NS875 Celiac Diease Learning Activity by Digital Education @ CTLM https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5 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. en-us 2019-03-19 18:58:56 UTC 2023-01-24 02:43:03 UTC hello@padlet.com Time to Diagnose and Complications amhoppe https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/344314722 I did not realize that the average length of time that a patient suffers from Celiac's before diagnosis is 4 years!  And that the longer it goes unidentified, the greater the risk of long term cancers.  Additionally, with gluten craze in the media, complication of a diagnosis require the patient to be eating gluten, whereas many people with Celiac's or gluten sensitivity have already removed gluten from their diet and are not eager to add it back just to achieve a positive diagnosis.
- Amanda Hoppe]]> 2019-03-22 17:13:42 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/344314722 Time to heal the gut, intestine and colon amhoppe https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/344316909 How long after removing gluten from the diet does it take for the micro-villi in the brush border and other damaged areas of the GI tract to heal, whereas they are producing all expected enzymes and such? So if a patient suffers from secondary lactose intolerance, how long after removing gluten from the diet is it to be expected before he or she can reintroduce dairy?
-Amanda Hoppe]]> 2019-03-22 17:18:21 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/344316909 amhoppe https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/344318238 I love these gluten free pretzels.  I find that they are lighter and crunchier texture than traditionally pretzels.  Wheat tends to make products a bit thicker and clumpier, whereas these are crunchy, taste like pretzels and feel lighter.  Highly recommend!
- Amanda ]]> 2019-03-22 17:21:19 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/344318238 Schar GF Pizza Crust https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/344896853 I'm sharing this Schar gluten free pizza crust. As I mentioned in my comment on Amanda's post, my patients with inborn errors of metabolism use a lot of gluten free products because they are low in protein. These crusts are low (2 g protein in 1/3 of the crust) and fit nicely in their diet prescriptions. The patients like the taste, and I was able to try it at a patient event topped with sauce, veggies, and vegan cheese and it was delicious! The only complaint I receive is that the crusts can be difficult to find in our local stores. - Jessica Burfield

]]> 2019-03-25 16:06:38 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/344896853 Carb content of GF free foods https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/344900616 I enjoyed learning that we need to pay special attention to the carbohydrate content of gluten free foods,  be sure to recommend whole gluten free grains, and monitor for weight gain in patients implementing a gluten free diet. I found this interesting because I am working with a patient who had a liver transplant (due to his inborn error of metabolism - MMA). His new liver, unfortunately, has become fatty. His parents feed him a gluten free diet (due to preference rather than a diagnosis of CD), and I learned from the NAFLD RD that the higher carbohydrate content of his processed gluten free choices are partly to blame for his fatty liver.  He has also gained weight over the years, likely due to the higher calorie content  (due to added sugars, fat, syrups, etc.) of his gluten free options.  We've since counseled the family on choosing unprocessed whole grain gluten free options, portion control, and other ways to eat more healthfully.  -Jessica Burfield]]> 2019-03-25 16:13:46 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/344900616 Diagnosis of Celiac Disease https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/345492687 I did not realize that a second EGD is needed after gluten has been removed from the diet to confirm the diagnosis of celiac disease. Not only is the person required to make a major life change, but the process of diagnosing celiac disease can be quite a burden itself. 
-Melanie Hocker]]> 2019-03-26 23:21:48 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/345492687 GF Crackers https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/345493655 Here are two types of gluten free crackers that I really enjoy. They taste great and are a lot healthier than Ritz type of crackers. As you can see from the food labels I included, one serving is a lot of crackers (note the Crunch Master brand are mini crackers). This could also be nice for individuals trying to lose weight. I like to pair these crackers with low fat string cheese, and it's a very filling snack.
-Melanie Hocker
P.S. I didn't realize I could only attach one picture per post, so please see my other two posts above this for the front of the boxes :)]]> 2019-03-26 23:26:46 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/345493655 Blue Diamond Crackers https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/345495278 Here is another brand of of GF crackers I enjoy as discussed in my post below.
Melanie]]> 2019-03-26 23:37:07 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/345495278 Crunch Master Crackers https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/345495451 See my post below for details.
Melanie]]> 2019-03-26 23:38:04 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/345495451 Best Cornbread Ever https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/345910589 This is the only cornbread we use in my house. My youngest and I both have a sensitivity to gluten so we try to avoid as much as possible. This is one of my favorites. Our local grocery chain, HEB, carry a significant amount of gluten free options including some that are store brand (read cheaper) than some of the name brand stuff. ]]> 2019-03-27 21:43:19 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/345910589 Developing Other Autoimmune Diseases and Being Asymptomatic https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/345915698 I was not aware that individuals with Celiac Disease have a greater risk for developing other autoimmune diseases, including type 1 diabetes, autoimmune thyroid disease, Addison's Disease, autoimmune hepatitis, and multiple sclerosis. In addition, I did not know that the longer someone with Celiac Disease consumes gluten, the greater chance of developing cancer, especially lymphoma.  I was also unaware that 60% of pediatric and 41% of adult patients are asymptomatic. I knew that it was possible to be asymptomatic, but had no idea that the percentages are that high!
-Meridith Maricque]]> 2019-03-27 22:11:24 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/345915698 Down Syndrome and development of Celiac D https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346001499 What I had not known before was that people who have Down syndrome are at risk of developing celiac disease and that it can affect as many as 16% of the people with Down syndrome. The reasons for the development of celiac disease aren't entirely clear, but children with Down syndrome are at a greater risk to develop auto-immune diseases. Since celiac disease is an autoimmune condition, this may briefly explain why celiac disease affects people with Down syndrome. - Wai Yee MAH

]]> 2019-03-28 07:07:55 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346001499 GF Pretzels https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346307384 I have had these gluten free pretzels before and they are delicious! I couldn't taste a difference from a normal yogurt covered pretzel, although the consistency of the pretzel was a little different. Not to say it was bad, but you could definitely tell something was different about it. I really enjoyed this product though!]]> 2019-03-28 19:07:56 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346307384 What about IgG “Sensitivity Tests”? https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346487947 The measurement of serum antibodies to tissue transglutaminase is considered the first screening test for patients with suspected celiac disease; serum IgG antibodies is measured in those with IgA deficiency. I know a lot of people who have spent a lot of money on food “sensitivity testing” that measures serum IgG antibodies to a variety of foods. These tests might suggest several food sensitivities; gliadin, “dairy” (lactose or a milk protein is often unclear), eggs, celery, or even brown rice for example. I thought IgG testing was not scientifically backed/ validated? If one of these IgG tests suggest gluten sensitivity, could it mean celiac? Non-celiac? How do we approach this type of IgG food sensitivity testing? 


]]> 2019-03-29 10:59:52 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346487947 Associated Diseases with CD https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346786986 1)      I learned a great deal of information from the PowerPoint and article reviewed for this assignment. I did not know that up tp 16% of people with Down Syndrome have Celiac Disease and that those with Celiac Disease have a higher than normal risk for autoimmune diseases including Type 1 Diabetes, Addison’s Disease, Autoimmune Hepatitis and Multiple Sclerosis. 
Emily VanAcker ]]> 2019-03-30 15:24:02 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346786986 Latent/Silent CD https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346787093 2) One question I have regarding things I have learned from the materials in this assignment is regarding the Latent/Silent version of Celiac Disease. A family member of mine was diagnosed with Celiac Disease via blood test confirmation following an increase of GI symptoms. She does not however follow a gluten free diet and seems to live a normal life other than the occasional GI symptoms. Does the Latent/Silent Celiac Disease not have the negative consequences as other types of the disease or is her disease causing the same amount of damage to her intestines without any drastic symptoms yet?  
Emily VanAcker ]]> 2019-03-30 15:25:04 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346787093 Barilla Pasta https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346787332 3)  I eat gluten free foods due to an elimination diet of gluten relieved some severe GI symptoms I was having in 2011. Although I do not have Celiac Disease, after reviewing the material for this assignment maybe I could be categorized as non-Celiac gluten sensitivity. One of the foods that I feel tastes similar to the regular version is Barilla pasta. When I make dishes for pot lucks at work or gatherings at friend’s houses I use the gluten free pasta (so I can enjoy it too!) and no one can tell the difference!
Emily VanAcker

]]> 2019-03-30 15:27:41 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346787332 Gillian's Gluten Free Breadcumbs mdenos https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346793874 I think this is a great product! I've used it for meatloaf, meatballs, and for breading chicken or eggplant. Everything I've made with it has turned out great. 

Note: I'm not sure if it's just my computer, but the picture isn't showing up. If you click on it though it will.]]> 2019-03-30 16:32:58 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346793874 A variety of Taste Testing https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346810494 My daughters and I tried a few things for this assignment.  First, the Saffron Road Lentil Chips.  These were cracked pepper flavored and were very good.  We all agreed that we would eat them anytime, even though none of us is gluten-free.  Next, the Tate cookies were called Ginger Zinger.  Amazing!  They were crispy, sweet and buttery with chewy bits of candied ginger.  Loved them!  Third on the list was the Enjoy Life mini cookies.  They are portion packed with 110 calories and 2 g of fiber for 8 tiny cookies.  Two of us really liked them, but one daughter thought they were a bit dry.  I can see that, but if you want a little chocolate treat, this would hit the spot.  The last one was Snyder's of Hanover GF pretzel rods.  You really would never know they were GF if you didn't see the bag.  They looked and tasted just like a typical pretzel.  Maybe a huge pretzel fan might find a difference in texture, but you'd have to be really looking for it.  I say yes to all 4 products.~Jeanne]]> 2019-03-30 19:11:44 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346810494 Asymptomatic & Diagnosis https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346850628 There were several new things that I learned from the powerpoint and article. The two most surprising to me was the average length of time that it takes to get a diagnosis and that patients with Celiac disease can be asymptomatic. Four years seems like a long time to go without diagnosis especially if they are experiencing symptoms, which may be severe. It was also really surprising to me that so many patients are asymptomatic. 

Sami Miller-Edel]]> 2019-03-31 04:25:13 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346850628 Gluten Free Cornbread https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346906251 I had my family over for chili and cornbread, initially I thought I had a gluten sensitive individual coming to the gathering so I made sure my chili was gluten free and being short on time I bought boxed corn bread mix. I purchased it from Aldi (they have a good variety of gluten free products through their store line ‘Live G Free.’ My family are not health conscious individuals and very much stuck in their food habit ways although they LOVED these corn bread muffins, I enjoyed them as well! 

 

Thank you, 

Michelle Cote

]]> 2019-03-31 15:58:58 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346906251 I am very familiar with many of the symptoms of Celiac's Disease but I didn't realize how many extra-intestinal symptoms can present. Specifically, I hadn't realized it could be associated with anemia, arthralgia, arthritis, infertility, osteoporosis, and peripheral neuropathy. One of my fellow dietitians has Celiac's disease and has been complaining of joint pain recently. Now I realize that pain is likely connected to her disorder. https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346934163 Rachel Kleinman]]> 2019-03-31 19:18:48 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346934163 Gluten Free Cake https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346934190 This past Friday it was my interns last day with me and she is my only one that is gluten free! This was really challenging for me because I haven't really tried many gluten free products and I really had to explore what was out there. I went to woodman's and I found this cake, link to follow because my picture is weird. This cake was amazing! it was nice and soft, the four was not sweet at all it was the cookie flavor and frosting that gave the sweetness to the cake. My interns loved it! I will definitely be purchasing this product again. I am going to purchase it and see if my nephews to are 10 and 3 years old approve. http://inspired-by-happiness.com/inspired-products/?noredirect=en_CA

--Lorena Reyes

]]> 2019-03-31 19:19:04 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346934190 GF Pretzels https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346947984
I have had these gluten free pretzels before and they are delicious! I couldn't taste a difference from a normal yogurt covered pretzel, although the consistency of the pretzel was a little different. Not to say it was bad, but you could definitely tell something was different about it. I really enjoyed this product though!- Katherine F
]]> 2019-03-31 20:51:47 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346947984 Celiac Disease and Genetics ligiasmith134 https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346993866 One of the things I learned with the materials reviewed this week was that people with Down Syndrome are more susceptible to Celiac Disease. In general, 16% of Down syndrome patients have Celiac Disease. Often patients with Down Syndrome will present with constipation (which may be a symptom of Celiac Disease). However constipation may be put down to low muscle tone rather than given proper medical investigation. 

The prevalence of Celiac Disease is  also increased in individuals with the other Genetic  disorders as follows [per NIH Consensus Committee 2005]:
  • Down syndrome (prevalence of celiac disease: 5%-12%)
  • Turner syndrome (~3%)
  • Williams syndrome (3%-10%)
  • Selective IgA deficiency (~2%-10%)
  • Insulin-dependent diabetes mellitus (~6%)
  • Sjögren syndrome (~5%)
  • Autoimmune thyroid disease (~2%-4%)

Ligia Brochi
]]> 2019-04-01 01:54:11 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/346993866 Infertility and CD dmdeleon https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/347001580 I learned multiple things from the CD power point presentation. I was unaware of the non GI-related symptoms such as infertility and increased risk for miscarriage. Since CD might take up to 4 yrs to be diagnosed and 41% of adults dx are asymptomatic, are there any studies showing how often adults seeking fertility treatment are screened for CD? 
Denisse de Leon]]> 2019-04-01 02:43:21 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/347001580 Celiac Disease and Genetics ligiasmith134 https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/347004652 My question is what is the genetic explanation for this increased association of Celiac Disease and several chromosomal abnormalities?
Ligia Brochi]]> 2019-04-01 03:02:11 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/347004652 GF Pretzels ligiasmith134 https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/347004830 I have tried Gluten-Free pretzels from GLUTINO and SNYDERS OF HANOVER and I really like them. They taste very similar and texture was very similar to regular pretzels. Differently with other products like bread for example, where the texture can be very different compared to regular bread. 
 
http://www.glutino.com/products/chips-crisps-pretzels/pretzels/pretzels-twists-8oz-us/ 
 
https://www.snydersofhanover.com/gluten-free-pretzels/

Ligia Brochi

]]> 2019-04-01 03:03:36 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/347004830 Nothing Bundt Cake - Gluten Free https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/347009467 This weekend I was planning my cousin's bridal shower, and she happens to follow a gluten free diet. Oftentimes, gluten free cakes and breads can be very dry or have a different texture. A friend of mine suggested I check out the store (which is also a franchise nationwide I learned) called 'Nothing Bundt Cakes'. I tried their chocolate chip gluten free bundt cake and it was very good! It was tender and moist, so I think I found a winner for the bridal shower. In talking with the store manager I learned that they do not have a true gluten free kitchen. Therefore, this may not be a good option for someone who has true Celiac's disease as cross contamination would be a risk. None the less, here is their Facebook link!
https://www.facebook.com/nothingbundtcakes/photos/a.84416292022/10155404753577023/?type=3&eid=ARDB2atJFHeSSPY8fiS86_1tlPaQxxOTVYA79Py0AKyXlEbE1W1marC9d4BUL61lD_R9q0W67V0IImaO&__xts__%5B0%5D=68.ARCaSPvxVGLq3W3J260c1MPQNInL7K_1SFjXqubSF6ogGXo3sWVqiubeXFqN0k2Ut7m0OoM9xH2e7uc0QJg-0H0FI4X62UTDlbwdbbnXSPSzcIGYZcDFg-jZbJCQQS8A9JHx7-589SBAd8MMFe0SWIVtDhCoOXqHwZWHtkb4bxa3huhUqwCAIvP5OKPx-RZgmGZUMbphB3NQ1xmuPH8hlyyCbkKMQ1rPaMrFTFQI1OLJt90sHj51irOdIiVjlHgH1wuXmr8df5j5DXtqhg03uMlk7YdmKXR0fznJqzxn41nBZUGLfRrBkDRDzceeo250c7Uer0uVxY52i0jy-Q&__tn__=EEHH-R

]]> 2019-04-01 03:35:50 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/347009467 Blue Diamond Nut Thins https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/347162120 Hello! I was actually Gluten-Free for 1 year for medical reasons. During that time, I consumed more than my share of Blue Diamond Almond Nut Thins. I found them to be great with cheese (a Wisconsin necessity). Towards the end of my time being Gluten-Free, I also discovered Silly Yak Bakery in Madison, WI. I was going to suggest the Madisonians in the class to go and try some of their gluten-free products, but Google said that it has permanently closed. they had great gluten-free pizzas, bagels, cinnamon rolls... you name it! It was an awesome place to purchase the Gluten-Full items you were missing!]]> 2019-04-01 13:36:16 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/347162120 Asymptomatic CD https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/347548199 I also didn't realize someone can have no symptoms with CD.  I always thought diarrhea had to be a present.  So, thanks to this course, I plan on having one of my daughters tested.  She has been experiencing headaches for years, and now has peripheral neuropathy and occasional joint pain.  Constipation has been a problem for many years, which I thought was associated with her Asperger's.  She wasn't diagnosed with that until the age of 18.   So CD is not extremely likely, but I'd rather rule it out than wait, especially with damage and cancer risk increasing the longer gluten is consumed.  ~Jeanne Smith

]]> 2019-04-02 10:24:23 UTC https://padlet.com/digital_edu_ctlm/q1fq46gcv2n5/wish/347548199