CD or food allergies often ask you, the nutritional professional, for recommendations, and this is a way to share on a food, even if you have not tried it. Plus, it’s fun to try new foods. To add your comments for each prompt, click the plus sign (+) below each column. ADD YOUR NAME at the end of your post to get credit for your work. en-us 2021-09-02 16:32:57 UTC 2023-02-18 15:38:31 UTC hello@padlet.com Gluten-Free Flour https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1790779942 One of my closest friends was diagnosed with Celiac disease in our sophomore year of college. Since we often baked and made dinner as a friend group, we experimented with different gluten free flours until we found this one - Bob's Red Mill 1-to-1 Baking Flour. Most baked goods turn out similar to using gluten-containing flour, so this was the product we would always use. If I was going to bake gluten-free on a regular basis, this is the flour that I would choose to use. 
- Kinzie Matz]]> 2021-10-04 20:05:58 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1790779942 Something I learned https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1800201044 As a RDN with Celiac disease myself, I like to think I know everything but I find myself always learning new things! One thing that surprised me was that the average length of time to be diagnosed with CD is 4 years. I don’t know of other diseases that take this long to diagnose. This is especially concerning given the significant medical risks associated with undiagnosed CD. For example increased chance of cancer or developing an autoimmune disease.

-Ellen Magnuson  ]]> 2021-10-07 15:25:20 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1800201044 Question https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1800202668 Does celiac disease cause changes to the gut microbiota?

-Ellen Magnuson ]]> 2021-10-07 15:25:46 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1800202668 GF Bread https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1800216187 This is one of my favorite brands of gluten free bread. It works well for sandwiches because it’s soft, and tastes good toasted. My only complaint is how the small the slices of bread are, especially considering the price ($6.99). This brand also makes a gluten free sourdough bread, which is amazing! The slices are very large (for gluten free bread) but it only comes with 5 slices per package, and the price is $5.99 at most grocery stores which is so expensive compared to regular bread!

-Ellen Magnuson]]> 2021-10-07 15:29:26 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1800216187 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1803481779 What I really found interesting was the second case study discussed in the article, “Importance of Nutritional Assessment and Collaboration between Physicians and Registered Dietitians in Detecting Celiac Disease: Two Case Studies.”   The patient had become underweight due to diarrhea following childbirth that lasted 9 months.   Upon reviewing her labs, her liver enzymes were elevated and she was experiencing hypoalbuminemia.  The RD upon reviewing her labs was knowledgeable enough to determine pancreatic enzymes in addition a low gluten and low lactose diet would help resolve her systems.  The RD then referred the patient to a physician to test her for Celiac Disease which she had.  I didn’t realize pancreatic enzymes can be used to help treat patients with Celiac Disease.  What is also unusual about this case is that the symptoms seem to have presented following childbirth.  

 

Jennifer Ephraim 

]]> 2021-10-09 00:44:26 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1803481779 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1803482592  

Referring back to the case study in the article, “Importance of Nutritional Assessment and Collaboration between Physicians and Registered Dietitians in Detecting Celiac Disease: Two Case Studies, ”    I referred to my earlier post, I was confused about the connection with the elevation in liver enzymes and Celiac Disease and why pancreatic enzymes were able to remedy the patient’s condition.  Also, why did Celiac Disease present itself in this patient following childbirth? 

 

Jennifer Ephraim 

]]> 2021-10-09 00:45:33 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1803482592 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1803494707 I decided to try these gluten free brownie bites cookies from Goodman today.  I have tried many gluten free products at the FNCE events I have been to and much like this product I found the taste to be blander and the product to have a dryer texture than those with gluten is the best way I can describe it.  It's not awful but it's not great either.  

Jennifer Ephraim ]]> 2021-10-09 01:01:05 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1803494707 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1804198236  
Hello Classmates!
For this discussion I chose to present a gluten-free food product called BRAZI BITES. 
I first learned about this product while watching one of my favorite TV shows- “Shark Tank”.   For those of you who never watched this show, it is a show featuring entrepreneurs who are seeking funding and business advice from five “sharks” who are multi-millionaires/billionaires and experts in the business world.  They made a deal with “shark” Lori Grenier and today they are available in most grocery stores.   
The product was developed by Junea Rocha and Cameron Mac Mullin.   Junea explained that a child growing up in Brazil she enjoyed these snack, developed from treasured family recipes and made from tapioca flour which is naturally gluten-free.   The company sells three products: Brazilian Cheese Bread, Empanadas, and Breakfast Sandwiches, which vary in their nutrient content.    The products are sold in the frozen food section and cooking instructions recommend they remain frozen until they are baked for about 20 minutes in a 400–425-degree oven.   They are very easy to prepare and are recommended to be served warm.  
The first time I sampled the product was at my local grocery store, and, after sampling the Brazilian Cheese Bread I purchased a bag.      I would consider they to be somewhat pricy (a bag usually costs > $4.00 and has about 3 servings.   The product is advertised as being certified gluten-fee, trans-fat free, sugar free and soy free.  The cheese bread bites have about 45 calories per piece and are fiber-free.   The bean and cheese empanadas have about 70 calories and provide about 2 g fiber per piece.  Sodium content ranges from 210 – 370 milligrams per serving.  
The Garlic Asiago Brazilian Cheese Bread was flavorful and had a good texture which was flaky and not “doughy”.   The Black Bean & Cheddar Empanada also had a nice, flaky texture, but, I was disappointed because it had a very thick crust and not much filling. 
I have a sister-in-law with celiac disease who rarely visits, but, I would definitely consider serving the Garlic Asiago cheese bites to her as an appetizer.   I would also recommend BRAZI-BITES as a quick and easy to prepare gluten-free snack.   My main concerns with the product is the high cost and although they are appropriate for gluten-intolerance and other food allergies, I would not consider them to be a nutrient-dense food.   Therefore, if I were recommending these to a patient with celiac disease, I would recommend them for an occasional snack but not as part of their normal dietary pattern.   
 This posting is being share by Karen Brokken RD CNSC - NS 726. Assignment 3-1 Module 3, Padlet Celiac Disease Activity.
]]> 2021-10-09 15:10:28 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1804198236 Gluten-Free Granola and more https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1804511933 One of my favorite types of granola is from the brand Safe + Fair. The company makes delicious tasting products that are not only gluten-free but also free of the top 9 allergens including peanuts, tree nuts, eggs, milk, and soy. This is especially great for those with celiac disease who have additional food allergies or intolerances. Some of their top flavors include birthday cake, apple pie, key lime pie, and blueberry cinnamon just to name a few. They also have a line of brownie mixes, popcorn, chips, and protein powders allowing those with food allergies to enjoy tasty products sometimes challenging to guarantee gluten-free. 
-Sarah Luzinski

]]> 2021-10-09 20:03:56 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1804511933 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1804824111 My Costco store used to carry this edamame spaghetti and I LOVED it (although I did need to add quite a bit of salt).  The flavor was nutty and slightly sweet, but not starchy like wheat pasta.  It also doesn't get gluey like some gluten free pastas do when cooked.  The protein content per serving (45 g) is 21 g with 18 g of carbs and 9 g of fiber!  It has 27% DV for iron and 13.6% for calcium which is great for me as a vegetarian who doesn't like milk (and for someone with Celiac Disease).  Tossed with olive oil, salt, black pepper, and red pepper flakes (with or without veggies like bell peppers, spinach, mushrooms, tomatoes), it is a perfect simple lunch! 
Jill Endres ]]> 2021-10-10 03:38:41 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1804824111 Favorite GF Product https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1805882189 One of my favorite gluten-free products is—Mary’s Gone Crackers. It is a certified organic and gluten-free product. The ingredient list is fairly short and sweet: whole grain brown rice, quinoa, brown flax seeds, brown sesame seeds, water, sea salt, and wheat-free tamari. It has good amount of fiber and protein, 3 g of fiber/protein per 13 crackers. Most importantly (along with its nutrient profile) is the fact that they are tasty. The taste profile is a rich nutty flavor. IT is a convenient product to incorporate healthy grains into the diet. It pairs well with hummus and a piece of cheese or avocado. I enjoy having different textures to my dishes and these crackers do the job. They have a satisfying crunchiness when served along with foods that are creamy and soft. Reading through my post, it sounds like an informercial haha! 
 
https://shop.marysgonecrackers.com/Original-Crackers/p/MGC-000106&c=MarysGoneCrackers@Crackers

-Agnes Kim
]]> 2021-10-10 18:25:43 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1805882189 Non-GI Symptoms https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1805989074 I was unaware of the non-GI symptoms that could be indicative of CD. I work in a setting that does not see a lot of CD and the patients we get with CD typically have had it for some time and are not admitted because of CD. It was particularly interesting that 90% of people who present with dermatitis herpetiformis do not have any GI symptoms. The deficiency-related manifestations certainly make sense, but not something I had previously considered. Additionally, infertility stood out to me as I have a family member who was recently dx with CD and struggled with infertility (she had no GI symptoms, only feelings of weakness and low energy levels which is what brought her to see her MD). Only after viewing this lecture did I realize her infertility was perhaps a symptom of undiagnosed CD. She got pregnant after being dx with CD and adhering to a GF diet. I think she had started using IVF so of course the connection may or may not be there, but it was interesting to consider! As a side note, this person has an identical twin who got tested after her sister tested positive (though had no symptoms) and her test came back positive as well.
-Ashley Massart]]> 2021-10-10 19:47:44 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1805989074 when listening to the CD and Gluten Sensitivity slides, I didn't realize that a common "non-GI symptom" of CD was Iron Deficiency Anemia. I also didn't realize that so many pediatric and adult patients were asymptomatic. How do you know to treat for CD if you don't realize you have it? https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1806000706 Brandee Grenda]]> 2021-10-10 19:57:00 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1806000706 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1806080581 It was interesting to learn that diagnosis of celiac disease is twice as common in females vs males while there is similar occurrence of the disease. The authors reported that it may be related to sex-difference in healthcare utilization may be attributing to this stark difference. They stated that some conditions that are associated with celiac disease is more common in females vs males (i.e. hypothyroidism), and therefore are more frequently screened for celiac disease. 
King, J. A., Jeong, J., Underwood, F. E., Quan, J., Panaccione, N., Windsor, J. W., Kaplan, G. G. (2020). Incidence of Celiac Disease Is Increasing Over Time: A Systematic Review and Meta-analysis. American Journal of Gastroenterology, 115(4), 507–525. https://doi.org/10.14309/ajg.0000000000000523
-Agnes Kim
]]> 2021-10-10 21:04:06 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1806080581 GF Teething Wafers https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1806351431 The most recent GF food that my family and I have tried are these HappyBaby Organics Teething Wafers in the orange box (sweet potato and banana flavor). These are dissolvable solids that are supposed to help support painful teething. I'm not sure they help with painful teething but I do like the long shape of the wafer that makes it easy for my son to hold in his hand and work on bringing food to his mouth. There's not much to them nutritionally but I like to give them when I'm cooking in the kitchen over other solids that impose a bigger choking risk. My husband and I decided that there could be some improvement in the flavor department - I don't taste much sweet potato or banana which is disappointing. We've liked the blueberry and purple carrot flavor of this product much better!
-Ashley Peña Elsbernd]]> 2021-10-11 01:18:29 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1806351431 I learned a lot more about the diagnosis of Celiac Disease (CD). I knew that the small bowel endoscopy was the gold standard but was not familiar with the types of IgA and genetic testing needed. Additionally, it was fascinating that 41-60% of individuals are asymptomatic prior to diagnosis. I am curious what their compliance rate with a GF diet is. - Kristina Eggener https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1808552696 2021-10-11 19:00:11 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1808552696 GF Bread https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1809046475 As someone who is gluten free (and dairy free), I have gone through trial and error finding good GF products. Three Bakers 7 Ancient Grains is one of the best GF friendly breads I have come across so far. It is gluten free, dairy free, and soy free. Some GF prepackaged bread products tend to be denser in calories and less so in nutrients and fiber. This particular product has 7 g of dietary fiber in 1 serving (2 slices) whereas a leading brand in gluten containing wheat bread has ~1 g fiber. Compared to Canyon Bakehouse, another GF bread, that is sold as 7 Grain Bread contains 1 gram of dietary fiber as well.  

In my experience, Three Bakers 7 Ancient Grains bread is stored best frozen and tastiest when toasted. When not frozen, the breads do not last as long. Also, GF breads tend not to hold up very well when not toasted. Although this brand can be a bit pricier, you are getting a greater amount of nutrition and fiber out of it than many other brands. 

Annalee Althouse]]> 2021-10-12 00:11:06 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1809046475 GF Bread annaleealthouse https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1809073981 As someone who is gluten free (and dairy free), I have gone through much trial and error finding good GF products. Any seasoned GF person will tell you finding decent bread can be challenging. I love Three Bakers 7 Ancient Grains because of the high amount of fiber that it contains. In 1 serving (2 slices) provides 7 grams dietary fiber. Canyon House 7 Grain Bread (another GF bread), offers 2 grams dietary fiber. A leading brand of gluten containing wheat bread also offers 2 grams dietary fiber. 

Although pricier than other brands, Three Bakers 7 Ancient Grains provides a good source of fiber. I like to store it frozen--it keeps longer that way and I find it holds up best when toasted. 

Annalee Althouse ]]> 2021-10-12 00:25:03 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1809073981 GF cinnamon coffeecake https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1809300703 My sister-in-law has Celiac's disease and whenever we visit she makes this for breakfast. I do not have CD, nor the necessity to avoid gluten and I think this product is absolutely delicious. Honestly, I wouldn't know its gluten free just by tasting it. And my kids approve, which says a lot! I have tried other GF bakery products such as muffins, breads, etc... which all leave me disappointed. They seem to all have a "saw-dust" like texture. But this coffeecake mix is delightfully fluffy and full of cinnamon flavor. It is not overly crumbly or dry. The cost of a box is not much more than the non-GF version, so I don't see cost being a huge barrier. I would recommend this to GF individuals looking for a tasty treat or for a special occasion, like Christmas morning. Additionally, if someone were to want this for breakfast, I would recommend adding a protein to the meal such as eggs, or GF turkey/chicken sausage for improved nutritional value and to promote satiety. -Kelly Petersen]]> 2021-10-12 01:58:24 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1809300703 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1811144330 As someone who has an autoimmune disease that avoiding gluten helps, I am constantly trying new products. I tried the gluten free pumpkin spice bagels from Trader Joe’s this morning and they surprised me. Normally the gluten free bagels i have tried are always too dense and kind of chalky. These were light! And tasted good! I had to try them because of the pumpkin spice. But I did notice there were no certifications on the packaging. I definitely checked the ingredients to double check! I cant wait to see if there are products I haven’t tried that the class posts!

Miranda Miller]]> 2021-10-12 15:25:26 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1811144330 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1811211832 There were actually a few things that I learned from the power point presentation. I did not realize that each grain have their own prolamins. I had only been taught about glutenin and gliadin when referencing celiac disease. I also was not aware that there are celiac patients that are asymptomatic or silent. And those patients are most likely diagnosed from addressing a different health concern. 

Miranda Miller]]> 2021-10-12 15:44:29 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1811211832 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1811257347 My story is referencing about 12 years ago or so before there were many GF options. My best friend has celiac disease. When she and I were figuring out what she could eat, some times we would get it wrong and she would have other reactions than typical GI responses. I specifically remember one time when her eye was completely swollen shut and random spots on her arms would swell. I am still confused on how this happens. I know I read in the Celiac Disease and Nonceliac Gluten Sensitivity A Review article that gliadin can cross the epithelial barrier, but what happens after that is where the process doesn’t make sense to me. 

Miranda Miller

  1. Leonard MM, Sapone A, Catassi C, Fasano A. Celiac Disease and Nonceliac Gluten Sensitivity: A Review. JAMA. 2017;318(7):647–656. doi:10.1001/jama.2017.9730


]]> 2021-10-12 15:58:19 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1811257347 For those of you who work with patients with celiac disease (or have it yourself), what trips patients up the most with label reading, and what do you find patients struggle the most with following a gluten free diet? https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1811422990 Rebecca Boenig]]> 2021-10-12 16:52:06 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1811422990 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1811781460 I've tried these Enjoy Life soft-baked cookies in the past that my friend had bought. It's been awhile since I had them but from what I remember, the lasting impression was that they were rather dense and dry and didn't seem overly flavorful. In general though, I think cookies are a food that everyone has their own preference of the texture of different cookies which likely played a factor as well. However, I think it is nice that this brand avoids many of the common allergens and offers a variety of products, both sweet and savory.

-Kelsey Eisner 

]]> 2021-10-12 19:05:59 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1811781460 Hidden Gluten https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1811796717 I learned quiet a few things about CD and gluten that I did not know before. I have a basic understanding of CD, but I have not actually worked with any patients that were recently diagnosed or getting worked up for diagnosis, so I learned a lot about treatment and things to look out for in regards to products that may have gluten. 

I learned from the PowerPoint that hidden gluten may be found in something such as shredded cheese. I never would have thought to tell a patient to watch out for this and would have assumed it was ok. I learned that shredded cheese may have gluten because they may use wheat or a starchy powder to prevent clumping of the cheese. Another thing I would not have considered is that some medications may contain gluten in them as well. This emphasizes the importance of discussions with the pharmacist about these patients - especially if they were recently diagnosed. With children especially, I learned being mindful of things that kids may accidently eat too that may have gluten in them such as pet food and Play-doh. 

Does anyone have any other hidden sources that they know about that were not mentioned in the lecture?

- Kaitlyn Kivi




]]> 2021-10-12 19:12:21 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1811796717 Sex Differences in CD https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812059800 I learned that Celiac Disease is diagnosed nearly twice as common in females as compared to males! I was interested to read that the etiology of this is quite unclear given that recent studies suggest that incidence of CD is actually equal in males vs. females. I learned that CD may actually be underdiagnosed in males, possibly contributing to this discrepancy. 

- Rachel Comstock]]> 2021-10-12 21:33:48 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812059800 Mortality and CD https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812073879 Our readings indicate that some studies show that CD is associated with increased mortality, while others do not. A recent meta-analysis overall risk for malignancy does not increased with CD. My question is- do these studies account for malnutrition associated with CD? As we know, malnutrition complicates almost all aspects of care and can increase mortality. Do malnourished patients with CD have increased risk for mortality?

Rachel Comstock

Leonard MM, Sapone A, Catassi C, Fasano A. Celiac Disease and Nonceliac Gluten Sensitivity: A Review. JAMA. 2017 Aug 15;318(7):647-656. doi: 10.1001/jama.2017.9730. PMID: 28810029.]]> 2021-10-12 21:42:51 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812073879 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812078697 I recently tried this product (on accident). I really love this company's non-GF variety of this product and I picked up the GF version incidentally. The taste was about the same but the texture was a little different. Overall I still thought it was an enjoyable experience and I might recommend to a GF patient or peer. 

Rachel Comstock]]> 2021-10-12 21:45:29 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812078697 Daiya Gluten free frozen pizza https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812132326 I wanted to mention Daiya gluten free pizzas. The Daiya brand is a pretty common dairy free brand, and many of their products are top 8 allergen free (and gluten-free). This is a frozen pizza that comes in many flavors/types that all use a gluten-free crust and dairy-free cheese. I find pizza something people commonly ask for and have a hard time finding a fast, convenient option. With secondary lactose intolerance fairly common with uncontrolled or newly-diagnosed Celiac disease this would be a way to avoid gluten while also making sure it is lactose free by avoiding dairy. -Tracy Solomons

]]> 2021-10-12 22:24:35 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812132326 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812147692 Something I learned in regards to celiac disease that was interesting to me is that some people might have gluten sensitivity but might not necessarily have celiac disease. I learned about celiac disease in school as many of you might have but I don't remember learning that someone could have all the symptoms of celiac disease after eating gluten but only be sensitive to it. This is interesting to me. I remember in the lecture it was mentioned that someone who has gluten sensitivity might avoid some food items based on trial and error. Does that mean that they can tolerate some gluten food items and not others? If that is the case, aren't they at risk of developing celiac disease if they consume the items containing gluten? So do the patients that have gluten sensitivity have to also avoid gluten as someone with celiac disease? This is something that always confuses me because I believe a gluten free diet is very restrictive and if they are only sensitive to gluten why do they have to follow this diet, but if they don't follow the gluten free diet what are the consequences are they at risk as someone who is asymptomatic but continues to eat gluten?

- Samantha Sanchez]]> 2021-10-12 22:36:09 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812147692 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812147743 There were many new information I learned about celiac disease. What I thought was quite fascinating was the diagnosis process. I had the notion that it was diagnosed like allergies through a skin prick test. I never realized the extent of a celiac diagnosis. As mentioned in the PowerPoint I can see why many may or may not  follow through with the diagnosis. 
Also I would have not guessed French fries to potentially have hidden sources of gluten. I was serving food when a student said she needed a gluten free meal and and French fries was on the menu. Luckily the coworker assisted me and we did not serve that to her. 

-Naomi]]> 2021-10-12 22:36:11 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812147743 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812354945 Prior to this module, I didn't know what prolamins were and that gliadin was not a component of wheat, barley, and rye. It turns out that wheat, barley, and rye all have their own prolamins and gliadin is only found in wheat. I also thought it was interesting how celiac disease was first discovered. This is something I had not learned in previous classes!

-Libbi Chitwood]]> 2021-10-13 00:45:15 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812354945 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812399066 It was stated in the powerpoint that the average time to diagnose celiac disease is 4 years. Is it 4 years from onset of symptoms? I'm also still a little fuzzy on how someone "develops" celiac. I understand that it occurs in individuals with genetic predisposition, but what causes is to be present in a child vs an adult, or is it always present but just becomes symptomatic at a certain point?

-Libbi Chitwood]]> 2021-10-13 01:03:55 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812399066 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812419410 I absolutely love these gluten free, dairy free, vegan cookies! I've tried the chocolate chip and fudge brownie ones. I don't have celiac and I don't eat gluten free, but I am vegan and it seems like these days many of the vegan "junk foods" are also gluten free. These cookies are so nice and convenient when I'm dying for some chocolate chip cookies but don't feel like making any from scratch. I highly recommend them! I also love Boom Chicka Pop kettle corn, which is gluten free and vegan as well.

-Libbi Chitwood]]> 2021-10-13 01:12:13 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812419410 For those of you who work with patients with celiac disease -- https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812626488 Do you find patients have a combination of symptoms,  or commonly present with just one symptom? For example, when I see a patient with anemia, my mind first goes to micronutrient deficiencies. However, is it common for anemia to be the only symptom for a patient with celiac disease? (Or, any other symptom alone -- from the symptomatic or atypical subtype)

One of my dear friends is having issues with infertility, so that has been on my radar lately. She's had every fertility exam in the book - her doctors & her are dumbfounded. So, when I saw infertility listed as a symptom of celiac disease, my eyes lit up. This is the first time I've heard of this symptom, so I'm curious if anyone has had any experiences with this symptom. What an interesting concept! -Jessica Hansen]]> 2021-10-13 02:37:08 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812626488 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812711816 In regards to the celiac disease and other conditions slide, why would someone with celiac disease also be at risk for Type 1 diabetes?

-Naomi]]> 2021-10-13 03:14:19 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812711816 https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812730004 These were good, I enjoyed them! As a past food service worker we were given the opportunity to try products and rate them before offering them to patients. I couldn't even tell the difference between flour and gluten free however some may disagree. Plus, I love anything bakery/bread so I am really not picky.

-Naomi]]> 2021-10-13 03:21:51 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812730004 I learned several new things from this unit on Celiac Disease. I hadn’t previously known how high the prevalence of Celiac Disease in individuals with Down syndrome was. About 1 in 16, or 6% of those with Down syndrome have Celiac Disease.(1) The average duration (4 years) that individuals often have CD before it is diagnosed. The longer the time until diagnosis, the more side effects or complications that can occur.(1) The article by Maureen et al describes that even after 2 years of adhering to a gluten-free diet, 25-40% of adults’ mucosal linings still will not have fully recovered.(2) I learned that the incidence rate of Celiac disease is significantly more prevalent and/or more frequently diagnosed among females than males (17.4 versus 7.8 per 100,000 person years, respectively).(3) References: 1. Bach T. Celiac Disease MNT PowerPoint. University of Wisconsin-Madison. 2019. 2. Leonard MM, Sapone A, Catassi C, & Fasano A. Celiac Disease and Nonceliac Gluten Sensitivity: A Review. American Medical Association. 2019;318,7:647-656.3. King JA, Jeong J, Underwood F, et al. Incidence of Celiac Disease Is Increasing Over Time. The American College of Gastroenterology. 2020;115:505525. -Nicole Tellock https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812847815 2021-10-13 04:22:35 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812847815 To diagnose someone for Celiac disease, we know that they need to consume gluten (whether or not they have already removed it from their diet) for the intestinal biopsy to show damage to the villi. Many patients could be understandably wary of reintroducing products containing gluten. Is there a certain amount (based on body weight, a standard, or another factor?) and duration of time that is necessary for gluten-containing products to be consumed for the diagnosis of Celiac disease? How might you use nutrition counseling to help the patient see the benefit in reintroducing gluten temporarily for an effective diagnosis? -Nicole Tellock https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812852870 2021-10-13 04:25:16 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812852870 Gluten Free Pasta https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812856586 I have tried the Barilla gluten-free red lentil pasta in the past, which is made only from red lentils. The texture and flavor are quite similar to that of wheat pasta, which I found pleasant. The cook time is very similar to wheat pasta too. This pasta is also a great source of plant-based protein (13 g) and fiber (6 g), and it contains 15% of the DV for iron, which is beneficial from a nutrition standpoint. Pasta may often be a "safe" food for children, so it may be difficult to exclude pasta for patients who are recently diagnosed with Celiac disease. This lentil pasta could provide a reasonable substitute that is overall even more nutrient-dense than wheat pasta. That said, the cost of this red lentil pasta is significantly higher than wheat pasta (like most gluten free foods), at about $2.69 per 8.8 ounces versus as little as $1 per 16 ounces of wheat pasta. It is a product that I enjoy and would eat when a friend or family member needs to restrict gluten, and it seems to be a quality product that I would recommend if a patient wants a pasta alternative (if there aren't financial restrictions to purchasing it).  
- Nicole Tellock]]> 2021-10-13 04:27:40 UTC https://padlet.com/digital_edu_ctlm/br43a2oxgqbz26ax/wish/1812856586