Don t Get Stuck on Gluten Practical information and tools to help - PDF document

Don ’ t Get Stuck on Gluten Practical information and tools to help you build your gluten free program Prepared By: Ron Shalit Director of Sales & Marketing October 30 , 2012 601 Magnetic Drive, Unit 24 Toronto, Ontario, Canada, M3J 3J2 Tel: 800.969.699 www.shalitfoods.com Agend nda • Celiac Disease (CD) and Gluten Sensitivity (GS) • Nutrition Concerns & The Gluten Free (GF) Diet • Sources of Gluten in Foods • Foods & Ingredients allowed on a Gluten Free Diet • Gluten Free Labeling • Gluten Free Strategies at Your Facility • Cooking with Gluten Free Foods • Sourcing Gluten Free Foods • Resources, Website, Recipes • Questions 1

Cont nten ent t Acknow owled edgemen ement • Why am I speaking about Gluten Free? • Shelley Case, RD – Renowned international expert • Author of ‘ The Gluten Free Diet ’ – www.glutenfreediet.ca Celiac Diseas ease e (CD) • CD is one of the most common inherited disorders • It is an autoimmune disease triggered by gluten in the diet • The villi of the small intestine are damaged by gluten (primarily from wheat, rye and barley and some commercial oats) • Symptoms are highly variable, many are associated with the GI are and gut functioning, but they vary CD affects many other organ systems 2

Celiac ac Disease e Con ’ t • If untreated, CD can result in nutritional deficiencies, osteoporosis, increased risk in intestinal cancers, infertility/miscarriage and other autoimmune disorders • Untreated it may also lead to significant discomfort in the GI tract • Sometimes misdiagnosed as irritable bowl syndrome, lactose intolerance, fibromyalgia, chronic fatigue syndrome and ulcers • The only treatment for CD is a Gluten Free Diet for life!!! Gluten en Sensitivi vity (GS) • Gluten Sensitivity – literally a sensitivity to gluten. Not an autoimmune disease and does not cause damage to the villi in the small intestine. • Symptoms can be similar to CD • Much higher rates in the population, varied intensity • How did this come about? Gluten is abundant in our diet • Wheat allergy is also quite prevalent, tied directly to wheat 3

Nutri rition n Concerns rns and the Gluten en Free e Diet • Strict Gluten Free Diet for Life • Temporary lactose free diet may be needed • A GF diet can lead to iron deficiency – need iron rich foods • Adequate calcium and vitamin D needed • Dietary Fibre needed from non gluten food sources Sourc rces es of Gluten n in Foods • Many grain based products such as breads, cereals, pasta ’ s • Commercial soups and sauces (including soy sauce) • Snacks and candies • Prepared deli meats, salad dressing etc. • Beer (wheat, barley based) • Flavored coffee and some tea • Nutrition supplements • ** Coatings on many foods and ingredients to preserve quality are not always disclosed. 4

Ingredi edien ents ts Conta tainin ning Glute ten n – Read the Label, , Know your Gluten en • Barley • Bran • Bulgur • Couscous • Durum Flour • Kamut • Modified food starch (if you don ’ t know the source) • ** Oats – most commercial • Rye Flour • Spelt • Triticale • Wheat flour, starch, bran, germ, grass Foods ds Allowed ed on a GF Diet • Plain meats (red meat, poultry, fish, eggs, etc.) • Pulses (Beans & Lentils), Nuts (non coated), Seeds • Milk products (cheese, yogurt, etc.) • Fruits and Vegetables • GF flours, cereals and starches • Distilled alcohol and wines • Beer made from rice • All vinegars except malt vinegar 5

Gluten en Free e Labeling ng • No world wide definition for GF (yet) • New food allergen regulations in affect Aug 4 th , 2012 • http://www.hc-sc.gc.ca/fn-an/label-etiquet/allergen/index-eng.php • The new legislation requires manufacturers to declare smaller ingredient components, giving more visibility. • Wheat Free is not Gluten Free • Labels can change without notice – check them frequently Cross Contaminat ation • Cross contamination is the greatest challenge • Need to understand the severity • Surfaces – GF prep in a separate area is the best way to avoid it • Alternatively, strict cleaning guidelines between production • Watch for “ airborne ” gluten • Store GF items separately • Use single serve condiments, desserts, etc • Clearly label GF equipment (toasters, cutting boards, utensils, etc.) • Change gloves, aprons, hair nets etc. • Check your cooking mediums – oils, water, etc. 6

GF Strategi egies es at Your Facility • Training, Training, Training • Provide training for all staff – including awareness of the consequences • Place training materials throughout the kitchen • Identify risk areas in the kitchen • Incorporate GF practices as a standard of regular work processes, tied into sanitation practices • Detailed training on Cross Contamination GF Strategi egies es at Your Facility Con ’ t • Suggested training agenda for Staff: • What does CD and GS mean? • What is a GF diet? • What happens a GF diet is not adhered to? • Understanding the seriousness of cross contamination • Simple solutions for serving a GF diet • Understand specific challenges at your facility • Identify problem areas 7

Operat ration onal al Control ols that Can Minimize e Errors • Know your GF residents and inform the staff regularly • Be aware of menu substitutions • Use bright, clear labeling • Supervise and spot check service • Communicate! GF Strategi egies es at Your Facility Con ’ t • Start with the resident: • Understand their history • Check their knowledge base – is it accurate? Can we expand the scope of their diet? • Involve the dietitian as a key resource and communicator with the resident 8

Sourci rcing ng GF Foods • Sourcing: • Your distributor is key – what ’ s available? • Demand more from your manufacturers • Coordinate with your peers • Ensure clear labeling and straightforward information Challenges ges to Sourcing ng • Cost – Specialty pre-packaged foods can be expensive (look at opportunity cost) • Purchase bulk for all diets • Limited storage • Products/Labels can change without notice • Dialogue with suppliers to ensure they understand • Small volumes at the distributor level (5 cases/week movement) • Work with your peers • Identify items that solve multiple diet issues 9

Cooki king g Gluten n Free • Cooking gluten free doesn ’ t have to be complicated • Keeping it Simple is the rule • Stick to primary unprocessed ingredients • Stick to whole foods for maximum nutrition • This makes it easier to ensure ingredients are GF The Power r of Quinoa • One of the most nutritious whole grains, rich in fibre and iron • Incredibly versatile • Sides & Pilafs • Cold Salads • Soups • Patties & Quinoa Balls 10

Seasoni oning ng and coating • Many commercial seasonings contain gluten • Check for Gluten Free Label • Use cumin, cayenne pepper, tumeric etc. • Use butter and olive oil to keep moisture and add flavor • Use quinoa flours, rice flour, potato flour etc. A Balanced ed Diet • Variety = more nutrients, more excitement, happy residents • Avoid too much corn and soy • Different beans and legumes • Change up the vegetables 11

Baking ng • Breads and Pasta ’ s are more difficult • More commercial variety available • Serve warm, fresh • Refer to Carol Fenster ’ s guide to baking • Learn about the characteristics of each flour • Try different rice pasta varieties – wash away the starch Easy Recipe pe Concept epts • Chicken with Rice & Beans • Quinoa spinach salad • Beef and rice macaroni • Quinoa lettuce wraps • Chicken meatballs and mashed potatoes 12

Don ’ t Let Gluten n Be a Sticky Issue in Your Operat ation on • Educate • Train • Source the right items • Prepare your facility • Stick to clean, simple ingredients • Serve a balanced variety • Work with your peers Resourc rces es • Gluten Free Diet: A comprehensive Resource Guide (Shelley Case, RD) • Celiac Disease for Dummies (Dr. Ian Blumer & Sheila Crowe) • Canadian Celiac Association Pocket Dictionary: Acceptability of Foods and Food Ingredients for the Gluten Free Diet • Real Life with Celiac Disease: Troubleshooting and Thriving Gluten Free (Melinda Dennis, RD & Dr. Daniel Leffler, MD) 13

Websites es • www.celiac.ca • www.celiacguide.org • www.csaceliacs.org • www.celiac.org • www.gluten.net • www.celiaccentral.org Certification: • www.celiac.ca/index.php/about-the-cca/certification • www.gfco.org GF High-Fibre re Hot Cereal al  75 ml Flax Seed Meal (ground Flax)  Combine all ingredients except vanilla  Cook until thick and creamy, on stove top  75 ml Cream of Brown Rice Hot Cereal or in microwave  325 ml water  Stir in vanilla  Dash Vanilla  Serve with brown sugar, nuts and/or dried Option: add brown sugar, nuts and/or dried fruits fruit for daily variety Packed with Fibre and omega-3 fatty 250 ml Serving: 225 Kcal, 30 g CHO, 10 g Fat, 6 g Pro, 7 g Fibre acids 14