Going gluten-free: Reflections on what worksBy Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/gluten-free/MY01651
- With Mayo Clinic nutritionists
Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.read biographyclose window
Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.Katherine Zeratsky and Jennifer Nelson
Jennifer K. Nelson, M.S., R.D., L.D., C.N.S.D.
Jennifer Nelson is your link to a better diet. As specialty editor of the nutrition and healthy eating guide, she plays a vital role in bringing you healthy recipes and meal planning.
"Nutrition is one way people have direct control over the quality of their lives," she says. "I hope to translate the science of nutrition into ways that people can select and prepare great-tasting foods that help maintain health and treat disease."
A St. Paul, Minn., native, she has been with Mayo Clinic since 1978, and is director of clinical dietetics and an associate professor of nutrition at Mayo Clinic College of Medicine.
She leads clinical nutrition efforts for a staff of more than 60 clinical dietitians and nine dietetic technicians and oversees nutrition services, staffing, strategic and financial planning, and quality improvement. Nelson was co-editor of the "Mayo Clinic Diet" and the James Beard Foundation Award-winning "The New Mayo Clinic Cookbook." She has been a contributing author to and reviewer of many other Mayo Clinic books, including "Mayo Clinic Healthy Weight for EveryBody," "The Mayo Clinic Family Health Book" and "The Mayo Clinic/Williams Sonoma Cookbook." She contributes to the strategic direction of the Food & Nutrition Center, which includes creating recipes and menus, reviewing nutrition content of various articles, and providing expert answers to nutrition questions.
Katherine Zeratsky, R.D., L.D.
As a specialty editor of the nutrition and healthy eating guide, Katherine Zeratsky helps you sort through the facts and figures, the fads and the hype to learn more about nutrition and diet.
A Marinette, Wis., native, she is certified in dietetics by the state of Minnesota and the American Dietetic Association. She has been with Mayo Clinic since 1999.
She's active in nutrition-related curriculum and course development in wellness nutrition at Mayo Clinic in Rochester, Minn., and nutrition related to weight management and practical applications of nutrition-related lifestyle changes.
Other areas of interest include food and nutrition for all life stages, active lifestyles and the culinary arts.
She graduated from the University of Wisconsin-Madison, served a dietetic internship at the University of Iowa Hospitals and Clinics, and worked as a registered dietitian and health risk counselor at ThedaCare of Appleton, Wis., before joining the Mayo Clinic staff.
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Jan. 11, 2011
Going gluten-free: Reflections on what works
By Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.
Celiac disease is a potentially fatal condition triggered by eating the protein gluten that is found in wheat, rye and barley (and any food or ingredient that has even miniscule amounts of these grains). Eating gluten causes an immune reaction and damage to the small intestine, leading to abdominal pain, diarrhea and weight loss. Essential nutrients are not absorbed, which leads to a host of deficiencies including anemia, osteoporosis, infertility, skin rashes, joint pain and even certain cancers. Undiagnosed and untreated, celiac disease quadruples the risk of death. Treatment is avoiding anything with gluten.
It's hard to believe that it's been 10 years since my husband was diagnosed with celiac disease. He has carefully followed a gluten-free diet and has thrived. I asked my husband what has helped him be successful with this life-changing disease.
Q: What did you think when you were diagnosed?
A: I was relieved. I thought I was lucky that I had a disease that I could do something about and that I could live a long time. What was really important was that I took responsibility for deciding what I'd purchase and put into my mouth. This forced me to take charge — and it gave me confidence that I could do it.
Q: What steps did you take to become gluten-free?
A: I tried to learn as much about the diet as possible. There are resources including websites and celiac disease support groups that provide lists of manufacturers who make gluten-free foods including brand names of items. We also opted to make our kitchen gluten-free. This made me feel safe — that I could eat anything at home without thinking too much about it. (Note: Not all families may decide to do this. It may be more practical to designate which cupboards or part of the refrigerator is gluten-free.)
I looked hard for and found good-tasting everyday foods (breads, crackers, pasta). I especially like rice crackers and pasta — they're even less expensive than the wheat-containing ones. It took a while to find gluten-free bread that had good taste and texture. Over the years food manufacturers have really come through with great gluten-free products.
Q: What remains a challenge?
A: Eating out. I don't like having to work through the menu with waiters and chefs to determine what might be gluten-free. You also wonder if all ingredients used are gluten-free, you wonder if the food is cooked and handled so there is no cross-contamination. It's also no fun when food is made so plainly that there is no taste. What is a joy is to find restaurants that have taken training and become certified gluten-free.
I'm also concerned about a recent study that showed cross contamination of naturally gluten-free grains. Of the 22 grains samples that are assumed to be naturally gluten-free, 7 contained gluten at levels higher that the proposed Food and Drug Administration cut-off. Our food supply — every step of the way from farm to table — is complex. We need to find out where cross contamination occurs.
I'm looking forward to the FDA releasing federal standards for labeling foods gluten-free. Currently it's voluntary for food companies to test their foods for presence of gluten, and they don't have to take cross contamination into account.
Q: Anything else?
A: It's amazing how quickly I felt better going gluten-free. I felt better in less than a week — and I still feel great.
If you have celiac disease — or any other medical condition treated by diet — what has worked for you? Share your thoughts.
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- Thompson T, et al. Gluten contamination of grains, seeds, and flours in the United States: A pilot study. Journal of the American Dietetic Association. 2010;110(6):937-940.