sports and celiac staying gluten-free shares his …...skiier with celiac disease, he not only survives but thrives on a gluten-free diet. SaBRina’S laW food Allergies And celiAc

A speciAl Advertising feAture by MediAplAnet

FOOD ALLeRGIes AnD CeLIAC

A 10-year-old boy shares his story of coping with a lifetime of allergic and anaphylactic reactions

IT’S CANDY SEASON. ARE YOUR KIDS SAFE?

pH

oto

: pa

Ul

Ste

Wa

RD

sports and celiacA competitive skiier shares his story

staying gluten-freeAlexandra Anca’s tips

IT’S CANDY SEASON. 3

TIPS

A speciAl Advertising feAture by MediAplAnet2 · october 2010

CHALLenGes

“eating gluten-free enables me to eat healthier. i know that this more positively impacts my skiing.”

We RecommenD

pAge 7

Teens and food allergies p. 5dietary restrictions don’t get easier with age—teens face a whole new set of challenges.

Dining out with celiac p. 7Knowing how to navigate a menu can help keep you safe.

Recent studies show that allergies a� ect more than two million Canadians—36,000 school aged children in Ontario alone have peanut allergies.

A Canada-wide study finds that 7.5 percent of Canadians report they have a food allergy.

The study, Surveying Canadians to Assess the Prevalence of Com-mon Food Allergies and Attitudes towards Food Labelling and Risk (SCAAALAR), conducted between 2008 and 2009 and sponsored by Health Canada and the AllerGen re-search network, confi rms that pea-nut and tree nut allergies are among the most common allergies in Can-adian children.

Still, experts have yet to reach a consensus as to how environment-al factors and early dietary practices infl uence the development of food allergy.

Dr. Susan Waserman, Professor of Medicine in the Division of Clinic-al Immunology and Allergy at Mc-Master University, says a conclusive reason for the apparent rise of food allergy has not been found, but cites the “Hygiene Hypothesis” as a pos-sible theory.

She explains that our avoidance of infection in the developed world could cause our immune systems to become “dysregulated.”

“We’re living a lot more sanitized

a life… so our immune systems, not as busy fi ghting infections, have re-acted to normally harmless substan-ces in the environment, leading to allergy.”

Peanut prevalenceWaserman suggests that there may be additional reasons why peanut allergy in particular is so prevalent in our society.

Peanut protein is widespread in many foods and household products,

cannot be broken down by cooking and is “dry roasted” in North Amer-ica which may contribute to its al-lergenicity. Timing may also be im-portant. For the past decade or so, the issue of whether to introduce pea-nuts into a child’s diet early on has been highly controversial and con-tinues to be the subject of ongoing research.

Waserman states, however, that while some research implicates early introduction to peanut as a possible culprit, recent information suggests that early exposure to peanut may in fact be protective and result in less peanut allergy.

“We’ve been telling patients to avoid the early introduction of pea-nut—which may have contributed to the problem—we don’t know for sure.” Ongoing research will hopefully help address this issue.

While a “cure” for the peanut al-lergy is not imminently foreseeable, Dr. Ann Clarke, Professor of Medi-cine in the Division of Allergy and Clinical Epidemiology at McGill University, says allergy research is advancing.

“Tremendous progress is being made along epidemiological lines, we’re looking at… better ways to diagnose food allergy and how it’s

managed.”Clarke also refers to recent trials

of desensitization, which involve scientists gradually giving aller-gic children incremental amounts of allergenic foods.

“There’s certainly the hope that these desensitization proto-cols will remove or eradicate the allergy.”

Research fi nds allergies on the rise

DR. SUSAN WASERMANProfessor of Medicine, Clinical Immunology and Allergy,McMaster University

Sabrina’s Law was enacted in Ontario in January, 2006 and was the first law of its kind worldwide.

Named in memory of Ontario teen Sabrina Shannon, who died in 2003 from an anaphylactic re-action while at school, the law re-quires that all school boards in Ontario establish and maintain an anaphylaxis policy that includes:

■■ Risk reduction strategies to minimize exposure to allergens in schools

■■ Regular staff training on dealing with life-threatening allergies

■■ Individual emergency plan for each at risk student

Dudley CoulterAs a competitive skiier with celiac disease, he not only survives but thrives on a gluten-free diet.

SaBRina’S laW

food Allergies And celiAc1st edition, october 2010

Country Manager: gustav [email protected] Manager: Jackie [email protected] Developer: David [email protected]

Responsible for this issue:Publisher: Kelsey [email protected]: penelope [email protected]: alexandra anca, mHSc. RD, Dudley coulter, lori Heller, indrani nadarajah, Jodie Shupac, anaphylaxis canada, canadian celiac association

Distributed within:toronto Star, october 2010this section was created by mediaplanet and did not involve the toronto Star or its editorial Departments.

Mediaplanet’s business is to create new customers for our advertisers by providing readers with high-quality contentthat motivates them to act.

jOdIE ShUPaC

[email protected]

!

DR. ANN CLARKEProfessor of Medicine, Allergy and Clinical EpidemiologyMcGill University

Anaphylaxis management takes a community

Co m m u n i t i e s play an import-ant role in all our lives. For individ-uals—especially children—with serious allergies

and at risk of anaphylaxis, commun-ities are depended on to help keep them safe. Although primary re-sponsibility for managing allergies lies with individuals at risk, the sup-port of friends, neighbours, teachers and others is vital in avoiding a pos-sibly life-threatening reaction.

Food allergy is a growing pub-lic health issue in this country. Re-cent Canadian research estimates that food allergies aff ect more than two million people. In Ontario alone, approximately 36,000 school-aged children have a peanut allergy and thousands more have other serious allergies.

An anaphylactic reaction is an overreaction of the body’s immune system to a triggering agent (an al-lergen). Food is the most common

cause of anaphylaxis, but insect stings, medicine, latex and exercise can also cause a reaction. The most common food allergens in Can-ada include peanuts, tree nuts, fi sh, shellfi sh, egg, milk, sesame, soy and wheat.

Knowing the signs of an anaphyl-actic reaction—and how to treat to one—could mean the diff erence in saving a life. Reactions range from mild, such as a rash or hives, to the most serious—including diffi culty breathing and sudden drop in blood pressure. There is no way of knowing how quickly a reaction will progress or how severe it may be. If not treat-ed quickly, anaphylaxis can be fatal.

There is no known cure for an-aphylaxis; therefore, proper diag-nosis, avoidance of allergens and ac-cess to, and familiarity with, the use of epinephrine is the key to staying safe for those at risk.

Anaphylaxis Canada, the nation-al advocacy organization for people with serious food allergies, cre-ates education and awareness cam-

paigns to further public under-standing of the issue. We also work with community stakeholders—schools, healthcare professionals and the food industry— on initia-tives aimed at protecting allergic individuals.

One such eff ort was Sabrina’s Law, legislation designed to en-sure public schools in Ontario have plans in place to safeguard stu-dents at risk of anaphylaxis. This law, named for teenager Sabrina Shannon who died after an allergic reaction, has been in eff ect since January 2006. With improved pro-cedures, increased training eff orts, and better community awareness, this initiative has helped to cre-ate safer environments for allergic students.

As prepared and vigilant as any-one with food allergies can be, the support of those around them goes a long way. By working together as a community, we can all help those with food allergies stay safe.

Visit www.anaphylaxis.ca.

Beatrice Povolodirector, Marketing & communicationsAnaphylaxis canada

■■ Carry an epinephrine auto-injector (e.g. EpiPen® or Twin-ject®) and wear MedicAlert® identifi cation

■■ Eat safe snacks from home■■ Let others know about your

allergies■■ Reading ingredient labels and

preventing cross-contamination in food preparation

■■ Washing hands and utensils thoroughly when preparing or serving meals/snacks

■■ Knowing the signs of a reaction and how to help

my BeSt tipS

READING LABELS IS

CRUCIAL TO MAINTAINING A HYPO-ALLER-

GENIC LIFESTYLE

READING LABELS IS

1TIP

courtesy of Anaphylaxis canada

A speciAl Advertising feAture by MediAplAnet

A speciAl Advertising feAture by MediAplAnet4 · october 2010

Shelley Mackie was a new mother when she was hit with a bombshell—she found out her then six-month-old son Charlie had life-threatening food allergies. Charlie is now 10 years old and loves sports and eating

out. Here is their story.

Living on high alert

InsPIRATIOn

pRoFile

Charlie Mackie

■■ Born: august 22, 2000, in nyc

■■ Anaphylactic to: peanuts and treenuts

■■ Allergic to: shellfi sh, legumes, lentils, peas and cats

■■ Loves: pizza, chicken wings, ice cream

■■ Hates: avocado

Shelley: On the lookout

“Having a son with severe food allergies has been life-altering for our family. I live my life on high-alert all the time, on the lookout for potential hazards. Charlie was diagnosed as severely allergic when he was six months old. It was just by chance as he wasn’t even really eating solid food yet. When the blood test showed the range of foods he was allergic to, I was stunned. Neither my husband nor I have food allergies and it was the beginning of a slow creeping trauma for me.

Seeking safetyIt got harder when he got to school age. Charlie was born in New York and many schools there still serve peanut butter sandwiches at lunch! It was diffi cult to get the school environment changed to a nut-free environment because some parents

insisted that their kids could not change their diet, even though the children were willing to. We moved back to Toronto two years ago, and life at school is a little easi-er now, in part because of Sabrina’s Law. As he gets older, I will have to learn to let him venture out on his own. Gradually the re-sponsibility for checking that food is safe and the carrying of emergency medicine will transfer to him alone which is nerve-racking for me.

It isn’t always fairLiving this way is all he has ever known, and he accepts it, but some-times the unfairness of it really gets to him. Charlie was all set to go to a sleep away camp last summer. He had spent all winter planning for it. Ten days before he was to go, the camp or-ganizers called and said they could not accept him because of his aller-gies. He was very upset. I know it will stay with him for the rest of his

life, but we found a better camp in the end and he had a great summer.”Charlie: making the most of life

“I am anaphylactic to peanuts and tree nuts, and also allergic to shell-fi sh, legumes, lentils, peas and cats. I can pat cats, but I cannot put my face too close to them, but that’s OK, be-cause I have a dog at home. My friends are pretty good and it helps that four kids in my grade have nut allergies. The good thing is that because of the allergies, I understand food a lot bet-ter than many of my friends and I also read labels well. My mom has taught me to do that.

Always awareWe eat out a lot, about twice a week. We can’t eat at Chinese restaurants, but most Italian restaurants are fi ne, and so are steak places. I like steak and fries. My mom and dad are also teaching me

how to look at a menu quickly and pick out foods that would be OK for me. Every Halloween, I go trick-or-treating with my friends and get lots of candy. We bring it all home, and tip it out on the basement floor. I swap the candy that I can’t eat for those that I can. Oh, and I also wear an EpiPen when I go trick-or-treat-ing. Honestly, I don’t think about food too much. I know what I can and can’t do. There are three words that I would use to describe my-self: active, joyful and a risk-taker. I love sports and being outdoors. These activities and reading, Lego and my family make me happy. I’m a risk-taker, especially with skiing—I love being at the top of a steep slope, sucking up the fear and racing downhill.”

HoW We DiD it

IndranI nadarajah

[email protected]

READY FOR ANYTHING1. Charlie and his mom, Shelley.2. Charlie won’t let aller-gies mess with Halloween!PHOTO: PAUL STEWARD1

nonuts golden peabutterNoNuts Golden Peabutter is a de-licious spread made from a spe-cial variety of peas and Omega 3 rich canola oil. Peabutter is nu-tritious, peanut free, nut free and gluten free. It is excellent in school lunches as well as an in-gredient in cookies, squares and sauces.

Toll free phone : 1-800-961-2470Email : [email protected] : www.peabutter.ca

pRoDUct SHoWcaSe

Nonuts Golden Peabutter

nud fudnūd fūd (pronounced “nude food”) was created by a Holistic Nutrition-ist that was frustrated with the lack of healthy and delicious snacks avail-able.

We create organic, raw, vegan snacks free of preservatives, trans-fats, GMO’s, or anything artifi cial, using fresh produce, sprouted nuts, and seeds. and sweetened only with organic fruits. Free of common aller-gens such as dairy, soy, corn, wheat, and eggs, making them gluten-free and almost all are low glycemic so they are suitable for celiacs and diabetics.

[email protected]

pRoDUct SHoWcaSe

Nud Fud

Hain celestialFrom our garden to your kitchen! Fresh herbs, succulent seasonings and the fi nest organic ingredi-ents will bring a warm smiles to your family mealtimes. Choose heat and serve soup or use organic broth in your own creations. Im-agine soups and broths are all or-ganic, low fat, dairy free (even the creamy ones), do not contain any preservatives or artifi cial ingredi-ents, and they may also be low so-dium. And look for our new gluten free gravy. Imagine is found wher-ever natural and organic products are sold.

Visit hain-celestial.ca/

pRoDUct SHoWcaSe

Hain Celestial Imagine Low Sodium Garden Tomato Soup

A speciAl Advertising feAture by MediAplAnetA speciAl Advertising feAture by MediAplAnet october 2010 · 5

2

Sydney Proudfoot had just finished a trail mix bar at school when she began to feel really ill. “I knew I was having a reaction—my ton-gue felt numb and I felt very hot and sweaty,” she says.

The then grade nine student was sensible enough to seek adult help. She ended up being rushed to the emergency department in an ambu-lance, sirens blaring. That was four years ago. Today, Syd-ney, 17, knows that she is allergic to peanuts and all tree nuts. “I have al-ways had allergies—I was lactose in-tolerant as a baby. I am also allergic to dust mites, pollen, dust, dogs and cats.” Allergies have curtailed some parts of her life. She used to be an enthusi-astic horseback rider, but had to give it up when she developed an al-lergy to hay. “It’s tough, but you try to think about positive things. I am now trying triathlons and I’m get-ting good at them too.” She recently placed fi rst in the junior female category at a MultiSport Can-ada Triathlon, in Welland, Ontario.

The school environmentUnfortunately, her severe food aller-gies have contributed to a fraught re-lationship with her peers at school. The students joke about bringing peanuts to school and tell her that they’re too afraid of needles to help her use the EpiPen. “It is disappointing because it’s

very hard to get them to under-stand that severe food allergies can be life-threatening and are more than just a few sniffl es. It’s not like I have a choice in this,” she says. “But I keep talking to my classmates and reaching out to them, to try to explain that I am not over-reacting. Some days I do manage to make a connection.” Sydney always carries hand sani-tizer and hand wipes with her. “I never ever share food with any one, and I always bring an ex-tra-tasty lunch so that I am not tempted.”

Daily precautionsThe teenage years with increased independence and dealing with high school can be the most challen-ging period, says Kyle Dine, Youth Coordinator at Anaphylaxis Canada. Telling friends about allergies, carry-ing an auto-injector at all times, wearing MedicAlert identifi cation, and not taking risks with food are all important steps for a teen taking greater responsibility in managing their allergies, says Dine. Even though she does not have as

much support at school as she would like, Sydney has chosen to see her al-lergy problem as a blessing in dis-guise. “It’s opened my eyes to things that I would never have ordinarily tried.” Since her nut allergy diag-nosis, she has had three trips to the emergency room. Her hospital ex-periences have helped her decide to be a doctor and specialize in emer-gency medicine.

She has also become more determined and ambitious. “I want to do well in sports and at school. I don’t want the kids at school to know me as the girl with allergies, but as someone who excels.”

IndranI nadarajah

[email protected]

Why is it important for companies to introduce peanut free products?

1Nestlé Canada is committed to providing our most popu-lar chocolate bars in snack-

size formats that are produced in a peanut-free facility. Our facility where these products are made has been peanut-free for almost 20 years. We know that parents are concerned about peanut allergies either due to concerns about their own children or relatives or friends. Our products allow kids to enjoy a treat while their parents can feel confi dent that they were made in a peanut-free facility.

According to Nestlé research, two thirds of consumers believe peanut-free is an important consideration for Halloween treats. As well, we know that parents like to purchase foods they themselves loved eating as a child. Nestlé’s brands are long-time consumer favourites that have been enjoyed by kids and parents alike for over 50 years.

What steps should a company take to ensure their products are free of possible cross-contamination?

2At Nestlé, we have rigorous quality control processes in place to ensure our peanut-

free status. Firstly, there are no pea-nuts/nuts or peanut/nut-con-taining ingredients used or permit-ted in the facility, any time, any-where. We have extensive raw ma-terial, ingredient and fi nished prod-uct testing programs and conducts regular audits of the facility. Suppli-ers much assure us that their ma-terials have no potential for peanut contact before arriving at the facil-ity and we do extensive allergy-awareness training with employees. We have dedicated and certifi ed al-lergen control staff and established Good Manufacturing Processes.

With Halloween approaching what advice would you give to parents?

3Our advice to parents is to make safety a priority at Halloween. This should be a

fun evening for kids so parents can take some simple precautions when it comes to the treats collected to ensure it is also a safe event. We rec-ommend that parents always check their children’s candy before it is eaten. Reminding children to wait until they get home before digging into their bag is always a good idea.

tipS

CaThErInE O’BrIEn

director, corporate Affairs

nestlé canada inc.

Keep your candy safe: nestle’s tips

Sydney Proudfoot17-year-old student and athlete with severe allergies

SHoWcaSe

NEW OPPORTUNITIESSydney had to give up her favorite activites due to al-lergies, but finds success with triathlons.

not just a kid’s issue: Teens and allergies

LEARN TO NAVIGATE A MENU WHEN EATING OUT

A speciAl Advertising feAture by MediAplAnet

2TIP

Recipe

With rice flour and potato starch

Ingredients:■■ 3/4 cup shortening ■■ 2 eggs ■■ 1 cup canned pumpkin ■■ 1 tsp vanilla ■■ 1 cup sugar ■■ 1 1/2 tsp baking soda ■■ 1 1/2 tsp baking powder ■■ 1 tsp pumpkin pie spice

■■ 1 1/4 cup rice fl our ■■ 3/4 cup potato starch ■■ 3/4 cup raisins

Preparation:■■ Preheat oven to 325 degrees F. ■■ Cream together the shortening,

eggs, pumpkin, vanilla and sugar. Add baking soda, baking powder, pumpkin pie spice, rice fl our, potato starch and raisins. Mix well.

■■ Spoon out on cookie sheet (greased lightly) about the size of a walnut. Bake for about 15 minutes.

■■ This pumpkin cookie recipe is gluten-free.

Allergy Free cooking hits close to home for The Chef Upstairs JR Chef Program founder Lori Hel-ler whose daughter was diag-nosed with severe peanut aller-gies at 18 months. As a result the

hands on and interactive cook-ing experience she offers at the JR Chef Program is in a peanut and nut-free studio; they also provide ingredient substitutions depending on the allergies with-in each class.

Gluten-free pumpkin cookies

LOrI hELLEr

the chef upstairs

[email protected]

A speciAl Advertising feAture by MediAplAnet6 · october 2010

PROFessIOnAL InsIGHT

AVOIDING CROSS-CON-

TAMINATION IS PART OF LIVING GLUTEN-FREE

AVOIDING

3TIP

Tips for avoiding cross-contamination in your home:

■■ Invest in a new toaster for glu-ten-free toast: washing the toaster or dividing a four-slot toaster into the “gluten” and “gluten-free” sides will not eliminate contamination with bread crumbs.

■■ Label your name on any jars or containers that may be shared by others: butter or margarine, pea-nut/nut/seed butter jars, jars of jam, jelly, fruit butters or honey. Al-so consider purchasing products in squeeze bottles.

■■ Clean the counters: before start-ing meal preparation, or when-ever you prepare you own snacks or meals, make sure you clean the counters to avoid the risk of con-taminating your food with an-other member of your household who might have left crumbs of bread, crackers or cookies on that counter.

■■ Use a separate mesh colander for straining your gluten-free pasta: It is often diffi cult to wash out small pieces of regular pasta if the colan-der is used for both regular and glu-ten-free pasta.

■■ Keep a separate cutting board for foods containing gluten.

■■ Replace or line baking ware, particularly the metal kind, with parchment paper.Hidden sources of gluten:

■■ Modifi ed food starch: the source of starch may be from wheat, soy, corn and potato. When the source of starch is not identifi ed, check with the manufacturer. Modifi ed food starch from wheat is also a source.

■■ Hydrolyzed vegetable protein: the source of vegetable protein may be from wheat, soy or corn. When the source is not identifi ed, check with the manufacturer. Hydrolyzed vegetable protein from wheat is also a source.

■■ Seasonings: seasoning mixes may contain wheat flour, wheat starch or barley malt.

Alexandra AncamHSc. RD, author, complete gluten-Free Diet and nutrition guide

Staying glUten-FRee

Living and thriving on a gluten-free diet

For some, Celiac Disease might seem like a big hassle and just another in-convenience in one’s life. Not to me. Being an elite athlete living with CD—although an inconvenience at times—has actually been a bene-fi t. I am a competitive cross country skier currently living and training in Thunder Bay. I am racing for the Cross Country Canada-governed Na-tional Development Center in Thun-der Bay, which is one of four across our nation. I was born in Whitby, On-tario in 1990 and eventually moved to the small town of Marathon, On-tario on the top of Lake Superior.

Once I realized how passionate I was about skiing, I decided to take my ski career more seriously and moved to Thunder Bay to train professionally.

Being an athlete with Celi-ac Disease isn’t as hard as people think it is. Actually I think its eas-ier! Why? Because eating gluten-free enables me to eat healthier. I know that this more positively impacts my skiing. Any person can follow the Gluten Free (GF) diet, and, in fact, many athletes are choosing to do just that. Follow-ing the GF diet stops the inflow of useless carbohydrates like pizza, baking, sugary cereals and much more. Some people eat GF tempor-arily as a means of cleansing out their system—and I do that every day. I’ll admit, its not always fun while on a ski trip as I watch my teammates order delicious look-ing meals that I cannot have. But really, I’m eating my own kind of

delicious—usually something like fish and rice or steak and potatoes.

If you have been recently diag-nosed and are struggling with all the changes, do what I do. First, take a breather—everything will work out. Secondly, do some re-search into where your local GF providers are. All of the dishes you normally eat can be replaced by something equal or better. For example my ultimate pre-race meal is oats with honey, yogurt, fruit and a slice of bread with butter. My GF oats are provided by Cream Hill Estates Pure Rolled Oats. I make my own bread but GF frozen bread is often found at the nearest supermarket or specialty store. In the end, if you strictly follow your diet, there is no reason why you can’t be the best in your sport. Hav-ing CD has made me healthier, has opened a new world of sponsorships and most of all I’m well on my way to reach my Olympic goals.

■■ Question: How does a com-petitive athlete not only live with celiac disease, but thrive?

■■ Answer: He uses it as added incentive to maintain the clean, healthy diet required of athletes.

SHoWcaSe

Dudley Coultercompetitive skiier

A speciAl Advertising feAture by MediAplAnetA speciAl Advertising feAture by MediAplAnet october 2010 · 7

news

Twenty years ago, pizze-ria Il Fornello developed a pizza crust with spelt flour, which they advertised as gluten-free

However, they soon discovered that wasn’t the case. “When we found out spelt isn’t gluten-free, we felt badly that we had been mistaken and so researched more and found a rice crust,” says Ian Sorbie, Il For-nello president. Their gluten-free pizza options have gone through a few permutations since then, but Il Fornello now works with a local gluten-free baker for their pizza crust and it is something they are happy with, he adds.

The restaurant also offers gluten-free pasta on their menu. “Custom-ers love the flexibility of being able to order pretty much the complete menu,” says Sorbie.

Celiac confusion?Il Fornello’s well-intentioned

mistake then merely highlights the fog that continues to surround this disease. For starters, celiac disease is not an allergy, but an auto-immune disorder, explains the Canadian Celiac Association (CCA). This causes gluten to damage the absorptive surface of the small intestine, resulting in the body’s inability to absorb nutrients like protein, fat and carbohydrates.

Symptoms can vary from anemia, chronic diarrhea, weight loss and cramps to no symptoms at all. De-pression is also a symptom among

celiac sufferers. Although one may have no obvious symptoms, dam-age to the intestinal lining may still occur, the CCA said.

Statistics are not readily avail-able, but it is estimated that 1 in 133 people in Canada are affected by ce-liac disease. Yet only three percent are diagnosed—and according to a recent CCA survey, this takes an average of 12 years. The condition seems to affect more women than men.

Forgoing glutenGluten is a protein found in wheat, rye, triticale (a hybrid of wheat and rye) and barley. It is the gluten in these flours that helps bread and other baked goods bind and pre-vents crumbling. Gluten is widely used in many processed and pack-aged foods.

Celiac disease has no cure but it is treated by following the gluten-free diet, for life. As such they must be careful to read all ingredient labels on prepared foods including soups, luncheon meats, sausages and even soy sauce.

Eating Out Ellen Bayens was diagnosed with

celiac disease at the age of 45. Like 85 percent of celiac sufferers, she found eating out challenging and no longer enjoyable.

“This is why I set out to compile a list of celiac-friendly restaurants on my website, The Celiac Scene,” she says. Thai, Mexican and East Indian foods are generally safer for

celiac sufferers to enjoy. Celiac disease is enjoying media

attention as celebrities and the health conscious adopt the gluten-free diet. “The increased awareness has been a double-edged sword,” acknowledges Bayens. “The gluten-free diet as a lifestyle choice does not always help our cause.”

While more restaurants are rec-ognizing that including gluten-free specific menus is good for business, celiacs must be vigilant that a par-ticular restaurant has the gluten-free awareness and precautions in place. Bayens has published a list of questions on her website to help celiacs determine whether a res-taurant can meet their needs.

Restaurant chains like Boston Pizza, Pizza Pizza and Pizza Nova are also becoming much more knowledgeable about the stringent requirements of the gluten-free diet. After extensive research, Pizza Nova introduced its gluten-free multigrain pizza crust in November 2008. Preparation surfaces for the gluten-free pizza are kept separate and there are designated paddles, ladles, and cutters for the pizzas.

According to Stephanie Ange-lone, Pizza Nova Vice President of Sales &Marketing, demand for their gluten free multigrain crust increased 46 percent over the same period the previous year.

Recognizing celiac SymptomS

Waiting 11 years befo-re receiving a diagnosis shouldn’t happen, especial-ly when reliable tests exist—but that’s currently the aver-age wait time in Canada.

From the onset of symptoms to a final diagnosis, most patients saw a variety of doctors and specialists and received a number of misdiag-noses before they finally found out what was making them so ill. Some were literally on their deathbed in hospital before the right blood test was ordered.

The problem seems to stem from the fact that many doctors were taught that celiac disease is rare but nothing could be farther from the truth. Research puts the prevalence of celiac disease at close to one per-cent in North America.

Celiac disease is a genetic auto-immune disease. It is also associated with other autoimmune conditions, such as Type 1 diabetes, liver and thy-roid conditions. Osteoporosis and lymphoma are potential outcomes of untreated celiac disease or celiac dis-ease discovered late in life. There is no cure, but there is an effective diet-ary treatment that allows the dam-aged lining of the small intestine to heal.

So, what are the symptoms that should make your doctor consid-er celiac disease? There are many—when you consider that these may appear singly or together, you begin to understand why doctors are often at a loss:

■■ Anemia■■ Vitamin and folate deficiencies■■ Abdominal pain, bloating, gas,

cramping, vomiting■■ Recurring or persistent diarrhea■■ Constipation

■■ Extreme weakness■■ Chronic fatigue■■ Unintended weight loss■■ Lactose intolerance■■ Itchy skin rash■■ Elevated liver enzymes■■ Canker sores■■ Easy bruising■■ Bone or joint pain■■ Swelling of hands and/or feet■■ Menstrual irregularities■■ Male and female infertility■■ Recurrent miscarriages■■ Migraine■■ Depression■■ Neurological symptoms such as

ataxia

In addition, children can also dis-play irritability, delayed growth or short stature, delayed puberty and dental enamel abnormalities.

If you recognize yourself some-where in this list, don’t just assume that stress and a hectic lifestyle are responsible. Your doctor can diag-nose celiac disease by starting with a blood screening test, followed by an endoscopy and biopsy performed by a gastroenterologist. If your doc-tor won’t consider celiac disease de-spite your symptoms, or you don’t want to pay around $100 or more for the lab test (Ontario is the only province where the test is not cov-ered), you can purchase a home celi-ac blood screening test, approved by Health Canada, and take the result to your doctor. Do not skip this last step as the blood test alone does not pro-vide a definitive diagnosis.

Don’t put yourself on a gluten-free diet without a confirmed diagnosis. You will never be able to get a prop-er diagnosis without going back on gluten for a prolonged period of time and that could make you very ill, all over again.IndranI nadarajah

[email protected]

Dining out with Celiac Disease

courtesy of canadian celiac Association