The Savvy Celiacs Quick Guide to the First 30 Days: Start Your New Gluten Free !

i"e Now
Amy Leger Copyright 2013 Amy Leger Learn more about Amy Leger at http://www.thesavvyceliac.com

Ta#le o" Contents:

Introduction Chapter 1 - The Celiac Diagnosis why did this happen to me? Chapter 2 - What is and is not gluten free, and e erything in !etween Chapter " - #hopping and $a!els - la!el reading clear as mud? Chapter % - In the &itchen Cross-Contamination, 'amily (ecipes ) #u!stitutions Chapter * - #ociali+ing,The -.n/0appy 0our? Chapter 1 - #chool2Daycare3ass-produced lunch madness4 Chapter 5 - 3o ing 'orward,6etting 7our #a y 8n4

$ntroduction
That irst month going gluten ree can be a !oo"y. #ou go rom eating all the pasta$ pi""a an! restaurant or grab%an!%go oo!s you want to planning nearly every bit o your oo! or the rest o your li e. &t soun!s grim an! you are li'ely sa! or yoursel or a amily member an! that is o'ay. (ut really this !iagnosis o celiac !isease or non%celiac%relate! gluten intolerance is opening new !oors to a better an! healthier #)*+ The goal o this boo' is to be a ,uic' re erence to get you up to spee! on the very basics o celiac !isease an! the gluten% ree li estyle. & am not a health care provi!er. The in ormation insi!e comes rom lessons learne! since my !aughter was !iagnose! in 2000$ plus$ as a -ournalist$ & en-oy researching an! interviewing e.perts on the sub-ect. #ou may in! this gui!e help ul to give to your amily an! close rien!s$ because$ let/s ace it$ coo'ing a big holi!ay meal is never too ar away. &t is always goo! to remember$ i you thin' you may have celiac !isease$ get teste! be ore you go gluten% ree. & you thin' you have non%celiac%relate! gluten intolerance$ also please consult your healthcare provi!er.

Cha%ter &ne The Celiac Dia'nosis: (hy did this ha%%en to )e*
Celiac !isease is a cra"y an! tric'y thing. &t is an autoimmune !isease$ li'e rheumatoi! arthritis$ multiple sclerosis an! type 1 !iabetes in that the bo!y is ighting itsel . &n the case o celiac !isease$ The 0ational 1oun!ation or Celiac Awareness puts it this way$ celiac 23!amages the villi o the small intestine an! inter eres with absorption o nutrients rom oo!3.4ssentially the bo!y is attac'ing itsel every time a person with celiac consumes gluten.5 A 2003 groun!brea'ing prevalence stu!y on celiac !isease oun! appro.imately 1 in 133 Americans have the !isease$ but most remain un!iagnose!. The only way to treat celiac !isease

at this time is to eat a strict gluten% ree !iet. That means no wheat$ barley$ rye an! !erivatives o those very popular grains. That irst shopping trip or gluten% ree oo! may have you saying to yoursel $ 26ow !o people !o this7 8heat is in 494:#T6&0;+5 The answer is%% you can !o it+ <any people !o it success ully every !ay an! you can too+ The reality is =an! you may nee! to remin! yoursel o this o ten> i you are going to have a !isease$ celiac !isease is a goo! one to have. 8hy7 7ou do not need to ta9e e:pensi e prescription drugs e ery day It is treated !y a diet that can !e healthier than the diet you may already !e eating ;s long as you are eating a strict gluten-free diet, most people can li e a healthy normal life 0ow T6)?4 are a ew goo! reasons+ #ou may be sa! right now$ but eventually$ with a little time an! e!ucation$ you may come aroun! to un!erstan!ing that celiac is not so ba!. @iagnosing Celiac Celiac !isease is tric'y in part because it mani ests itsel in so many !i erent ways. The huge range o symptoms may 'eep a !octor rom !iagnosing you with celiac !isease an! instea! he or she may -ust hone in an! treat your speci ic symptom. The <ayo Clinic/s list o symptoms is vast: classic symptoms o ab!ominal pain$ !iarrhea an! bloating are what !octors may 'ey into or a common celiac !iagnosis. (ut then a!! in the others: !epression$ anemia$ -oint pain$ muscle cramps$ s'in rash$ mouth sores$ !ental an! bone !isor!ers =such as osteoporosis>$ tingling in the legs an! eet =neuropathy>$ weight loss$ general wea'ness an! atigue$ oul%smelling stools that may be atty or oily$ stunte! growth in chil!ren. 1rom my own e.perience with my !aughter an! my brother$ & woul! a!! other symptoms li'e liver !ys unction$ an! atigue so e.treme it mimic'e! some symptoms o narcolepsyA my !aughter ha! the classic !isten!e! belly as well. & you thin' you nee! to be teste! or celiac please as' your !octor. &t is a basic bloo! test as a irst screen. & your !octor will not !o it =an! there may be some who will not>$ in! another !octor who will. :e,uest a 2celiac panel5 or your bloo! tests. Accor!ing to the Center or Celiac :esearch an! Treatment this inclu!es: tT;%&gA or tissue transglutaminase%&gA A;A%&g; or Antiglia!in &g; A;A%&gA or Antiglia!in &;A Total &;A The tT; test is very accurate or pre!icting celiac !isease. A;A !etects wheat allergies. & the results are positive or point in a !irection o a possible celiac !iagnosis$ you will then be !irecte! to get an en!oscopy an! biopsy o the small intestine. The Center or Celiac :esearch

an! Treatment says it is currently 2the gol! stan!ar! in the !iagnosis o celiac !isease an! there ore consi!ere! essential.5 <any people =an! honestly$ sometimes healthcare provi!ers> believe a patient can -ust go gluten% ree an! i they eel better$ great+ 8hat they !o not 'now is i the patient ever wants to get the bloo! wor' or celiac !isease$ he or she will have to go bac' on gluten or wee's to get any hope or an accurate result. &t is best that the bloo! test be !one or celiac !isease be ore going gluten% ree. & you are !iagnose! with celiac !isease$ you will want to consi!er getting irst%!egree relatives =parents$ siblings an! chil!ren> teste! too. The 2003 prevalence stu!y also showe! 1 in 22 irst% !egree relatives have celiac !isease. 1 in 3B secon!%!egree relatives =aunts$ uncles$ cousins> have celiac !isease. Those ol's may want to be teste! as well. 1or e.ample$ my great aunt was !iagnose! !eca!es be ore my !aughter was !iagnose! in 2000$ then my brother got his !iagnosis. & your celiac panel comes bac' negative$ you coul! still have non%celiac gluten sensitivity =0C;?>. :esearchers e.plaine! !uring the ?eptember 2013 &nternational Celiac @isease ?ymposium =&C@?> there is a lot to be learne! about 0C;?. :ight now$ researchers believe the range o people with 0C;? is wi!e. @uring &C@? 2013$ researchers sai! as ew as .C percent o the population has 0C;?$ but other estimates point as high as D percent =which woul! be appro.imately 1E million Americans>. @octors ?te ano ;uan!alini o the *niversity o Chicago Celiac @isease Center an! Alessio 1asano o the Center or Celiac :esearch an! Treatment at <ass ;eneral in (oston e.plaine! to the 0ational 1oun!ation or Celiac Awareness that there is no true test at this time which con irms 0C;?. This is an area where research is going on now. #a y Tips< Celiac disease is an autoimmune disease ) !y following the only treatment a strict glutenfree diet -- you can li e a full and healthy life 0a e symptoms? 6et the celiac panel !lood test Consider ha ing your immediate family tested Celiac test negati e? 7ou may ha e non-celiac-related gluten intolerance

Cha%ter Two (hat $s and (hat $s not Gluten Free* +,nd everythin' in #etween8hen learning what you can an! cannot eat$ the irst thing to 'now is that you 8&LL 0)T see gluten written li'e an ingre!ient on the si!e o a pac'age. 6owever$ you may see the wor!s 2gluten ree5 or a 2;15 symbol. ;luten is not an actual ingre!ient li'e you woul! see 2wheat5 on a label. The <ayo Clinic !e ines gluten ree as a !iet that 2e.clu!es the protein gluten which is oun! in all wheat$ barley$ rye an! triticale ingre!ients5 =inclu!ing spelt$ 'amut an! more>.

?o what is gluten ree7 The most comprehensive list & have seen o 2?a e &ngre!ients5 comes rom www.celiac.com. There are too many to list here but here are some highlights =an! even with this list$ it is always wise to chec' the ingre!ient labels>: <illet <onoso!ium ;lutamate =<?;> )ats =must be certi ie! gluten ree> 9inegar =all e.cept malt vinegar> (a'ing ?o!a Amaranth (lue Cheese ;lutinous :ice F 1lour <alto!e.trin Guinoa ?orghum :ice Corn As or 2gluteny5 ingre!ients$ www.celiac.com/s list o 2*nsa e &ngre!ients5 is also very !etaile!. 6ere are a ew: 8heat (arley :ye (ran <alt =syrup$ vinegar> ;raham lour 6y!roly"e! 8heat Hrotein <at"o ?emolina 9ital 8heat ;luten Hasta <a'e sure you go to the bottom o the www.celiac.com list to see the oo!s that sit on the ence Ithey may or may not be gluten ree. They inclu!e caramel color$ bouillon cubes$ natural lavor$ lavoring an! oo! starch. ?ome o those generic terms are vague an! can be consi!ere! re! lags in the gluten% ree worl!. (ottom line is there are hun!re!s o ingre!ients out there that normally most o us woul! -ust s'im over on an ingre!ient list. 0ow that you are gluten ree$ you nee! to 'now what is in your !iet an! what is out. That means getting amiliar with even the most obscure ingre!ients li'e: Disodium Wheatgermamido Peg-2 Sulfosuccinate which you may have suspecte! is in!ee! ille! with gluten. #a y Tips< Wheat, !arley, rye,!ad4

(ice, Corn, =uinoa good4 &now the red flag ingredients and find out their source to determine gluten-free status

Cha%ter Three Sho%%in' and .eadin' !a#els: Clear as /ud*

<y irst trip to the store a ter my !aughter was !iagnose! seeme! to ta'e orever. 6onestly$ the trip seeme! to go in slow motion an! the grocery store & 'new so well$ now seeme! unrecogni"able. & en!e! up crying in the store over the :ice Jrispies not being gluten ree =they now have a gluten% ree brown%rice version>. & only purchase! eggs$ Cheetos an! Corn Hops =inci!entally that cereal is no longer gluten ree>. 8hen & le t & was convince! 494:#T6&0; ha! gluten an! it woul! be pain ully !i icult to ee! my 1C%month%ol! chil!. That shopping e.perience is as vivi! in my memory now as when it actually happene!. The irst ew shopping trips will ta'e a lot o time an! resources an! it @)4? get better. 6ere are some suggestions to prepare you or your irst gluten% ree shopping trip: Hic' a health/natural oo! store. These 'in!s o stores will li'ely have sta with more e.perience with gluten% ree oo!s than a big%bo. grocery store. @oing this will give you a 2lay o the gluten% ree lan!5 an! basic un!erstan!ing o the options available to you. <y health oo! store also puts a re! arrow on the price 2stic'er5 which is poste! near the gluten% ree pro!uct an! it has gluten% ree oo! events where you can taste%test gluten% ree oo!s. & you go to a regular grocery store$ the gluten% ree oo! may be sprea! throughout the store or it coul! be put all in one section. At my big%bo. grocery store they have the gluten% ree section right in the mi!!le o the pasta aisle =yes$ let/s -ust twist the 'ni e a little$ but it is better than the ba'ing aisle li'e it was be ore> an! & !o not believe anyone in the store coul! actually help you with any ,uestions regar!ing gluten% ree pro!ucts. &n my opinion a big general grocery store coul! be overwhelming at irst. & your grocery store -ust !oes not have the gluten% ree selection you woul! li'e to see$ be sure to as' or the gluten% ree oo!s you woul! li'e them to carry. #ou never 'now$ they may actually start carrying them+ @o gluten% ree shopping online. This is a per ect option or ol's who may live in smaller communities an! cannot get to a health oo! store too o ten. Companies li'e Ama"on.com an! ;luten1ree<all.com are companies that have several selections rom which to choose. & you in! a bran! you are particularly in love with$ chec' to see i you can or!er !irectly rom the manu acturer. ;et a gluten% ree ingre!ient/pro!uct list. This will ma'e li e easier or you. #ou can either print up the ingre!ient lists rom www.celiac.com or you can ,ueue them up in your smart phone or tablet an! bring them along. There are apps or in!ing gluten% ree pro!ucts as well. )ne App & have oun! or the iHhone is calle! 2&s that ;luten 1ree75 &t has what appears to be thousan!s o pro!ucts liste! with

in ormation rom the manu acturers. &t also has a list o sa e an! unsa e ingre!ients. Learning what/s sa e an! unsa e ,uic'ly will ma'e shopping a smoother e.perience. ?tay current on gluten% ree news. ?ince 2000$ & have seen both !istille! vinegar an! oats come o the unsa e list an! be a!!e! to the sa e list. #es$ sometimes things change. )ats are a gluten% ree grain$ but e.perts say stan!ar! oats get contaminate! in the processing. #ou nee! to loo' or gluten% ree oats. @istille! vinegar is gluten reeIbut malt vinegar is not !istille! an! as a result is not gluten ree. *n!erstan! oo! labels an! ingre!ient lists: 8ith your gluten% ree lists in han!$ get use! to rea!ing labels. ?ome!ay$ with e.perience$ you will be able to !o this without your list. The 1oo! Allergen Labeling an! Consumer Hrotection Act =1ALCHA> really helpe! ma'e label% rea!ing easier when it was enacte! in 200K. 1ALCHA re,uires that the top oo! allergens be liste! i they are in any ingre!ient in a pro!uct. 8heat is among the top allergens$ but gluten is not. Lust because an ingre!ient listing !oes not say it contains wheat$ !oes not mean the pro!uct is gluten% ree. &n August 2013$ the 1oo! an! @rug A!ministration =1@A> announce! the new gluten% ree labeling rule. &t is a set o stan!ar!s that a company must ollow i it wants to promote a pro!uct as being gluten ree. &t is not across%the%boar!$ man!atory labeling or all companies li'e the re,uirements in 1ALCHA. The voluntary gluten% ree labeling stan!ar! re,uires companies to have any pro!uct they label gluten ree to be below 20 parts per million o gluten. They can only use the term 2gluten ree5 rather than 2no gluten5$ 2low gluten5$ etc. The 1@A says companies that want to label their oo!s gluten ree must be in compliance by August C$ 201K. Although the labeling will help shoppers 'now that anything mar'ete! as gluten ree ha! to ollow e!eral stan!ar!s$ it may not be the answer to all your gluten% ree shopping ,uestions. &t is possible that even a ter the labeling rule goes into e ect$ there coul! still be companies that !on/t promote their gluten% ree status an! as a result !on/t nee! to ollow the gluten% ree labeling stan!ar!s. Those companies coul! still leave you ,uestioning ingre!ient labels. Consi!er coo'ing rom scratch when assembling your shopping list. (y purchasing the ingre!ients an! ma'ing things li'e coo'ies$ ca'es an! lasagna on your own$ you will not only be able to control the cost a little more but also you can control the ingre!ients that are put in your oo!. A lot o gluten% ree oo! is loa!e! with sugar an! e.tra at to ma'e it taste better. Hro!uce$ meat an! !airy sections have a lot o naturally gluten% ree oo!s. Takeaway lesson: Purchase these items and your waistline and pocketbook will likely thank you. Cosmetics$ health an! beauty pro!ucts shoul! not be overloo'e! or gluten. 6owever$ @r. Lohn Mone$ Chairman o the @epartment o @ermatology at the *niversity o *tah says while you shoul! never have gluten in your toothpaste$ !ental loss$ mouth wash or lipstic'/lip balm$ other cosmetics cannot be absorbe! through the s'in. This hol!s true or both ol's with celiac an! !ermatitis herpeti ormis =@6>. @6 is basically the s'in version o celiac. 8hen gluten is ingeste! in a person with @6$ they get a s'in reaction an! the gluten is !oing !amage to their intestines. (ut e.perts say ol's with @6 !onNt get a reaction by touching gluten to the s'in.

@uring the &nternational Celiac @isease ?ymposium$ ?eptember 2013$ @r. Mone !escribe! humans as having a protective barrier$ calle! stratus corneum$ which acts li'e a ?aran 8rap on the s'in that 'eeps gluten molecules out. 6e sai! gluten can be absorbe! through the mouth an! a lesion or cut to the s'in. The O?aran 8rapO is also in the hair ollicle area so gluten cannot be absorbe! through your hair pro!ucts. 4.perts at the <ayo Clinic also say gluten cannot be absorbe! through the s'in$ but i you have a s'in reaction to a cosmetic$ shampoo or lotion with gluten in it$ you shoul! see your !octor. &t coul! be a wheat allergy or something else causing your s'in reaction. 8ay bac' when my !aughter was younger her gran!parents gave her a bottle o bubble bath. A ter using it a ew times$ or no real reason$ & turne! the bottle over an! loo'e! at the ingre!ients. ?ure enough it sai! 2wheat5 right on the ingre!ient label. & threw out the bottle because & was not worrie! so much about her s'in$ but rather that as a to!!ler she might get the water in her mouth. #ou may eel that you want gluten% ree cosmetics an! health an! beauty pro!ucts$ -ust to be sa e$ but$ it is not re,uire! on a gluten% ree !iet. #a y Tips< >ic9 a store that is managea!le and not o erwhelming ? ery time you go to your regular grocery store, re@uest the gluten-free foods you would li9e them to carry 8!tain lists of safe and unsafe ingredients for the gluten-free diet, learning the lists @uic9ly will help create an easier shopping e:perience >hone or Ta!let ;pps could !e ery helpful when !eing mo!ile at the store 'amiliari+e yourself with ';$C>;, gluten-free la!eling rule and reading la!elsA Teach others the sameA #hop the perimeter of the store and coo9 from scratchA 'resh meats, egeta!les and dairy will !e !etter for you in the long run and could sa e you money and calories $oo9 for gluten-free lipstic9, lip !alm, mouth wash, and toothpasteB other health ) !eauty products are o9ay

Cha%ter Four $n the 0itchen: Cross Conta)ination1 Fa)ily .eci%es and Su#stitutions
#ou have your oo! purchase!$ an! now what7 8here !o you begin with the preparation an! coo'ing o gluten% ree oo! A0@ what i not everyone in my house is gluten% ree7 0ow is the time to loo' at your 'itchen with a new set o eyes+ #our gluten% ille! 'itchen nee!s a ma'eover an! a !eep clean. 8ithout it$ you run the ris' o un'nowingly contaminating yoursel or the gluten% ree person in your home over an! over.

This is where many people !eci!e the whole house will go gluten ree. That is your choice. ?ome ol's !o a combination houseIli'e my amily. 4ither way the ollowing tips or cleaning up your house will help you. Let/s start with the appliances. #our toaster is a culprit or cross contamination. &t is 'nown or accumulating a lot o crumbs when it heats up gluten% ille! bagels$ toast$ an! wa les. That !oes not count the number o chun's o brea! that have become stuc' insi!e the toaster as well. & you are going gluten ree$ you nee! a new toaster P an! i!enti y it as only allowing gluten ree items. &n my amily the re! toaster is or gluten% ree oo!s only+ Choosing a !i erent color an! style will help i!enti y the toaster that is sa e or you. )ut with the woo! an! in with the 048+ Those porous woo! spoons$ spatulas an! cutting boar!s will not be use ul to someone going gluten ree. The cross%contamination ris' is high. (ecause they are porous$ it is very !i icult to get woo!en tools clean. 8oo! =an! plastic> cutting boar!s are even worse because the grooves rom sharp 'nives leave slits in the woo! that can harbor crumbs. #ou will want to replace the coo'ing tools with another easier%to%clean pro!uct. As or cutting boar!s$ i you !o plastic$ consi!er !oing another color =li'e the a orementione! toaster> that is easily i!enti iable as gluten ree. ;lass cutting boar!s are great because they !o not leave grooves an! are easy to clean$ however they can !ull your 'nives ,uic'ly. 6oles in the colan!er hol! gluten. #ou will want to have a separate colan!er or gluten% ree pasta. & you have ever use! a colan!er or pasta$ you probably have notice! that resi!ue an! little pieces o pasta o ten stic' to the colan!er an! insi!e the holes$ ma'ing it very !i icult to clean. (e sure to purchase another P easily gluten% ree i!enti iableIcolan!er or your home. Hurchase new butter$ peanut butter$ -am$ ba'ing pow!er$ ba'ing so!a3.any o those share! oo!s or ingre!ients. They can en! up cross contaminate! !uring coo'ing an! ba'ing. & you have a combine! gluten an! gluten% ree home$ you/ll want to 'eep separate pro!ucts li'e peanut butter an! 'eep them labele! as such. & you are going strictly gluten ree$ then throw away any o the contaminate! pro!ucts. There are a ew optional changes you can ma'e. Clean o a shel or an entire portion o a pantry or your gluten% ree pro!ucts. This way you !o not run the ris' o acci!entally eating something. 8e have !one it this way in our house or years. &t helpe! my !aughter when she was very young to be able to i!enti y her sa e oo!s. &t continues to help visitors =an! perhaps a babysitter> 'now what is gluten ree an! what is not. ?ome ol's li'e to have separate pots an! pans an! even !ishwashing sponge. )ur amily has share! the pots an! pans. ?oap an! hot water is the best way to ri! gluten rom sur aces. 8e have not ha! a problem with it as long as the pots an! pans are cleane! well. 4liminate all crumbs on counters an! table tops. A common cross%contamination problem can be crumbs+ ?imply put$ the counters nee! to be cleane! be ore using the 'itchen. Crumbs on the counter an! on the tables not only are generally messy$ but they leave the enemy$ gluten$ ripe to cross%contaminate. #a y Tips<

(eplace toasters, wood utensils and contaminated food ;ssign a color to the new gluten-free 9itchen supplies for easy recognition during coo9ing &eep a clean 9itchen to eliminate the possi!ility of cross-contamination during food prep

Cha%ter Five Sociali2in' The 34n56a%%y 6our*

6ere/s a ,uic' story. An ac,uaintance o mine ha! gone well into a!ulthoo! without a care about glutenIli'e most everyone in the *nite! ?tates. (ut then she was !iagnose! with celiac !isease. ?he mentione! how !i erent she elt the ne.t time she went out with her co%wor'ers when she ha! to navigate the gluten% ree lan!scape in the !eep% rie! an! beer%la!en worl! o 6AHH# 6)*:+ & can only imagine how !i icult$ aw'war! an! even rustrating that moment coul! be. ?ociali"ing when you are gluten ree goes beyon! happy hourA it inclu!es holi!ays with the amily or going out or a bite to eat on a 1ri!ay night with rien!s. &t can be$ at times$ overwhelming. 1or the most part$ the rules an! tips will be the same or a!ults an! 'i!s with celiac. Arrange or call ahea! to your !estination. & you are going out to a restaurant$ call ahea!. As' what they might have that you can eat. & woul! recommen! calling !uring 2o 5 hours =li'e 10:00 a.m. or 2:00 p.m.> so you are getting the un!ivi!e! attention o the manager or che . #ou can set up your or!er ahea! o time an! when you arrive$ tal' to the server about the pre% arrangement o your gluten% ree meal. 8ebsites li'e www.glutenfreeregistry.com or www.findmeglutenfree.com have ;:4AT resources on gluten% ree menus. Hic' the happy hour location$ base! on one o these lists+ Always 'eep in min!$ when eating outA you are ta'ing a ris' because you are not in charge o your own oo!. ;etting contaminate! will li'ely happen at some point P un ortunately. The best you can !o is be loyal to the companies that 'now how to !o gluten% ree right. & you are uneasy about eating somewhereI!o not eat it. &t may be easier sai! than !one$ but always go with your gut+ @o not be shy about your nee!s. & your rien!s =or your 'i!s/ rien!s/parents> !o not 'now about your gluten% ree nee!s$ how will they ever accommo!ate a gluten% ree rien!ly location7 Tell them about your gluten% ree !iet an! why you nee! it. Let them 'now a ew easy oo!s they can always have aroun! the house to accommo!ate your !iet. Always bring snac's. #ou never 'now when you are going to be stuc' somewhere with absolutely 0) oo! choices =airports$ in my opinion$ are one o these places>. ?o you shoul! always have some oo! on han! to cover those moments. 1or 'i!s$ there will be times when a parent or coach o their sports team han!s out cupca'es or coo'ies$ an! your chil! is le t out. 4ven i a!ults 'now about the gluten issue$ most o them bring the treats anyway P it is a act. As a parent o a gluten% ree chil!$ it is always nice i you can pull out their avorite can!y$ or

maybe ta'e them out or ice cream instea!. ?ports an! activities shoul!n/t always be about oo! Ibut sometimes they -ust are. Tal' to parents be ore play !ates. Ji!s love to play together an! eventually you will not be there. As you wor' to help your chil! be in!epen!ent an! spea' up or themselves$ you also nee! to protect them !uring those early years. & your chil! is going to a rien!/s house$ tal' to the parents about what 'in! o snac's they have. #ou coul! also sen! a variety o snac's with your chil!. & they are a goo! rien!$ you coul! sen! a list o sa e snac's. 4!ucation can help re!uce the ear other parents may have about ma'ing your chil! sic'. The parents o my !aughter/s best rien! always have Cocoa Hebbles$ Cheetos an! an acceptable hot !og aroun! the house P -ust in case she nee!s to eat when she is there. 8e are so than' ul or this. #a y Tips< Ce prepared for any scenarioA 7ou do not want to !e stuc9 star ing somewhere or worse yet, !e tempted to eat something unsafe Dust !ecause you are hungryA Wor9 with colleagues and parents to come up with fun gluten-free solutions during parties and other social e entsA

Cha%ter Si7 School 8 Daycare: /ass 9roduced !unch /adness

8hen my !aughter irst starte! 'in!ergarten in 200K$ having gluten% ree lunch was nearly unhear! o . At !aycare be ore she entere! elementary school she ha! to bring her lunch =an!$ no$ our amily !i!n/t get a !iscount or giving them one less mouth to ee!>. #ou cannot be prepare! enough or this because sometimes getting gluten% ree accommo!ations is easy an! other times it is not an! it is har! to pre!ict which is which+ @aycare: #ou will nee! to in,uire with your provi!er on how they !eal with gluten% ree !iets because there is no e!eral gui!eline here. (ut you can chec' with your state human services !epartment to in! out what their re,uirements are or chil! care provi!ers. &n <innesota$ or e.ample$ the only licensing rule that a!!resses special !iets is this: 2The provi!er shall ollow written instructions obtaine! rom the parents$ at the time o enrollment$ on each chil!/s special !iet or oo! nee!s. Harents shall be consulte! about special oo! pre erences.5 This is relatively vague. & you have a provi!er who wants you to supply the gluten% ree chil!Ns oo! =li'e sen!ing a !aily col! lunch an! supplying snac's>$ then you may want to !iscuss some 'in! o tuition !iscount. (ut i they are willing to coo' or your chil! =using oo! you provi!e or the oo! the !aycare provi!es> employees nee! to un!erstan! the issues o cross%contamination an! what is sa e or your gluten% ree chil! to eat. This boo' coul! be a goo!$ very ,uic' primer or that.

?chool is a !i erent beast. & your school receives e!eral ai! =an! most !o> it must ollow the gui!elines with the Americans with @isabilities Act =A@A>. Accessibility or me!ically% prescribe! !iets that treat a health issue is a relatively new aspect with the A@A. ?chool nutrition !epartments an! even some classroom teachers now have to consi!er gluten% ree !iets in their practice. &n an interview with ?cott Lissner$ Hresi!ent o A64A@ =Association on 6igher 4!ucation Awareness an! @isability>$ he e.plaine! a !isability is !e ine! by the A@A as a 2mental or physical impairment that substantially limits a ma-or li e activity5. &n a 2012 settlement between the *? @epartment o Lustice an! Lesley *niversity =which tac'le! the sub-ect o gluten% ree accommo!ations>$ the !ocuments state! 2eating5 an! 2ma-or bo!ily unctions li'e the gastrointestinal system5 as being e.amples o 2ma-or li e activities5. There are some schools =elementary$ secon!ary or college> where parents will have to get involve!. Lissner o ere! these tips to parents who want gluten% ree accommo!ations or their chil!ren: ;o to your school/!istrict/university/s !ietician irst. Lissner recommen!s you go to the school/s website or !ining halls$ resi!ence halls or oo! service. & there is a way to contact a !ietician about your school/s oo! plan/options$ ta'e a!vantage o that. & there is no option to tal' to a !ietician or nutrition services$ then chec' with your !isability services. At a large university it coul! be an entire o ice sta . At an elementary or secon!ary school it may be one person !esignate! as the !isability/A@A/C0K Hlan coor!inator. 8hat is a C0K Hlan7 The American @iabetes Association e.plains a C0K Hlan this way$ 2The C0K Hlan sets out an agreement to ma'e sure the stu!ent with !iabetes Qor celiac/gluten% ree !ietR has the same access to e!ucation as other chil!ren. &t is a tool that can be use! to ma'e sure that the stu!ent$ the parents/guar!ians an! school personnel un!erstan! their responsibilities an! wor' through challenges or misun!erstan!ings to avoi! problems in the uture.5 #ou can use a C0K Hlan to get accommo!ations at lunch$ in home%ec coo'ing class an! even in art class. Hlease consi!er getting one o these even i you !o not eel li'e you nee! one. Lissner eels eventually the A@A will e.ten! to school%relate! activities as well. The school will li'ely re,uire a note rom your !octor regar!ing the me!ical !iagnosis. #ou shoul! e.pect this re,uest rom a!ministrators. 8hen my !aughter ha! home%ec class$ the teacher wante! her to help ma'e the gluten% ille! oo!$ but not eat it. (y not accommo!ating her gluten% ree ingre!ient nee!s =which & o ere! to supply>$ in my opinion$ my !aughter !i! not get the same e!ucational e.perience as other stu!ents. The teacher may have been in violation o the A@A. ?he$ in my opinion$ !e initely was in violation o the C0K Hlan arrange! or my !aughter. & thought the C0K Hlan woul! be the saving grace & nee!e! to ensure my !aughter/s e.perience in coo'ing class woul! be great. (ut it !i! not. Harents nee! to be very involve! when a C0K Hlan is in e ect.

Activities: Always tell a coach or lea!er o your chil!/s school organi"ation about your chil!/s !ietary nee!s. 4ven provi!e that person with a list o approve! restaurants an!/or snac's i you can. & the team goes to an 2away game5$ or e.ample$ an! plans to stop an! eat somewhere$ the coach may choose some place more gluten% ree rien!ly. As a general rule$ always have a ew snac's on han!. #a y Tips< Chec9 with your #tate Department of 0uman #er ices a!out re@uirements for gluten-free accommodations in a child-care facility or in a home daycareA 6et a *E% >lan and meet with the ;D; coordinator for your childFs school to get the accommodations he or she needs to li e a normal life at school and ha e the same e:periences as other studentsA Tal9 to your coach a!out your dietary restrictions

Cha%ter Seven /ovin' Forward Gettin' your Savvy on:

0ow you 'now the basics$ so what/s ne.t7 (eing savvy with the celiac !iagnosis an! gluten% ree li estyle ta'es a lot o practice+ (ut it will get better. As you loo' ahea! to the uture$ continue to e.pan! your gluten% ree hori"ons. This gui!e gave you the very basics o what you nee! to 'now. 0ow it is time to venture out a bit. Try new lours$ new 'in!s o gluten% ree oo!s an!/or coo'ing techni,ues. *se your 'nowle!ge to try new recipes or try converting an ol! amily% avorite an! ma'e it with a gluten% ree lair+ &t may ta'e a ew tries =an! a ew ingre!ients>$ but !o not get !iscourage!. ;oo! recipes an! new 'nowle!ge will come rom those e.periments. 8atch your amily grow closer with the news o the celiac !iagnosis. This happene! or us when my !aughter was !iagnose!. <y husban! an! & ha! to ban! together to ma'e sure she was getting the oo! she nee!e!. <y brother an! his wi e also ha! a amily !ynamic change with his !iagnosis. 6e was so sic' pre%!iagnosis$ that when he went gluten ree he seeme! normal again Ian! subse,uently li e became so much better. Loin a support group+ 1in! people you can tal' an! relate to about celiac !isease. &t is a goo! way to share great in ormation on new pro!ucts$ celiac news an! li estyle tips. 9olunteer at a celiac or gluten% ree event. They happen across the country at various times o the year. )rgani"ers AL8A#? nee! volunteers. This is another way to meet people an! to give bac' to your new li estyle. @onate gluten% ree oo! to your local oo! shel . ;luten% ree oo! options are sparse in oo! shelves an! there are ol's who not only nee! the oo! or their health$ but also cannot a or! it.

Tal' to your church about o ering gluten% ree communion i it !oes not alrea!y !o so. There are gluten% ree communion wa ers that you or your church can easily purchase online. Catholic churches have !i erent re,uirements o their communion an! a gluten% ree wa er may not be available$ but you coul! ma'e arrangements or wine%only by tal'ing with your priest. Changing everything you 'now about ee!ing yoursel or your amily is scary. This is what happens with a celiac !iagnosis. 0ow you 6A94 to rea! ingre!ient labels$ plan out restaurant outings$ an! have the willpower to say no when tempte! with the ol! gluteny oo!s you use! to L)94. (ut by thin'ing positive$ getting e!ucate! an! ta'ing action$ it will ma'e your new gluten% ree li estyle much easier to live an! you will be well on your way to becoming a savvy celiac+

(ork Citations
A. 1asano$ <@A & (erti <@A T ;erar!u""i$ <@A T. 0ot$ <@A : Colletti$ <@$ ?. @rago$ <?A #. 4litsur$ <@A H. ;reen$ <@A ?. ;uan!alini$ <@A &. 6ill$ <@A <. Hiet"a'$ <@A A. 9entura$ <@A <. Thorpe$ <?A @ Jrys"a'$ (?A 1. 1omaroli$ <@A ?. 8asserman$ Hh@A L. <urray$ <@A J. 6orvath$ <@$ Hh@A Prevalence of Celiac Disease in Atisk and !ot-At- isk "roups in the #nited $tates% Archives o &nternal <e!icine 1ebruary 10$ 2003 Celiac Disease: Can "luten be Absorbed Through the $kin&% <ayo Clinic$ www.mayoclinic.com/health/celiac% !isease/A001D23$ Accesse! 10.1.13 Center or Celiac :esearch an! Treatment$ www.celiaccenter.org$ Accesse! 3.1B.2013 Diagnosis of !on-Celiac "luten $ensitivity% 0ational 1oun!ation or Celiac Awareness$ www.celiaccentral.org$ Accesse! C.12.13 1oo! LabelingA ;luten%1ree Labeling o 1oo!s$ 1e!eral :egister C August 2013 <ayo Clinic$ www.mayoclinic.com$ Accesse! 3.1B.2013 <innesota A!ministrative :ules: ChapterBC02%0KKC Licensing o @aycare 1acilities$ https://www.revisor.mn.gov/rules/7i!SBC02$ Accesse! K.1K.2013 0ational 1oun!ation or Celiac Awareness.www.celiaccentral.org Accesse! 3.1B.2013 !utrition and 'ealthy (ating% <ayo Clinic$ www.mayoclinic.com$ Accesse! 3.1B.13 $afe "luten-)ree )ood *ist +$afe ,ngredients-% Celiac.com$ www.celiac.com$ Accesse! 3.1B.13 $ection ./0 Plan American @iabetes Association: http://www.!iabetes.org/living%with%!iagbetes/parents%an!% 'i!s/!iabetes%care%at%school/written%care%plans/section%C0K%plan.htmlA Accesse! K.1K.2013 $ettlement Agreement between #nited $tates of America and *esley #niversity$ @L 202%3D%231A http://www.a!a.gov/lesleyTuniversityTsa.htmA Accesse! K.1K.2013 #nsafe "luten-)ree )ood *ist +#nsafe ,ngredients-% Celiac.com$ www.celiac.com$ Accesse! 3.1B.13

,uthor ;io'ra%hy
Amy Leger is an 4mmy Awar! winning television news pro!ucer who now ocuses on celiac an! gluten% ree relate! news. Amy is the 1amily 4!itor or "luten )ree *iving 1aga2ine an! oun!e! The ?avvy Celiac$ a website !e!icate! to empowering an! e!ucating people with celiac !isease an! gluten sensitivities. Amy has a long history o celiac !isease in her amily !ating bac' our generations$ inclu!ing her own !aughter !iagnose! in 2000 at the age o 1C months an! her brother !iagnose! in 200E. Combining her -ournalistic bac'groun! in research$ !esire to raise awareness about celiac !isease an! problem%solving through many gluten% ree li e e.periences with her amily$ Amy has turne! her passion into action with her writing$ spea'ing engagements an! e.pertise.

Connect with the Author: Jeep up with Amy an! timely gluten% ree/celiac news an! relate! a!ventures at her website F blog: http://www.thesavvyceliac.com 1aceboo': https://www. aceboo'.com/The?avvyCeliac Twitter: UAmyLeger &nstagram: UAmyLeger 9ine: UAmyLeger