O F F I CI A L M AGAZINE OF COELIAC NEW ZEAL AN D
| Gluten-free living
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AUTUMN 2021
AFTERNOON TEA AT THE PARK HYATT
MEET OUR PATRON BOB ANDERSON
STAYING OPTIMISTIC IN THE FACE OF A
OELIAC Cdiagnosis
HOW TO RECOVER FROM GLUTEN EXPOSURE
HEALTHY GLUTEN FREE FOOD CHOICES
NOTE This is a R E D A C T E D V E R S I O N of the official CNZ magazine – Coeliac Link.
HIGH TEA ideas
New gluten-free products * Gluten Free Recipes * CNZ Conference confirmed
LI V I N G COELIAC SAFE C O N FE R E N C E
LIFE CENTRAL, MT EDEN A U C K L A N D, S AT U R DAY NOVEMBER 13, 2021
G L UT E N F R E E FOR LI FE
B O O K YO U R TI C KETS TODAY! MEET OUR AMBASSADORS MAKE CONNECTIONS * LATEST RESEARCH BE INSPIRED INTERACTIVE SETTINGS * * MEDICAL EXPERT GUEST SPEAKERS A BETTER LIFE
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Free goody bag!
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coeliac.org.nz
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Support to be coeliac safe and gluten free for life.
Book online: coeliac.org.nz/conference-2021 Prices incl GST. Students aged 13-21: $45 (member), $90 (non-member). Limited early bird tickets adult: $75 (member), $150 (non-member). Full price ticket costs available on website after early bird tickets sold out. Gluten free lunch and a goody bag filled with treats included.
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O U R V I S I O N | That people with coeliac disease live healthy lives every day. ____
Contact Coeliac New Zealand PO Box 9734 Newmarket, Auckland 1149 Email admin@coeliac.org.nz Website coeliac.org.nz
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F EATU R E S
How age impacts diagnosis and treatment.............................. 12
E C N IE IL S E
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The varying ways coeliac disease presents in people of different ages. Building resilience........................ 14 Y
How to stay optimistic.
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Medical Advisory Panel Professor Andrew Day MB CHB MD FRACP AGAF; Dr Kamran Rostami MP PhD Consultant Physician and Gastroenterologist; Dr Kristin Kenrick Senior Lecturer University of Otago; Professor Clare Wall, University of Auckland Faculty of Medical and Health Sciences; Dr Jonathan Bishop MB ChB MRCPCH CCT (UK) Paeds FRACP Paediatric Gastroenterologist and Hepatologist; Dr Richard H Steele MbChb FRCPA FRACP Clinical Immunologist and Immunopathologist; and New Zealand Registered Dietitian’s: Anna Richards, Sylvia North, Julie Leeper and Margaret Thorsen. Honorary Patron Dr Simon Chin MBChB Dip Obst DCH 1985 FRACP Patron Professor Bob Anderson MBChB, BMedSc, PhD FRACP
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Board Dawn Folkard, Brett Thorburn, Corinne Cameron, Kirsty Vercoe, Max Smitheram, Jenny Kuttel, Rosie Jerram.
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Editor and advertising enquiries Dana Alexander +64 9 414 7467 dana@coeliac.org.nz ____
Art Director Sue Pepper marketing@coeliac.org.nz
Disclaimer: All reasonable attempts are made to ensure the accuracy of the content of this magazine. The contents are not independently checked for medical accuracy and are not necessarily endorsed by Coeliac New Zealand. We welcome submissions; however, please note that articles may be edited.
'S E H T O
Accepting a life-long disease. Finding a new tune on life............ 18
Meet filmmaker Hayley Rapton. Getting back on track................... 22
R EGU LAR S
Recovering after accidental exposure to gluten.
A note from the General Manager ��������� 4 A note from the Editor ............................. 5 News ....................................................... 6 Thumbs up .............................................. 6 Dining Out Programme ........................... 9
An afternoon tea affair................. 28
Find out what inspires Zachariah Mead's and Sam Heaven's gluten-free dishes. Coeliac New Zealand Incorporated is a registered charity. Our Charities Commission Registration Number is CC27810.
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Life after a coeliac diagnosis......... 16 M
Summer issue deadlines Booking 1 October Material deadline 1 November Magazine in mailbox 15 November
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GF meal inspiration ........................ 30 GF bites and delights ...................... 32 Recipe from Jo Seagar ..................... 35 Recipe from Park Hyatt .................. 36
R EGI O N AL
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Regulars / C N Z B O A R D
MESSAGE from the GENERAL MANAGER D A N A , F R E D and I were delighted to welcome Lisa Jury to the team at the end of January as our Health Promotion Manager. Lisa works 20 hours a week and has developed her work plan for the next 12 months towards our health promotion objectives. The key things we will be working towards include providing support, education, and advocacy for those with coeliac disease throughout New Zealand. We want you to feel empowered to be your own advocate, especially with family, school, and workplaces. Lisa tells you more about this in an article on Page 11.. Our annual Coeliac Awareness Week campaign in June provided the opportunity to broaden our impact in the community, and to celebrate life with coeliac disease. This year we have looked to educate Kiwis that coeliac disease is a serious auto-immune condition and that a 100% gluten-free diet is the first-line, lifelong treatment – it is not just a trend. We’ve also brought more attention to the ‘gluten free’ label and what it means, to help remove the stigma around the condition and to demonstrate that eating gluten free for life is mandatory – there’s no choice. We held our annual general meeting via Zoom on the 26th June and this provided an opportunity for members to not only hear our report on the year to March 31st 2021 but also to ask health related questions to our Medical
Advisory Panel and to hear from our guest speaker Brent Martin, executive chef for Park Hyatt. A recording of the MAP’s Q&A and Brent’s presentation at the AGM is available on our Youtube channel. Planning is well underway for our Conference on Saturday 13th November, at Life Central Auckland. The day will include a preevent breakfast seminar & master class for health professionals. There will be dual presentations for both adults and students aged 13-21. We will be bringing together inspirational healthcare and community educators in both guest speaker and interactive settings; and there will be lots of time for networking and kōrero. Early Bird tickets are now available and there is a 50% discount for members. Also, if you join Coeliac New Zealand until the 1st September you will receive $20 off your joining fee. It's very worthwhile helping CNZ to support those with coeliac disease so if you've ever thought about joining, now's the time!
WE WANT YOU TO FEEL EMPOWERED TO BE YOUR OW N ADV O CATE, E S P E C I A L LY W I T H F A M I LY, SCHOOL AND WORKPLACES
MEET THE
TEAM
B O A R D (Clockwise from top) Dawn Folkard (Chair), Corinne Cameron, Jenny Kuttel, Kirsty Vercoe, Max Smitheram Rosie Jerram, and Brett Thorburn (Vice-chair).
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Nga mihi
WENDY BREMNER General Manager
DA N A’ S
Welcome! If you are feeling like the DIAGNOSIS of coeliac disease has got the better of you, YOU ARE NOT ALONE!
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journey is inspiring. This time we hear from a range of people diagnosed across very different life stages and see how they have learnt to cope and adjust to their new normal. Sometimes just by acknowledging to yourself that what you or your child are feeling and experiencing is okay, is all the reassurance you need. Be sure to check out and share the short film ‘Glutened’ produced by fellow coeliac and filmmaker Hayley Repton based in Manchester, UK (page 18) for an insight into the emotional underbelly of life as a coeliac! We would also like to warmly acknowledge our industry supporters and Ambassadors for supporting Coeliac Awareness Week 2021 which took place from June 7-13, and thank Countdown, Kellogg’s, FreshLife and Bakels for their generous contribution. ____
EEPING
healthy as a coeliac is not always as straightforward as simply adapting to a gluten free diet. It’s a large adjustment to have to think so deeply about food and eating out. But as many people with coeliac disease know, it always gets better with time. Your volunteer coordinator and the wider coeliac member community is available for support, particularly if you are seeking recommendations for safe places to eat out and shop for glutenfree food in your local community.
In this issue of Coeliac Link, you can find out about Coeliac New Zealand’s (CNZ) commitment to health promotion and the launch of the new Coeliac Safe ToolKit for schools that will be available for download from the website from mid-June (page 11). You will also find excellent tips on how to build resilience and stay optimistic (page 14); and advice to support your gut recover if you accidentally consume gluten (page 22), along with some delicious gluten free recipes, new products, and inspiration for hosting a Gluten-free High Tea. I know that for many readers finding out about other people’s coeliac
Ng mihi.
Dana
DANA ALEXANDER Editor, Coeliac Link
News / F R O M T H E O F F I C E
We are fortunate to be advised by a Medical Advisory Panel made up of NZ’s leading gastroenterologists, researchers, dietitians, pharmacists and medical practitioners. We express gratitude to our patron, Professor Bob Anderson, who has dedicated much of his life’s research to the coeliac community (page 24). You can hear more from Bob and a range of medical
experts at the CNZ Conference planned to be held in Auckland in November. As plans gather for Coeliac Awareness Week June 7-13 it is more important than ever that you stay involved in this community. Whether that is by renewing your membership, donating towards research or volunteering and getting involved in CAW – we need your support.
T H U M B S U P G F R ECO M M E N DAT I O N S ! If you are short of gluten-free restaurants to explore, try out the 'top 10' voted favourites from our Facebook community! Please take the ordinary precautions to check the gluten-free menu choices are right for you! The Attic Bar and Restaurant based in Mission Bay, Auckland is a family owned, beachside restaurant offering GF options for the majority of the menu. The Attic is Auckland’s number one gastro pub. theatticbar.co.nz/menu Baker and Co bakery in Glendowie offer breakfast meals, cakes and high tea. The owner is GF, therefore if you request a GF option, the staff will avoid cross-contamination. bakerandco.co.nz At The Auction House Invercargill almost everything can be made GF. The chef has a coeliac partner, so they really get it! theauctionhouse.co.nz Fry Guys in Glen Innes, Auckland make delicious burgers, fish and chips and sides at an affordable price. They offer the majority of their items with GF options. thefryguys.co.nz The Chosen Bun in Stonefields, Auckland is deservedly popular for their generous servings and flavour packed dishes! facebook.com/ thechosenbun.nz Munch café in Palmerston North is 100% coeliac-safe and offers options for vegan, keto and dairy free
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as well. The street food menu is sure to surprise and delight the coeliac in your family. facebook.com/munchpalmy Erik’s Fish and Chips in Queenstown and Wanaka take pride in their menu being 100% GF. The restaurant sources locally, is NZ owned and halal. eriksfishandchips.co.nz Keto by D is a café in Orewa who specialise in gluten free, sugar free and low carb foods. The donuts, cakes and salads certainly do not compromise on the aesthetic and taste. ketobyd.co.nz
Coeliac safe gluten free afternoon tea, Park Hyatt Auckland Park Hyatt Auckland has launched a new Coeliac Safe Gluten Free Afternoon Tea menu. CNZ Ambassador Brent Martin (and his culinary team) are the genius behind this delectable menu which is poignant as Brent was personally touched by coeliac disease, when his father was diagnosed late in life with the condition. Brent is passionate about using his knowledge of gastronomy to showcase coeliac safe gluten free cuisine at Park Hyatt. Enjoy a four-course menu that will leave your tummy (and gut) happy! The Coeliac Safe Gluten Free Afternoon Tea is available on request - just remember to make a note that you're coeliac when booking. ____
For bookings and enquiries call Aimee Tuck 09 366 1234 or email: aimee.tuck@hyatt.com Just remember to note that you're coeliac when booking.
No Grainer Café in Mount Albert, Auckland is a small café that prides themselves in offering the best fresh, plant based wholesome foods that are delicious! They provide gluten free options, vegan and paleo upon request. nograiner.co.nz/our-cafe Dalton St Kitchen in Napier is a local favourite. They pride themselves in providing 100% gluten free meals, which makes the selection process much easier. Definitely make sure to grab one of their well-loved as Munch well. facebook.com/ daltonstkitchen
Brent Martin, Park Hyatt
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VALIDATION OF ENDORSEMENT MERCY HOSPITAL in Dunedin is proud to be into its THIRD YEAR of DINING OUT ACCREDITATION with Coeliac New Zealand. OOD IS
a vital component of the hospital experience for most people and a key part of their recovery. For those with allergies and intolerances, eating away from home can be stressful and difficult, potentially adding to the challenges of hospitalisation. Being able to provide confidence and reassurance to patients around food safety in all its wider aspects is important to Mercy Hospital. Room service for in-patients has been in place for three years now at Mercy, and has allowed better information collection on patient allergies, intolerances and dietary preferences. We know that coeliac disease and gluten intolerance are the most common allergy and intolerance amongst our patient group. Many other patients choose low- or no-gluten diets. That’s before we even start looking at the needs of our day patients, staff, doctors and café customers! The Dining Out Programme
is therefore very relevant for Mercy. Jackie Wilde, Support Services Manager, says “We are always mindful of applying our core value of hiranga or 'excellence' to our food service, and a key part of excellence is continually improving.” Maintaining Dining Out accreditation has been embedded into Mercy’s processes, with head chef Rachel Bond (herself a coeliac) working through the DOP checklists and carrying out regular audits of ingredients and processes. Glutenfree training for new food services staff is part of the induction process, and recent improvements have ensured this extends to part-time and casual staff. Dining Out accreditation provides reassurance to Mercy’s coeliac patients that they can trust that our glutenfree food truly is gluten free. Mercy is continually looking for new ways to use the Dining Out logo to reassure patients, staff and customers. The logo currently features on newer copies of the room service menu, in the public
DINING OUT AC C R E D ITATI O N PROVIDES REASSURANCE TO MERCY’S COELIAC PATI E NTS THAT TH EY CAN TR UST THAT O U R G F F O O D T R U LY IS GLUTEN FREE
Marinoto Café, on the Hospital’s website and on Mercy’s staff meals online ordering form. Mercy Hospital were very impressed with the DOP toolkit, commenting that it aligned perfectly with their quality process improvement model. Their use of the toolkit to achieve accreditation has been written up as a ‘Quality Project’ and won an internal Quality Award. Mercy is now taking their Dining Out project write up to the Quality Awards at the NZPSHA (NZ Private Surgical Hospitals Association), because of its applicability through the sector. Mercy Hospital would encourage other hospitals around the country to work with CNZ on this well thought-out programme. ____
mercyhospital.org.nz
coeliac.org.nz || 7 7 coeliac.org.nz
News / D I N I N G O U T P R O G R A M M E
A S GOOD AS HOME, B UT
EVEN BETTER
Coeliac Link talks to THE ATTIC owner JARED RANSOM about customer service. O DAY
more eateries have gluten free options available on their menu, however not all establishments have the correct kitchen and food handling procedures in place to cater for people who need to adhere to a coeliac safe diet. Voted as one of the CNZ Facebook communities favourite places to eat out, this popular gastro pub is now Dining Out Programme (DOP) accredited as well. For the new owners of The Attic Bar and Restaurant in Mission Bay, Jared and his wife Sara are committed to delivering customer service and satisfaction. Both enjoy getting to know their customers needs intimately, which is more than just recognising their name. Jared says, “It gives me an enormous sense of selfsatisfaction seeing customers who might previously have been tentative about
eating away from home return time and time again, because I realise we’re doing things right.” The previous owners Matt and Natalie Burton had three family members with coeliac disease, and so do a few of Jared and Sara’s friends and their children. One thing that they heard from talking with their coeliac customers was the struggle faced to find a place the whole family could eat out. As huge foodies themselves they found it heart breaking to hear that coeliacs have such limited choices and their dietary needs are not taken more seriously. With that in mind it was an easy decision to continue The Attic’s reputation as a favourite hangout for the Auckland coeliac community, and go one step further by getting accredited. They recognised that their
customers, particularly those with coeliac children, wanted to feel like “everyone else” and not be ostracised for having specific dietary requirements. They wanted to feel inclusive and not be a burden to the chefs, but needed the reassurance that the restaurant would take their health condition seriously. “If you are going to offer GF dishes, you must stand by the words ‘gluten free’ and understand what it means for people with coeliac disease”, said Jared. “We believe it is about ensuring that our staff are knowledgeable about the disease and can comfortably respond to the customers enquiries and are able to explain our gluten free food handling processes in a meaningful way. Having the DoP certification gives our customers that additional confirmation that they can relax, knowing they are in safe hands!” CL ____
theatticbar.co.nz
Join the DINING OUT PROGRAMME
so diners will know they can trust your food to be truly gluten free Register today! coeliac.org.nz
Helping Kiwis with coeliac disease and gluten sensitivity eat gluten free, confidently.
TEL 09 414 7467 EMAIL dop@coeliac.org.nz
DINING
THE MAD BUTCHER GETS GLUTEN FREE ACCREDITED THE MAD BUTCHER in Glen Innes rcently adopted the DINING OUT PROGRAMME (DOP). And its the only butcher in New Zealand that is Dining out Programme accredited, which is something worth celebrating! OR THOSE
of you who are new to Coeliac New Zealand, or just haven’t heard about the DOP yet, here’s a little background information about the programme and why we developed it.
The importance behind the gluten free claim With the right education and support people newly diagnosed with coeliac disease can adapt to a strict gluten free diet and find it easier to prepare their own meals at home. They learn to carefully read food labels on packaged foods and combined with the naturally GF foods like fruit and vegetables; meat, fish, and chicken; eggs, milk, and cheese; nuts and seeds; and all kinds of grains like rice, millet, quinoa, and amaranth they start to accept and adhere to the lifelong diet. However, whilst plain fresh cuts of meat, including beef, poultry, lamb, and fish are GF by ingredient, readymade marinated dishes, breaded or floured meat cuts typically contain wheat (and therefore gluten) and can be problematic if incorrectly labelled. Similarly, sausages, hot dogs, hams, and imitation deli meats frequently contain gluten and are unsafe for people with coeliac disease or noncoeliac gluten sensitivity. Awareness of being coeliac safe It is one thing for cafes, restaurants, and artisan food suppliers to be
aware of GF diets and offer options with gluten free ingredients. But it is another thing to guarantee the food is coeliac safe, and that the business has taken the necessary precautions to remove all risks of cross-contamination. Failure to stand by a gluten free claim and to understand that even trace amounts of gluten can trigger an immune response and make someone with coeliac disease very unwell is both irresponsible and misleading. Greener Pastures partners with The Mad Butcher Bevan McKenzie, owner of Greener Pastures is more pedantic than most people about eliminating the risks of cross contamination, whether that is in terms of allergens or strictly following cleaning procedures in his butchery. He totally stands by his GF product claims – not only ensuring all products are accredited with the Crossed Grain Logo and tested annually by Asure Quality, the premises at The Mad Butcher Glen Innes which he will now use to make his products is accredited with the DOP. Michael Morton and Dan Adams from The Mad Butcher wanted their staff to be knowledgeable about coeliac disease, after demand for GF meat products was increasing to about 1-2 customers daily. Both businesses wanted to guarantee to their customers that
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their GF claims were independently audited by a recognised certification scheme and backed by CNZ Commitment going forward Bevan had spent years perfecting his GF sausage recipe to ensure it’s not only high in protein and uses less meal as a binder, but also combined only natural ingredients and was preservative free. Similarly, his Greener Pastures GF bacon is cured using organic solar dried sea salt and is naturally dry cured for more than 10 days. With the backing of The Mad Butcher, it is their hope that being part of the DOP will mean coeliacs will feel assured that their health and wellbeing are being taken seriously – and that they will feel confident in the butchery meats they purchase in store or online. As demand for coeliac safe GF meat increases you can expect to see their product offer expand. As the number of hospitality and catering outlets across the country are accredited to the Dining Out Programme standard – which we hope to see continue to rise over the coming years, we are most excited to have The Mad Butcher, Glen Innes on board. ____
Visit instore or order online for overnight nationwide delivery: madbutcher.kiwi/stores/glen-innes/ Purchase CGL accredited Greener Pasturers gluten-free sausages and bacon from The Mad Butcher Glen Innes or online.
coeliac.org.nz | 9
News / C O N F E R E N C E
COELIAC NZ CONFERENCE IS ANNOUNCED!
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both adults and students aged 13-21. Hear from a range of medical experts including guest speakers Dr Tom Mulholland and CNZ Ambassador Erin Simpson; as well as learn tips and tricks to enjoy a glutenfree lifestyle. Entry to the Conference includes a special gluten-free buffet lunch and afternoon tea prepared by our Dining out Programme accredited cafes – including The Attic, Pan Paella and Noodlechick, plus a goodie bag filled with Crossed Grain Logo accredited products. Coeliac NZ members receive 50% discount on Conference tickets; and for a limited time new members receive $20 off the joining fee by using the code SPRING21 when purchasing online. For help or further information email admin@coeliac.org.nz Early bird ADULT conference tickets $75 (member); $150 (non-member) STUDENTS (aged 13-21 years) $45 (member); $90 (non-member).
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Living coeliac safe – and gluten free for life Although a gluten-free diet is effective in controlling coeliac disease symptoms there are recognised challenges, particularly from a social perspective and especially during teenage years. Most people who have a severe food reaction to consuming gluten, have them as a result of eating food prepared by another person. Even a tiny portion of gluten has serious consequences and that’s why families living with coeliac disease need to learn how to avoid even trace amounts of gluten, in food but also in medications and when eating out – and to actively seek support from others also living with the disease. We are excited to be able to host the Coeliac New Zealand Conference again this year, on Saturday 13th of November at the Life Centre in Mt Eden Auckland. The conference is open to anyone interested in coeliac disease or living gluten free for life. Topics will be tailored separately for
(Above) Join the conversation; (Below) Alana Scott talks gluten free shopping on our YouTube channel.
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Click here to buy your ticket.
Although a gluten-free diet is effective in controlling coeliac disease symptoms there are recognised challenges, particularly from a social perspective. MEDICAL BREAKFAST SEMINAR MEDICAL
Breakfast Seminar will precede the Coeliac New Zealand Conference with a master class for health professionals, including GPs, Dietitians, Nutritionists, and Pharmacists and will focus on Coeliac Disease: looking beyond the masquerades. This is a unique opportunity to hear
10 | Autumn 2021 Coeliac Link
from our expert advisory panel as they unmask coeliac disease with a range of presentations followed by an interactive question and answer session. Find out about the latest research and updates in post-diagnostic dietetic care and other topics including: • causes for persisting symptoms, • screening strategies, • monitoring and follow up after
diagnosis – what tests and when paediatric pathways national pathways dietitians at forefront dietitian’s Standards of Care – best practice • medicines and coeliac disease • current international research • • • •
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Click here to buy your ticket.
THIS IS A UNIQUE OPPORTUNITY TO HEAR FROM OUR EXPERT ADVISORY PANEL AS THEY UNMASK COELIAC DISEASE
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BECOME A CNZ MEMBER OR VOLUNTEER
H E A LT H P R O M O T I O N I N A C T I O N
Coeliac Link talks to LISA JURY about this year’s FOCUS for delivering our HEALTH PROMOTION STRATEGY. E A L T H promotion is predominantly about enabling people to improve and increase control over their own health condition so that they can better manage their own health outcomes. The four core service elements related to health promotion include: 1. Prevention of disease and illness 2. Health education, anticipatory guidance, and parenting skill development 3. Providing support to build confidence and reassure parents and caregivers 4. Create supportive environments to build community capacity.
For the next twelve months CNZ will focus on ‘creating supportive environments’ – which is one of the five health promotion measures of success in the ‘Ottawa Charter’. This will see a continuation of activities to raise awareness and understanding of coeliac disease via our national Coeliac Awareness Week campaign and participation at food shows and conferences, including the Healthy Living and General Practice Conference and Medical Exhibition. We will also develop new resources for the website and support our volunteers to improve the quality of life for people living regionally throughout New Zealand. The first piece of work which will be launched during CAW is the development of our ’Living Coeliac Safe’ toolkits. These will be a series of PDF documents written in plain english that can be downloaded from the website to help navigate those living with the disease in the following situations:
• Early childhood education, schools • Workplaces • Marae, clubs, and faith-based organisations • When talking to health professionals. We already have a great Dining Out Programme for hospitality, and we hope to provide the individual training component of that to those studying in the hospitality and food industry via training institutions and schools. By raising awareness about coeliac disease, and initiating corrective interventions to improve the lives of coeliacs we will see, over time, behavioural changes that benefit the individual, community, and the wider population. We encourage you to be your own advocate and spread the word about living coeliac safe – and gluten free for life. ____
Click here to download the ’Living Coeliac Safe’ toolkits to be launched June 7-13 2021 during CAW.
PLEASE HELP SPREAD TH E WORD Every day we provide support, advice, and advocacy for kiwis with coeliac disease. As a small charitable organisation we rely on our wonderful volunteers who give up their time to help others living with the disease. Become a member or volunteer for Coeliac New Zealand to grow your connections within the coeliac community; share knowledge and experience and contribute to the only organisation dedicated to the vision statement that people with coeliac disease live healthy lives.
FIND OUT MORE ••• Phone +64 9 414 7467 ••• Email admin@coeliac.org.nz
No voice is too soft when that voice speaks for others. ____
JANNA CACHOLA
New Zealand
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together we are
Feature / A G E D - R E L A T E D D I F F E R E N C E S
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IAGNOSIS and treatment OF COELI AC DI S EAS E Researchers are increasingly aware of the varying ways COELIAC DISEASE presents in people of DIFFERENT AGES.
YMPTOMS
can differ greatly across age ranges, meaning identifying and diagnosing coeliac disease at different life stages can be an issue. Because coeliac disease was initially only described in children, for a long time it was thought to be an exclusively paediatric condition. Recognising symptoms at different ages Symptoms can present themselves clearly in children, with some children showing signs of coeliac disease as soon as they start on solid foods. Children might experience malnutrition, persistent diarrhoea, and a delay in growth – meaning their condition is normally noticed and identified relatively quickly. We now know that coeliac disease can occur at any age and affect any person. While some young children still present with very severe symptoms, most children will be older and have
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belly pain or variable bowel habits. There’s also been a significant increase in the number of adults diagnosed with coeliac disease in recent years as people become more aware of the condition and how it presents itself in adulthood – however some adults are still going undiagnosed. There are few ‘textbook’ symptoms that all adults with coeliac disease will definitively experience – research has found that older adults sometimes show less gastrointestinal symptoms and more atypical symptoms. These can include anaemia, fatigue, bone or joint pain, liver problems, depression, anxiety, and migraines. Some will have problems such as infertility, lethargy or poor concentration. Other people will have no symptoms at all. Many of the symptoms that adults might experience can be seen in a number of other health problems – meaning that diagnosing coeliac disease can be a long and difficult task. Getting a diagnosis Recognising the symptoms is one thing. But as many people know, a diagnosis of coeliac disease
is a whole other hurdle. Blood tests are important steps in working towards a diagnosis. These include tests for specific antibodies that are made when the gut is damaged in coeliac disease. Other blood tests, such as blood count and iron levels, may also be helpful. Generally, the next step would be proceeding to a duodenal biopsy (taken during a scope test). This would be considered essential in all adults. In some settings, children may be diagnosed without a biopsy if certain criteria are met. Biopsies are also commonly repeated in adults after a period on a gluten-free diet to confirm recovery of the gut. Genetic testing can also be undertaken. Coeliac disease is a genetically linked condition, and is associated with the genetic markers HLA DQ2 and HLA DQ8. More than half of the community will have these markers, but only a small number of individuals will also have coeliac disease. Usually, the genetic tests would be considered only when the diagnosis is uncertain (and are not done in all cases).
There are few ‘textbook’ symptoms that all adults with coeliac disease will definitively experience.
Learning to live with coeliac disease at any age Once diagnosed, people of all ages face a big adjustment and challenges to overcome. A gluten-free diet can be an intimidating prospect – whether the person is a child just beginning to learn about food, or an adult who is used to eating gluten-free without question. Elderly who are diagnosed with coeliac disease commonly struggle to adapt to a GF diet after many years of never considering what food contains, and it can be a big task to learn how to understand ingredient lists. Additionally, many older people are dealing with these adjustments while still feeling unwell; older adults’ intestines tend to recover much slower even on a GF diet due to years of damage. While children diagnosed with coeliac disease generally begin to feel better after adhering to a gluten-free diet, it can be an uphill journey dealing
SYMPTOMS CAN PRESENT TH E M S E LV E S C L E A R LY I N CHILDREN, WITH SOME CHILDREN SHOWING SIGNS OF COELIAC DISEASE AS SOON AS TH EY START ON SOLID FOODS
MEDICAL BREAKFAST SEMINAR ––– LIFE CENTRAL, MT EDEN AUCKLAND, SATURDAY NOVEMBER 13, 2021
with the impacts of delayed growth and malnutrition. Not to mention how tricky it is to understand what gluten is and how to safely eat while at school or at social events! CL ____
The important thing to remember at any age is that you are not alone. Navigating coeliac disease is an intimidating process – but there are 100,000 kiwis with you on your coeliac journey!
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Feature / Y O U T H A M B A S S A D O R
BUILDING R E S I L I EN C E CNZ Ambassador MORGAN MCKENZIE-MOORE shares how to STAY OPTIMISTIC in the FACE of a COELIAC DIAGNOSIS.
NY LIFE
change will come with challenges and setbacks, and a coeliac diagnosis is a massive life change. Food is a part of our daily life, and changing routines and habits takes a lot of physical and mental work. Research shows that many coeliacs develop anxiety around food and social situations, so it’s important that we learn how to build resiliency and learn to be kind to ourselves when adapting to a coeliac lifestyle. It’s also important to follow a strict gluten free diet, as committing to living
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gluten free for life is an important way you can improve both your long term physical and emotional health. Within the weeks that follow your coeliac diagnosis, it’s easy to feel like there is an overwhelming number of new challenges and changes to your lifestyle that you may not have considered at the time of diagnosis. Something I found extremely useful after reading Dr Simon Knowles, ‘Mind Over Gut’ free online services, is to write down these challenges and brainstorm ways to adapt to
F O O D I S A P A R T O F O U R D A I LY L I F E , A N D C H AN G I N G R O UTI N E S A N D H AB ITS TA K E S A L OT O F PHYS I C A L A N D M E NTA L W O R K.
them. As a practical example, perhaps you are going out for dinner for the first time as a new coeliac, and you’ve found that there are little to no dishes, you can eat and the waitstaff have informed you that they can’t guarantee cross-contamination in their kitchen. You might feel embarrassed, upset, even 'hangry'! Unfortunately, these situations are almost unavoidable for a new coeliac as you aren’t provided with resources and practical tips about living as a coeliac by your doctor.
How we view adversity and stress strongly affects our ability to adapt. However, it doesn’t mean you can’t learn from these situations or ask for help. Writing down the challenge (not being able to eat out) and brainstorming solutions (calling ahead to the restaurant, looking for coeliac friendly places to eat, keeping a snack on you just in case) will better prepare you for overcoming these setbacks or
T H E I M P O RTA N C E of R E S I L I E N C E Resilience – or resiliency – is our ability to adapt and bounce back when things don't go as planned. R E S I L I E N T people don't wallow or dwell on challenges or setbacks; they acknowledge and learn from the situation, and then move forward Even if you're not a naturally resilient person, you can learn with the right support to develop a resilient mindset and attitude that will help you to better cope with the situation. If you are struggling with diagnosis reach out to someone in the coeliac community to get help. You may also find by resetting your mindset and adapting your daily routine that you will see improvements in your thinking. Learn to relax. When you take care of your mind and body, you are better able to cope effectively with challenges or setbacks. Start by developing a good sleep routine and try to incorporate both regular physical exercise and relaxation techniques, such as meditation or breathing into your daily life. Practice thought awareness. Resilient people don’t let negative
thinking take over. Talk to friends and family or see a health professional if you are having difficulty facing a particular challenge in your diagnosis journey and learn how to reframe disappointments or setbacks into more optimistic thinking. Its okay to ask for help. If you or someone you care about is struggling with the diagnosis of coeliac disease and need a bit of extra help, don’t hesitate to contact a professional: • Your GP or family doctor • Free text or call ‘1737’ to talk or text with a counsellor (available 24/7) • Lifeline (0800 543 354) to speak with a counsellor (available 24/7).
completely avoiding them in the future. Staying optimistic about having coeliac disease can be hard at first because what is there to be happy about removing some of your favourite foods from your diet, having to spend significantly more amount of money at the supermarket, and feeling anxious when eating out. But whenever you are feeling upset about having coeliac disease, it’s a good time to check in on how far you’ve come already. These milestones will be personal to you, but for example, something I’m always reminding myself is that my physical health has drastically improved since diagnosis, and that’s something I’m incredibly grateful for. How we view adversity and stress strongly affects our ability to adapt, and this is one of the most significant reasons that having a resilient mindset is so important. If you are looking for more resources and strategies around managing and thriving with a chronic illness, I would highly recommend looking at Dr Simons Knowles' website mindovergut.com CL ____
Thank you to Associate Professor Jason Tye-Din for his expert review of mindovergut.com and Mr Stephan Möller for his assistance in writing up this article. For a full list of references please visit coeliac.org.nz MORGAN MCKENZIE-MOORE
is a gluten free recipe developer and creator of 'How to Coeliac'. She has a passion for food, comedy, and living her best gluten free life.
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CNZ is committed to developing more online resources to support early diagnosis,and help those living with coeliac disease better manage the condition. See the videos on our YouTube channel.
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Feature / M E M B E R S T O R I E S
LIFE AFTER A
Cdiagnosis
OELIAC
Accepting a LIFE-LONG disease.
DIAGNOSIS
of coeliac disease is a transformative and intimidating time. It often follows years of unknown discomfort and pain – and while it’s a relief for many to be diagnosed, it marks the beginning of a whole new chapter. It’s a large adjustment to have to think so deeply about food and eating out. But as many people with coeliac know, it always gets better with time. Here, we share the stories of three people diagnosed with coeliac across different life stages to learn how they coped and adjusted to their new normal. Sue’s story In my early forties I became unwell, overnight. I woke one morning saturated with exhaustion and within hours I could barely walk. This escalated to the point where my coordination was affected, as if I had had a stroke or was quite drunk. I developed severe vertigo and nausea. Days, weeks and months disappeared with me confined to bed. I needed help to do
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the supermarket shopping; I needed handrails to help me in the shower. I became very depressed. Without the
unwavering support of my husband, I would not be here today. I made, many visits to the
MICHELLE’S STORY I CAN LOOK
back and think of numerous times over several years feeling ill – bloated, constant reflux or indigestion, nausea bouts, cramping and vomiting, diarrhoea and then constipation. I was not taken seriously by my doctors, and had so many tests come back with no results. One day exactly three years ago, with an enormously bloated stomach and crying my eyes out, I visited a new doctor. I pleaded with her to help me find out what was going on with me, thinking it was something sinister. My new doctor was so thorough and so helpful, checking and testing for some answers. Sue Eventually, a test for coeliac disease came
back positive, and my diagnosis was confirmed by further investigation and a biopsy. Finally, I had a reason for my ailments! I began to work through a diet plan, but mostly I was just so happy to know what was happening in my body. I realised that going on a gluten-free diet was the very least of my worries considering how much help there is! While adjusting to a gluten-free diet can be a pain in the beginning, it can be easily worked through. Not to mention that there is so much great gluten-free food available now in supermarkets and online. Now, I am feeling so much better and I am so thankful for my amazing doctor. If you are recently diagnosed, it is certainly not the end of the world and things could be worse. You can adapt and life is good!
doctors, to no avail. Doctors thought it was everything from a virus or a migraine through to a neurological problem. They prescribed a number of pills and tried various treatments, but nothing worked. I started to work to regain my strength through swimming but one night we dined out and within twenty minutes, I was unconscious, breaking my tooth and nose. In hospital following the incident, we finally clicked that it might be because of food – and coeliac disease made sense, given that my dad was coeliac as well (albeit with very different symptoms!). Post diagnosis, I had a rough couple of years – with so much inflammation in my system, I had several injuries and slowly lost the use of my left hand. However over time, I started to eat more anti-inflammatory foods, my hand improved, and my health overall got so much better. I am in my 60s now, and am trying to make up for all that time lost to illness. Charlotte’s story – as told by her mum When Charlotte was little, we always had trouble trying to figure out why she was crying despite all her needs being meet. She had severe abdominal pain, and eventually stopped eating and started losing weight. We had visited a dietitian who thought that she might be lactose intolerant but I pushed for a coeliac blood test. Finally, when she was two and a half years old, we got the diagnosis. Before her diagnosis we weren’t aware of gluten and how much of it is hidden in everything. We ended up doing plenty of research and gave our kitchen a good clean up with new utensils, as well as starting fresh with gluten-free ingredients. It’s been difficult for Charlotte growing up trying to navigate the world as a child with coeliac disease. At her school of 300 kids, she’s the only one who is gluten-free, meaning she misses out on the chocolate and lollies people bring in for their birthdays. She
even had to miss school camp this year because it was too hard for the school to do her meals. She struggles to trust anyone besides her dad and me to give her food and when her twin sister is eating gluten, they have to stay apart. Life with coeliac disease is certainly not an easy road, and it can lead to a lot of frustration. But as Charlotte grows up, she begins to learn more and more about what gluten is and how to read ingredients to know whether she can or can’t eat something. We enjoy baking things she can enjoy – mostly anything with chocolate! Now that she’s ten years old, I hope that she’ll know one day how to manage her disease completely on her own.
As the years fly past Charlotte has learnt what she can and can’t eat and how to read food labels.
Charlotte Having coeliac disease and following a strict gluten-free diet is not all doom and gloom. We just need to be prepared for any situation! CL
S H E R Y L’ S S T O R Y When everyone told me the first six months would be the hardest, they were right! B U T N O W,
as I approach two years diagnosed with coeliac disease, I am the most comfortable I’ve been post-diagnosis although it’s certainly been a journey! Even though I stopped eating gluten straight after my biopsy, it took a long while for my symptoms to subside. My immune system was shot so I had colds and flu for the best part of the year, and I struggled with reflux and bad headaches. My overwhelming memory of those first six months is being tired and frustrated by having to expend so much mental energy thinking about food. What was I going to eat? Where could I get safe food when I was out? Which restaurants or cafes were safe to eat at? Food was suddenly my sole focus. I’m blessed with a fantastically supportive family and friends who have gone out of their way to learn
about coeliac disease and ensure I’m catered for. Despite some initial incredulity that their much-loved barbecue was a potential source of contamination and that glutencontaining and gluten-free food couldn’t go in the same container, they have embraced the new rules. Everyone is happy to eat out where I can enjoy the food – it just means I’m now organiser-inchief when it comes to bookings! At work I’m asked for venue suggestions if we are eating out and I’ve learned to do restaurant research ahead of time when going to a new town or suburb. If you are new to this, it’s okay to get sad, frustrated and overwhelmed. Just know that it will get better. A friend asked me this week if I’m ever tempted to eat gluten. The honest answer is no. Eating glutenfree has become second-nature!
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Feature / H A Y L E Y R E P T O N
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finding a
EW TUNE
ON LIFE
Hayley Repton shares with Coeliac Link why MAKING A FILM encouraging coeliacs to FIND their INNER VOICE followed her own PERSONAL JOURNEY. WAS
diagnosed with coeliac disease in April 2019. The day I was told, I felt like I had been slapped around the face with a wet fish. Fortunately for me, I didn’t have many of the typical symptoms, but it was found by chance through another blood test, which led to the endoscopy and biopsy to confirm it.
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I just knew I had to put the diagnosis to good use and raise as much awareness as possible. Within a couple of weeks, I started to draft ideas and I began writing the short film ‘Glutened’. After the diagnosis, I had followed a lot of coeliac support groups on social media and many of the coeliac members were posting about the anxiety around social events. It was clear that some coeliacs were surrounded by people who don’t take
the autoimmune disease seriously or think that its ok to take ‘cheat days!’ Oh no, no, no! That was a major driver for me to make the film, with the aim of giving these misunderstood people a stronger voice. I wanted to make sure that I portrayed a large proportion of their stories through the one character. That was really important to me. I believe that sometimes getting a point or emotion across to someone verbally, doesn’t necessarily have the same impact as showing them
something through sound, vision and storytelling. Most of the content I have seen is focused on the physical, rather than the effects that coeliac disease can have on someone mentally. There were many different creative ideas and many ways to tackle the subject, but I was finally happy with the vision. It is a rhythmic, short film which expresses the impact that everyday life has on a newly diagnosed coeliac and how she discovers her own tempo. The main character Holly is an Irish woman who takes the treatment following diagnosis seriously. This means she has to say goodbye to all thing’s gluten, and this sudden lifestyle change takes her on a turbulent journey; with a mix of frustrating occasions, a splash of envious times and a sprinkling of lighthearted moments. It covers supermarket shopping, social gatherings, reminiscing on spontaneous times and everyday
food prep. The film also highlights the importance of taking crosscontamination seriously. Sound design plays a big part in the film. I wanted the audience to be with the character throughout, as though they were stepping into her shoes. At times, we hear Holly’s inner body sounds as I wanted the viewer to totally immerse themselves into what the character was feeling and experiencing. The rhythmic effect throughout the film also reflects the planning and incessant vigilance a coeliac must have in their everyday life. When making the film there were times of doubt and I was anxious about releasing the film, but it’s had positive reactions from companies and charities across the globe. I’ve received hundreds of messages of appreciation from coeliacs saying that they laughed, cried and that they can use it as a tool to share with people who are not taking it seriously or who are unfamiliar with
WHEN FOUND A SUBJECT LIKE COELIAC D I S EAS E THAT I’M PAS S I O N ATE A B O U T, I H A D N O CHOICE BUT TO MAKE THE FILM!
coeliac disease. This response from the tight-knit coeliac community makes me eager to make more. I am extremely grateful to everyone who was involved and played a part in some way. Hopefully, this is the first, but not the last film I produce on the subject as there are still so many stories to tell and many ways to do it. Watch this space. CL ____
To view Hayley's video visit vimeo.com/486284734 H A Y L E Y R E P T O N is a filmmaker
based in Manchester UK. She is primarily an Editor but occasionally writes and directs too. Her passion for music and sound design stems from her background as a DJ which kicked off in 2007. A decade later, in her midtwenties she decided that she wanted to start a career in filmmaking. She went to university to study film production at 27 and has never looked back
Feature / J O D I E C L A P P
TURNING LEMONS INTO LEMONADE JODIE CLAPP talks about her NEW BOOK 'What the...? I can't eat that anymore?' and the rewarding experience of starting ‘THE GF HUB’.
E L L O CNZ members, my name is Jodie, and I'd like to share with you a little journey of turning lemons into lemonade. Have you gone through years of your life knowing that there was something wrong inside you but couldn't figure it out? Have you spent countless visits at the doctors trying to get some help and guidance, only to walk out feeling that it's apparently "All in your head"? Know, you're not alone. I’m a true-blue Aussie girl through and through (and like a lot of kiwi’s) aside from work, my life consisted of BBQs on the beach, beer and galivanting around the world, tantalising my taste buds with some of the most sumptuous foods available! I ate my way around the world without getting a single belly ache, so it was the biggest surprise to me when a haematologist gave me the life-changing news: "You have coeliac disease!" Coeliac disease never once entered my mind as a possible cause for my health concerns, so the diagnosis hit me like a slap across the face. In a flash, I felt like my life of culinary, care-free adventures was ripped away from me. I didn't get sick from food, so why can't I eat certain foods now? Turns out, I was
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an 'asymptomatic' aka 'silent' coeliac disease sufferer. From that very moment, I cut out gluten immediately, but what followed was completely unexpected. My body deteriorated quickly; I was breaking out in rashes, I had flu-like symptoms for months, but no cold and I felt like I was losing my mind. Needing to understand what was happening, I dove deep into research of this disease and uncovered some shocking truths along the way to discovering a new way to live. Firstly, I learned that gluten can have an addictive hold over the brain and body. So, it turns out I was actually detoxing from this druglike effect ! I was relieved to know I wasn't going crazy after all. Remarkably, I was coming down and having withdrawal symptoms for months from this drug-like effect that had been going on in my brain for the best part of 30 years. Wow! The second shocking truth I learned was that even though I had removed gluten from my diet, I was still at risk of staying sick. Some gluten-free foods (which most people reach for when newly diagnosed) can cause inflammation in the gut long after gluten is removed. So you think you are supporting your body by not eating gluten, but perhaps wonder why a couple of years later, you really don’t feel as amazing as you are supposed to. Inflammation can affect every part
of the body from your little pinkie toe on your foot, to the hair on your head and it usually starts in the gut. So, what was supposed to be a simple diet switch was not what it seemed. This was the fundamental changing point in my life when lemons became lemonade. I spent the next few years reading, studying, attending seminars, and speaking with physicians worldwide to better understand this disease and take back some control of my life and my body. After a few years of successes and failures, I wanted to share my journey and what I learned along the way to help as many others as possible. So, I wrote a book titled "What the...? I can't eat that anymore?" and started a community centred blog called 'The GF Hub.' CL ____
Read the full article in the CNZ newsroom. M A K E A D O N AT I O N AS A
charitable organisation we are reliant on the philanthropic dollar which is particularly competitive in this COVID 19 times.
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S HO PPING
/ Feature
NAVIGATING the SUPERMARKET Coeliac Link talks to COUNTDOWN nutritionist DEB SUE about supermarket shopping.
F Y O U H A V E coeliac disease, it’s highly likely that you are already a master label reader when you’re shopping for food. However, if you’ve recently been diagnosed then knowing what to look for can feel like a minefield and very overwhelming. Deb Sue, Countdown’s in-house nutritionist, has shared with us some of her top advice and tips to help navigate the supermarket and ease the burden of being newly gluten free. The good news is that being gluten free today is a lot easier than a few years ago! Lots of food producers have invested in creating plenty of variety for coeliacs. No longer is being glutenfree considered a passing diet fad; now there are complete sections of aisles dedicated to coeliacs. Gluten is a protein found in wheat, rye, barley and oats. In New Zealand, if a product contains gluten or wheat then under the Food Standards Code, it must be declared on the ingredient list or on the allergy statement (usually found on the back underneath the nutrition information panel). There are lots of naturally gluten free foods already available of course. These include all fruit and vegetables, plain meat poultry and seafood, eggs, dairy products (unflavoured milk, plain yoghurt, cheeses), unflavoured beans and legumes, plain nuts and seeds, plain rice, butter and oils.
As a newly diagnosed coeliac, you’ll need to get into the practice of double-checking ingredient labels before you buy or eat new products. Some manufacturers add gluten to products that you wouldn’t even suspect would include gluten - like soup, salad dressing or potato chips! So when grocery shopping, it’s always best to double check the ingredient list, even on products that state they are gluten free. You're looking for ‘Gluten Free = nil detected’, on the nutrition information panel, or no ingredients containing gluten. Otherwise, look for products with the Crossed Grain Logo. If a product Deb Sue displays this logo it has been certified as GF by CNZ but be aware that not all gluten free products carry this logo. It’s also helpful to know that other countries have different definitions of what's gluten free. In New Zealand (and Australia), our Food Standards Code defines gluten free as ‘nil gluten detected’, whereas in Europe and the United States gluten free is defined as less than 20 parts per million. So, if you’re eating food imported from Europe or America that state they are GF, it pays to read the food label to check how much gluten it actually contains.
Another watch out is marinated meats, rubs and seasonings;. Many marinades include soy, which isn’t always gluten free. I like to use tamari when I am making marinades; it is a good alternative as almost all versions are gluten free. Also lots of seasonings or rubs also have wheat flour as a carrier for the herbs or spices, so please always double check the ingredients list. You might also think that some alcohol is off limits, however, even brewers are considering coeliacs in their range and you’ll be pleased to know that there are a variety of beers that are now gluten free.. Finally, I know that one of the biggest complaints from people with coeliac disease is that they miss treats like biscuits, cakes and snacks like chips. At Countdown, we’ve got an entire range dedicated to coeliacs. Check out our ‘Free From Gluten’ range in the health food aisle, there are lots of biscuits, snacks and cake mixes. Not only have these products been tested to guarantee that they are gluten free, they’re also tasty and affordable. CL ____
If you are unsure about your dietary requirements, please see a registered dietitian for more advice.
I F Y O U ’ V E R E C E N T LY B E E N D I A G N O S E D T H E N K N O W I N G W H AT TO L O O K F O R C A N F E E L LIKE A MINEFIELD AND VERY OVERWHELMING. coeliac.org.nz | 21
Feature / N U T R I T I O N
GETTING BACK ON TRACK Tips for a SPEEDY RECOVERY after accidental EXPOSURE to gluten. F YO U H AV E
coeliac disease (are gluten intolerant or have other food intolerances) eating out can be especially challenging. Despite your best efforts, it's easy to be accidentally exposed to gluten or other allergens eating out at restaurants or at parties. It can be hard to completely control what you are eating unless you bring along your own food. Here are some practical tips to help you recover quickly if you are accidently exposed to gluten. One the first things to do is to drink plenty of water, which will help flush out any toxins and move the gluten through your digestive system quicker. If your gut is very inflamed after gluten exposure, it is important to eat easy to digest foods such as soups with cooked vegetables using meat stock and avoid raw salad items which can be harder to digest. To stop compounding the problem, it is worth avoiding for a few days any hard to digest inflammatory foods such as dairy, sugar, grains, and processed
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foods, which can aggravate the inflamed gut lining further. After exposure to gluten, it can be helpful to consume about three cups of meat stock a day to help reduce the inflammation in the gut and to help heal the enterocyte cells of the small intestine. Meat stock is made from some meat with a joint and connective tissue. It is the joint and connective tissue that produces an abundance
of gelatine in the stock, which is the healing substance we need to help heal the digestive tract. Meat stock is one of the core foods used on the GAPS (Gut and Psychology Syndrome or Gut and Physiology Syndrome) Gut Healing Protocol, which was created by Dr Natasha Campbell McBride a worldrenowned neurologist and nutritionist. Meat stock is often confused with bone broth, which is also helpful
BONE BROTH HAS ITS PLACE For everday use, that jiggly gelatinrich broth made from bones is a naturally high source of nutrients known for strengthening the delicate villi that pave our intestinal lining. In the same way we use aloe vera gel on sunburn, emerging research from Italy has shown the potential role of gelatin in healing intestinal gut-
barrier damage. While broth won’t cure every ill, and certainly isn’t going to raise the dead, scientific reasoning suggests adding 1-2 cups of broth a day may have a role to play in encouraging the healing of gut damage. ____
Read the full article from Sylvia North in the CNZ newsroom.
for healing the gut lining, but you must introduce bone broth slowly if your gut is sensitive and inflamed. The main difference between meat stock and bone broth is that meat stock is cooked for a shorter duration than bone broth (only 1-3 hours) and uses meat and meaty bones rather than just bones. So, with chicken stock you would cook a whole chicken in a pot in water for example rather than just using the frames like you would with bone broth. The chicken meat is used afterwards in meals so does not go to waste. As bone broth is cooked for anywhere between 8- and 48-hours, compounds such as histamine and glutamine can be released from the bones over time which may be problematic for people with very sensitive guts and allergies. Probiotic rich foods such as sauerkraut or kefir can be helpful to soothe the gut, support optimal digestion, regulate an overactive immune system, and dampen down the inflammation caused by the gluten exposure. Probiotic foods should be a
Consuming fresh pineapple can work wonders as it contains the natural digestive enzyme bromelain. regular part of the diet for anyone with autoimmune issues and coeliac disease. Fresh ginger tea can be helpful to ease stomach cramping due to its anti-inflammatory properties. You can even add some extra anti-inflammatory action with a teaspoon of turmeric root. With the meal or as soon as you can afterwards, take a digestive enzyme with the enzyme dipeptidyl peptidase (DPP-IV) which helps the body break down gluten and reduce the levels of the reactive gluten protein gliadin. If you are coeliac or have severe gluten intolerance, I would always carry a bottle around with you and take one every time you eat out in a restaurant just to be sure you are not exposed by cross contamination. Consuming fresh pineapple after gluten exposure can also work wonders as it contains the natural digestive enzyme bromelain which
helps to break down proteins, therefore reducing some of the damage from the gluten protein. CL ____
NOTE: This information in this article is based on the writers' own experience. CNZ are not aware of any published research on this topic. C A T H E R I N E G A R N E Y is a
Registered Clinical Nutritionist and Certified GAPs Practitioner. She says, "As a nutritionist with coeliac disease, these suggestions have been helpful for me and many of my clients."
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Feature / U P D A T E F R O M O U R P A T R O N
A
symptoms
FTER GLUTEN
BOB ANDERSON MBChB, BMedSc, PhD FRACP, AGAF DISCUSSES SYMPTOMS after GLUTEN.
OB ANDERSON
graduated in medicine and then completed a PhD in experimental medicine from the University of Otago in New Zealand. His specialist training in adult gastroenterology was in Melbourne. This was followed by a 4-year post-doc at Oxford University where his work drew on vaccinology approaches to understand the targets for gluten immunity in coeliac disease. He returned to Melbourne in 2002, and established the coeliac disease research program at the Walter and Eliza Hall Institute that continues today led by Associate Professor Jason Tye-Din. During this time, Bob and his team designed Nexvax2, the first targeted immune therapy for coeliac disease. Bob co-founded the biotech startup, Nexpep, in 2005 and led the preclinical and first in human testing of Nexvax2. He moved to the United States in 2012, and continued
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the clinical development of Nexvax2 as Chief Scientific Officer at ImmusanT. He returned to Australia in January 2020. Bob practices in Mackay QLD as a gastroenterologist, and continues his interests in immunology research as an Honorary Fellow at Wesley Medical Research in Brisbane, and
Dicke’s description, in 1953, of the effects of gluten in children with coeliac disease is regarded as perhaps the most important study in coeliac disease because it laid the foundation for the gluten free diet. ____
BOB ANDERSON
CNZ Patron
in development of new approaches to diagnosis and treatment of coeliac disease. Willem Dicke’s original gluten feeding studies Dicke’s description, in 1953, of the effects of gluten in children with coeliac disease is regarded as perhaps the most important study in coeliac disease because it laid the foundation for the gluten free diet.1 Dicke and his colleagues wrote, “If wheat is banished from the diet and rice flour, maize starch, peeled, boiled potatoes are given instead, the anorexia, vomiting and abdominal pain disappear, the acute attacks of diarrhoea cease, the faeces
become darker in colour, the patient gains in weight and finally the growth in height becomes normal, or even more than normal. If wheat is given again, the anorexia returns, the attacks of diarrhoea reappear, the stools become more liquid and lighter in colour, the weight decreases and growth slows down or is arrested.” Twenty-six years later, researchers in London studied 28 adults with coeliac disease on gluten free diet who were told, “to eat a normal diet containing at least four slices of bread (10 grams gluten) per day”.2 They went on to observe, “The commonest symptom was tiredness followed closely by
INADVERTENT EXPOSURE TO GLUTEN IN FOOD YOU THINK IS GLUTEN-FREE IS P R O B A B LY Q U I T E COMMON FOR MANY PEOPLE WITH COELIAC DISEASE
TA K E AWAY S F R O M T H E S E S T U D I E S • Consistency. Symptoms after vital wheat gluten food challenge have been very similar in two separate studies in volunteers with coeliac disease from Australia, New Zealand and the United States. The strong relationship between elevations in serum interleukin-2 with nausea and overall severity of gastrointestinal reactions has been consistent in five separate studies, and using different gluten challenge formats.10, 11 • Dose and duration. In each study, the amount of gluten ingested has been relatively high, so future studies are planned in Australia to test the effects of small amounts of gluten. There is a strong suggestion that symptoms caused by regular gluten intake are milder than after occasional exposures, and this should also be explored in future studies.4 In fact, symptoms during extended gluten challenges mimic irritable bowel syndrome, but it is
an open question whether these symptoms may be caused by FODMAPs if the food challenge material is standard wheat bread. • FODMAPs are important. Careful attention is needed to ensure that future studies seeking to understand the effects of gluten should avoid the confounding effects of FODMAPs. • Gluten without symptoms – silent damage. These recent studies convincingly show that early onset nausea and vomiting after ingestion of gluten in people who have coeliac disease are closely linked to immune activation. There are also many people with coeliac disease, overall a third in these recent studies, who did show elevations in interleukin-2 after gluten but had minimal or no obvious symptoms.
diarrhoea, distension, and feeling unwell. It was interesting that 19 patients did not have diarrhoea. Four patients complained of pain; in two this was sharp: one had odd niggles and the last had back pain similar to that she had had before the initial diagnosis of coeliac disease was made.” Inadvertent exposure to gluten in food you think is gluten-free is probably quite common for many people with coeliac disease.3 Most people with coeliac disease who strictly avoid gluten will be fairly confident that they know when they have been “glutened”.4 Abdominal pain followed by diarrhoea are the digestive symptoms most often identified after gluten.4 Few people with coeliac disease identify nausea as their most troubling digestive symptom after gluten, but as many as one-five report vomiting.4 RESET CeD Nexvax2 study: gluten without FODMAP There has been very little research that has carefully teased apart what symptoms are caused by gluten after a single exposure. One view has been that anticipation of distressing symptoms (“nocebo” effect) plays a role when people on gluten-free diet knowingly consume gluten.5 Gluten is often found in food that worsens digestive symptoms in people who don’t have coeliac disease. For example, high levels of poorly absorbed carbohydrates (FODMAPs) in wheat flour can cause symptoms similar to irritable bowel syndrome in people who don’t have coeliac disease.6, 7 Over 60 years after Dicke’s studies, the RESET CeD Study assessing whether Nexvax2 protected against symptoms caused by gluten was the first study in coeliac disease to separate effects of gluten and the immune reaction to gluten from those that may be caused by FODMAPs.8 Participants consumed a series of food challenges. Participants and staff in the RESET CeD Study knew that the first food challenge contained gluten, about half the daily amount in an
Feature / U P D A T E F R O M O U R P A T R O N ( c o n t . )
____
Most participants reported that their worst symptom after gluten was either diarrhoea or abdominal pain. unrestricted diet. It was taken over twominutes as a liquid slurry of ten grams vital wheat gluten mixed in water. Vital wheat gluten is a protein-enriched food product prepared from wheat flour by washing starch from a dough. The food challenge contained about 8 grams of gluten protein. The second and third food challenges in the study were three to four months later. To control for the potential nocebo effect, these food challenges were matched in appearance, taken with the same flavoring, and staff and participants were unaware which was the gluten-free “sham” or gluten-containing “active” challenge. The active challenge had the same amount of gluten as the first food challenge. All of the food challenges were low in FODMAPs. Gluten symptoms are early, reproducible, and usually include nausea not diarrhoea At the start of the RESET CeD Study, most participants reported that their worst symptom after gluten was either diarrhoea or abdominal pain. After food challenges, participants graded severity of their symptoms. A final aspect of these food challenges was that a new blood biomarker (serum interleukin-2) discovered during the Nexvax2 development program was used to monitor activation of gluten immunity over the hours after food challenge.9 Nausea and vomiting were the dominant symptoms after the “masked” gluten food challenge, collectively they affected two-thirds of the
volunteers. Overall, symptoms like irritable bowel syndrome were absent unless nausea was also experienced. Diarrhoea was uncommon except when reactions were severe, and nausea and vomiting were present. For the one in three participants who did not experience nausea after gluten, their symptoms were no different from those after the gluten-free sham food challenge. Symptoms were similar after the masked and unmasked gluten food challenges, which indicated that the nocebo effect after this was small. Tiredness, headache, abdominal pain and cramping were also more severe after gluten, but were not significantly more common compared to sham because these were often present to some degree with the sham food challenge. A detailed time course for symptoms after the unmasked gluten challenge showed that onset of symptoms was usually 1-2 hours, and peaked at 3-4 hours. Nausea was relatively early and usually began after one-andhalf hours. If vomiting happened, it began half-an-hour after the onset of nausea. Diarrhoea was a relatively late symptom. Overall, serum interleukin-2 levels were elevated in almost all participants, and correlated with the timing and severity of nausea and overall severity of digestive symptoms. CL
DISCLOSURES Consultant to GSK (USA), Takeda Pharmaceutical Company Ltd /Millennium Pharmaceuticals (USA), Allero Therapeutics BV (Netherlands), Kanyos Bio Inc (USA), Atheneum Partners GmbH (Germany), TregTherapeutics, Inc (USA), Bioniz Therapeutics, Inc (USA), and Malaghan Institute of Medical Research (Wellington, NZ); Founder, Novoviah Pharamceuticals Pty Ltd (Brisbane, QLD); and inventor with no financial interest for 60 granted and 91 pending patents applications (18 patent families).
26 | Autumn 2021 Coeliac Link
Dicke WK, Weijers HA,Van de Kamer JH. Coeliac Disease. II. The Presence in Wheat of a Factor Having a Deleterious Effect in Cases of Coeliac Disease. Acta Paediatr. 1953;42(1):34-42. 2 Kumar PJ, O'Donoghue DP, Stenson K, Dawson AM. Reintroduction of Gluten in Adults and Children With Treated Coeliac Disease. Gut. 1979;20(9):743-9. 3 Syage JA, Kelly CP, Dickason MA, Ramirez AC, Leon F, Dominguez R, Sealey-Voyksner JA. Determination of gluten consumption in celiac disease patients on a gluten-free diet. Am J Clin Nutr. 2018;107(2):201-207. 4 Silvester JA, Graff LA, Rigaux L, Walker JR, Duerksen DR. Symptomatic Suspected Gluten Exposure Is Common Among Patients With Coeliac Disease on a Gluten-Free Diet. Aliment Pharmacol Ther. 2016 Sep;44(6):612-9. 5 Servick K. What’s really behind ‘gluten sensitivity’? Science 2018; 360(6391):doi:10.1126/science. aau2590 6 Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology. 2014;146(1):67-75. 7 Skodje GI, Sarna VK, Minelle IH, Rolfsen KL, Muir JG, Gibson PR, Veierod MB, Henriksen C, Lundin KEA. Fructan, Rather Than Gluten, Induces Symptoms in Patients With Self-Reported Non-Celiac Gluten Sensitivity. Gastroenterology. 2018;154(3):529-539. 8 Daveson AJM, Tye-Din JA, Goel G, Goldstein KE, Hand HL, Neff KM, Williams LJ, Truitt KE, Anderson RP; RESET CeD Study Group. Masked bolus gluten challenge low in FODMAPs implicates nausea and vomiting as key symptoms associated with immune activation in treated coeliac disease. Aliment Pharmacol Ther. 2020;51(2):244-252. 9 Tye-Din JA, Daveson AJM, Ee HC, Goel G, MacDougall J, Acaster S, Goldstein KE, Dzuris JL, Neff KM, Truitt KE, Anderson RP. Elevated serum interleukin-2 after gluten correlates with symptoms and is a potential diagnostic biomarker for coeliac disease. Aliment Pharmacol Ther. 2019;50(8):901-910. 10 Goel G, Tye-Din JA, Qiao SW, Russell AK, Mayassi T, Ciszewski C, Sarna VK, Wang S, Goldstein KE, Dzuris JL, Williams LJ, Xavier RJ, Lundin KEA, Jabri B, Sollid LM, Anderson RP. Cytokine release and gastrointestinal symptoms after gluten challenge in celiac disease. Sci Adv. 2019;5(8):eaaw7756. 11 Tye-Din JA, Skodje GI, Sarna VK, Dzuris JL, Russell AK, Goel G, Wang S, Goldstein KE, Williams LJ, Sollid LM, Lundin KE, Anderson RP. Cytokine release after gluten ingestion differentiates coeliac disease from self-reported gluten sensitivity. United European Gastroenterol J. 2020;8(1):108-118. 12 Daveson AJM, Tye-Din JA, Anderson RP. Editorial: inaccuracies in attribution of symptoms due to gluten-not just in those with self-reported noncoeliac gluten sensitivity. Authors' reply. Aliment Pharmacol Ther. 2020;51(3):403-404. 1
All your pantry favourites covered The Countdown Free From Gluten range has everything you need to enjoy the foods you love
Proud partner of Coeliac NZ
Range may vary by store.
Feature / PT AR RA K V EHL Y A T T
T
AN
afternoon
EA AFFAIR
Coeliac Link talks to two talented chefs ZACHARIAH MEADS, and SAM HEAVEN, who both have a passion for gluten free dining at the PARK HYATT in Auckland. FTERNOON
tea – what’s not to love? A delicious and mouthwatering selection of pastries, savouries, cute cupcakes, biscuits, specialty teas and perhaps a glass of bubbles if you’re in for an afternoon affair. But unfortunately, most of the finger food delights which we associate with traditional afternoon tea can’t
28 | Autumn 2021 Coeliac Link
be enjoyed by those following a strict gluten-free diet – or can they? Meet two chefs who believe that food should be enjoyed by everyone. Find out what inspired Zachariah to reinvent this English tradition at the Park Hyatt; and where Sam's top award will take him.
TH E M E N U W A S A D D E D P R O O F TH AT C O O K I N G A N D B A K I N G G F I S C O M P L E T E LY P O S S I B L E I N EV E RY H O S PITA LIT Y E STA B LI S H M E NT
We are moving in the right direction by providing the opportunity [for coeliacs] to experience the full food journey that we offer.
Zachariah Meads When I was in my late teens my mother was diagnosed with gluten intolerance. Albeit not with coeliac disease she was still stuck with a coeliac diet. At the same time, I was progressing through college and chef training. So, for practice I ended up making the majority of my trial's gluten free, so that my number one
taste tester could try as well. Who else better to critique? A few years down the line working full time in the hospitality industry with more experience under my belt, it has opened my eyes even more with the need to provide fully gluten free menus and dishes to those affected by coeliac disease, as they have always
SA M H E AV E N TA K E S o u t t h e TO P AWA R D In response to the challenges presented by the successive hospitality lockdowns the The Nestlé Golden Chefs Hat Award inspired young chefs to push the boundary of their culinary talent. I N R E S P O N S E to the challenges presented by the successive hospitality lockdowns the The Nestlé Golden Chefs Hat Award inspired young chefs to push the boundary of their culinary talent. Moving to video entries in late 2020 enabled New Zealand chefs to enter the competition despite the travel restrictions. This allowed even more young chefs to put themselves to the test, showcasing their best dishes to judges in a virtual presentation. Sam Heaven’s was awarded as the winner of the Nestle Golden Chefs Hat Award and his entry can be seen online at youtube. com/watch?v=Cn8Usf3orcg Sam says, “What motivates me the most is the fact that I’m
third generation hospitality, my grandfather and my father were both pastry chefs and I really wanted to follow in their footsteps, but I wanted to make my own path and make my own journey at the same time. I really wanted to use the passion that they passed down to me because hospitality is really in my blood, but I want to find my own way in the industry so that’s why I picked cookery.” Sam works in the banquet team at Park Hyatt Auckland and has the ambition to continue his culinary learning in Scandinavia before one day returning to New Zealand to open his own restaurant.
had trouble dining out. With that in mind, while creating the Park Hyatt Auckland Autumn Afternoon Tea Menu I set out with an aim to make all the savoury dishes 100% gluten free. Successfully creating the menu was added proof to myself that cooking and baking gluten free is completely possible in every hospitality establishment; and to provide an experience just as good for those suffering coeliac disease as those who can consume gluten. For the future of the industry and food scene I strongly believe 100% gluten free menus are a necessity. And for us here at Park Hyatt I believe we are moving in the right direction by providing everyone who suffers from coeliac disease the opportunity to experience the full food journey that we offer for the Afternoon Tea Menu from savoury to sweet. CL ____
See p36 for Sam's vegan nut bread and mushroom puree recipe.
coeliac.org.nz | 29
Gluten-free / M E A L I N S P I R A T I O N Nicole 'Percy's fruit sundae.
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Alana Scott’s salami pizza bread stars. CLICK HERE
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HIGH TEA ideas
Countdown's Mexican burrito bowl.
Alana Scott’s Kellogg’s breakfast jars. CLICK HERE
Morgan McKenzie-Moore's tempura veg.
O O K I N G F O R some inspiration to make an indulgent gluten-free treat, or to find a coeliac safe recipe of a classic dish? These easy but impressive dishes are great for gatherings, big or small Log into the member section of the Coeliac New Zealand website to find the 7-day meal plans and to purchase half price Conference tickets.
Sally Holland's almond shortbread. CLICK HERE
FreshLife flatbread.
30 | Autumn 2021 Coeliac Link
FreshLife salmon blinis.
IT
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S
TIPS •••
P
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Top with fresh chopped herbs and CITRUS
slices.
Citrus marscarpone sugar crepes.
B
gluten
Park Hyatt Auckland's banana waffles.
FREE
RUNCH IDEAS
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PURCHASE AN EARLY-BIRD CONFERENCE TICKET AND BE IN TO WIN 1 OF 10 MASSEL GLUTEN FREE GIFT PACKS WORTH $15.00 EACH (T’S AND C’S APPLY).
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iMade for omnivores and flexitarians, vegansi iand vegetarians, this award winning range i iof Food Nation products tastes as good as iti ilooks. Jam-packed with fresh ingredients,i ithe focus is on fresh NZ vegetables andi ithese are all gluten free! foodnation.co.nzi iVitality Bars are a delectable blend of ifinest quality nuts and seeds dipped ini i75% dark organic chocolate every bar isi ia nourishing treat packed full of energy.i iUse the coupon code LINK10 at thei icheckout and receive 10% of youri ifirst order. wellandtruly.nzi
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iIf you've been avoiding gluteni iand missing your favourite i icereal, that's all about toi ichange. Kellogg’s® Corn Flakes,i iSpecial K®, and Sultana Bran®, i iare available in Gluten Free.i iGluten free cereal that tastesi iamazing, so everyone cani iexperience something speciali iat breakfast!ikelloggs.co.nzi iFudge and James i iSalted Caramel Biscotti –i itraditional Italian style biscottii iwith decadent salted carameli iand almonds. These addictivei igluten-free treats make thei iperfect gift for coffee lovers!i ifudgeandjames.co.nzi
iLove baking? Check out FreshLife’si irange of specialty gluten free flours.i iPerfect for making pancakes, flatbreads,i icookies, cakes and so much more.i ifreshlifefood.co.nzi
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32 | Autumn 2021 Coeliac Link
LO O K FO R TH E CROSSED GRAIN LO G O Your easy choice when shopping gluten free
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Support to be coeliac safe and gluten free for life.
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Enjoy baking it gluten free!
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For more recipe inspiration, visit our website www.freshlifefood.co.nz @FreshlifeFood
J O
S E AGAR
/ Recipes
BACON AND EGG PIE
INGREDIENTS
2 x 200g Pavillion Flaky Pastry Sheets or 400g block Pavillion Flaky Pastry thawed to room temperature ¼ cup GF maize cornflour or GF flour mix for dusting bench/rolling pin 1 cup grated tasty cheese 5-6 large eggs 6 rashers rindless streaky bacon 2 tbsp chopped parsley Salt and freshly ground black pepper
1. Spray a 23cm pie plate with oil or GF non-stick baking spray. Sprinkle cornflour or GF flour onto the bench and dust a rolling pin. 2. Roll cool pastry into a rectangle and cut two 23cm circles. If you are using pastry sheets these may need to be joined to be large enough. 3. Place one circle into the plate and gently press into the base. Sprinkle half of the grated cheese into the base. Cover with bacon rashers. 4. Break eggs onto bacon, reserving
TIPS ••• This kiwi classic is perfect HIGH TEA
fare.
Cut into petites and top with chutney.
the second circle over the top. Press edges together, crimp with a fork. 7. Whisk reserved yolk with a teaspoon of cold water and brush the surface and edges of the pie. Prick surface with a fork or tip of a sharp knife to allow steam to vent. 8. Place prepared pie in the fridge or freezer to cool – pastry should be very cold going into a hot oven for best baking results. 9. Preheat oven to 200°C. Bake pie for 20 minutes then reduce the
one egg yolk. Puncture yolks, but do
temperature to 180°C and cook a
not mix. If they are whisked, the pie
further 15-20 minutes until pastry
becomes more like a quiche.
is crisp and the pie well risen.
5. Sprinkle chopped parsley, salt and pepper, and the remaining cheese. 6. With a wet pastry brush, moisten the edges of the pastry and place
10. Cool in the plate for 10 minutes before carefully turning out to cut. ____
Serves 8-10
coeliac.org.nz | 35
Recipes / B R E N T M A R T I N
VEGAN NUT BREAD
DAY O N E I N G R E D I E N T S
450g Bakels Gluten Free Flour Mix 500g tepid water 10g Bakels Dried Yeast 250g of Hazelnut Flour 150g of roughly chopped toasted nuts (any desired nuts) 20g of olive oil
1. Mix all day one ingredients together and put into large bowl. 2. Cover. Leave to sit at room temp
DAY T WO I N G R E D I E N T S
temperature a further time to 150°C and bake 15 minutes.
for 1 hour. Then place in fridge for
This gives the bread time to dry
two days. (Overnight will do but
out and fully cook in the centre.
the flavour won’t be as good)
This time isn’t imperative but
3. Day three mix Salt, Coconut Yoghurt and Gluten Free Flour together. Fold into your day
10g dried yeast or 20g Fresh Yeast 50g Coconut Yoghurt (my favourite Raglan Coconut yoghurt) 150g Bakels Gluten Free Flour 10g salt (I love to use Marlborough Flaky Sea Salt)
10 minutes. I then lower the
it’s good to do if you are wanting crispier crust. 11. When finished baking remove
one mix. After this is fully
from oven and place on a
incorporated add your remaining
cooling rack.
yeast and mix once again. Your
12. Slice a generous slice and eat with
dough should be thick but still
lashings of Lewis Road Creamery
slightly runny, reminiscent of a
Butter, or for my vegan and dairy
focaccia bread dough.
free friends, lather the bread with
4. Line a tray or loaf tin (We use Le Cresuet loaf tin) with baking
lashings of coconut butter. 13. Keep in an airtight container or
paper and spray with oil spray
wrapped in the freezer portioned
or brush with olive oil. Put your
out to make it easy to use and
dough into the tray smooth out
wrapped at all times to keep from
the top and cover with cling wrap.
drying out.
5. Leave to sit in a warm spot to rise. Somewhere from 1 hour to
One of the wonders of gluten free
2 hours. Or when the dough has
bread is its ability to be frozen
risen by one third.
and stay almost as good as it is
6. Preheat oven to 220°C fan bake.
CNZ
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7. Place a tray with cold water in the
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36 | Autumn 2021 Coeliac Link
when baked. We use this bread for our
bottom of your oven, this will help
Afternoon Tea menu. Toasted and
keep the bread moist and give it a
topped with nuts, mushroom and
delicious crispy crust. 8. Place your loaf in the oven and bake 10 minutes at 220°C. 9. Lower oven to 200°C a further 10 minutes. 10. And a third time at 180°C for
micro herbs. ____
Makes one loaf. For the mushroom puree afternoon tea recipe, visit the member recipe section of the Coeliac New Zealand website.
VO LU NTE E R
CO O RD INATO RS
/ Directory
••• Our coordinators are L I S T E D on the following page. •••
REGIONAL DIRECTORY
Northland Whangarei
Jo c e ly
Warkworth Hibiscus Coast Coromandel
nH
AUCKLAND
nd
e
Tauranga/Katikati
Waikato
ry,
N elso n
Rotorua Taupo
Taranaki
s, N
Email: admin@coeliac.org.nz to check if there is a volunteer in your area – we can then connect you!
g
s
em Sa m W
ys
Hakwes Bay
a pi e r / H a s t
in
NO RT H
Wairarapa
Nelson
Blenheim
Buller/Karamea
I SLAND
North of Auckland Rodney Julienne Law
WELLINGTON
____
Hokitika/West Coast
Whangarei Natalie Carmichael FBK Whangarei Coeliac Group
North Canterbury (Amuri) CHRISTCHURCH
____
Ashburton Wanaka Queenstown
Hibiscus Coast Dannielle Walker
South Canterbury
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Oamaru/Otago
Auckland Auckland North/East Ben Grant
DUNEDIN
Southland
____
Teres a Al
l
en
,N
a pier/ H astin
gs
Auckland Kids Club Auckland Juliane Winter-Noakes FBK Coeliac NZ Auckland Kids Club
coeliac.org.nz | 37 coeliac.org.nz | 37
Directory / A R E A C O O R D I N A T O R S
Coromandel Thames Jan Autumn
Wellington Kids Club Wellington Nerys Foster
North Canterbury Christchurch Rob Rae
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Nelson Margaret Watson
South Canterbury Nancy Webster, Joan Simpson and Joy McNulty
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Nelson Kids Club Nelson Jocelyn Hendry
East Otago Dunedin Heather Wilson
____
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Marlborough Blenheim Libby and Sophie Westenra FBK Coeliac Marlborough Support Group
Otago Rebecca Heffernan
SO UTH
____
Waikato Hamilton Marina Grantham-Campbell ____
Hamilton Kids Club Hamilton Leagh-Ann Wesselson ____
Tauranga Elly McKenzie ____
I SLA ND
Eastern BOP Kids Club Rotorua Lizzy Eckersley
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South Waikato Taupo Jill Henson
West Coast West/Central Sandra and Karl Jackson
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Napier/Hastings Fiona Lambert, Sam Wemyss, and Teresa Allen.
North Canterbury Amuri Danette Moriarty
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Wellington Wellington (Vacant)
Christchurch Kids Club Christchurch Pip Meads
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West Coast/Buller Barry Chalmers
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Wanaka Kids Club Wanaka Zoe Huggett ____
Dunedin Kids Club Dunedin Lisa Russell ____
W E N E E D YO U ! ••• If there is no coordinator in your A R E A please get in touch!
A BIG THANKS to our funders – COGS, Lottery Grants Board, Pub Charity, The Lion Foundation, and The Southern Trust – without whose support we would not be able to deliver educational tools to increase diagnosis, or develop resources to support the everyday existence of people living with coeliac disease.
Join the team to learn new skills and connect with people in your community
IT’S B ETTE R TO G ETH E R
FIND OUT HOW! Email: admin@coeliac.org.nz
VOLUNTEERING IS ESSENTIAL TO OUR O RG A N I SAT I O N
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SOPHIE
Volunteer Coordinator
ENDORSED
A & NZ ALI TR
ELIAC AU CO S BY
