All posts by : Nadine Grzeskowiak, RN

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse’s Memoir of Celiac Disease from Missed Diagnosis to Food and Heal

Why No Dairy on a Gluten-Free Diet? EP068

If you’re just getting used to eliminating gluten from your diet, it may feel like a burden to remove dairy as well—especially if you’re a fan of comfort foods like cheese and ice cream. Why exactly do many practitioners recommend a gluten- AND dairy-free diet to patients diagnosed with celiac disease and non-celiac gluten sensitivity?

The Gluten Free RN is walking us through the similarities between gliadin and casein, explaining how the proteins found in gluten, milk and cheese impact our brains. She discusses how Marsh 1 damage from celiac disease leads to an inability to break down the sugar in milk and why we crave the very foods that are making us sick.

Nadine shares the story of a young man with autism whose health improved once his family went gluten-free, describing the well-documented gut-brain connection and how the right high-fat diet can repair the neurological system. Listen in for the Gluten Free RN’s insight around dairy replacement options and get empowered to reclaim your health with a gluten- and diary-free diet!

What’s Discussed:

The similarities between the gluten and casein proteins

Molecularly very similar, bodies read as toxins
Both capable of crossing blood-brain barrier

How the casein protein impacts the brain

Causes inflammation, hypoxia (decrease flow of oxygen)
Brain fog, anxiety, depression, irritability and fatigue

The effect of Marsh 1 damage due to celiac disease

Microvilli damaged or destroyed
Can’t produce enzymes that break down sugar in milk

How gluten and casein proteins act as exorphins

Bind with opium receptors in brain
Crave foods that make us sick

Nadine’s recommendations for dairy replacements

Coconut, hemp, almond or hazelnut milk
Kite Hill and NuCulture cheese options

How a gluten-free diet helped a young man with autism

More interaction with family, fewer GI issues
High-fat diet repairs neurological system

The story of Dr. Terry Wahls

Diagnosed with MS, healed on gluten-free diet

Resources:

Dr. Terry Wahls’ TED Talk

The Wahls Protocol by Dr. Terry Wahls

Dr. Terry Wahls’ Website

Connect with Nadine:

Dough Nation: A Nurse’s Memoir of Celiac Disease from Missed Diagnosis to Food and Heal

Books by Nadine:

Indigenous Populations, Celiac Disease and NCGS EP067

‘Globally, indigenous peoples suffer from poorer health, are more likely to experience disability and reduced quality of life, and ultimately die younger than their non-indigenous counterparts.’

A UN Report on the health of indigenous peoples points to a significant problem, but the question is WHY? Why are native populations more prone to autoimmune disorders and type 1 diabetes? Why do they have a higher incidence of alcoholism and drug addiction? And why the lower life expectancy?

The Gluten Free RN is exploring the role of food in health outcomes for indigenous populations around the world. She begins with an explanation of the dietary differences between hunter-gatherer and agricultural societies, discussing how native populations were exposed to the gluten in grains only when European conquerors came to occupy their lands.

Nadine shares her challenge in finding information about indigenous populations and celiac disease, explaining why further study is necessary. She speaks to the highly processed nature of the commodity foods provided to Native Americans in the US and the shortcomings of Canada’s Food Guide when it comes to the health of First Nations people. Listen in and learn the significance of educating indigenous populations around celiac disease and non-celiac gluten sensitivity, empowering those groups to make choices that will improve their health and quality of life!

What’s Discussed:

The global indigenous population

370M in 70-plus countries
Rich diversity of cultures

The health status of indigenous populations

Higher incidence of autoimmune disorders, T1D
Higher prevalence of addictive disorders, cardiovascular disease
Lower life expectancy, increased morbidity/mortality

Why indigenous populations have more health issues

Access to health care, isolation and lifestyle
Food (hunter-gatherer vs. agricultural society)

The lack of information around indigenous populations and celiac disease

Very few studies available

The impact of grains on the native population

Significant change in health care outcomes, quality of life

The prevalence of celiac disease in indigenous populations

At least 1%, likely 3% or higher
No way to know without mass screening

Why eating healthy is a challenge for the indigenous population

Food scarcity, desserts
Reliance on commodity foods provided by government

The conclusions of the Prairie Nymph blog on Canada’s Food Guide

Based on diet of European origins, doesn’t mention celiac disease
Ignores health benefits of traditional diet for First Nations people

Why it’s important to educate indigenous people around celiac disease

Empower to make food choices with better health outcomes

What & Where I Eat: A Q&A on Re-Find Health

I recently had the pleasure of answering a few questions on Re-Find Health about how I handle eating out at restaurants as well as what I eat at home. Here are a few of the questions (and answers) but be sure to click through to the original article on Re-Find Health to read them all.

CA: Do you put much thought into where you eat out? Or do you simply go anywhere and try to make do with what’s on the menu?

NG: I put a fair amount of thought into where we can safely eat out. Unfortunately, I learned quickly and completely that while many eateries say they can provide safe, gluten free food, often that is not the case. Pizzerias that offer gluten free pizzas but they toss the dough into the air are contaminating everything in that restaurant, even the salads. Unless a restaurant has a separate designated gluten free kitchen, the risk of contamination with gluten is enormous. Corporations, fast food joints and restaurants like to jump on the gluten free bandwagon because they understand that many people are interested in eating gluten free, not just the people diagnosed with celiac disease and this is impacting their profits. They offer gluten free options without realizing or taking into account how to prevent contamination and cross-contamination. Additionally, if I am going out to eat with my family, friends or for business, I look for a restaurant that is safe for me with good, quality food that we all can enjoy. I always look for and ideally choose restaurants that are designated gluten free, if that is an option.

CA: Most memorable restaurant meal in (or near) Salem?

NG: I have to confess, my most memorable gluten free restaurant meals have taken place at Eats and Treats Cafe in Philomath, Oregon. Several years ago, when Katy McHenry was employed at Gluten Free RN, we held a community meeting with the intention of having someone (but not us) open up a safe restaurant in our area. Katy’s Dad showed up to take notes for the meeting. It wasn’t long after that initial meeting that Katy’s Mom and Dad opened up Eats and Treats Cafe. The very first meal at Eats and Treats Cafe several years ago was extremely exciting and memorable, as has been every meal since. People, quite literally, travel great distances just to experience the incredible 100% gluten free barbecue, baked goods and other tasty foods on the extensive menu. Whenever Katy is back in town for a visit, we happily, proudly and safely eat out at Eats and Treats Cafe.

CA: Most memorable restaurant meal outside of Salem?

NG: My most favorite and memorable restaurant meal occurred in the Mission District of San Francisco, California at Pica Pica which serves 100% gluten free Venezuelan food. My mouth is salivating just thinking about their great food. The first time we ate there, we just kept ordering more and more food because we could not get enough of the incredible flavors. The arepa are handmade with either white or yellow corn fresh, every day. The meat options are spicy and tasty beyond belief. They also offer yuca fries on the menu. The food is fresh, tasty, gluten free, not expensive and amazingly fabulous. Thankfully, I find myself traveling to San Francisco frequently and always make sure at least one trip to Pica Pica is on the travel agenda.

CA: For people with special diets, how do you suggest they talk with restaurant staff in order to get what they need?

NG: I recommend that people do their homework first by asking people they trust for recommendations for safe restaurants. There are a few restaurants that I recommend that are not 100% gluten free but my criteria is pretty strict. People need to be very clear in communicating their needs to the restaurant staff. It might help to call ahead and ask the important questions before you show up. One app that we rely on when we are traveling is Find Me Gluten Free. We use that as a starting point but continue to ask questions until we are relatively certain the place is safe. Ask as many questions as you need to in order to get the information you need to eat safely. Whenever your food is delivered to your table, always ask the person presenting it to you, “Is this food gluten free?”. It is amazing how many times that simple question at the point of delivery has prompted that server to say that ‘well, no, it isn’t gluten free’. There are times restaurant staff have assured me that food is gluten free, but when I test to with my Nima Sensor or EZ Gluten test strips, it tests positive for gluten. If you really want to have another way to feel safer eating out, invest in either of these options and test the food at your table. You have to be prepared to not eat the food if it comes up positive for gluten.

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How to Easily Go Gluten-Free or Paleo EP066

‘It’s too hard.’ ‘It’s too expensive.’ ‘It’s time-consuming.’ ‘My family won’t support me.’

There are lots of excuses why you can’t go gluten-free or Paleo, but the Gluten Free RN argues that if it’s hard, you’re doing it wrong. And today, she’s prepared to explain how to easily go gluten-free or Paleo and either maintain or regain your health.

Nadine begins with a discussion of the connection between food and pain or discomfort. She explains how the processed, non-food that most people consume causes damage that prevents us from absorbing the nutrients our bodies need. She offers insight around where to go for gluten-free, organic food and how to jump-start a gluten-free or Paleo diet.

The Gluten Free RN provides tips on taking control of your food choices, trying new foods, and gluten-free cooking—minus the cheap fillers. She also outlines a shopping list for nutrient-dense foods that will heal your leaky gut and feed your neurologic system. Listen in and learn the easy way to go gluten-free or Paleo and optimize your health!

What’s Discussed:

The value in recognizing how you feel

Shouldn’t have pain, discomfort daily
Underlying cause traced back to food

Nadine’s response to excuses for not going gluten-free

No more expensive, must buy food anyway
Food is medicine, good choices can improve health

How to avoid non-food with empty calories

Stay away from soda, sugary coffees
Pass up highly processed and fast non-food

The difference between organic and conventional food

Conventional food—herbicides, pesticides, genetically modified
Roundup causes leaky gut, even in absence of celiac disease

Nadine’s suggestions around where to go for gluten-free food

Grocery stores that cater to gluten-free population
Local food co-ops, farmers

Nadine’s advice for going gluten-free or Paleo

Try new foods in the produce section
Learn to pack simple breakfast, lunch and dinner
Consider putting in garden
Get re-educated, take control of food choices
Replace cutting boards, toasters, etc.

How to get started on a gluten-free or Paleo diet

Whole30 Program (eliminate grains, sugar and dairy)

Nadine’s shopping list for a gluten-free diet

Fruits and vegetables
Nuts and seeds
Meat, fish and eggs

Resources:

Connect with Nadine:

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse’s Memoir of Celiac Disease from Missed Diagnosis to Food and Heal

Russia and Celiac Disease EP065

As stories about Russia continue to dominate the news cycle, you are probably familiar with the recent sanctions against the country, Vladimir Putin’s reelection, and even the expulsion of Russian diplomats from the EU and US. But what do you know about celiac disease in Russia?

The Gluten Free RN is taking a closer look at the limited information about celiac disease in Russia, giving us an overview of the country’s size and population and the likely number of celiac cases based on the global tendency. She discusses the thriving wheat production industry in Russia as well as the gluten-containing traditional Russian diet.

Nadine walks us through a presentation created by Dr. Elena Roslavtseva at the Scientific Center for Children’s Health in Moscow, sharing how the diagnoses of celiac disease changed from the 1970’s through the 2000’s, the inconsistencies with testing for celiac disease around the nation, and the challenges of maintaining a gluten-free diet in Russia. Listen in as the Gluten Free RN covers the Journal of Immunology Research’s overview of celiac disease in Russia, explaining why the reported frequency probably doesn’t reflect the true prevalence and the necessity of a mass screening.

What’s Discussed:

General information about the country of Russia

Population of 144.3M
Dual nation state, 185 ethnic groups
Largest country by land mass

Russia’s thriving wheat production industry

Very high, exported to Middle East and Africa
Ban on genetically modified wheat

The first diagnoses of celiac disease in Russia

Late 1970’s—1980’s
Cases of severe malabsorption
No gluten-free foods available

How celiac diagnoses changed in the 2000’s

Diagnosed more often, well-known in most regions
Research done in many universities, med centers

The Eastern European countries that have done mass screenings

Romania, Slovakia, Slovenia, Estonia

Why the data around celiac disease in Russia is unreliable

Variation in how practitioners test for celiac disease
Belarus—HLA-typing not available in most cases
Latvia—mandatory screening for patients with IDDM and AIT

The problems associated with celiac disease in Russia

Unreliable data in absence of mass screening
Gluten-containing traditional Russian food

The overview presented in the Journal of Immunology Research

Diagnostic tools for celiac disease in Russia vary significantly
Reported frequency of 0.2-0.6%, but real rate unknown

Resources:

‘Coeliac Disease and Gluten Related Disorders in Russia and Former Soviet Republics’ by Dr. Elena Roslavtseva

‘Overview of Celiac Disease in Russia: Regional Data and Estimated Prevalence’ in the Journal of Immunology Research

‘Russia, Argentina and Canada Displace US, Europe in Global Wheat Trade’ in agriCENSUS

‘Russian Wheat Sales Expand Global Reach with Surge in Sudan’ in Bloomberg

‘Russia’s Wheat Industry: Implications for Australia’ from the Australian Export Grains Innovation Centre

‘Growing Importance of Russian Milling Wheat Worldwide’ from Solaris Commodities

‘How an Oil Giant (Russia) Came to Dominate Wheat’ in Bloomberg

‘Celiac Disease in Russia and the Former Soviet Republics’ in The Celiac Scene

Connect with Nadine:

Melodies of the Danube Gluten-Free Cruise with Nadine

Books by Nadine:

Dough Nation: A Nurse’s Memoir of Celiac Disease from Missed Diagnosis to Food and Heal

Review of Columbia University Celiac Disease Conference 2018 EP064

When faced with new information, it’s important to consider the source. Stop for a moment and examine whether the material is coming from someone with YOUR best interests at heart. The Gluten Free RN has just returned from the Columbia University Celiac Disease Conference, and she is breaking down the information presented to determine what’s useful—and what might be tainted by the pharmaceutical or food industry agenda.

Nadine begins with a workshop led by General Mills that offered some questionable information about how grains are processed at their factories and a talk led by University of Chicago faculty on the topic of a gluten challenge. She also speaks to the differences between celiac management in the US and countries with universal healthcare like Italy and Australia.

Nadine covers new testing that detects gluten exposure in stool or urine and what that reveals about the systemic nature of gluten damage as well as her take on practitioners who perpetuate the myth that grains are necessary and nutritious. Listen in for the Gluten Free RN’s insight around pharmaceutical treatments for celiac disease and the danger in volunteering for studies backed by drug companies.

What’s Discussed:

The two programs available at Colombia’s 2018 conference

Clinical (nurses, RDs and laypeople)
International (doctors, scientists, industry and VC)

How celiac disease is managed in Italy

Presentation by Dr. Carolina Ciacci
Law mandates gluten-free options

Nadine’s frustration with the General Mills presentation

Major sponsor of conference
Claim to separate grains at factory

Nadine’s take on gluten-free Cheerios

Should be avoided, not truly gluten-free

Nadine’s confusion around Dr. Bana Jabri’s comments

Wouldn’t put ‘potential celiac patient’ on gluten-containing diet
Did not include patients with positive antibody test but negative biopsy

Why the biopsy for celiac disease is problematic

Only tests one foot into duodenum
GI tract is 30 feet in length

Nadine’s insight on a gluten-free challenge

No possible benefit for patient
Unnecessary, unethical

The systemic nature of gluten damage

New tests detect gluten exposure in stool, urine
Urine test indicates passage through every system

Nadine’s stance on pharmaceutical treatments for celiac disease

No pill or vaccine will treat or cure CD
Harmful to people in studies

The myth that grains are necessary and nutritious

Practitioners who perpetuate are ‘toeing company line’

Why it’s important to understand the source of your information

Should be untainted by pharmaceutical money, agenda

Australia’s requirements for gluten-free food

Standard of less than 3 ppm

Resources:

Celiac Symposium Program

Connect with Nadine:

Dough Nation: A Nurse’s Memoir of Celiac Disease from Missed Diagnosis to Food and Heal

Books by Nadine:

Poland and Celiac Disease EP063

To pierogi or not to pierogi…

If you have celiac disease, there is no question that you should avoid anything made with flour or grains, no matter how delicious the dish may be. Although the Gluten Free RN has fond memories of her Polish grandmothers making traditional pastries, she contends that you don’t have to eat customary Polish food to celebrate your Polish heritage.

In preparation for her upcoming trip to Warsaw in July, Nadine is taking a closer look at celiac disease in Poland. She discusses a 2009 study assessing the prevalence of celiac disease in Polish children, highlighting the asymptomatic and oligosymptomatic nature of the disease and explaining her own false negative test. Listen in for the Gluten Free RN’s insight around preparing for a trip to Poland, including research on the available gluten-free food and adult beverages!

What’s Discussed:

Why Nadine is concerned about her upcoming trip to Poland

Flour, grains used in cooking and baking

Nadine’s Polish heritage

Fond memories of grandmothers making pierogi, pastries

The 2009 study of celiac disease in Poland

Assessed prevalence in children, only screened for IgA EmA, IgG EmA
3,235 children in Bydgoszcz tested, 25 identified (seven with Marsh III)
Predominantly asymptomatic or oligosymptomatic

Nadine’s genetic predisposition for celiac disease

HLA-DQ2.5 homozygous

How Nadine is preparing for travel in Poland

Aware of Polish translations for gluten-free, celiac (bezglutenowe, trzewny)
Take ‘rescue food’ for emergencies

The prevalence of celiac disease in Poland

1:100 (matches worldwide estimate)

The gluten-free alcoholic beverages available in Poland

Potato vodka, honey mead

Nadine’s caution against eating bread in Europe

Wheat, grain causes damage regardless of location

The overlap between autoimmune and celiac disease

CD is grossly unrecognized, underdiagnosed

Nadine’s suggested diet for celiac patients

Meat, fish and eggs
Nuts and seeds
Fruits and vegetables

Resources:

NIH Consensus Development Conference on Celiac Disease

‘Screening for Celiac Disease in Poland’ in the Medical Science Monitor

Gluten-Free Globetrotter Blog on Poland

Gluten-Free Travel in Poland—Coeliac Youth of Europe

Poland Travel Guide—Coeliac UK

‘Graves’ Disease, Celiac Disease and Liver Function Abnormalities in a Patient—Clinical Manifestation and Diagnostic Difficulties’ in ACTA Biochimica Polonica

‘Neuropsychiatric Symptoms and Celiac Disease’ in Neuropsychiatric Disease and Treatment

‘Evaluation of HLA-DQ2/DQ8 Genotype in Patients with Celiac Disease Hospitalised in 2012 at the Department of Paediatrics’ in Przeglad Gastroenterologiczny

For Visitors with Coeliac Disease—Polskie Stowarzyszenie Osob z Celiakia i na Diecie Bezglutenowej

Connect with Nadine: