Category: Resources

Ask the Dietitian: Gluten in medications

Question: I have been advised by my primary doctor not to use perscription drugs because they do not have to say if the fillers they use are wheat or barley. My insurance charges more for non generic and some of the meds are unafordable. Can you give me advise on this as It’s costly enough at the grocery store. My primary doctor is also a Celiac. Thanks for your time.

Answer: Your physician is correct in that medications do not fall under the Food Allergen Labeling and Consumer Protection Act of 2004, which applies to food. Rather than reinvent this wheel, I would like to refer you to the website of pharmacist expert, Steve Plogsted, RPh. www.glutenfreedrugs.com Steve has identified a long list of prescription & over-the-counter meds which have been deemed gluten-free, ingredients to question, questions for your pharmacist & manufacturers, a list of manufacturer brand practices, etc. I’ve also included a link to an informative interview he gave a couple years ago: https://glutenfreeandmore.com/

If you don’t get your questions answered in these two places or through your pharmacist or manufacturer, Steve welcomes questions via e-mail on his site. Lastly, a bill was introduced in the House of Representatives last fall with a goal of helping to clarify this matter of gluten in medications. No action has been taken on the bill as of this date. Gluten in Medicine Disclosure Act of 2015

Important note: Countless prescription (brand & generic) and over-the-counter medications are considered to be gluten-free. Best to you in evaluating yours.

Trisha Lyons, RDN, LD

Ask the Dietitian: Eating Gluten-Free While in Hospital

Question: I have to stay at [a local hospital overnight and they are not very helpful with gluten free options. I was told I have to pick food off the regular menu. I can’t believe a hospital does not have gf food. Suggestions? Thanks.

Answer: Thank you for writing with this excellent question. Patients who require a gluten-free diet should certainly be able to eat safely & nutritiously while in the hospital, of all places! Here are some suggestions:

1) Contact an inpatient clinical dietitian or food service supervisor at the hospital to discuss your medical dietary needs (Is it safe to assume you have celiac disease?) Please explain that your diet is not a choice but rather the sole treatment for your autoimmune disease.
2) While the hospital may not offer specialized GF items such as bread or pasta, they do serve numerous foods which happen to be naturally gluten-free. If they have not done so already, they should identify those foods and provide a detailed list from which you and future patients can select.
3) If your inpatient stay will last longer than a few days (during which time you should expect to receive variety and balanced, nutritious meals), the dietary department may wish to consider providing frozen GF entrees for increased variety as a simple, short-term solution.
4) Please ask how the hospital handles allergies (e.g. allergy wrist band?) While you technically do not have an allergy, this type of flag will raise awareness when hospital staff is providing food and medication.
5) Speaking of meds, please notify the nursing staff and pharmacy of your gluten restriction.
6) If something does not “look” or seem right, please inquire. Humans make mistakes. If a staff member quickly dismisses your concern, ask to speak with a supervisor or chef.
7) Lastly, you may be able or even encouraged to bring in your own food. While you may choose this option, it should certainly not be a necessity.

All hospitals should be able to meet the medical dietary needs of their patients. Best wishes to you.

Trisha B. Lyons, RDN

Gluten Free ? That is the question

Gluten Free:
To Be… or Not to Be…
That is the Question!

Northeast Ohio Celiac Network
NEOCN
www.neohioceliac.com
info@neohioceliac.com

Written by Laurie Sammon

Gluten Free seems to be everywhere you look. Should you be gluten free? For those with celiac disease,
A strict gluten free diet, considered a medical diet, is their only treatment. No medication or therapy, just a strict adherence to not eating anything made from wheat, barley, rye, and sometimes oats (which can be cross contaminated). Not even a crumb!

Why no gluten for those with celiac disease?
The gluten protein found in these grains causes intestinal damage to those diagnosed, often after years of baffling gastro-intestinal distress, or unexplained symptoms: i.e. diarrhea, constipation, bloating, weight loss, infertility, anemia, osteoporosis, peripheral neuropathy, skin problems, or muscle wasting. Celiac disease is both an autoimmune and genetic condition, triggered by gluten.

For those without celiac disease?
Some people have been tested and celiac disease was ruled out. They’ve noticed symptoms stop on a GF diet, so they are considered gluten sensitive or gluten intolerant. No damage happens internally, but the symptoms are often the same as those with celiac disease. They may choose to totally eliminate gluten, or cut back on it. Others with autism, rheumatoid arthritis, neuropathy and more, find relief from symptoms, although science can’t verify. Some find GF foods easier to digest.

Is the gluten free diet a weight loss diet?
No. But first—— think about what items in the grocery store do not have grains in them. THESE ARE ALL GLUTEN FREE: fruit, vegetables, milk, real cheese, eggs, plain meat, juice, beans, fish, and seafood. Most of these are found at the perimeter of the grocery store. Eating these foods in moderation will help with weight loss. But how many people are able to eat just these foods all the time, or limit flour based products in their diet— cookies, cake, pasta, cereal, bread, pizza, crackers, etc.? So, gluten free products exist for those on the life-long strict gluten free diet.

Baked goods are baked goods. Regular or GF, they add calories…
Gluten free baked goods sometimes have more fat and sugar added to improve the texture of the GF substitute flours in them (i.e. potato, rice, sorghum, garbanzo, amaranth, millet, quinoa, tapioca flours). Most GF flours are not enriched while regular wheat flour is enriched with, B vitamins, iron, calcium & sometimes fiber. So GF baked goods may have more calories and less nutrition than their gluten counterparts, although some GF companies have begun to enrich. Supplemental B vitamins, fiber, iron & calcium should be discussed with a doctor.

Are gluten free foods here to stay or just a fad?
Only about 17% of people with celiac disease have been diagnosed, yet 1:133 have the condition. Recent statistics from the University of Maryland’s Celiac Disease Center have estimated another 1-6% of the population as gluten sensitive. That means as many as 20 million Americans are affected by gluten. Gluten free foods are here to stay to help those who have been diagnosed or have found relief from symptoms.

Gluten Free 101: Pantry Products We Love

Gluten Free 101: What’s in Our (GF) Pantry/Fridge/Freezer?
Suggested Gluten Free Staples by Northeast Ohio Celiac Network Members
www.neohioceliac.com by Laurie Sammon

Giant Eagle
Bell and Evans GF chicken tenders or nuggets
Conte’s pasta, pierogi, ravioli, gnocchi
Udi’s Bread, hamburger & hotdog buns, pizza crust, muffins,
French Meadow Cupcakes
Prego spaghetti sauces (some)
Tinkyada pasta
Quinoa pasta
Post Coco Pebbles
Chex 5+ flavors
GF Rice Krispies
Snyder’s of Hanover GF Pretzels
Crunchmaster crackers
Rice Works snacks
Giant Eagle brand deli meats (some)
Pop Chips
Nathan’s Hot dogs/Hebrew National marked GF
Fruit Rollups/snacks General Mills
Betty Crocker GF mixes
Edy’s/Turkey Hill/Breyer ice cream (without any gluten add-ins)
Klondike bars (Unilever declares all gluten plainly-read label)
Nestle’s semi sweet morsels
SanJ Tamari Sauce (soy sauce) La Choy soy sauce
Progresso soups (some)
Nestle Dibs ice cream (some)

Heinens
Rudi’s gluten free bread
Against the Grain Baguettes, buns, pizza crust
Chebe Roll mix, Focaccia mix
123 GF Pan Bars, Baking mixes
San J Soy Sauce (Tamari)
Pamela’s pancake mix

Mustard Seed, Whole Foods, Earth Fare, Raisin Rack
Kinnikinnick Panko bread crumbs (crispier)
Corn Thins
Glutino Chocolate Wafer cookies
Kinnitoos (like GF Oreos)
Jovial fig fruit cookies (like GF Fig Newtons)

Marc’s
Pacific foods cream of mushroom/chicken
Bob’s Red Mill GF oatmeal Marcs
Popped Crisps (Marcs)
Hodgson Mills mixes, pasta
Herb Ox Bouillon
Gluten Free Bisquick

Nature’s Bin
Goodbye Gluten fresh (not frozen) bread

Restaurants & Bakeries
We have over
50+ restaurants/Bakeries listed by location and if they have a gluten free menu.
Go to www.neohioceliac.com
When dining, check the webpage the day before. Read the GF dining tips to get a sense of questions to ask. Print out the gluten free menu and plan to take it with you. Call the manager (not during peak times) and tell him/her you will be dining gluten free. Ask what precautions they will take in the kitchen for the gluten free customer. Get a sense of how knowledgeable you think they may be. If in doubt, do not give them your business.

Traveling?
These are worth the drive:
Bistro of Green, Uniontown, OH
Ferrara’s, Sharon PA
Wildfire, Chicago, Ill.
Rose’s Bakery, Evanston Ill. Dine in Cafe
Sinfully Gluten Free, Dayton Dine in Cafe
www.neohioceliac.com

Gluten Free 101: Grocery Shopping/Getting Started

Gluten Free 101
Grocery Shopping–Getting Started on the Gluten Free Diet in Northeast Ohio

NEOCN-Northeast Ohio Celiac Network
www.neohioceliac.com
Written by Laurie Sammon

There is more information at the Celiac Disease Foundation: www.celiac.org or at www.neohioceliac.com. Grocery shopping will take a little longer in the beginning. Plan to take your time and your reading glasses…

1) Learn unsafe ingredients
NOT allowed: Wheat, Barley, & Rye. Oats are not allowed unless marked gluten free.
Wheat on a food label includes these names:
Flour, bulgur, semolina, spelt, frumento, durum (also spelled duram), kamut, graham, einkorn, farina, couscous, seitan, matzoh, matzah, matzo, cake flour, hydrolyzed wheat protein, wheat starch, wheat germ, tritcale-a hybrid of wheat & rye, emmer, faro, udon, panko, bran
Wheat grass and buckwheat are gluten free even though they have wheat in their names.
Barley includes malt, malt flavoring, & orzo.
Rye is not as common in foods
Oats- Only use Gluten Free Oats: Cream Hill Estates, Gluten Freeda, Bob’s Red Mills, etc.
(Caution: these companies may have regular as well as gluten free oats. Please read label carefully)

2) Learn hidden sources of gluten.
High Probability:
Bouillon, broth, imitation seafood, Play Doh, communion wafers, licorice, beer,
soy sauce, gravy, spice blends, seasonings, flavorings, brewer’s yeast, canned soup.

3) Get acquainted with new gluten free brands.
Contes, Bell and Evans, Udi’s, Rudi’s , Against the Grain, French Meadow, Glutino, Betty Crocker GF mixes, GF Bisquick, Bob’s Red Mill, Kinnikinnick, Pamela’s, Chex, Post Coco Pebbles, GF Rice Krispies, 123 Gluten Free, San-J soy sauce, La Choy soy sauce, Goodbye Gluten Bread.

4) Prevent cross contamination in your home and educate your family.
Separate toasters, colanders, food storage and food prep areas. Beware of shared butter, peanut butter, jelly, mayo jars- -toast crumbs can contaminate. Learn about toaster bags for travel.

5) Restaurants–our website www.neohioceliac.com offers 50+ restaurants that offer GF Menus. Print out
the menu, and be prepared to ask questions. Calling ahead to talk to the manager is recommended. If in doubt about the restaurant’s knowledge, do not give them your business. If they do well, tell them and tip accordingly. We want to encourage gluten free dining.

Where to shop in Greater Cleveland/Northeast Ohio:

• Mustard Seed: Designated GFsection. GF Taste Fair in October. Solon & Fairlawn.
• Heinen’s : 17 locations; 8 are designated as wellness centers that may have more GF items. GF Taste Fair in spring/fall. All locations have designated GF area with GF foods also marked in each aisle.
• Giant Eagle: Giant Eagle now has its own line of gluten free products. Market District stores have dietitians who do GF Tastings and “GF In Aisle Excursions”.
• Whole Foods: Woodmere & University Hts. Udi’s bread available shelf ready, not frozen. They have their own national GF bakehouse.
• Aldi’s, Target, Walmart, Costco, Marc’s- surprisingly have increased GF options.
• Trader Joe’s: Crocker Park & Chagrin Rd. Keeps gluten free shopping list at customer service.
• Vital Choice: N. Royalton. Smaller store, but 2 aisles of GF food. Great for staples.
• Acme has increased their GF options recently
• Raisin Rack in Canton has probably the largest GF selection in Ohio. Westerville store too.