Once you’ve explained gluten-free labels, it’s important to explain good nutrition in general to your celiac patients and their parents. Ms. Cureton recommends using the new dietary guidelines that can be found at www.myplate.gov to help patients understand the other components of a healthy diet.
"Weight gain is a huge issue in this group. They have been malabsorbing calories for however long they were undiagnosed. Now they’re diagnosed, and the gut heals and they absorb those calories," she said.
For example, a patient might have been eating 3,000 calories a day and maintaining their weight because they were only absorbing half of that. "They need to look at their portion sizes. Just because it says gluten-free doesn’t mean that you get to eat a whole box of brownies."
Eating out at restaurants is another really important topic to go over because this is such a large part of American culture. "We like to eat out. Somebody with celiac disease is no different. They like eating out as well. However, this becomes quite a challenge ... people with celiac disease feel left out."
She suggested these simple tools for eating out:
• Ask if there is a gluten-free menu (or check the menu online).
• Tell the server that you have a "food allergy" to wheat (technically not correct, but people understand this term).
• Carry an ingredient card as a cheat sheet.
• Be very specific when ordering (no croutons, no meat marinades).
• Order simple dishes.
• Bring your own sauces or foods.
• Send back unsafe foods (don’t pick the croutons off your salad).
• Tip well, if you’ve been served well.
Some helpful resources include www.eatright.org, www.glutenfreediet.ca, and www.glutenfreedietitian.com.
Ms. Cureton reported that she had no relevant financial relationships.