CanadianCELIAC - IS KISSING OK? GROWING UP CELIAC
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CanadianCELIAC
IS KISSING OK?
Plus
GROWING UP
CELIAC
p. 12
VALENTINES
RECIPES
p. 36
CCA board of directors
A magazine for Canadians with celiac disease
and gluten sensitivity
Executive Directors
WINTER 2020
Treena Duncan, President Meredith Birchall-Spencer
Janet Bolton, Vice President Tamara Close
David Congram, Secretary Jessica Danford
Andrew Kotys, Treasurer Selena DeVries
Contact us
Canadian Celiac Association
“Life is like a box of chocolates, you never know
1450 Meyerside Dr., Suite 503
Mississauga, ON. Canada L5T 2N5 what you’re going to get.” – Forest Gump.
Phone: 905.507.6208 or 800.363.7296
Fax: 905.507.4673 | Email: info@celiac.ca
www.celiac.ca Managing life with celiac disease and gluten sensitivity can sometimes feel like
Forest Gump’s quote. Inside this edition, we try to dispel some of the myths or
Canadian CELIAC bring facts forward from kissing, gluten in makeup and school supplies while
offering tips on how to manage your disease after diagnosis to help take out some
A MAGAZINE FOR CANADIANS WITH of the mystery. Our Growing Up Celiac ongoing features shows how kids in sports
CELIAC DISEASE AND GLUTEN SENSITIVITY and at a Calgary camp are empowering themselves.
Editorial Board
Melissa Secord
Kim Shiffman FOLLOWING UP AFTER DIAGNOSIS. Page 7
Janet Dalziel
Jessica Danford
RonniLyn Pustil
Gayle Grin
HE SHOOTS, HE SCORES. Page 13
Graphic design by
www.gaylegrin.design
BABY BITES. Page 16
Contributors
Janet Dalziel
Dr. Justine Dowd
Dr. Mohsin Rashid
Cheryl Richmond
PUCKER UP: KISSING AND
Dr. Donald Duerksen
Dr. Dominica Gidrewicz
Léa Saad
Melissa Secord
COSMETICS. Page 23
RonniLyn Pustil Dr. Jocelyn Silvester
COVER PHOTO BY LÉA SAAD
THE FLOURS THAT BE: BAKING
Copyright © 2020 by the Canadian Celiac Association
Publication Agreement#40787580 FOR SUCCESS. Page 32
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. VOLUME 4 | ISSUE 1 2
Canadian CELIAC | 3
2 | Canadian CELIAC
From the editor’s desk CCA board nominations
When we hit a milestone like a new decade, we often look back and
stake stock or regroup and cast our eyes ahead. What’s on our horizon? CALL FOR NOMINATIONS –
As a community, a lot has changed: more gluten-free products on the
shelves, more people aware of celiac disease and gluten sensitivity, more
CCA BOARD OF DIRECTORS
gluten-free options at restaurants and now more than ever we are on the
horizon of a potential drug therapies and breakthroughs. We still have The Canadian Celiac Association (CCA) is seeking nominations for its national board of directors for the
much to do, though. People are still getting ill from cross-contact, ‘may July 1, 2020 to June 30, 2022 term.
contain’ statements are on way too many labels and Ontario still hasn’t
joined the rest of the country on diagnosis coverage. Nominations Close: March 6, 2020
For the CCA national volunteer board, the year 2020 means drafting a Who are we? Since 1972, the Canadian Celiac Association (CCA), a national not-for-profit charity, has been the
new vision for the organization and strategic plans to address the chal- national voice for people who are adversely affected by gluten, and is dedicated to improving diagnosis and
lenges you and they as individuals who also have the disease or a rela- quality of life. In addition to a small national office located in Mississauga, Ontario, CCA is backed by support
tive, still face. The plan, which you’ll see in the coming months, arrives as the organization moves this year groups and chapters across Canada serving members locally.
away from traditional membership—a challenge for many non-profits, not just CCA — to serving the broader
gluten-free community at large. It will allow all of us to come together to advocate for better precautionary Our Vision: The Gluten Solution – Find, Treat, Cure.
labelling, review tax policy and blood testing coverage, support research and Canadian trials, offer more
education and create more awareness. Our Values: Science based, integrity and compassion
This edition of Canadian Celiac showcases just some of the broad-scale work that has and is being accom- Is this role for me?
plished thanks to the incredible support received from individual like you. Take for instance the update on • Are you passionate about helping people impacted by celiac disease, dermatitis herpetiformis or non-celi
the ‘Doggie Bag’ study which was supported by a CCA JA Campbell grant, and the guidance on cosmet- ac gluten sensitivity?
ics and gluten free from our hard-working Professional Advisory Council members, who source the latest • Do you want to be involved in making decisions that could help improve their lives?
research to help empower your decision-making. Working together, we can bring together people like Dr. • Do you want to grow your professional and personal skills and network in board governance, strategic
Mohsin Rashid, a Halifax gastroenterologist and long-time volunteer, to provide reviews for all of us on the thinking, problem solving, financial oversight and issues management?
latest advice on how to manage celiac disease after diagnosis.
We need you to be ready to:
CCA is seeing people like Léa Saad and Drew Flemming. Léa is a young woman who was diagnosed in high • Read and review all meeting materials in advance.
school, who turned to the community for support and now gives back sharing her story on navigating dating • Participate on bi-monthly board meeting calls which average two hours in length and attend up to three
and a social life in this column and on her very own blog. Drew is a young hockey player who’s growing up weekend in-person meetings per year, one of which is CCA’s Annual General Meeting.
celiac but not letting it stand in the way of his dreams. • Actively participate in all strategic and financial discussions and issues impacting CCA
• Evaluate the role and performance of the Executive Director
CCA is you, and when you support CCA, you are making an investment in yourself and paying it forward to • Respect final decisions of the board and adhere to board confidentiality and privacy
change the landscape, make improvements and help others who share a similar journey. In the short three • Participate on one board standing committee: Executive, Governance, or Finance/Audit which may involve
years that I have been with you, I have seen an incredible growth and energy and I can’t wait to see what another one to two hours per month
you do over the next 10 years.
Are you the candidate for us?
Respectfully yours, • Candidates should have at least five years of work experience.
• Volunteer experience especially in the not for profit sector or previous board service is an asset.
• Preference will be given to individuals who have a background in the following area: fundraising/grant
writing, agri-food or food production.
• Some knowledge of celiac disease, gluten sensitivity or dermatitis herpetiformis is an asset but not required.
Melissa Secord
Executive Director Interested? Visit https://www.celiac.ca/get-involved/nominations/
Applicants need to submit the Board Nomination form, along with a cover note and resume
by March 6, 2020.
4 | Canadian CELIAC Canadian CELIAC | 5
Managing your celiac
It’s crunch time! Switch to a tastier, healthier
FOLLOWING UP
You’ve been diagnosed with celiac and you’re on a GF diet.
Do you need to continue seeing a gastroenterologist?
alternative to bread.
PHOTO FROM BING IMAGES
LÉA SAAD
Celiac disease (CD) is a chronic autoimmune disorder in which ingestion of gluten (a protein present in
wheat, rye and barley) causes damage to the lining of the small intestine in genetically susceptible individ-
uals. It is a common disorder affecting about 1% of the population. The treatment of CD is a strict life-long
gluten-free diet. Follow-up of patients with CD is important. The recommendation regarding follow-up can
vary depending on the clinical condition of the patient and the resources available locally.
BY DR. MOHSIN RASHID endoscopic small intestinal biop- should also include an assess-
Made with High in fibre Vegetarian
sies performed by a gastroenter- ment by a dietitian. After that, pa-
wholegrain oats Q How often do I go back to my ologist. It is recommended that tients are usually seen yearly. For
gastroenterologist? Do I ever patients goes back to see their adults, if you’re doing well, your
need to? gastroenterologist in follow up gastroenterologist may determine
A In the majority of cases, the three to four months after start-
diagnosis of CD is confirmed with ing the gluten-free diet. This visit Continued on next page
Discover the range at
WWW.NAIRNS-OATCAKES.COM/WORLDWIDE-EXPORT/NAIRNS-CANADA Canadian CELIAC | 7
CD can negatively impact growth and development.
Therefore, follow up of toddlers ... is more frequent ...
oats
Continued from page 7 mal initially. These general guide- in gluten-free diet is essential. The
lines apply to patients of all ages. first year or so after diagnosis can
that follow-up can be provided by be challenging, as one gets used
your family physician. Pediatric pa- What is tested depends on the to the diet.
tients, on the other hand, are fol- clinical condition of the patient.
sweet oats.
lowed by their gastroenterologists The years of symptoms before Q Do things change if I have
generally on a yearly basis. Young diagnosis may not have any another autoimmune disease or
children are seen more often. significant impact. What’s import- chronic condition?
ant is how severely a patient was A Celiac disease is an autoim-
Q Can my family doctor manage affected at diagnosis. mune disorder and patients are
my disease? at risk of developing a second (or
A This depends on the family Q How does the ongoing man- third) autoimmune disorder. The
doctor’s experience and knowl- agement of celiac disease differ most common of this is thyroid
edge of CD. For patients who are at different ages and stages disease, for which patients are
Bring home a tastier, healthier snack. stable, a family physician should
be able to provide effective on-
of life?
A The gluten-free diet is effective
monitored. A strict gluten-free diet
is helpful but does not take away
going care. (The website of the for all ages. One thing that distin- the risk of developing other auto-
Canadian Celiac Association has guishes children is their growth, immune disorders completely.
some excellent resources for phy- as CD can negatively impact
sicians on this issue.) growth and development. There- To summarize: Regular follow-up
fore, follow up of toddlers and of patients with celiac disease is
Q Are there any ongoing medi- young children is more frequent important. The annual follow-up
cal tests I should be having? and should be provided by a should consist of a detailed his-
A The celiac serology (TTG an- pediatric gastroenterologist. For tory, review of gluten-free diet
tibody blood test), which is ab- adults, the overall principles of adherence, complete physical
normal at diagnosis, is generally management/follow-up remain examination including growth mea-
repeated about a year or so after similar, irrespective of age. surements (weight, height, body
being on a gluten-free diet. The mass index), and checking the TTG
test will eventually become nega- Q What about people who are antibody and thyroid function. u
tive, although it may take longer in newly diagnosed? What should
some patients depending on how they expect as far as follow up? Written by Dr. Mohsin Rashid MD, MEd,
abnormal it was at the beginning. A A strict gluten-free diet is highly AGAF, FRCP(C), Education Committee,
Other ongoing tests for nutritional effective in resolving symptoms Canadian Celiac Association; Profes-
assessment (iron, vitamin D, etc.) and healing the intestine. Coun- sor of Pediatrics (Gastroenterology &
are repeated if they were abnor- selling by a dietitian with expertise Nutrition), Dalhousie University.
Nairn’s know a thing or two about oats. We’ve been baking with them since
1896 and they are the main ingredient in everything we make. Whilst our
product range has changed a lot since our humble beginnings, our commitment
to making simple, natural and wholesome products that taste great is as import-
Made with Source of Gluten free ant now as it was back then.
wholegrain oats fibre
Oats have become something of a superfood in recent times. Nairn’s diverse oat-
based range now includes oatcakes, sweet biscuits, crackers and flatbreads and
Discover the range at Baked we are continually launching new products to meet consumers needs for tasty and
in Scotland. nutritious healthy snacks.
WWW.NAIRNS-OATCAKES.COM/WORLDWIDE-EXPORT/NAIRNS-CANADA
May we help you?
Gluten free superfood PRECAUTIONARY
LABELLING GUIDANCE
made super simple
Bursting with vitamins and nutrients wholegrain oats (like the ones we use in
Watch for an announcement on label reading including may contains from CCA in a few weeks. After consul-
tations with Health Canada and extensive research from a team of dietitians from across Canada, a guidance
document has been developed.
CCA conducted a consumer survey last May and confirmed the confusion of product labels with precaution-
our flatbreads) always make for a great snack. This recipe is so simple to make, ary statements.
you may never go back to sandwiches again…
CCA has been working with Health Canada and other allied stakeholders to improve food ingredient labels
and to require manufacturers to stop over-labelling where there is no risk to the gluten-free consumer and
Roasted Squash & Carrot Spread provide more verification of when statements are used.
Ingredients Webinar Recording Available: Request to receive a recording of CCA Professional Advisory Council mem-
ber and registered dietitian, Shelley Case’s webinar on Navigating Labels by clicking here.
1kg butternut squash, cubed
4 carrots, chopped
1 large red onion, quartered
3 garlic cloves STAKE YOUR CLAIM!
CELIAC AND MEDICAL CLAIMS
1 tsp oregano
Olive oil
Salt & pepper
Your favorite
Nairn’s Flatbreads CCA has developed in conjunction with Revenue Canada tax volunteer, Lynda Marie Neilson, a series of
tools and resources to help individuals who wish to claim for the incremental cost of gluten-free products. A
webinar recording, handouts and sample spreadsheet are available by request using this link: https://www.
celiac.ca/news-events/events/
UPCOMING EVENTS
Instructions
Preheat your oven to 390°F.
Add the squash, chopped carrots,
red onion, garlic, oregano into a large GF 101: Navigating the gluten-free diet webinars
baking tray and drizzle with olive oil Join CCA Registered Dietitian Gauri Bawa for our one-hour FREE webinar on how to navigate the gluten-free
and sprinkle a large pinch of salt and diet. Perfect for individuals or caregivers of people who are newly diagnosed.
pepper. Place in the oven for 35-40 Date: Wednesday, February 19
minutes until it browns. Put all the Time: 9 – 10 pm Eastern
ingredients in a blender and pulse Click here to register
until desired consistency. Top your
Nairn’s Flatbreads and enjoy! CCA National Conference
Date: June 5-7, 2020
Doubletree Hilton Hotel, Regina
See pagee 42-43
Discover the range at
WWW.NAIRNS-OATCAKES.COM/WORLDWIDE-EXPORT/NAIRNS-CANADA Canadian CELIAC | 11
N 17 e, ial
Growing up CELIAC
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HE SHOOTS, HE SCORES! Drew Flemming won’t let anything stand in the way of
his ambitious hockey dreams — not even celiac disease
BY RONNILYN PUSTIL
At age five, when many kids
haven’t learned how to ice skate
yet, Drew Flemming was al-
ready playing hockey in a house
league. Two years ago, as an
eight-year-old in the AA division,
he scored more than 60 goals, by
far the highest on his team. To-
day, he plays for the Windsor Jr.
Spitfires AAA Zone—the highest
level of hockey for someone his
age—and is the third-highest goal ey because of it. He just kind of kind of like a whole team thing,” figure something out. “One time anymore when I go on the ice, so
scorer on his team. fought through it.” Lindsay says. Because they’re the team went a restaurant that I can focus more on hockey and
together so often—as frequent- couldn’t accommodate Drew, but skills.” His mom agrees: “Since
“Drew is very competitive and Finally, in May 2017, the Flem- ly as six times a week, thanks there was a Boston Pizza next going gluten free, Drew is stron-
very determined,” says his mom, mings got an answer to all of to practices, games and travel door, so we ordered him pasta ger, both in his body and mentally
Lindsay. “He wants to win and Drew’s mysterious symptoms time—“we’re kind of like a big from there and brought it into the at school. He’s a very athletic boy
goes out and tries his best. He’s when he was diagnosed with family.” Food plays a big part in restaurant and they were fine with and just knowing that he’s thriv-
always drawing plays on his celiac disease. He also had very their hockey lives, whether they’re it. This way he still feels part of the ing and growing with celiac is our
hockey white board and is always low levels of iron, a symptom that celebrating someone’s birthday or team and not left out.” main goal.”
playing road hockey or shooting often accompanies a celiac diag- eating out on the road. “The other
pucks in the driveway. He watch- nosis and explains the darkness parents have been so awesome in Still, Drew sometimes struggles Drew has another goal in mind.
es hockey on TV and checks all around his eyes. accommodating Drew,” says Lind- with having to be gluten free: “It Though he’s a huge Leafs fan, he
the scores and stats on his TSN say. “They’ll pick up gluten-free sucks,” he admits. “I want to be would love to meet his role model,
app every morning before school. The diagnosis offered clarity, but pizza for him for birthday parties. able to eat what everyone else Montreal Canadiens player Max
He just loves the game.” also represented a challenge. “It They’re all aware and ask ques- does and it’s not fair. When I go to Domi. Drew has read Domi’s mem-
was a big learning curve when he tions about how to prepare food my friends’ houses, I worry about oir No Days Off, which chronicles
Drew loves hockey so much was first diagnosed,” Lindsay says. and avoid cross-contamination.” the food that they have, or I bring his life as a kid with type 1 diabetes
that, even when he started com- “The Canadian Celiac Association my own snacks. Sometimes I get and his journey to the NHL. They
plaining of stomach aches at age Facebook page was so helpful. Being on the road can be tricky. mad that I have it, even though my have a lot in common: They both
seven, he kept on playing. Around And a friend whose daughter has When they have to travel for mom and dad try to make it easier come from the same hometown of
this time, he was also experienc- celiac disease was also a good a tournament, the Flemmings for me.” Belle River, they both play compet-
ing loose stools and headaches, source of information.” bring their own gluten-free food itive hockey and they both have
PHOTOS BY RACHEL MITCHELL
and was throwing up in the mid- for breakfast and snacks and But despite his young age, he’s celiac disease. And neither seems
dle of the night. His parents no- T EA M P L AY ER S have their go-to places where well aware how much being to be letting their illness get in the
ticed he was getting dark around they know Drew can eat safe- gluten free has helped him. “Now way of the game. u
his eyes.“He was really sluggish, When it came time to let Drew’s ly. When the team goes out for that I’m on a gluten-free diet, I
too,” Lindsay recalls. “But I don’t teammates and their families dinner, Drew’s parents check the feel better and have more ener- For top dining out tips
think he ever missed any hock- know about his diagnosis, “it was menu ahead of time and try to gy,” he says. “I don’t have cramps https://youtu.be/ec27yP5zkXY
Canadian CELIAC | 13
Growing up CELIAC
CAMP CONNECTIONS Rod McDaniel Celiac Kid’s Camp is the perfect
summer escape for kids who must eat gluten free
BY THE CALGARY “The camp is extremely popu-
CHAPTER, CANADIAN lar; always selling out and many
CELIAC ASSOCIATION children returning year after year,”
says Calgary Chapter president
Jim Calverley. “This is a true
As kids get older and you’re
success story for the children,
planning their summer, the idea
the community and the Calgary
of sleep-away camp may come
Chapter.”
up. Sleepover camp offers many
benefits to kids—it increases their
Camp Horizon has committed to
confidence and independence,
a safe environment by complet-
and offers new experiences and
ing the GFFP certification prior to
connections with other kids. But
each camp. The chef ensures that
unfortunately for kids with celi-
meals and snacks are gluten free,
ac disease, many camps cannot
and other special diet needs are
accommodate a child’s strict
met. There is also a registered
gluten-free diet.
nurse on site.
Since 1995, the Calgary Chapter
The program is unique in that
of the CCA has partnered with
everyone has a choice of the
camp in Southern Alberta to
activities in which they want to
provide a gluten-free camping ex-
participate. The day begins when
perience for children with celiac
the campers emerge from the
disease.
bunk houses they share with
other girls or boys of similar age
From the original two-day day
and proceed to the grand dining
camp with 12 campers to our
cabin for 8:30 breakfast. Morning
current five-day overnight event,
activities begin at 10, and there
it has evolved and grown into an
are numerous choices including
annual camp for children from
swimming, biking, high ropes,
ages 7 to 17. Over the years,
archery, giant swing, ball games,
both awareness and attendance
arts and crafts and more. Offsite
has grown, and today, kids come
activities include whitewater raft-
from all over Alberta, and many
ing, wilderness survival, overnight
return each year. This August,
outdoor campouts and day hikes.
the camp—which is held in
After lunch, there is a rest period
partnership with Easter Seals at
followed by more great activities
Camp Horizon, wonderful moun-
until dinner at 5:30. The evening
tainous location in the heart of
usually involves team games like
Kananaskis Country—anticipates
more than 80 kids will attend. Continued on next page PHOTOS BY CALGARY CHAPTER, CCA
14 | Canadian CELIAC
I make friends every year that understand the struggles of having celiac disease. It is also so great to go to a camp where
I don’t have to worry about food ... It is such an amazing thing not to be the odd one out for once.
Continued from page 14 ute to helpus keep the cost of the
camp as low as possible.
capture the flag, kart races, and
treasure hunts. At dusk campers Kids who attend typically have
gather for a campfire and s’mores high praise for the camp. “This
before heading to their bunks. was my seventh year coming to
celiac camp,” said Sydney, age
The last night of camp is espe- 15, in a note to the camp written
cially memorable. This is when last summer. “I make new friends
the campers and counsellors every year that understand the
get their glitz on and celebrate struggles of having celiac dis-
with a special farewell banquet ease. These friends have shared
and dance. experiences with me at camp that
we will never forget. It is also
Registration fees are subsidized so great to go to a camp where
through the generosity of some of I don’t have to worry about food
our chapter members and fundrais- and where being gluten free is
ing events like the Scotiabank mar- normal. It is such an amazing
athon. Also, many donors, sponsors thing not to be the odd one out
and the Edmonton Chapter contrib- for once.” u
16 | Canadian CELIAC
When to intoduce gluten to babies?
BABY BITES that we offer whole grain glu-
ten-containing foods or fermented
gluten products (like sourdough),
along with an anti-inflammatory
Do not put your
your health care provider about
the best approach for your family.
My primary area of research is
diet (think whole foods based diet child on coping with celiac disease, so
What’s the best way to introduce gluten to a baby rich in vegetables, fruit, protein, please don’t let gluten introduc-
a gluten-free diet
who’s at risk of developing celiac disease? healthy fats, iron and low in pro-
cessed foods and sugar). Overall,
tion be a cause of stress! I do
not get caught up in measur-
we aim to offer a small amount of before testing for ing food and if we are out and
no differences in development of
celiac disease between early and
gluten to my young boys at two to
three meals per week, which on
celiac disease or my sons have something with
a larger amount of gluten or
late gluten introduction. average equals out to about two consulting with processed foods, I take a deep
grams or less per day. breath and make a mental note
Researchers have also been ex- your pediatrician, to offer less gluten over the fol-
ploring how the amount of gluten Most importantly: Do not put your lowing week or two. We are all
in an infant’s diet may impact child on a gluten-free diet be- as this can result in doing the best that we can do.
development of celiac disease. In fore testing for celiac disease or Aiming to offer a whole foods-
2019, results from a prospective, consulting with your pediatrician, false negative test based diet in your home will
large-scale study revealed that a as this can result in false negative allow you to be more relaxed
higher level of gluten consump- test results. Make sure to watch results when dining out and you have
tion over the first five years of life for symptoms of celiac disease less control over the food your
was an independent risk factor and ensure that you speak with child consumes. u
for celiac disease. Genetically at-
risk children who consumed only
two grams per day or less over
the first five years of life had the
lowest rates of celiac disease au-
toimmunity and celiac disease. Ac-
BY JUSTINE DOWD, PHD high risk infants (i.e., those with cording to Andrea Hardy of Ignite
POSTDOCTORAL FELLOW, a first degree relative diagnosed Nutrition, two grams is equivalent
UNIVERSITY OF CALGARY with celiac disease). While find- to about half a cup of whole wheat
ings from several studies suggest pasta, half an English muffin or
As a diagnosed celiac and mom that breastfeeding may offer some half a cup of wheat-based cereal.
of two young boys, I have been protective effects for infants at Generally speaking, one serving
eagerly following the research on high risk of celiac disease, results of a wheat-based food is equiva-
how feeding practices influence of a systematic review indicate lent to two to four grams of gluten.
the development of celiac disease that breastfeeding does not offer
among infants at high risk of the any protective effects against the So what do these recommenda-
disease. development of celiac disease. tions actually look like in everyday
Results of other studies suggest life with a baby?
Over the past 20 years, research- that timing of gluten introduction
ers have been examining the (i.e., before or after four to six Through discussions with our pe-
months of age) may affect the diatrician, we decided to introduce
PIXABAY PHOTO
effects of breastfeeding, timing of
gluten introduction and quantity of development of celiac disease, a small amount of gluten at five to
gluten introduced, on the risk of however, authors of a systematic six months of age. When we offer
developing celiac disease among review concluded that there were gluten, we do our best to ensure
16 | Canadian CELIACFibre tip sheet
SPOTLIGHT ON
FIBRE RICH GLUTEN-FREE FOODS
GRAINS
DIETARY FIBRE
Food Fibre (grams)
1 cup of Almond Flour .................................................... 11
1 cup of Corn Bran .......................................................... 60
1 cup Soy Flour .................................................................8
1 cup of Quinoa ................................................................5
How regular are you? It’s not something you would ask someone at a dinner party but it’s an important 1 cup of Steel-Cut Oats .................................................. 6
question to ask yourself. Canadians in general often don’t get enough fibre in their daily diets. For some- 1 cup of Brown Rice (long grain) ..................................3
one required to be on a gluten-free diet, getting enough fibre in the diet can be more of a challenge.
Fibre, a type of carbohydrate, is part of all plant foods that the body cannot digest or absorb. It is some-
times called roughage or bulk. FRUIT
Food Fibre (grams)
1 cup of Raspberries or Blackberries ......................... 8
TWO TYPES OF FIBRE HOW MUCH FIBRE DO ADULTS NEED?
1 medium Pear ..................................................................6
1 medium Apple ...............................................................4
Age Aim for an intake of grams/day
Insoluble-promotes regularity and 1 medium Banana ............................................................3
Men 19-50 ...................................................................................................... 38
a healthy digestive system Men 51 and older ......................................................................................... 30
E.g., wheat bran, whole grains Women 19-50 ............................................................................................... 25
Women 51 and older ................................................................................... 21 V E G E TA B L E S
Soluble-helps lower blood cho- Breastfeeding Women 19 and older......................................................... 29
Food Fibre (grams)
Pregnant Women 19 and older ................................................................. 28
lesterol and control blood sugar 1 cup of Acorn Squash ................................................... 9
levels, slows digestion and ab- 1 medium Baked Potato with skin ............................... 4
1 cup cooked Broccoli ....................................................5
sorption of foods 1 cup cooked Spinach ....................................................4
HOW MUCH FIBRE DOES MY CHILDREN NEED?
E.g., oranges, oats, psyllium
Age Aim for an intake of grams/day
GLUTEN-FREE DIET AND FIBRE Boys and Girls 1-3 ......................................................................................... 19
Boys and Girls 4-8 ........................................................................................ 25 LEGUMES
Boys 9-13 .........................................................................................................31 Food Fibre (grams)
Gluten-free diets can often be
Girls 9-13 ......................................................................................................... 26 1 cup of Navy Beans .......................................................19
low in dietary fibre because many Boys 14-18 ....................................................................................................... 38 1 cup of Black Beans ...................................................... 15
whole grains contain gluten. Girls 14-18 ........................................................................................................26 1 cup of Lentils ..................................................................16
*There is no upper limit for fibre intake 1 cup of Chickpeas 13
Remember to: Read labels for gluten-free products and try to NUTS AND SEEDS
choose foods with more than 4g of fibre per serving. Contact your
Food Fibre (grams)
physician or dietitian for further information.
1 tablespoon of Chia Seeds ..........................................3.7
¼ cup of Almonds (whole with skins) .........................3.8
Additional tips: Increase fibre intake gradually.
1 tablespoon of Sesame Seeds ................................... 1
Starting with a small amount can help prevent abdominal cramps and
gas. Drink more fluids each day as you increase fibre.
18 | Canadian CELIAC Canadian CELIAC | 19My celiac journey DATING AND REL ATIONSHIPS
MY CELIAC STORY If you’re dating
How young bring this up?” I’d wonder. “Will
someone who isn’t I also made sure to educate my
they find it weird that I’m asking boyfriend on the condition. If
professional them to brush their teeth after celiac, likely you’re dating someone who isn’t
having a beer?” So many anxious celiac, likely they will be con-
Léa Saad thoughts ran through my head, they will be suming products that may not
and I was afraid my condition be gluten free. The best way my
navigates life with would steer people away or that consuming boyfriend and I have navigated
they would think I was crazy for this is by carrying a travel size
celiac disease making these odd requests. products that may toothbrush. If Nick decides to
have a beer, or eat a gluten-con-
BY LÉA SAAD
Eventually, like everyone facing a not be gluten free. taining dish, he washes his hands
celiac diagnosis, I had to get out and brushes his teeth afterwards.
of my own head and face it—and The best way my We find this helps with preventing
I was 16, in my junior year of high I’ve learned a lot along the way. potential risk of cross contamina-
school, when the stomach aches I’m often asked how I navigate boyfriend and I tion. Even though the risk is very
started. “It’s mild stomach pain, social situations. minimal, it allows us to both enjoy
sure it’ll go away,” I remember have navigated the things we love.
thinking. I was wrong. I struggled To that I’d say: It might be hard
with stomach aches for three in the beginning because friends this is by carrying My last tip would be to empow-
years and had countless doctor and family may not understand er yourself. Take charge of your
visits before finally getting my the extent of your condition, but a travel size health. When I was first diag-
celiac disease diagnosis in the just keep advocating for yourself nosed, I started my blog, www.
summer of 2014. and help them understand. Print toothbrush theceleaccorner.com and I started
off information sheets from the sharing my gluten-free lifestyle. I
Today, six years later, I am a young Canadian Celiac Association’s When navigating social situa- share product finds, restaurants,
professional living in Toronto trying website and share it with them. tions, your best bet is to educate and recipes. I also share them on
to navigate her 20’s living with Educate them on foods you can yourself! Spend some time doing my Instagram page. Sharing my
celiac disease. or can’t have. I would also sug- some research on where you can journey on Instagram has em-
gest connecting with others who eat, what you can eat, experi- powered me in so many ways. It
Living with an autoimmune condi- also live with celiac disease to ment in the kitchen, and share has connected me with so many
tion definitely has its challenges, avoid feeling alone. I have done this information with others! fellow celiacs. This has led me
especially one like CD where your so by joining the CCA’s Facebook to believe that I was meant to
immune response is triggered by a group. This is a great place to I put together a list of restaurants share my story in order to help
ubiquitous ingredient. Post diag- seek support from others who are I could safely eat at. Whenever others. So do not be afraid to
nosis, I definitely worried about living with the same condition as my friends or boyfriend want share yours—you never know
going out with friends. I would you, and to connect with peo- to go out, I always make sure who’s life you may be impacting.
think to myself, “Will they under- ple who understand what you’re to recommend a restaurant off Need some extra support on your
PHOTO BY LÉA SAAD
stand cross-contamination? Will going through. I found this crucial my list. If I’m going to a friend’s journey? You can find me at @
they be ok with me bringing my in my journey since I am the only house, I always bring a dish or leasaad on Instagram or email me
own dish?” I also worried about one diagnosed in my circle of fam- dessert to share and nobody at leasaad@theceleaccorner to
dating. “How and when should I ily and friends. ever complains. connect. u
20 | Canadian CELIAC Canadian CELIAC | 21Ask the expert KISSING AND MAKEUP
SEALED WITH A KISS THE MAKE-UP
ucts are not available in Canada,
some were from large companies
that also supply products in Cana-
OF MAKEUP
da. In dental tablets, mouthwashes
and lip-balms, the gluten level was
Can you get ‘glutened’ by smooching minutes then waiting 30 minutes, within limits not expected to cause
or waiting 60 minutes. All partic- problems in CD (ranging from
someone who just ate gluten? ipants had undetectable peanut undetectable to 12.2 ppm). Thus
after eating a peanut-free meal 94% of the products tested can be
An expert weighs in (up to five hours after eating Some personal care products may considered gluten-free and safe
the peanut butter sandwich).
contain a bit of gluten. Here’s why to use by celiac patient. However,
four products (three toothpastes
BY D R. JOCELYN SILVESTER These studies suggest that pea- experts say it’s no cause for concern and one lipstick) showed a gluten
nut allergen is present in small level over > 20 ppm (maximum 35
Q I have celiac disease, but my amounts for a limited time after ppm in one toothpaste brand).
partner doesn’t. Is it safe for me eating a food containing peanuts. BY THE CCA PROFESSIONAL products to cause the intestinal
to kiss him after he’s consumed Case reports of allergic reactions ADVISORY COUNCIL damage? A smaller US study from 2012
food with gluten? after kissing identify the tested four lip products and two
sensitivity of the patient and A small handful of studies have body/face lotions. In this study, the
A Patients ask this question a lot. Gluten in personal care products,
“passionate” kissing as risk looked at the gluten content in products were specifically chosen
To accurately answer it, doctors toiletries and cosmetics is a com-
factors. these personal care products. A for testing as they contained at
would need to know how much mon concern among patients with
gluten is in saliva after eating celiac disease and other gluten-re- 2019 study out of Italy tested 66 least one ingredient derived from
How can we extrapolate these oral hygiene products and cos- gluten or oats (as they are contam-
gluten. Unfortunately, this is one conducted a study to see how lated disorders. As these products
results to celiac disease? Fortu- metics, even though none of the inated with gluten). There was no
of many practical questions which long peanut can be detected are applied around or sometimes
nately, people with celiac ingredients in these products came quantifiable gluten found in any of
has not been well-studied. How- in saliva. Adults and adolescents inside the mouth, there is a con-
disease don’t get anaphylactic from wheat, barley or rye. The re- these six products.
ever, while specific data on gluten (without peanut allergy and on cern for gluten ingestion. A small
reactions to gluten. Also, al- searchers studied 36 toothpastes,
is not available, we can learn from a peanut-free diet for the study) amount of these products may be
though the amount of gluten two dental tablets, five mouthwash-
the experiences of people with se- ate two tablespoons of peanut accidentally swallowed, especially Overall, the evidence suggests that
transferred through kissing may es, 10 lip balms, and 13 lipsticks,
vere (anaphylactic) food allergies. butter in a sandwich and lipsticks, lip balms and toothpastes. it would be rare for enough gluten
vary, it is unlikely to be a signifi- all selected due to their popularity
collected serial saliva samples. Gluten absorption through the skin to be absorbed into the intestine
cant amount. Parts per million is in Italian stores and pharmacies.
Local symptoms (for example, After five minutes, a peanut has not been proven to be toxic for following exposure from cosmetics,
a concentration, so there is more Though many of these exact prod-
hives and mouth swelling) after allergen was detectable in saliva patients with celiac disease (CD) shampoo, other toiletries and skin
gluten in a 3 oz (90 g)
kissing somebody who has eaten from 30 out of 36 (83%) partic- as it cannot cross from the skin care products. The vast majority of
slice of cake with 5 ppm gluten
a food they are allergic to was ipants. The amount of peanut blood vessels into the intestines. It products have a negligible amount
than a teaspoon (5 mL) of saliva
spontaneously reported by 5% allergen ranged from 0.07 to is possible that some gluten may of gluten and given the small
with 50 ppm gluten. Therefore, it
of respondents to one survey 35 ppm (parts per million). The be ingested if the person does not amounts (if any) normally ingest-
is safe to say that it’s very unlike-
and 12% of respondents to anoth- researchers also tested how to wash their hands after touching ed, gluten contamination in oral
ly that kissing results in signifi-
er survey that asked the question clean the allergen from products prior to eating. In order hygiene and cosmetic products is
cant gluten exposure for most
directly. These individuals re- the mouth. for gluten to cause damage in unlikely an issue for patients with
individuals. u
ported symptoms within minutes people with CD, sufficient amounts celiac disease. A further advance
of kissing an individual who had Many different methods were Thanks to this issue’s expert, of gluten must be swallowed and has been the decision by many
eaten the food minutes to a few found to substantially reduce pass into the small intestine where manufacturers to indicate that their
FREEPNGING PHOTO
Dr. Jocelyn Silvester, Attending
hours earlier. the amount of peanut allergen Physician, Division of Gastroenterolo- it causes damage. products, such as toothpaste and
present, including brushing teeth gy, Hepatology and Nutrition, mouth rinses, are gluten free, pro-
Researchers at the Mount Sinai only, brushing teeth and rinsing, Instructor of Pediatrics, Harvard The question is: Can enough glu- viding additional reassurance for
School of Medicine in New York rinsing only, chewing gum for 30 Medical School. ten be absorbed from any of these patients with celiac disease. u
22 | Canadian CELIAC Canadian CELIAC | 23The Gluten- Free Certification Program features bakery
Known for its
delicious breads,
Little Northern
Bakehouse
is certified 100%
gluten free.
PHOTO BY LITTLE NORTHERN BAKEHOUSE
BREAD WINNER
Chia Hot Dog Buns of the program, Little Northern allergy-friendly foods products.
z Artisan Pizza Crusts: Original Bakehouse products are regular- Some of our latest innovations
Artisan, Thin Artisan ly tested at the bakery by a third have been exceptionally well-re-
z Bagels: Plain, Everything, Cinna- party to make sure the product is ceived. For our new line of ba-
mon Raisin, Blueberry fully gluten free. gels, we crafted a gluten-free
bagel that proudly lives up to our
Q When did Little Northern Bake- everyone can really enjoy. Our most popular products are the Q What’s unique about your Q Where can customers find commitment to giving you baked
house get its start? Seeds & Grains classic loaf and products? Little Northern Bakehouse prod- goods that aren’t just good for
A Little Northern Bakehouse was While the founders do not have Whole Grain Wide Slide loaf for A They taste like the real thing. ucts? gluten free, they’re good, peri-
created in 2015 to offer great tast- celiac, their priority is to provide their added nutrition and fibre pro- Everything is gluten free, non- A Little Northern Bakehouse od. We are also excited for our
ing bread and bakery products ev- healthy and honest eating choic- vided by a delicious array of whole GMO and made with plant-based products are found at national new artisan-style pizza crusts
eryone can enjoy, especially those es, that are still delicious, for every grains and seeds. The Whole Grain ingredients to create truly deli- grocery stores, Costco, health- that deliver a delicious choice of
with food sensitivities. At our core, person to enjoy. Wide Slice is especially popular for cious and soft baked goods. food stores, and local natural subtle, doughy original, or crisp,
we’re a bakery before we’re a sandwich-making. co-ops throughout Canada and thin-crust.
gluten-free bakery—a bakery who Q What products do you offer, Q Why did you become certified? the U.S. Find them in the freezer
believes in sharing the joy of ex- and what’s your most popular For the complete Little Northern Why the Gluten Free Certifica- section of many stores. Gluten-free and wheat-sensitive
ceptionally delicious baked goods item? Bakehouse portfolio: tion Program? diets are becoming increasingly
with everyone. That dedication A Little Northern Bakehouse z Classic Loaves: Seeds & Grains, A It is very important to Little To find the store closest to you, use common, with more food sensi-
extends to all aspects of how we offers a variety of delicious, Cinnamon & Raisin, Millet & Chia Northern Bakehouse to provide the store finder on our website. tivities and allergies than ever
make our products so we only use gluten-free and allergy-friend- z Wide Slide Loaves: Whole Grain products our consumers can enjoy before. We hope to continue filling
non-GMO and plant-based ingre- ly breads and bakery products Wide Slide, White Wide Slice and feel safe eating and serving Q Where do you see as the fu- any food voids people have with
dients without any eggs or dairy. including classic loaves, wide slice z Sprouted Loaves: Sprouted 7 to friends and family. The on-pack ture of gluten-free products? delicious products everyone can
In addition, Little Northern Bake- loaves, sprouted loaves, original Grain, Sprouted Honey Oat GFCP seals give our consumers A Little Northern Bakehouse enjoy.
house products are free of the top buns, artisan pizza crusts, and z Original Buns: Millet & Chia the confidence and peace of mind hopes to continue innovating and
nine allergens, making it a product bagels. Buns, Classic Dinner Rolls, Millet & our products are safe. As part offering consumers delicious, littlenorthernbakehouse.com
24 | Canadian CELIAC Canadian CELIAC | 25The GFFP certifies bistro
A FINE TREAT
eastern European influence with
the tastes of Poland, Germany,
Hungary, and Austria.
You’ll find dishes such as Pero-
Offering traditional central and eastern gies (varieties include traditional
cheese and potato, cabbage and
European menu items, Continental Treat wild mushroom, and spinach and
gruyere cheese), Mom’s famous
Fine Bistro is also fully gluten free
GERMAN PICKLED
Dill Pickle Soup, Pork and Chicken
Schnitzel, and many more. Restau-
rant staff are known for making
Located in Edmonton, Continen-
tal Treat Fine Bistro is certified
GF-Dedicated by the Gluten-Free
Continental Treat Fine Bistro has
become a premier choice for
anniversaries, birthdays, romantic
every visitor feel welcome, and
every occasion a special one. VEGETABLE BEEF SOUP
Food Program. It specializes in dinners, small weddings, and busi- You may be wondering why Con-
traditional Germanic and Eastern ness dinners. tinental Treat Fine Bistro offers a This recipe has been handed cloves of fresh garlic (minced) cloth, make a ball the size of a
European dishes, but with a mod- fully gluten-free kitchen. Say the down for generations! season with salt and pepper. Add golf ball of pickling spice and tie
ern touch. Visitors enjoy warm European bis- owners: “After discovering that ¾ of a cup of quinoa or similar GF closed. Add fresh dill and vine-
tro charm with classical jazz music some of our staff were gluten To Make the Stock grain. Simmer for 3-4 hours. gar and parsley. Add vegetable
A family affair, three genera- playing in the background. sensitive, we tweaked some of z In a large stock pot combine z Scoop out all vegetables and bullion only to taste. Simmer 2-3
tions of the Borówka family work our recipes to be gluten-free, and water, 6 large beef soup bones discard. hours.
together to bring their romantic, Executive Chef Elizabeth Pal- decided, why not go 100%? The and 4 beef shanks. You can also z After an hour remove soup
turn-of-the-century dining vision mowski and her team are con- rest was history.” use 6 beef short ribs instead To Make the Soup bones and shanks or ribs and
PHOTOS CONTRIBUTED
to life. Proud to serve since 1982, stantly working to innovate the z Heat but do not boil. Skim z Now prepare new onions, car- remove meat. Add meat to the
owners Ryszard and Helena menu while keeping the distinc- off froth and let simmer for rots, green beans, cabbage, and soup.
Borówka, their son Sylvester, and tive, traditional flavour of our Continental Treat Fine Bistro is 4 hours. celery in bite sized pieces. Add 1 z In the last 30 minutes, remove
grandsons Matthew and Michal most popular European dishes. located at 10560 82 Avenue NW in z Add large cut onions, carrots, can of whole tomatoes and 1 can dill and pickling spice and add
oversee the restaurant. The menu reflects a central and Edmonton. celery, leeks, 5 bay leaves, 8 of diced tomatoes. Using cheese fresh peas.
26 | Canadian CELIAC Canadian CELIAC | 27Research GLUTEN FREE?
UNINTENTIONAL
INGESTION
You work hard to ensure your diet is 100% gluten free. But is it?
BY DR. DONALD D UERKSEN centration of gluten detected in
food varied considerably between
The University of Manitoba Celiac four ppm to as high as > 200 ppm
Study group recently collaborat- (the mean was 12 ppm). Gluten
ed with researchers from Boston was detected in the urine of eight
and Spain to determine whether participants (6% of samples) and in
individuals with celiac disease on the stool in five participants (11% of
a gluten-free diet are exposed to samples).
small amounts of gluten.
This real-world study demon-
To do so, researchers tapped 18 strates that gluten exposure may
adults with celiac disease and occur in individuals who are on
on a gluten-free diet for two a gluten-free diet and not inten-
years who were already a part tionally ingesting gluten. In many
of the University of Manitoba cases, a small amount of gluten
Celiac Disease Inception cohort. was detected, so the clinical
These adults were enrolled in the significance is unclear. Further
SHUTTERSTOCK PHOTO
“Determination of Gluten Grams research is needed to determine
Ingested and Excreted By Adults possible sources, the relationship
eating Gluten free” (DOGGIE to symptoms and mucosal recov-
BAG) study. ery, and optimal management
approaches.
Over 10 days, participants saved No intentional gluten exposures
a quarter of all of their food, as occurred during this time. This Dr. Donald Duerksen is Associate
well as stool and urine samples, study found that 12 out of 18 par- Professor of Medicine, University of
which were frozen, then analyzed ticipants had detectable gluten in Manitoba; Chair, CCA Professional
for gluten immunogenic peptides. their food, stool or urine. The con- Advisory Council
NEW STUDY – NOW RECRUITING!
Youth & young adults with celiac disease. If you are between the ages of 12-25 and have been diagnosed
with celiac disease you are eligible to participate in this online study. This study is conducted through the
School of Health and Exercise Sciences at The University of British Columbia Okanagan campus by Dr. Mary
Dedicated to Way of Life! Jung and Dr. Justine Dowd. Please email skylar.l.schmidtke@ubc.ca for more information.
Canadian CELIAC | 29Research GLUTEN EXPOSURE IN SCHOOLS
SAFE SCHOOL SUPPLIES z
Due to gluten found in pastes, clays and other kids’ craft items,
keeping kids safe at school goes beyond lunch and snacks.
BY D R. JOCELYN SILVESTER z Gluten-containing dry pasta surfaces, it may be challenging to
appears to pose a low risk unless ensure that these occur consis-
Further research from Children’s National in Washington D.C. and there is oral exposure. tently. As well, it is important to
Boston Children’s Hospital is providing more data regarding the risk of z Gluten-containing wet pasta (e.g. consider the developmental stage
gluten exposure in schools. The recently released paper, “A Quantita- sensory tables) tends to adhere of the individual child and how this
tive Assessment of Gluten Cross-contact in the School Environment for to hands and other surfaces might affect their exposure risk.
Children With Celiac Disease” published ahead of print in the Journal and poses a much higher risk of For example, some children suck
of Pediatric Gastroenterology and Nutrition helps to answer common environmental contamination and their thumb or put their hands or
questions about how to keep children who require gluten-free diets gluten exposure than dry pasta other objects (including Play-doh)
(GFD) safe at school. in their mouth.
Gluten-containing flour, powders
The authors tested four scenarios where it was thought that gluten and pastes: z Surfaces should be cleaned ad-
transfer could be high enough to lead to cross-contact resulting in a equately before a child with celiac
z Children with CD (and others
gluten-free food having a gluten concentration greater than 20 ppm. disease works in an environment
who follow a GFD) should only
This threshold was chosen because food containing less than 20 ppm where wheat flour or wet gluten
work with gluten-free flours, pow-
(less than 0.002 percent gluten) is considered to be “gluten-free” by containing materials have been
ders and pastes (such as paper
the U.S. Food and Drug Administration and products containing less used.
mâché)
than 20 ppm gluten can be labelled “gluten-free” in the United States, z Adequate supervision when glu-
z In classroom environments,
Canada and the European Union. ten containing materials are being
there is a risk if gluten flours are
used. This risk is related to aero- used in the classroom setting is
THE SCENARIOS TESTED WERE: a gluten concentration >20 ppm. detectable for 11/30 participants. Play-doh brand modelling clay is essential.
solization of flour, spread of flour
The child who did not have any Gluten transfer from the surface wheat-based and contains signifi-
dust, residual flour when surfaces z Hand washing is important.
Playing with modelling clay: Play- transfer did not like the feel of the occurred more than 70% of the cant amounts of gluten. It should
are not cleaned adequately, and z Food should never be eaten if
doh contained over 32,000 ppm pasta and had minimal contact. time, even after surfaces were not be eaten or played with by
unanticipated contact (e.g., spills, there is visible contamination on
gluten, which is nearly as much Playing with dry pasta did not pro- washed. children who may eat the Play-
food fights). hands, surfaces or the food itself.
as in wheat bread. Even when duce detectable gluten-transfer doh, put their hands in their mouth
z Use of gluten-containing liquids
children did not wash their hands, This is the first study to examine or engage in other behaviors that
(e.g., pancake mix) or wet pastes Clear communication with day-
there were no cases of gluten Paper mâché – All 10 children common educational activities put them at risk of ingestion.
is a risk for gluten contamina- care or school regarding celiac
transfer from hands to a slice of who used paper mâché had a and it provides useful data to z In situations when gluten-free
tion because it can be difficult to disease, including the need for a
gluten-free bread resulting in a significant amount of residue and help guide assessment of risk of modelling clay is not available and
remove all traces of gluten from gluten-free diet and maintenance
gluten concentration >20 ppm. transferred high amounts of glu- cross-contact and to advise our children are not at risk of inges-
hands and work surfaces. of a safe environment, is crucial.
In two cases, bread wiped on the ten to gluten-free bread. patients with celiac disease (CD). tion, play in a supervised setting
In addition to these conversations,
table surface with visible contami- with scrupulous cleaning of hands
It is important to recognize that a formal 504 Plan or Individual
nation had gluten levels >20 ppm. Baking project: Thirty children HERE’S WHAT THEY RECOM- and surfaces to remove all visible
handwashing and environmental Health Plan (IHP) may be helpful
rolled gluten-containing dough MEND BASED ON THE RE- contamination is likely safe.
decontamination practices are for the student with celiac disease.
PHOTO FROM BING IMAGES
Sensory tables with dry and wet and cut-out cookies on a surface SEARCH: highly variable, particularly among
pasta: After children played with dusted with gluten-containing Pasta:
children and in busy classroom Reprinted with permission from
wet pasta in sensory tables, 9/10 flour. After washing hands with Modelling Clay: z Children with CD (and others
environments. While thorough Boston Children’s Hospital
children had visible contamination water, soap and water or wet z Children with CD (and others who follow a GFD) should use
cleaning procedures are effective https://www.ncbi.nlm.nih.gov/
on their hands that transferred wipes, gluten transfer from hands who follow a GFD) should use gluten-free pasta for art and other
for removing gluten from most pubmed/31868785
to gluten-free bread resulting in to a slice of gluten-free bread was gluten-free modelling clays. classroom projects
30 | Canadian CELIAC Canadian CELIAC | 31You can also read
