Trisha

Ask the Dietitian: Should there ever be an ‘s’ on the end of the word celiac?

Question: I often hear people (even health care professionals) say someone has celiac’s disease or just celiac’s. Which is correct, celiac disease or celiac’s disease? -Jen R.

Answer: Brilliant question, Jen! There is no ‘s’ on the end of the word celiac. The correct term is celiac disease. (Side note: The adjective celiac means relating to the abdomen.)

While we’re at it, many folks don’t like being referred to as “celiacs.” They are simply adults and kids who happen to have an autoimmune disorder called celiac disease. They don’t wish to be labeled as “celiacs” or be defined by their disease. In comparison, we don’t call people lupuses, anemics, MSers, cancers, osteoporotics, allergics, or rheaumatoids! Referring to people as “celiacs” and even to oneself as “a celiac” is a common practice within the CD community – and is certainly never meant to offend. However, I’ve heard from many whom it is does bother since their autoimmune disorder is only a part of them, not their preferred label or description. One little boy in my office explained that when people call him “a celiac,” it makes him feel like an alien. 🙁

Take home message: We should refrain from adding an ‘s’ to the word celiac. In both cases, as described above, it is either incorrect (no disorder by that name exists) or, at minimum, offensive to some (including the bright, articulate young man described above). The last thing we should ever want to do is cause any amount of pain to a young child with a genetic disorder because of the label we’ve assigned to him/her.

Trisha B. Lyons, RDN, LD

Ask the Dietitian: Do hops in beer contain gluten?

Question: This question is in regards to ngb Gluten Free Lager. Where does the hops come from, or maybe better stated, what it hops, exactly? I always thought it was from barley, which is, of course, not gluten free.

Answer: Thank you for your excellent question, Aston. You are certainly not the first person to think hops provide gluten to beer – it is a common misconception! In fact, hops are indeed gluten-free and not derived in any way from wheat, barley, or rye. Hops are actually flowers from a hop plant and they provide flavor and aroma to beer. (Similarly, many think it is caraway seeds in rye bread which are gluten-containing. Caraway seeds are also gluten-free and can be added to gluten-free bread to resemble what we think of as rye.) Enjoy your hops! 🙂

Trisha B. Lyons, RDN, LD

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

Ask The Dietitian: Recipe For Successful Dining

Question: I have had celiac disease for 2 years and I’m comfortable cooking at home. When I eat out, however, sometimes I run into servers who don’t seem to take my dietary restriction seriously. How do I get them to understand that I have to be gluten-free and I’m not just on some fad diet that I read about in a magazine? -James W.

Answer: Your question is an excellent one. You are not alone! It has long been my opinion that restaurant eating is the most challenging aspect of being gluten-free. As a first step, please take a look at the detailed list of suggestions on our website. In addition to what you will read there, here are some other tips you may find helpful:

1. Having basic knowledge of how food is prepared provides a tremendous advantage and will help you to know which questions to ask depending on what you are planning to order.

2. It is important that your servers understand that you cannot have any items containing flour, wheat, or gluten. This may help them understand the scope of your restriction. Many people try to handle menu decisions on their own without involving the server, which increases their chances of receiving an unsafe meal.

3. Use of the word “allergy” vs. celiac disease: There seems to be a bit of a backlash against people with “gluten allergy” as evidenced by comments made on late-night talk shows and sitcoms, as well as memes shared on social networking. To clarify, celiac disease is an autoimmune disorder, not an allergy. However, many with CD use the term “allergy” with the goal of emphasizing the seriousness of their special diet. According to servers interviewed, some customers claim to have a “gluten allergy” and then proceed to order food with gluten. Understandably, this is confusing to wait staff! Since so many people use the phrase “gluten allergy” these days (including people who are trying a new fad diet, those who heard it was healthy, and those with true intolerance, wheat allergy, or celiac disease) this two-word phrase has become confusing and significantly less meaningful over the past several years. Perhaps you can say, “I have celiac disease so I need to be strictly gluten-free.”

4. To dine out safely, it is vital to understand the ins and outs of the diet. Know which ingredients you can and cannot have. When we solely rely on the wait and cook staff, who may have little or no knowledge of which ingredients contain gluten, it is risky. While they may be aware that bread and pasta contain gluten, they may not be trained to scrutinize ingredient lists for words such as malt, rye, oats, barley, or even wheat. If you would like to receive counseling to discuss the specifics of a GF diet, consider scheduling an appointment with a dietitian who thoroughly understands your disease and its sole treatment.

For more dining tips, check out
Dining Tips from Beyond Celiac
Celiac Disease Foundation Dining And Social Eating

Thank you for your question and I wish you happy and safe dining!

Trisha B. Lyons, RDN