Thursday, November 18, 2010

NC Piedmont Triad GIG Meeting Nov. 13, 2010 Recap

Our meeting began with the announcement of the availability of the latest (2010) Addendum to the Shopping Guide for the Gluten-Free Consumer, published by the NCPTGIG. Ordering information will be posted on this blog within the next few days. Click the link below to read the recap..........

Our team leader, Grace Johnston, then introduced our first speaker, Kathie Sigler, MS, RD, LDN, a clinical dietitian at Forsyth Medical Center. The co-occurrence of celiac disease with both type 1 and type 2 diabetes was discussed, with the emphasis on proper diagnosis of celiac disease among type 1 diabetics, as well as dietary modification to avoid pre-diabetes, the precursor to type 2 diabetes. Also of note was a discussion on the intestinal permeability and malabsorption problems associated with celiac disease, which have a profound effect on the pancreas, resulting in the reduction in insulin secretion in type 2 diabetes.

Additionally, healthy lifestyle changes such as exercise, the modification of holiday traditions to move away from food-centered family events, and the monitoring of carbohydrate portions, were discussed at length by the group. As many gluten-free foods are higher in carbohydrates than their gluten-containing counterparts, extra care must be taken to read the labels and determine the amount of carbohydrates consumed. This is especially important if you have, or are at risk for, diabetes. Remember that 1 serving of carbohydrate is 15 grams of carbs, a very small portion for most foods (roughly equivalent to the width of your hand). Men need an average of 3 to 4 carb servings per meal, while women need only 2 to 3 per meal, and snacks should not exceed 1 to 2 carb servings per day. Foods which contain significant amounts of carbohydrates should be restricted to avoid excessive carb consumption. These include bread, rice, beans, pasta, corn, peas, potatoes, fruits and juices, dairy, and yogurt. Foods low in carbs but high in protein and/or fiber can be consumed without restriction. Lean meats, fish, eggs, cheese, vegetables, healthy fats (oils), beans, nuts, and flax are examples of non-carb choices for a healthy diet.

Lastly, Dr. Hill and the group discussed pancreatic enzymes as dietary supplements for celiac patients. While these are sometimes prescribed after the diagnosis of celiac disease to aid digestion, there is no definitive evidence that they are cost effective for long-term use in celiac disease. Additionally, products such as GlutenEase, that are sold as supplements targeted to gluten intolerant consumers, contain a bacterially-derived protease (DPP-IV) that is purported to minimize the inflammatory response to prolamins such as gliadin. However, while these products have been shown to be effective in the laboratory, their efficacy in the human body has yet to be demonstrated. Bottom line: until science finally comes up with a proven therapeutic preventative, don't assume that the use of an enzyme supplement will protect you from getting glutened.

Finally, we were able to eat! A spectacular gluten-free holiday banquet was enjoyed by all. The triple-layered chocolate mounds cake was a big hit. Thanks everyone!

Our next meeting will be held on January 15, 2011 at 11:00 AM at Hope Moravian Church. Dr. Jillian Teta will present information on osteoporosis and celiac disease. Come prepared to practice a few bone strengthening exercises.

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