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CanadianCELIAC CANADIANS step up for CELIAC! PLUS The scoop on thyroid disease and celiac Busting food allergy myths Savoury recipes for autumn The Celiac Pipeline – What's on the horizon for research
CCA board of directors Executive Directors Janet Bolton, President Meredith Birchall-Spencer Treena Duncan, Past President Tamara Close Jennifer Stebbing, Secretary David Congram Andrew Kotys, Treasurer Jessica Danford Selena DeVries Kathryn Djordjevic Ravil Veli Contact us Canadian Celiac Association 1450 Meyerside Dr., Suite 503 Mississauga, ON. Canada L5T 2N5 Phone: 905.507.6208 or 800.363.7296 Fax: 905.507.4673 | Email: info@celiac.ca www.celiac.ca Canadian CELIAC A MAGAZINE FOR CANADIANS WITH CELIAC DISEASE AND GLUTEN SENSITIVITY Editorial Board Melissa Secord RonniLyn Pustil Kim Shiffman Gayle Grin Janet Dalziel Adam Weinmann Jessica Danford Graphic design: gaylegrin.design Contributors Dr. Kimberley Bender Justine Dowd Meredith Birchall-Spencer Rosie Fountotos Deborah Choi Julie Greene Nicole Cox Dr. Wendy Gould Janet Dalziel Dr. Laura Lachance Selena de Vries COVER PHOTO OF LUCAS WAY BY ELISA WAY Copyright © 2020 by the Canadian Celiac Association Publication Agreement#40787580 Canadian Celiac is published for the Canadian Celiac Association, L’Association Canadienne de la maladie coelique. Reproduction of this magazine in whole or in part is prohibited without the express written consent of the publisher. Disclaimer: The contents of Canadian Celiac are provided in good faith for information purposes only, and using the most current information available subject to amendment, and should not be used as a substitute for the advice of a qualified medical professional. The Professional Advisory Council of the Canadian Celiac Association (CCA) has not reviewed the contents of Canadian Celiac. Use of the information is at your own risk. The CCA does not endorse any product referenced in this publication. To the fullest extent permitted by law, the CCA, its local chapters and all persons involved in the compiling of this publication disclaim any responsibility for, and make no representations or warranties regarding the information provided. In no event will CCA, its Chapters or those persons involved in compiling this publication be liable for any damages of any kind resulting from the use of the information. 2 | Canadian CELIAC
A magazine for Canadians with celiac disease and gluten sensitivity FALL 2020 As we move into winter facing continued uncertainty about so many things, it’s more critical than ever to take care of our wellbeing. In this issue, we focus on physical and mental wellness, along with a healthy dose of comfort. RUNNING TOWARDS A CURE. 7 MY CELIAC JOURNEY. 11 8 STEPS TO FEEL BETTER, FASTER. 15 MENTAL HEALTH MATTERS, PART 2. 17 UH OH! I GOT GLUTENED! 21 THE GRANOLA IN THE ROUGH. 28 FOUNDERS KEEPERS: AWARD WINNING ANNAPOLIS RESTAURANT’S APRICOT CHUTNEY. 36 SEASONAL SOUPS. 31 THE PROACTIVE CELIAC STUDY. 39 2 VOLUME 4 | ISSUE 3 Canadian CELIAC | 3
From the editor’s desk COME TOGETHER Every marathon starts with a single step. This year, the road may have been filled with new obstacles, but by focusing on single steps, the CCA is staying the course. We may have been physically distanced this year, but in so many ways, the Canadian celiac community is more connected than ever. Earlier this year, the Canadian celiac community joined forces by participating in research on celiac disease and COVID-19. Last month, folks acoss the country stepped up to raise funds through the Scotia- bank Charity Run, coming together virtually in the fight to solve the challenge of celiac disease. I was proud to complete a virtual mara- thon, walking and running 42 Km. Recently, the CCA Facebook group surpassed 14,000 members. And this month, our second virtual con- ference of the year will deliver free, world-class education on celiac disease, right to people’s living rooms. Everywhere you look, the story is about coming together, rather than remaining apart. In this issue, we’ll look at some of the steps researchers at Provention Bio are taking to address celiac disease and some potential opportu- nities to participate in future research. We are constantly being armed with new knowledge about celiac disease. Early in the pandemic, CCA partnered with researchers at McMaster University in the first large-scale study to determine if people with celiac disease were at increased risk of COVD-19. The recently-released findings provide reas- The CCA created its magazine surance that the risks are no higher for those with celiac disease. with the goal of connecting the celiac community across the As we head into winter, with continued restrictions and ongoing uncer- country and to help empower tainty around the COVID-19 pandemic, this issue is also about steps we readers to find a better quality can take to bolster our physical and emotional wellbeing. We have had of life with celiac disease. Now experts weigh in on self-care, mental health, food allergies, thyroid dis- we’d like your feedback. Help ease and how to deal with the fallout of accidental exposure to gluten. the CCA with insights on how to provide the best support, We may be going through challenging, uncertain times, but we can take evidence-based information, time to comfort our souls and stay empowered and hopeful with the education and advocacy for ever-growing body of knowledge about celiac disease. Let’s take care the Canadian gluten-free com- of ourselves and stay connected, and we can make it to the finish line munity by taking this quick stronger than ever. survey on our magazine. https://www.surveymonkey. com/r/CDNCELIAC Melissa Secord 4 | Canadian CELIAC
FREE 2 menus. 16 plant- based recipes. All joy. GLUTEN-FREE Download your FREE Second Helpings holiday recipe book for gluten-free foodies. 16 plant-based recipes + 2 menus for HOLIDAY grown-ups and kid-inclusive feasts alike. Serve up gluten-free goodness, no matter RECIPE BOOK what holiday you’re celebrating. Get th r e c i p e b oe ok. Canadian CELIAC | 5
A DV E RT O R I A L The joy of the real thing – gluten-free It goes without saying that baked goods should taste good. We think baked goods should make you feel good, too. That’s why Little Northern Bake- house uses only the best plant-based, Non-GMO Project Verified ingredients to bake our certified gluten-free, allergy-friendly foods. From the generous portions of our soft and deli- cious wide slice loaves, to our hearty multigrain and sprouted grain breads, to our buns, bagels, and artisan-style pizza crusts, Little Northern Bakehouse makes gluten-free baked goods that deliver all the joy of the real thing. Our baked goods are made in Canada without eggs, dairy, peanuts, tree nuts, sesame, coconut, soy, other top allergens, and (of course!) wheat. One thing they’re never short on? Real bread taste and texture you’ll love. And to help you satisfy your inner foodie, sharing the joy of the real thing doesn’t stop at our delicious gluten-free baked goods. We’re all about helping every- one find the most delicious and healthy ways to live gluten-free. From our kitchen to yours, we’re here for you with recipes, tips, culinary tricks, and creative gluten-free ideas to keep you inspired from breakfast through dessert. All year long. Explore crave-worthy recipes in our collection. Stay deliciously informed through our newsletter. Get to know our delicious gluten-free breads. Or find a store near you. All at LittleNorthernBakehouse.com 6 | Canadian CELIAC
Scotia Bank RUNNING TOWARDS A CURE The CCA relies on fundraising, and this year, Canadians once again stepped up to the plate. Using the hashtag #teamglutenfree on social media channels, walkers and runners show- cased a beautiful fall across Canada for training. MOST PHOTOS ARE FROM PARTICIPANTS’ INSTAGRAM ACCOUNTS RonniLyn Pustil walks with her family Jennifer Stebbing, CCA National Director was our top fundraiser, matching her personal donations. Ashley Gismondi Canadian CELIAC | 7
We set out to “run across Canada” and show that celiac and gluten-related disorders are affecting people across the country. BY JULIE GREENE Over the past three years, the CCA has raised more than $45,000 through the Scotiabank Waterfront Marathon Run for research, diagnosis and support for celiac disease and gluten-re- lated disorders in Canada. This year we aimed to raise $25,000 and far surpassed that goal, rais- ing $33,000 over the month of October! We set out to “run across Can- Janet Hilson ada” and show that celiac and gluten-related disorders are af- fecting people across the coun- Sarah Hillaby try. We kicked off the campaign from Cape Spear, Newfoundland (the most easterly point in North America), we did a half-way point check-in on virtual race day (October 18) from Ontario on the Humber River, and we wrapped up in British Columbia Continued on next page Sarah Hignell Far left: Belinda Marcellus Left: CCA president Janet Bolton walks in support of her husband Bill Otten who has celiac disease 8 | Canadian CELIAC
CCA National Director David Congram and CCA Executive Director Melissa Secord Kimberly Orr on the 31st! Using the hashtag #teamglutenfree on social media channels, walkers and runners showcased a beautiful fall across Canada for training. Here is the race in numbers: z $33,130 raised for celiac re- search, diagnosis and support. z 38 walkers and runners worked together to reach this goal. z 18 industry partners stepped up to help us. Schar took the lead, donating $400 prize packs for the top fundraisers in each category. Total prizing for this event is val- ued at $3,000! z 4 participants did the “Whole Shebang” – 78km each! Davis family Canadian CELIAC | 9
This year we aimed to raise $25,000 and far surpassed that goal, raising $33,000 over the month of October! CCA president Janet Bolton cheered on by friends Lucas Way Julie Greene At left, Susie Senra Martin u 10 | Canadian CELIAC
My celiac journey MY CELIAC STORY What university student Rosie Fountotos has learned since her diagnosis. BY RONNILYN PUSTIL From a very young age, I had developed an intimate relationship with medicine, from going through the medical system so often. I con- sider my childhood pretty unique, as I was diagnosed with hyperthy- roidism at nine years old and had to undergo many surgeries. Later, at the age of 22, during my undergraduate degree in kinesi- ology, I was diagnosed with celiac disease. My celiac diagnosis came ap- proximately one year after I had PHOTOS SUPPLIED BY ROSIE FOUNTOTOS been experiencing low mood, extreme fatigue and absorption issues (with a thyroid medication). Rosie Fountotos If I hadn’t been closely monitored was diagnosed by specialists, I think I would have with celiac been undiagnosed for a long time disease in because I was asymptomatic. university Continued on next page Canadian CELIAC | 11
I soon realized the impact of celiac disease on my quality of life, mental health and personal identity. Initially, I didn’t think of celiac disease as a life-changing diagno- sis, especially since I already had experience with an autoimmune disease. However, I soon realized the impact of celiac disease on my quality of life, mental health and personal identity. I started encoun- tering many challenges, such as symptom management and adher- ing to a strict gluten-free diet. I feel that the social impact of ce- liac disease is underestimated. In my experience, my social engage- ment was reduced — I no longer felt comfortable eating at restau- rants, and the majority of social gatherings involve food. When I Infographics from Rosie’s Instagram account @celiacstudentdiaries was diagnosed four years ago, restaurants weren’t as accom- modating as they are now. There were limited gluten-free options (if any), no efforts were made to eliminate cross-contamination and waiters weren’t familiar with celiac disease, which added to the stress of going out. Celiac disease also affected my university experience. I couldn’t go to school to study without packing a day’s worth of food, due to the lack of gluten-free options on campus. Eventually, I stopped going to class and started listen- ing to my lectures from home as I dealt with abdominal pain from accidental gluten exposures. I Continued on next page 12 | Canadian CELIAC
I turned to online communities for support ... the CCA Facebook group and the celiac community on Instagram tried to accommodate myself as own bubble that what I was dealing tem today fosters inclusivity. With best as I could at that time. with had become my own normal. I an improvement in my overall was out of touch with the average wellbeing and with my symptoms I didn’t know anyone else my age 20-year-old student’s taking less control over my life, who had celiac disease, so I was living experience. When I finally sometimes I honestly forget I have navigating the obstacles on my opened up to other students, I celiac disease! own. I turned to online communi- started to acknowledge the added ties for support, such as the CCA obstacles I face due to celiac dis- Advice for a newly diagnosed Facebook group and the celiac ease. I learned to forgive myself for university student: “Self-com- community on Instagram, and being unable to thrive like my peers passion. We give others way started connecting with other girls — that really helped me to move more compassion than we give with celiac on social media. forward and work on my well-being. ourselves. Personally, I was very hard on myself throughout my In August 2020, I became a CCA I am presently doing my Master of undergraduate years. I wanted to peer supporter and decided to Science at McGill University and achieve so much and wanted to start my own infographic-based In- I am actually now balancing four reach the high academic stan- stagram account: @celiacstudent- chronic illnesses. My resilience dards I had set for myself. How- diaries. I wanted to bring aware- through my past experiences has ever, I fell short at times due to ness to the social, psychological harnessed such growth, which is challenges with my health. and biological aspects of celiac something I would never change. Being diagnosed with a chronic disease and how it affects us. My I’m grateful that my support sys- illness during university can be a Instagram page has allowed me burden and adds to the pressures to reflect on elements of my life you are already trying to manage. and how they’re interconnected. My advice to students is to allow I’ve always been artistic, and I yourself time to grow and to heal decided to channel my creativity physically and mentally from being into infographics. On my page, I diagnosed with a chronic illness. like promoting self-care practices Remember you are on your own and wellness, bringing awareness unique path to success and any to the disease itself, and provid- obstacle you encounter will lead ing support for other university to resilience and growth. Be pa- students with celiac. I don’t want tient and be kind to yourself. Your someone else to have to go journey may be bumpy right now, through this alone. but I promise it will get better.” u Throughout my undergraduate Stay tuned for our February issue degree, I was so closed into my of the Better Living Gluten Free newsletter, which will focus on Rosie graduating with her managing celiac disease for teens undergraduate degree and university students. Canadian CELIAC | 13
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The diagnosis A new diagnosis of celiac disease can be overwhelming. But you can do this! Try these eight steps to start you down the right path. YOU GOT THIS BY JUSTINE DOWD, PHD AND SELENA DEVRIES, RD We’ve been there – struggling with digestive pain, bloating, gas, diarrhea, headaches, and skin issues for years. Finally, a reason: celiac disease. This diagnosis may have felt bitter-sweet. Sweet in that you finally have a reason for all of your pain and discom- fort and there is something that you can do to feel better: the gluten-free (GF) diet! Bitter in that you may have to say goodbye to eating foods that you enjoy and the ease of eating anything when out. Many people feel lost, frustrated and alone after this diagnosis. You are not alone in these feelings – thousands of people are diag- 1. Take time to grieve. For some, a 2. Practice self-compassion. DEPOSIT PHOTO nosed with celiac disease annual- celiac diagnosis is welcomed as a Research shows that among ly. However, up to 47% of people reason for ongoing health issues. adults with celiac disease, with celiac disease still report gas- For others, it can feel devastating. those who practice self-com- trointestinal distress even while Take time to grieve this diagnosis passion report better quality of following a strict GF diet . Here and honour your feelings. Mental life and stricter adherence to a are eight steps to consider if you health care professionals can play GF diet. are newly diagnosed or struggling a key role in helping you to effec- with celiac disease: tively cope with your diagnosis. Continued on next page Canadian CELIAC | 15
We’ve been there – struggling with digestive pain, bloat- ing, gas, diarrhea, headaches, and skin issues for years. Here’s how to start practicing excited to try and create a shop- it plays an integral role in healing self-compassion: ping list so you can enjoy home the body after a celiac diagnosis. z Pay attention to your self-talk. cooked meals. Bacteria in the large intestine rely Do you speak to yourself as you on sufficient amounts of fiber for would a close friend? If you notice 5. Communicate your needs. Talk their survival. When bacteria have negative self-talk, start to replace to your family and friends about access to ferment a wide variety negative thoughts with positive your diagnosis so they under- of fibers, they create beneficial ones. Self-kindness is an effective stand why you have to be careful compounds for us including strategy when coping with adver- about what you eat. When your anti-inflammatory components sity. family and friends are well-educat- that help tame inflammation and z Remind yourself that you are ed on meal preparation for celiac strengthen the gut lining. Fiber not alone. Part of being human is disease, it can help you feel more can be found in fruits, vege- that we go through difficult times. at ease and better able to enjoy tables, GF whole grains, nuts, Reminding yourself that you are social gatherings. seeds, beans and legumes. Aim not alone in your struggles can re- to consume 25g (women + chil- duce the intensity of the distress 6. Learn the label lingo. Reading dren) upwards to 38g (men + male you feel. labels can cause a lot of stress teenagers) of fibre daily. Tips to z Embrace mindfulness. Mindful- and overwhelm, especially when increase fibre: ness involves relating to our expe- newly diagnosed. In Canada, we z Include fresh fruit at breakfast riences with non-judgment and are fortunate to have strict la- z Aim for two cups of vegetables acceptance. Focusing on your belling laws. All ingredients that at both lunch and dinner breathing is an effective way to come from, or are derived from, z Include nuts and seeds, daily. u bring your attention to the present gluten will always be identified moment and reduce rumination. on labels as: barley, rye, wheat, Dr. Justine Dowd, PhD, Post-Doctoral (regular) oats and triticale. Fellow, Faculty of Kinesiology, Univer- 3. Connect with others. One of sity of Calgary, is a health behaviour the top predictors of well-being 7. Connect with a registered change specialist, wholistic health with celiac disease is member- dietitian with expertise in ce- coach, diagnosed celiac and aca- ship in a support group. Support liac disease. A dietitian can be demic expert in self-compassion, groups, like the Canadian Ce- your best friend when it comes health behaviour change, and gut liac Association, are important to celiac disease management. health. w: https://www.justinedowd. because they provide current From clearing confusion with label ca/ e: jdowd@ucalgary.ca evidence-based information on reading, to identifying nutrient disease management and social deficiencies, to helping uncover Selena Devries, RD, is a registered support. lingering symptoms on a GF diet, dietitian, specializing in celiac disease a celiac dietitian can help you feel (after her own diagnosis), and a board 4. Plan for success. Creating a better, faster. member of the Canadian Celiac As- weekly meal plan is a great way sociation. w: www.healthbean.ca to set yourself up for success on 8. Focus on fiber. Fiber is often e: selenadevries@gmail.com a GF diet. Find recipes you are forgotten about on the GF diet but 16 | Canadian CELIAC
Ask the expert MENTAL HEALTH MATTERS Last issue, we asked a psychiatrist about the link between gluten issues and mental health. Here’s part two of the interview. BY L AURA L ACHANCE, , MD, MSC CANDIDATE PSYCHIATRIST AND RESEARCHER, McGILL UNIVERSITY Is there a proven link between ADHD and gluten? For example, some parents of kids with ADHD believe that gluten exacerbates their child’s symptoms. The research in this field is conflicting. Some studies have found that individuals with ADHD have an increased rate of glu- ten sensitivity while others have not. Two small clinical trials found that gluten-free diets had a positive effect on ADHD symptoms in individuals with celiac disease and ADHD. Another small study found that an elim- ination diet improved ADHD symptoms in children regardless of food sensitivities. Removing gluten from the diet can also lead to a reduction of sugar and ultra-processed food which can have impacts far beyond removing gluten itself. For example, we know that the western diet is a risk factor for mental health symptoms in children across diagnoses. If you or your child have ADHD and gastrointestinal symptoms, it’s worth talking to your doctor about being investigated for celiac, especially if there is a family history. Alternatively, you may want to consult a dietitian or nutritionist for guidance on trying an elimination diet to see if symptoms improve. Research is generally conducted with groups of people so it can be hard to predict what will work in any one person. That being said, elimination diets can be very challenging and are not feasible for some people. Is celiac disease linked to more the most well studied example. this antibody may explain why we serious neurological conditions? It has been demonstrated that are seeing so many neurological This is another emerging area of there is another form of anti-tis- symptoms in individuals with celi- research but the answer appears sue transglutaminase that can ac disease. to be yes, with gluten ataxia as attack the brain (anti-TG6) and Continued on next page Canadian CELIAC | 17
Avoidance feeds anxiety, meaning the more we say no to events involving food, the harder it becomes to say yes. Some people with celiac feel too anxious to go out at all. They refuse all invitations where food is in- volved. What advice would you have for people who feel this way? Avoidance feeds anxiety, meaning the more we say no to events in- volving food, the harder it becomes to say yes. Start by writing down a list of all the types of invitations or activities that make you feel anx- ious and then rank them from least threatening to most threatening. DEPOSIT PHOTO Start with the least threatening activity and practice it over and over until it no longer causes anxiety. For example, have friends over to your place for a meal or snack, until restrictions and they’ll adapt too. Self-help resources are a great place you can make it through without to start but won’t be enough for significant anxiety. Work your way When should an individual seek everyone. Check out Anxiety Canada up to going to a restaurant or going professional help for their for self-help resources or BetterHelp to eat at someone else’s home, one anxiety? Is a referral necessary? for workbook or web-based therapy, step at a time. Practice the skills You can start by speaking to your which can be exceptionally valuable above including sharing your food family doctor or a walk-in clinic doc- in the era of COVID-19. restrictions in advance and practic- tor about your anxiety. Tell them how ing “gluten-refusal skills”. If going to it is impacting your life, whether it be What signs or symptoms of de- someone else’s home and you are impacting your functioning, caus- pression or anxiety should a loved worried that it will not be safe, offer ing severe distress, or causing you one or caregiver be looking for? to bring something that you know physical symptoms like insomnia, Anxiety becomes a disorder when it you can eat. If you are unsure what racing heart, rapid breathing, muscle is excessive and out of control, and you will be walking into, it may be tension, difficulty concentrating and leads to a reduction in functioning best not to arrive hungry. Avoid- fatigue. Cognitive Behaviour Ther- or mental distress. Anxiety can lead ing gluten when you have celiac apy (CBT) is generally the first-line to panic attacks or other physical disease is a marathon not a sprint. treatment for anxiety and it can be symptoms such as shortness of We know that social support and delivered by a number of mental breath, heart palpitations, head- relationships are critical for health, health professionals depending on aches and insomnia. Untreated so don’t throw away that important the province you live in. Sometimes anxiety can cause depression resource over a food restriction. you need a referral to see a thera- and individuals who are depressed Over time, things will get easier. pist, but other times you can access are also prone to developing People will get used to your food the private system without one. Continued on next page 18 | Canadian CELIAC
Check out ... self-help resources ... workbook or web- based therapy ... valuable in the era of COVID-19. increased anxiety symptoms. What resources do you recom- https://www.anxietycanada.com/ Depression becomes worrisome mend to visit to get more infor- z Cognitive Behaviour Therapy when symptoms such as low mood mation on this topic? workbooks and reduced pleasure or motiva- The Anxiety and Worry Workbook tion to do things that the person z Web-based Cognitive Behaviour by Clark and Beck previously enjoyed persist beyond Therapy (CBT) Mind Over Mood by Greenberger two weeks. Hopelessness and https://www.mindbeacon.com/ and Padesky suicidal thoughts are symptoms of https://www.betterhelp.com/ z Meditation apps severe depression and clear indi- z General information about anxi- Ten Percent Happier cations to seek treatment. ety and coping strategies Calm u SU NDAY, N OV E M B E R 15 , 2 0 2 0 www.ccaconference.ca Join us for an afternoon of FREE world-class virtual education on celiac disease and gluten disorders. Register for a chance to win prizes! L EA D PA RT N ER S Takeda, Proventionbio and Schar Canadian CELIAC | 19
Growing up celiac LITTLE HELPERS Even kids can be part of the fight to find a cure for celiac disease. BY ADAM WEINMANN This year, people of all ages and stages joined the Scotiabank Run, including kids growing up celiac. Kitchener actor, dancer and singer Lucas Way was diag- nosed two years age of 8. This year, he stepped up in the 12 and under category of the run, and beat his goal of raising $1,000! Here’s what he had to say about his reasons for joining the run: “I’ve been training hard to run a 5K and decided to participate PHOTO BY ELISA WAY in this fundraising event for the Canadian Celiac Association to help find a cure for celiac dis- ease. My sister, Ella, and I have had celiac disease since we were 8 and 11 and my mom has it restaurants are safe, bringing ness sometimes even when I’ve too as do lots of my other fam- my own food to birthday parties done my best to make sure my ily members. Celiac can cause and peoples’ houses for dinner food is safe. Thank you for any serious health issues if you don’t because it’s almost impossible contribution you can make to manage it. Managing it properly to avoid cross-contamination help eliminate celiac disease and means not being able to eat out and then dealing with bad upset its complications. much at all because not many stomachs, headaches and tired- Xo Lucas” 20 | Canadian CELIAC
Managing your disease The pain of accidental glutening is no joke. Other than waiting it out, is there anything that helps? UH OH! I GOT It’s bound to happen at some point: you get three bites into your GLUTENED! meal at a restaurant before realiz- ing that the waiter mixed up your order. Accidental glutening is no joke, and when the pain, nau- sea and diarrhea get started, it’s DEPOSIT PHOTO normal to start wondering if there might be something – anything! – that might make you feel better faster. There are all kinds of myths, an- ecdotes and remedies out there, but what actually works when you’ve been exposed to gluten? We asked two experts on our CCA Professional Advisory Council – a doctor and a registered dietitian – DR. KIMBERLEY BENDER: The bad news: in general, if we ingest gluten by accident in celiac disease, the only thing that really affects resolution of symptoms is time, rest and avoidance of further gluten. Hydration with water is important to avoid dehydration, especially if the symptoms that Continued on next page Canadian CELIAC | 21
There are all kinds of ... remedies out there, but what actually works when you’ve been exposed to gluten? are experienced are digestive in nature (ie vomiting/diarrhea). Gravol (either orally or rectal- ly) does help with symptoms of nausea and vomiting, but it has sedative effects, causing fatigue and lethargy. It has been suggest- ed that activated charcoal may help by binding gluten and there- fore relieving symptoms; however, studies show that this is not the case and, in fact, it can cause side effects including constipation and black stool. Probiotics may help with symptoms, although evi- dence is not strong. The good news: if gluten is only ingested rarely, there are no long term implications and symptoms generally resolve fairly quickly within one to three days, with se- vere symptoms settling within six infographic from Rosie Fountotos’s Instagram account to 12 hours. @celiacstudentdiaries Dr Kimberley Bender, Medical Direc- ful. You may have lost fluids if you cause no harm, so it can’t hurt to tor - Restorative Care Unit - St Peter’s have diarrhea, so ensuring you try. Hospital, Family Physician/Hospital- are well hydrated is important. 3. Limit or avoid lactose: Partic- ist/Care of the Elderly Other suggestions which may be ularly if you have diarrhea, you helpful, but are not guaranteed to may temporarily lose your lactase DAYNA WEITEN, RD: work for everyone include: enzyme, so limit or avoid lactose for 1-2 weeks. If you have unintentionally eaten 1. Peppermint or ginger tea: gluten, there is no one remedy These may have a relaxing effect Finally, having small meals more that will help to ease the symp- on your intestine. Peppermint is often and going for walks are toms you may have. Each person also known to aggravate reflux, both helpful for digestion and may may find that different sugges- however, so if you have that as a improve symptoms. u tions work best for them. symptom, avoid peppermint. Drinking more water than usual is 2. Digestive enzymes: There is no Dayna Weiten, Registered Dietitian, one strategy that should be help- evidence they help, but they also Food for You Nutrition Consulting 22 | Canadian CELIAC
Thyroid and celiac Endocrinologist checking thyroid with ultrasound DEPOSIT PHOTO THE THYROID – CELIAC CONNECTION Connecting the dots between celiac disease and thyroid diseases BY D EBORA CHOI, BSC FN, MAN Celiac disease (CD) affects 1% of western society, while thyroid disease affects approximately 10% of Canadi- ans. Both are hereditary autoimmune diseases and it’s not uncommon for people with celiac disease to also be diagnosed with thyroid disease. In fact, among those with thyroid disorders, studies have shown a between 2-5% have celiac disease. Similarly, studies have also shown that individuals with CD are about four times more likely to be diagnosed with a thyroid disorder, compared to the general public. The reason for such coex- istence is partly because similar genes are involved in a variety of autoimmune conditions. Therefore, having one autoimmune disease increases the risk of getting a second or a third one. Despite the high prevalence of the two diseases coexisting, celiac doesn’t cause thyroid disease or vice versa. Continued on next page Canadian CELIAC | 23
CD and thyroid disease are not mutually causative – in other words, one does not cause the other. So what exactly is thyroid dis- ease? Thyroid disease is any illness caused by a dysfunction of the thyroid gland, the small butterfly-shaped organ located in the middle of the lower neck. Without us even being aware of it, the thyroid is quietly responsi- ble for releasing hormones which help control several essential DEPOSIT ILLUSTRATION body functions such as metabo- lism, Marthatemperature, Henderson hair and skin growth, and Pattyweight, and energy level. Massel When there is a disorder in the thyroid, it can lead to too much of these hormones (hyperthyroid- llustration of the location of the thyroid gland, a small butterfly- ism) or too little (hypothyroidism). shaped organ located in the middle of the lower neck. Grave’s disease and Hashimoto’s thyroiditis are the most common thyroid disease and vice versa. small intestine will start to heal. As autoimmune conditions that In fact, it is recommended that a result, absorption of nutrients cause hyperthyroidism and hypo- all patients with CD have their and medications will improve, and thyroidism, respectively. Grave’s thyroid function assessed with a less medication may be required. disease causes symptoms like blood test every 1-2 years. This If one has an autoimmune thyroid difficulty sleeping, tremors, palpi- is true even for those with no disorder and medication does not tations, weight loss and diarrhea, unusual symptoms, as testing for seem to be effective, screening while Hashimoto’s thyroiditis thyroid function can diagnose the for CD should be considered, can cause fatigue, feeling cold, problem before any symptoms because it may be affecting the excessive weight gain, constipa- develop. It is also important to amount of medication being ab- tion and dry skin. If left untreated, note that, despite both conditions sorbed in the body. these disorders can lead to heart being autoimmune in nature, failure, muscle weakness, infer- following a gluten-free diet will not What it’s like living with both tility, cognitive dysfunction, and help treat thyroid disease – only diseases: Carolyne was first even death. medication can do that. That said, diagnosed with Grave’s disease if you have an autoimmune thy- (autoimmune hyperthyroidism) Screening and diagnosis: CD and roid disorder and are medicated in early 2013. She’d experienced thyroid disease are not mutually for it, and you’re later diagnosed unexplained weight loss and was causative – in other words, one with celiac, going gluten-free may suffering from severe anxiety and does not cause the other. Howev- alter the amount of medication palpitations. Her doctor ordered a er, people with celiac can benefit you need. Why? When you stop full thyroid panel and she was from screening for autoimmune eating gluten, the lining of the Continued on next page 24 | Canadian CELIAC
sent to an endocrinologist, where controlled. After my celiac di- or just an overall issue. I have she was officially diagnosed. agnosis, I immediately changed mobility issues because I also my diet to eliminate all sources have multiple sclerosis, so I am In 2017, Carolyne experienced of gluten and avoid cross-con- no longer working and I spend some vague but unusual symp- tamination as much as humanly a lot of time at home, which was toms, and after blood work or- possible. I still eat out but limit not the case prior to my health dered by her family doctor, she myself to restaurants that I feel issues. The thyroid issues are ful- was diagnosed with celiac dis- are safe for me: those that have ly controlled so I don’t find those ease. The diagnosis came to her well-established protocols to try affecting my life at the moment. as a complete shock, because to avoid cross-contamination and The celiac, however, does make she wasn’t experiencing an upset offer gluten-free choices. I still it more challenging in social set- stomach. ask lots of questions even after tings. I can’t just meet someone three years. for dessert or a meal unless I can Q: How did things change for choose the restaurant and some- you when you already had Q: What are some of the difficul- times that isn’t possible. I can’t Grave’s and you were then diag- ties you face daily, and how do just eat somewhere quick while I nosed with celiac? you handle it? am out for the day, which makes C: I continued to take two sup- C: I still suffer from anxiety but things challenging. But with a plements daily to help control am unsure if that is related to any little planning, I don’t find I am the Grave’s disease and it is well of my health conditions directly missing out too much. u DONATE NOW at https://donatecar.ca/org/charitypage/donate.php?charity=CdnCeliac and you will receive an income tax receipt from the CCA after your car donation is complete! Canadian CELIAC | 25
Ask an allergist THE ALLERGY ARGUMENT Some people insist that celiac disease is just like a food allergy. It’s not—but how similar are they? We asked an allergist. BY WENDY GOULD, M.D., ALLERGY & IMMUNOLOGY As an allergist, I see patients with food allergies on a regular basis. A common request in my office is to DEPOSIT PHOTO know if we can skin test for a “gluten allergy.” Gluten ingestion has been linked to many symptoms, both gastrointestinal (GI) and non-GI, and avoidance often makes many people feel better. Although they are both immune-mediated, celiac disease and IgE-mediated food allergy (the type of immediate, potentially life-threatening reaction people normally equate with the word “allergy”) are not the same thing. There are some key differences, both in clinical presentation and in evaluation. Continued on next page 26 | Canadian CELIAC
Celiac disease is a disease that affects the small intestine and occurs due to an immune response triggered by gluten and directed against one’s own body as opposed to a foreign substance. This is called autoimmu- nity. In contrast, IgE- (immunoglobulin E, an antibody associated with allergic disease) mediated food aller- gy involves an immune response to a protein in a food (i.e., not against yourself), which can lead to acute life-threatening reactions. This is known as immediate hypersensitivity. Additional facts: condition. be more common than celiac dis- z Celiac disease occurs in 0.5 to 1 z Patients with celiac disease ease and includes the same symp- percent of the population. need to avoid all grains containing toms; however, blood work and z Small intestinal changes in celiac gluten. endoscopy are negative/normal. It disease include villous atrophy z Patients with wheat or other is not thought to be autoimmune (flattening of the intestinal mem- grain allergy can often eat other and it is not associated with the branes that lead to difficulty in grains without adverse reactions. complications of celiac disease. digestion/absorption) that can z Wheat allergy is found to be z Food intolerance is associated resolve within weeks to months outgrown by ~ 29% of patients by with gastrointestinal symptoms on a gluten-free diet. age 4 and ~65% by age 12. without risk for anaphylaxis and it z Celiac disease is a life-long z Non-celiac gluten sensitivity may is not immune-mediated. u CELIAC IGE-MEDIATED FOOD ALLERGY IMMUNE MECHANISM: z Autoimmune, immune re z IgE-mediated against a gluten sponse directed against self foreign antigen/protein CAUSES: z Gluten – found in wheat, z Most common: cow’s milk, barley, rye, triticale egg, wheat, soy, peanut, tree nuts, finned fish, shellfish SYMPTOMS: z GI: diarrhea, pain, weight loss z Hives, swelling, sneezing z NON-GI: rash, osteoporosis, iron nasal congestion, wheezing, deficiency, enamel defects vomiting, loss of consciousness TESTING/EVALUATION: z Blood work: IgA (or IgG) tissue z Skin testing to food allergen transglutaminase (tTG), gliadin z Blood work (ImmunoCAP) deamidated peptide loss of consciousness z Endoscopy and biopsy of small z Supervised oral food challenge intestine TREATMENT: z Avoidance of grains z Avoidance of triggering food containing gluten z Epinephrine auto-injector Canadian CELIAC | 27
Living Alive Granola THE GRANOLA IN THE ROUGH The inception of Living Alive Granola is a whirlwind story about Stephanie Brown’s love for her children, the wholesome, inexpensive PHOTOS SUPPLIED BY LIVING ALIVE GRANOLA ingredients that grow in Elgin County, and a lesson that everything in life is accumulative Joe Preston and Stephanie Brown, business partners 28| Canadian CELIAC
... I was bipolar. Living Alive Granola came to be ... be- cause I wanted to show the world I could do something BY SARAH MARIOTTI sick, and I wanted to show the world that I could do something…I “If you think [mental illness] isn’t figured, if I can work for myself, I talked about now, it definitely won’t get fired. [A lot of employ- wasn’t in 1989.” Stephanie Brown ers] don’t understand why you had her first breakdown when she count the money wrong — your was 14, and remembers it like it brain is going faster than you can was yesterday. Now in her forties, keep up.” Brown is determined to change the way people with mental illness The final component that brought are seen. In fact, her bipolar disor- the company to fruition was Joe der is the very reason her gluten Preston, a former Ontario Mem- free granola company, Living Alive ber of Parliament who offered to Granola, exists today. invest in the business during a serendipitous moment for Brown. “I was a single mom of [three She had just finished singing — young kids]; I wanted them to her artistic side, a story in itself — eat real food. And you can’t help in front of a crowd, for the Prime but live in Elmer, Ontario and not Minister of Canada. Just minutes get caught up in how to make a after, the two started to talk and perfect pie. I was always in the he expressed an interest in her kitchen. Every day when [my kids] nascent granola company. “I want would come home from school, I to inspire others and share that would have a fresh batch of whole everything you do is accumula- wheat chocolate chip cookies or tive,” Brown shares. Preston is warm, out-of-the-oven banana now Brown’s business partner bread. I learned how to utilize and the co-founder of Living Alive the rottenest bananas, because Granola. Since their partnership, they make the tastiest banana the two have built a brand from bread,” shares Brown. “I would do the ground up, initializing in anything at that time in my life to farmer’s markets in the heart of make sure they didn’t know we St. Thomas and London, Ontario, were poor.” and now selling in large groceries like Loblaws and Metro. Today Brown says she was unable to their reach offers safe and delight- hold a job when her kids were ful snacks to Canadians who are little. “I couldn’t admit to myself living off a gluten free diet…or any- that I was bipolar. Living Alive one who appreciates a delicious, Granola came to be because I did chewy granola. not want anyone to know I was Continued on next page Canadian CELIAC | 29
Illness doesn’t care if you’re rich or poor,” referring to both celiac disease and any kind of mental illness. “It’s almost like cookie dough,” latter, ten cents from every Living says Brown who describes the gra- Alive Granola bag is donated to nola as a cookie out of the oven. local mental health projects. “The Available in two noteworthy fla- ten cents are my way of saying, vours – honey almond granola and ‘Know that you are not alone,’” maple walnut granola – the entire Brown testifies, adding that since Living Alive Granola product line is the COVID-19 pandemic struck, made with pure protocol oats, sans she has been making it a point to additives and preservatives. ask every one of her employees how they are doing. To Brown and Preston, keeping To honour mental illness, ten prices affordable is just as im- “The only difference between you cents from every Living Alive portant as ensuring their facility and I is that I go knock on doors Granola bag is donated to local is certified gluten free. “Illness that no one’s knocking on, and the mental health projects. doesn’t care if you’re rich or funny thing is that people answer poor,” says Brown, referring to the door,” she remarks. u both celiac disease and any kind of mental illness. To honour the https://livingalivegranola.ca CCA ANNUAL holiday guide COMING SOON! DECEMBER 10 Tips and recipes for your family. SPONSORED BY NAIRN’S 30 | Canadian CELIAC
New establishment Mom’s Own Borscht, one of owner Chef Liz Pietrzak’s favourite soups, PHOTOS SUPPLIED BY SOUPS FROM ME TO YOU SENSATIONAL SOUPS High-quality, fresh and delicious soups can now be yours – completely gluten free BY NICOLE COX There are a few unmistakable signs that autumn is really here: the crunch of fall leaves, turkey on the ta- ble, pumpkins at the door and crisp, cool evening air. We start to bundle up and settle down for the colder months ahead. Adding to the warmth and coziness of the fall season – a delicious bowl of soup, chowder or chili. As celiac consumers continue to look for high-quality, delicious, accessible and certified food options, it is helpful to know which companies offer fully gluten-free products. Looking for gluten-free soups is no ex- ception! One such company offering a variety of delicious options is Continued on next page Canadian CELIAC | 31
All of our products are ... gluten free, have no preserva- tives and are low in sodium ... many offer vegan options. Clockwise from bottom left: owner and chef of Soups from Me to You, Liz Pietrzak; Beef Bone Broth and Southwest Pork Spice Rub. family-owned Soups from Me to to You is all about bringing robust, PHOTOS SUPPLIED BY SOUPS FROM ME TO YOU You. Made in Ontario, Soups from wholesome taste from our kitchen Me to You offers high-quality, fresh to yours! ingredients from a dedicated glu- ten-free facility! You offer gluten-free options within your list of soups and Owner Chef Liz Pietrzak tells chilis. Why is it important to us more about their gluten-free you for your company to do so? offerings: I have been preparing home Tell us a little more about Soups cooked meals from scratch my from Me to You: At Soups from entire life. This first started with Me to You, we use locally sourced traditional Polish/Ukrainian foods vegetables and meats to provide that I made with my mom. As our a wide selection of delicious family grew, it included cooking soups, chowder and chilis. All of for relatives and friends who our products are healthy, gluten have allergies, are celiacs and free, have no preservatives and vegans. Cooking for these peo- are low in sodium, and many offer ple then became a regular way of vegan options. All of our products cooking for me. Our website now come ready-made, from freezer offers soups, spice mixes, chilis to table – just heat, serve and and chowders for many different enjoy. We have a recipe for every diet types, including vegan and occasion or need! Soups From Me Continued on next page
...we offer a full list of our wholesome ingredients and consumers will ... find the GF label on all of our packaging offer a full list of our wholesome PHOTO SUPPLIED BY SOUPS FROM ME TO YOU ingredients and consumers will easily find the GF label on all of our packaging. In addition, all our products carry the new Ontario Made designation, ensuring they are all locally made. What are some of your personal favourite gluten-free products that you offer? I like them all! But if I had to choose, I would say a few of my personal favorites are Mom’s Own Borscht, Moroccan Lentil Asparagus Soup Soup, Nonna’s Minestrone and my new Curried Butternut Squash. Plus, gluten, dairy, nightshade and salt- are safe to consume, and consis- I do love all my of chilis! free diets. tently meet all gluten-free quality and regulatory requirements. Finally, where can our Celiac Are all of the ingredients in Our kitchen is certified as a ded- readers find your delicious soups? your gluten-free products cer- icated gluten-free facility and we We sell our soups online, with tified gluten free, and are they have obtained the Gluten-Free pickups available Monday through safe from cross-contamination? Dedicated certification for our Thursday. We also deliver in our How can our celiac readers feel products. local area. Additionally, our soups assured that the products meet can be found in a variety of stores their gluten free needs? We ad- Does the packaging clearly state and farmers markets – for a full here to, and abide by, strict pro- all ingredients? Does it carry a list of where to find our delicious cesses and controls to ensure gluten-free symbol and if so, products, you can visit our website: our kitchen and products is it easy to identify? Yes, we www.soupsfrommetoyou.com. A TIP FROM CHEF LIZ ON THICKENERS Our gourmet company Soups From the different soups and chilis my dish); and to thicken our chilis (meat Me To You features all gluten-free company offers. In our Roasted and vegan), we use corn starch. Our products. While trying many differ- Gourmet Mushroom Soup, we use featured recipe Curried Butternut ent gluten-free thickeners for soups diced potato; in our Roasted Garlic Squash Soup on the next page, and dishes, I have found many Tomato Bisque, we use tapioca uses roasted squash as its thicken- great substitutes for flour. I use a flour (this flour does not take away er. Instructions for roasting squash variety of gluten-free thickeners in or add any unwanted flavour to the are found in the recipe instructions. Canadian CELIAC | 33
CHEF LIZ’S RECIPE PHOTO SUPPLIED BY SOUPS FROM ME TO YOU CURRIED BUTTERNUT SOUP This Curry Butternut Squash soup is creamy, full of flavour and subtly infused with warming curry and coconut milk – a perfect soup for chilly weather. Enjoy it topped with toasted pumpkin seeds! INGREDIENTS z 1 tbsp avocado oil 1 tbsp olive oil) (14oz) z 2 medium shallots, thinly diced z 1 pinch each salt & black pepper z 3 cups vegetable broth z 2 cloves garlic, minced z 1 ½ tbsp curry powder z 1 tbsp maple syrup z 6 cups roasted cubed butternut z ¼ tsp ground cinnamon z 2 tsp Red Thai Curry Paste (vegan) squash (4 lb butternut squash, z 1x 400mL can light coconut milk Continued on next page 34 | Canadian CELIAC
INSTRUCTIONS 1. Preheat the oven to 400 de- squash flesh into a bowl. Set minutes. grees Fahrenheit and line a aside. 9. Taste and adjust seasonings, rimmed baking sheet with parch- 4. Heat a large pot over medium adding more curry powder, ment paper. Place butternut heat. salt, or maple syrup as desired. squash (halved vertically and 5. Once hot, add oil, shallots, Continue cooking for a few seeds removed) on the pan. and garlic. Sauté for 2 minutes, more minutes over medium heat. Drizzle each half with just enough stirring frequently. 10. Use an immersion blender olive oil to lightly coat the squash 6. Add butternut squash and and purée on high until creamy on the inside (about ½ tsp each). season with salt, pepper, curry and smooth. Rub the oil over the inside of the powder, and ground cinnamon. 11. This soup can be served hot or squash. Stir to coat squash. Then cover cold, as is or with your choice of 2. Turn the squash face down and and cook for 4 minutes, stirring garnishes. u roast until it is tender and com- occasionally. pletely cooked, about 45 min- 7. Add coconut milk, vegetable DEPOSIT PHOTOS utes. Set the squash aside until broth, maple syrup, and Red Thai its cool enough to handle, about Curry Paste. 15 minutes. 8. Bring to a low boil over me- 3. Once cooled, use a large dium heat. Then reduce heat to spoon to scoop the butternut low, cover, and simmer for 20
Founder’s House in NS CHIA CRACKERS WITH APRICOT CHUTNEY Located in Nova Scotia’s scenic Annapolis Valley, Founder’s House provides “elevated rural dining – rooted in sea and soil.” Their seasonal menu, inspired by the area’s terrain and history, incorporates locally-sourced ingredients to create a culinary experience that won the establishment a Fine Dining Award in 2019. Founder’s House has graciously provided a recipe for gluten-free chia crackers and apricot chutney that fits the season perfectly. CHIA CRACKERS INGREDIENTS z ½ cup chia seeds z ½ cup sunflower seeds z ½ cup pumpkin seeds z ½ cup white sesame seeds z 1 cup water z 1 large clove garlic, grated z ¼ tsp fine salt INSTRUCTIONS 1. Preheat oven to 300 degrees. PHOTO BY ZACHARY BLEASE 2. Mix all the ingredients in a large bowl, and allow to sit 10 minutes or so, for chia seeds to become sticky. 3. Spread the mixture as thinly as possible onto a baking sheet lined with parchment paper. The 5. Flip the sheet of seeds and con- 6. Remove from oven, allow to thinner you get it, the crispier it tinue baking for another 6 minutes cool and break into irregular- will be! or so, until it has a nice snap (with- ly-shaped, cracker-sized pieces. 4. Bake for 12 minutes. out burning). Continued on next page 36 | Canadian CELIAC
APRICOT CHUTNEY Makes 6 half-pint (8oz) jars. INGREDIENTS z 1 kg (7½ cups) dried apricots, roughly chopped z 500 g (3¼ cups) sultanas (golden raisins) z 500 g (3¼ cups) Medjool dates, roughly chopped z 250 g (1 cup, packed) brown sugar z 3 tbsp ginger (fresh, grated) z 1 tbsp coriander seeds z ¼ tbsp nutmeg z 750mL (3 cups) white wine vinegar z 500mL (2 cups) water z 1 ½ tbsp salt z 3 tbsp mustard seed z ½ tsp chili powder INSTRUCTIONS PHOTO BY ZACHARY BLEASE 1. Mix the sugar, vinegar and water in a large stock pot over medium heat. 2. Once sugar is dissolved, add the rest of the ingredients (apricot, sultanas, dates, ginger, coriander, 4. Divide into jars and refrigerate. nutmeg, salt, mustard seed and chili powder). Chutney should last up to 3. Turn the stove down to very low 6 months stored in the heat, and simmer until the chutney refrigerator, or you can can it for is thick ( just how thick is up to a longer shelf life. u you). Canadian CELIAC | 37
DELICIOUS Gluten-Free CLASSIC DINNER ROLLS Roll right into holiday season. Get any occasion rolling with our soft and versatile Classic Dinner Rolls. Gluten-free and allergy-friendly, everyone will reach for more. Seconds, anyone? Speaking of seconds, download your FREE Second Helpings holiday recipe book for gluten-free foodies. 16 plant- based recipes. All gluten-free. Get the recipe book.
New research study THE PROACTIVE CELIAC STUDY New research study could lead to a treatment for celiac disease. PROACTIVE Celiac Study: A POTENTIAL THERAPEUTIC FOR NON-RESPONSIVE CELIAC DISEASE ROSIE FOUNTOTOS, CSEP-CEP, MSC. (C), DIVISION OF EXPERIMENTAL MEDICINE, MCGILL UNIVERSITY With the evidence collected, PRV-015 has the potential to become the first celiac disease therapeutic ever approved. K E Y TA K E A W AY S z Run by Provention Bio, the PROACTIVE Celiac z Findings suggests that while PRV-015 may not al- Study will examine the usefulness of varying dos- low those with celiac disease to intentionally eat es of the drug PRV-015 in patients diagnosed with gluten, it could reduce the side effects of uninten- non-responsive celiac disease. tional cross-contamination while on a gluten-free diet. z Presently, PRV-015 is the only drug in a phase 2a study shown to simultaneously reduce both symp- z Researchers will be recruiting patients with celiac toms and inflammation in individuals with celiac dis- disease in Canada later this year. Stay tuned to learn ease, and has the potential to become the first celiac about possible participation in the trial soon! disease therapeutic ever approved. Continued on next page Canadian CELIAC | 39
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