Food Solutions Magazine May 2015 by Food Solutions Magazine

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TABLE OF CONTENTS

Science

When is it appropriate to introduce gluten to infants? Leigh Reynolds explains two (somewhat opposing) sides of the research and provides us with an educated ballpark timeline for first feeding gluten to babies.

Food

From Cooking with Cast Iron to nutrition facts and uses for this month’s gluten-free whole grain of the month, Amaranth, as well as plenty of easy to prepare gluten-free recipes, the Food section is your one-stop resource for a delicious month of meals!

Nutrition

Even if you do not have celiac disease, Dr. Mark Hyman suggests that gluten may be killing you. Read his latest on why gluten in the diet may be causing all your health problems and how to solve them.

26 Nutrition

Is Gluten Free Forever? That’s the question Dr. Aviva Romm is asking – and answering – in this month’s article on whether or not a gluten-free diet must be sustained over the lifetime.

Editor’s Letter................................................................................................ 4

Chicken Black Bean Wraps..................................................................... 40

Letters to the Editor.................................................................................... 8

Mexicana Chili with Quinoa....................................................................42

When Should Gluten be Introduced to Babies ................................ 10

Belgian Endive & Salsa.............................................................................44

Eating Gluten-Free the Right Way.........................................................15

Plantain Bacon Fritters............................................................................46

Check Up with Dr. Mark Hyman............................................................20

Editor’s Picks...............................................................................................48

Is the Gluten-Free Diet Forever?...........................................................26

Twice Baked Squash.................................................................................50

Celiac Disease Symptoms Checklist.....................................................30

Quest Raspberry Cheesecake................................................................ 52

Celiac Disease Facts.................................................................................. 32

Amaranth Whole Grain of the Month.................................................54

Top 10 Things to Love about Your Gluten-Free Diet....................... 35

Decadent Paleo Brownies.......................................................................56

Gluten-Free Products To Try Now.........................................................36

Cooking with Cast Iron.............................................................................62

This Month’s Recipes................................................................................38

Bonus: Upper GI Health............................................................................65

Healthy Artichoke Dip.............................................................................. 39

M AY I S S U E / F O O D S O L U T I O N S M A G A Z I N E /

GLUTEN FREE

Bonjour! I’m writing to you this month from the French countryside, enjoying the rolling hills and golden fields of Normandy, where I’ll be living and working until fall. Although we aren’t presently on the same continent, you and I are still connected by our need to live gluten-free every day for our health. While that may seem an insurmountable task in France, the land of the baguette and croissant, you may be surprised to learn it’s really not that different than in the good ol’ USA. Once you master the lingo (gluten-free = sans gluten) and learn where to look, gluten-free living is tres facile (very easy)!

Of course, it’s always our goal here at FSM to make gluten-free living easy for you, wherever you are. This issue, we are shining the spotlight of awareness on celiac disease in observance of Celiac Awareness Month during May. Our experts have some fantastic articles for us this month from discussing when to introduce gluten to infants to whether or not one must live gluten-free forever. We also welcome a brand new monthly contributor, Dr. Vikki Peterson of the HealthNOW Medical Center in Sunnyvale, California. This month, Dr. Vikki tells us how to eat gluten-free the right way! And speaking of eating, you’ll find plenty of delicious gluten-free recipes in this issue, along with a useful piece on May’s (naturally gluten-free) grain of the month, amaranth. It’s a terrific gluten-free whole grain that is also a complete protein, perfect for nearly everyone’s diet. Enjoy this, and so much more, and don’t forget – it’s important to spread a positive message about celiac disease and gluten-free living every month of the year. Why not share FSM with someone who may benefit from the fact-based information and the gluten-free recipes in each issue?! Sometimes it’s the smallest gesture that makes the greatest impact. Together, we can make a difference in the world’s understanding of celiac disease and the need for a gluten-free diet, regardless of where we are. Until next month, have a happy, healthy May!

Gigi Stewart, M.A. Editor in Chief

FOOD SOLUTIONS EDITOR-IN-CHIEF Gigi Stewart gigi@foodsolutionsmag.com CREATIVE SERVICES Kreative Direktions

CONTRIBUTING WRITERS Aviva Romm, MD Lisi Parsons Leigh Reynolds Mark Hyman, MD Jill Carnaham, MD Dr. Vikki Peterson COPY EDITOR Jodi Palmer PUBLISHER & CEO Scott R. Yablon syablon@foodsolutionsmag.com ADVERTISING SALES & MARKETING KMI: 561.637.0396 ADVERTISING SALES DIRECTORS Erica Singer 201.766.8471 Kristen LaBuda 717.574.3739 DIRECTOR OF CLIENT SERVICES Jody Baratz jody@foodsolutionsmag.com CHIEF TECHNOLOGY OFFICER Brian A. Yablon byablon@foodsolutionsmag.com TECHNICAL WEB DEVELOPER Dmitry Bogordsky ACCOUNTING accounting@foodsolutionsmag.com ARTICLE SUBMISSIONS gigi@foodsolutionsmag.com INFORMATION REQUESTS info@foodsolutionsmag.com

ADVISORY BOARD Cynthia S. Rudert, M.D., F.A.C.P., CD & Gluten Intolerance Specialist Marci Page Sloane, MS, RD, LDN, CDE, Registered & Licensed Dietician / Nutritionist & Certified Diabetes Educator Leigh Reynolds, GF Therapeutics / Celi-Vites President

/ F O O D S O L U T I O N S M A G A Z I N E / M AY I S S U E

CONTRIBUTORS

research, advocacy and public

Dr. Rudert is Medical Advisor for

policy work, he strives to improve

the Celiac Disease Foundation, the

access to Functional Medicine, and

Gluten Intolerance Group of North

to widen the understanding and

America and for the Gluten Free

practice of it, empowering others

Certification Organization (GFCO).

to stop managing symptoms and

She is Medical Director for Atlanta

instead treat the underlying causes

Gluten Intolerance Group (GIG),

of illness, thereby also tackling our chronic-disease epidemic. LEIGH REYNOLDS recognized a

and founder and president of the States that manages adults and

Atlanta Women’s Medical Alliance,

teenagers with celiac, she has

the largest alliance of female

need for high quality-gluten free

Dr. Hyman is Chairman of the

evaluated over 1000 patients with

physicians in the United States.

nutritional supplementation so she

Institute for Functional Medicine,

celiac disease and gluten

In demand as an expert in celiac

founded Gluten Free Therapeu-

and was awarded its 2009 Linus

sensitivity.

disease, she was the Keynote

tics™. Leigh set out to make one of

Pauling Award for Leadership

the most beneficial gluten-free

in Functional Medicine. He is

Dr. Rudert’s focus is identifying the

including the New England Celiac

supplement lines available. With

currently medical editor at the

core causes of gastrointestinal

Conference, co-hosted with the

high quality pharmaceutical grade

Huffington Post and on the

issues with a comprehensive

Beth Israel Deaconess Medical

ingredients and scientifically

Medical Advisory Board at The

evaluation enabling her to treat

Center/Harvard, and national GIG

researched formulations Gluten

Doctor Oz Show. He is on the

underlying medical conditions

meetings. Dr. Rudert was the

Free Therapeutics™ is proud to

Board of Directors of The Center

that may have previously been

advising physician for the popular

offer its customers a superior line

for Mind-Body Medicine, and a

undetected. Dr. Rudert then

television series House which

of nutritional supplements called

faculty member of its Food As

creates an individualized course

featured a segment concerning

CeliVites.

Medicine training program. He is

of treatment tailored to each

celiac. Dr. Rudert is a former

also on the Board of Advisors of

patient’s unique set of needs.

Assistant Professor of Medicine

Memhet Oz’s HealthCorps, which

Rather than just treating the

with Emory University. Learn more

tackles the obesity epidemic by

symptoms of the disease, Dr.

about Dr. Rudert and her practice

“educating the student body” in

Rudert believes the best results

at DrCynthiaRudert.com.

American high schools about

are achieved by getting to the

nutrition, fitness and mental

core cause of the problem and

resilience. He is a volunteer for

treating the disease accordingly.

Partners in Health with whom he

Dr. Rudert sees patients from all

worked immediately after the

over the United States for second

earthquake in Haiti and continues

opinion consults on a variety of

MARK HYMAN, MD has dedicated

to help rebuild the health care

gastrointestinal disorders.

his career to identifying and

system there. He was featured on

addressing the root causes of

60 Minutes for his work there.

chronic illness through a

Speaker for multiple programs

Committed to educating the public, patients and physicians about

MARCI PAGE SLOANE, MS, RD,

groundbreaking whole-systems

CYNTHIA S. RUDERT, M.D.,

this commonly missed disorder,

LDN, CDE is a Registered and

medicine approach known as

F.A.C.P., is a Board Certified

Dr. Rudert lectures throughout

Licensed Dietitian/Nutritionist and

Functional Medicine. He is a family

Gastroenterologist in Atlanta,

the United States and Canada on

Certified Diabetes Educator in

physician, an eight-time New York

Georgia, whose practice is

celiac disease. She also lectures on

south Florida. She grew up in New

Times bestselling author, and an

primarily devoted to the screening

inflammatory bowel disease, irri-

York City where she graduated

internationally recognized leader in

and following of patients with

table bowel syndrome, pancreatic

from Columbia University with a

his field. Through his private

celiac disease. With one of the

exocrine insufficiency and small

double Master’s degree in

practice, education efforts, writing,

largest practices in the United

intestinal bacterial overgrowth.

Nutrition and Physiology.

/ F O O D S O L U T I O N S M A G A Z I N E / M AY I S S U E

CONTRIBUTORS

Marci is CEO of Food Majesty, Inc.

that respects the intrinsic healing

HealthNOW is known for using

author of Reality Diabetes ~ type

capacities of the body and nature

a multi-disciplined approach to

2, The Diet Game: Playing for Life!,

- while helping women take their

address complex health problems,

The Divorced Woman’s Diet and is

health into their own hands. Her

many of which are rooted in

contributor to Chicken Soup for

goal is to foster greater access to

gluten intolerance. Patients travel

the Soul Healthy Living Series

a health-based, trans-disciplinary

from all over the world to experi-

Diabetes. Sloane is a nutrition and

health care model. Her primary

ence the best of what HealthNOW

disease counselor, speaks

commitment is to practicing and

offers, combining internal medi-

frequently in the community, is

teaching clinical medicine,

cine, clinical nutrition, chiropractic

coordinator of American Diabetes

Herbal Medicine for Women, a

promoting an ecological basis for

and physical therapy, to identify

Association (ADA) programs, an

distance course with over 800

health, and continuing to care for

the underlying root cause of the

ADA Valor Award recipient and

students around the world. An

mothers, children, and families.

patient’s health condition.

does radio, television and

internationally respected

magazine interviews. Marci is

authority on botanical and

Dr. Romm practices Functional

Practicing for over 20 years, Dr.

passionate about her work and it

functional medicine for women

Medicine for women and children

Petersen remains at the forefront

shows when you meet her.

and children, with 30 years of

at The UltraWellness Center of

of advances in the field of gluten

clinical experience, she is the

Dr. Mark Hyman in Lenox

intolerance, which earned her the

author of 7 books on natural

Massachusetts.

title of Gluten Free Doctor of

medicine, including Botanical

the Year.

Medicine for Women’s Health,

Learn more at www.avivaromm.

winner of the American Botanical

com and visit her on Facebook

She co-authored the book, The

Council’s James Duke Award.

www.facebook.com/AvivaRom-

Gluten Effect, celebrated by other

mMD

leading experts in the field as a

Dr. Romm is an Adjunct Assistant

huge advance in gluten sensitivity

Clinical Professor in the Depart-

diagnosis and treatment.

ment of Family Medicine at Tufts Chef LISI PARSONS, two-time

University School of Medicine. She

Dr. Petersen donates much of her

author of gluten-free & Paleo

is also a member of the Advisory

time to the community where she

Cookbooks, a recipe developer for

Board of the Yale Integrative

speaks about health awareness at

fitness professionals, and a

Medicine Program, is Medical

corporate events in Silicon Valley,

diagnosed celiac. She also suffers

Director of the American Herbal

inclusive of Fortune 500 compa-

from Hashimoto’s disease and

Pharmacopoeia and Therapeutic

nies. She is a national lecturer, ra-

recovered from a disabling nerve

Compendium, and sits on the

injury with the help of whole foods.

expert panel of the American

DR. VIKKI PETERSEN is con-

specifically on the topic of gluten

Lisi has worked as a personal

Herbal Products Association’s

sidered a pioneer in the field of

sensitivity and celiac disease.

trainer and meal planner for fire

Botanical Safety Handbook. She

gluten sensitivity and is ac-

and police departments. She is also

also serves on the Advisory

knowledged in the U.S. for her

She is on the advisory board

a frequent contributor to fitness

Committee of the American

contributions to, and education of,

along with holding an associate

magazines and fitness web pages.

Botanical Council and as Associate

gluten awareness in our country.

editor at-large position at Simply

www.wortheverychew.com

Editor of the Journal of Restor-

A certified clinical nutritionist, and

Gluten-Free Magazine. She has

ative Medicine.

doctor of chiropractic, she is also

been interviewed by CNN Head-

an IFM Certified Practitioner (Insti-

line News and Better Homes & Gardens, amongst others.

AVIVA ROMM, MD is a Board

dio personality and food blogger,

Certified Family Physician,

Dr. Romm is a leader in the

tute for Functional Medicine). She

certified professional midwife,

revolution to transform the

co-founded HealthNOW Medical

herbalist, and the creator of

current medical system into one

Center in Sunnyvale, California.

M AY I S S U E / F O O D S O L U T I O N S M A G A Z I N E /

M AY / L E T T E R S T O E D I T O R

Dear Food Solutions Team, I found you through a friend after I was diagnosed with celiac disease two months ago and I am in love! Thank you for all the delicious and easy to prepare recipes. I can make a single meal for my entire family and no one complains – my dream come true!! I tell everyone I know about this great publication, whether gluten-free or not. I think it’s a great resource for anyone wanting a healthier lifestyle. Karen K. Ontario Canada Hello FSM! I had to write to say I’ve made the cupcakes featured in the February issue 3 times since then. We had 2 birthdays in our family and I made the cupcake batter into 2 cake layers, filled with frosting and

decorated and everyone was shocked to learn the cake was 100% gluten-free! I felt like a rock star and had to share it with you! Thank you, Gladys M. Kuna, Idaho I discovered your magazine via a Twitter posting and decided to give it a read. What a lovely resource for anyone on a gluten-free diet. I have used several of the recipes from previous issues and all turned out fantastic! Thank you for such a reliable (free) resource. What a service you are doing the coeliac and gluten-free community. Richard A. London, England Would it be possible to provide nutrition information for all of the recipes you share? Thank you for

/ F O O D S O L U T I O N S M A G A Z I N E / M AY I S S U E

your magazine, my family loves the recipes I make from it each month. Morgan R. Richmond, Virgina Editor’s Reply: Dear Morgan, we will look into providing nutrition information for our recipes in the future. Thank you for the great suggestion and we’re so happy your family is enjoying those delicious gluten-free dishes!

SCIENCE

/ F O O D S O L U T I O N S M A G A Z I N E / M AY I S S U E

SCIENCE

The risk of developing celiac disease cannot be assessed by looking at only a single factor.

Researchers still don’t know! Our immune system is fantastic. It not only keeps invading germs under control, but it also “teaches” our body how to tolerate food antigens, including gluten. From the moment of birth, this interaction with the environment shapes how a baby’s immune system reacts to different stimuli. As such, early experiences – including the mother’s and the baby’s diet during breastfeeding and weaning - are likely to have a strong impact in the chances of susceptible individuals developing celiac disease. Interestingly, for many years researchers have been discussing whether the age at which gluten is introduced to atrisk babies is one of those factors or not. Maybe it is... It seems intuitive to expect that early introduction of gluten to babies with an increased risk of celiac disease is associated with a higher possibility of developing this condition. Indeed, several studies over the years have characterized this risk, with results showing children exposed to gluten before 3 months of age can be up to five times more likely to develop celiac disease than those with gluten introduced after they get a little older. What is somewhat unexpected is that

the same studies also spotted an upper age limit, after which the risk of developing celiac disease starts to increase again. Early results showed that if children were not exposed to gluten until after they’re 7 months old, they had a two-fold increased risk compared to those that started receiving gluten before.

6 months. Ideally, this should be done in small doses when the infant is still breastfeeding, and not receiving formula or bovine milk products. For example, this is the advice given in Europe by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and in the US, by the American Academy of Pediatrics (AAP).

This window of opportunity between 4 and 6 months gives the idea of a critical period in which the infant’s immune system is more willing to learn to “tolerate” the presence of food antigens, such as gluten. It is interesting to note that currently the World Health Organization recommends exclusive breastfeeding until 6 months of age. If this potential adverse effect of delayed introduction of solids proves to be right, it may lead to changes in future guidelines for those at risk of developing celiac disease.

What other factors may be involved? Nevertheless, these contradictory results forced researchers to dig a little deeper and find what else may be affecting the infants’ immune system and how it reacts to a first dose of gluten. It turns out the risk of developing celiac disease cannot be assessed by looking at a single factor, but it’s in fact a complex interplay of different elements, including how much gluten is consumed at the time of weaning, whether the baby is being breastfed when gluten is introduced and if so, for

… but maybe it isn’t! However, more recent research seems to suggest the best period to introduce gluten is not so restricted after all. In fact, in these studies, no differences in terms of risk of developing celiac disease could be attributed to the age at which infants started eating foods containing gluten. Curiously, when comparing different countries with markedly different approaches in terms of when to introduce gluten and diet at weaning - United States, Finland, Sweden, Germany - the time when gluten was first introduced was not considered a risk factor for the development of celiac disease. World-wide recommendations Despite these less than water-tight results, the advice in most countries around the world is still to take advantage of the window identified earlier and introduce gluten between 4 and

ABOUT THE AUTHOR Leigh Reynolds is the Founder and President of Gluten Free Therapeutics, Inc., the makers of CeliVites, a line of scientifically developed nutritional supplements specifically designed for celiac patients. Leigh set out to make one of the most beneficial gluten-free supplement lines available. With high quality pharmaceutical grade ingredients and scientifically researched formulations Gluten Free Therapeutics™ is proud to offer its customers a superior line of nutritional supplements called CeliVites.

M AY I S S U E / F O O D S O L U T I O N S M A G A Z I N E /

SCIENCE

how long breastfeeding continues afterwards. During the “Swedish Epidemic” for example, characterized by a higher than expected rate of patients suffering from celiac disease, the type of flour commonly used in that country had a much higher gluten content than in neighbouring countries. The same applies to different areas in India, where high rates of celiac disease correlate to the level of gluten in the babies’ diet. In addition, breastfeeding also plays a role in determining how babies react to the introduction of gluten. On one hand, this practice seems beneficial at the time when gluten is first introduced, but if maintained for a long period afterwards, some studies suggest the risk of developing celiac disease increases. This curious “Jekyll and Hyde” scenario is still a conundrum that needs further research to be solved.

Disease and Changes in Infant Feeding. Pediatrics 2013, 131(3): e687 -e694 Lionetti E, Castellaneta S, Francavilla R, Pulvirenti A, Tonutti E, Amarri S, BarbatoM, Barbera C, Barera G, Bellantoni A, Castellano E, Guariso G, Limongelli MG, Pellegrino S, Polloni C, Ughi C, Zuin G, Fasano A and Catassi C. Introduction of Gluten, HLA Status, and the Risk of Celiac Disease in ChildrenN Engl J Med 2014; 371:1295-1303 Norris JM, Barriga K, Hoffenberg EJ, et al. Risk of celiac disease autoimmunity and timing of gluten introduction in the diet of infants at increased risk of disease. JAMA 2005; 293:2343–51.

Vriezinga S, Auricchio R, Bravi E, Castillejo G, Chmielewska A, EscobarP, Kolaček S, Koletzko S, Korponay-Szabo I, Mummert E, Polanco I, Putter H, Ribes-Koninckx C, Shamir R, Szajewska H, Werkstetter K, Greco L, Gyimesi J, Hartman C, Esch C, Hopman E, Ivarsson A, Koltai T, Koning F, Martinez-Ojinaga E, Marvelde C, Pavic A, Romanos J, Stoopman E, Villanacci V, Wijmenga C, Troncone R and Mearin L. Randomized Feeding Intervention in Infants at High Risk for Celiac Disease. N Engl J Med 2014; 371:1304-1315

Johnston M, Landers S, Noble L, Szucs K, Viehmann L. Breastfeeding and the use of human milk. Pediatrics 2012; 129:e827–41. Shamir R. Can Feeding Practices during Infancy Change the Risk for Celiac Disease? IMAJ 2012, 14:50-52 Størdal K, White R and Eggesbø M. Early Feeding and Risk of Celiac Disease in a Prospective Birth Cohort. Pediatrics 2013;132:e1202–e1209

REFERENCES

Agostoni C, Decsi T, Fewtrell M, Goulet O, Kolacek S, Koletzko B, Michaelsen KF, Moreno L,Puntis J, Rigo J, Shamir R, Szajewska H, Turck D, Van Goudoever J. Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr 2008; 46:99–110. Aronsson C, Lee H, Liu E, Uusitalo U, Hummel S, Yang J, Hummel M, Rewers M, She J, Simell O, Toppari J, Ziegler A, Krischer J, Virtanen S, Norris J, Agardh D. Age at Gluten Introduction and Risk of Celiac Disease. Pediatrics 2015, 135(2):239-245 Guandalini S. The influence of gluten: weaning recommendations for healthy children and children at risk for celiac disease. Nestle Nutr Workshop Ser Pediatr Program. 2007;60:139-51; discussion 151-5. Ivarsson A, Myléus A, Norström F, van der Pals M, Rosén A, Högberg L, Danielsson L, Halvarsson B, Hammarroth S, Hernell O, Karlsson E, Stenhammar L, Webb C, Sandström O and Carlsson A. Prevalence of Childhood Celiac

Szajewska H, Chmielewska A, Pieścik-Lech M, Ivarsson A, Kolacek S, Koletzko S, Mearin ML, Shamir R, Auricchio R, Troncone R; PREVENTCD Study Group. Systematic review: early infant feeding and the prevention of coeliac disease. Aliment Pharmacol Ther. 2012 36(7):607-18.

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This original article was created by Gluten Free Therapeutics, Inc. the makers of CeliVites. It is their mission to provide safe and effective supplements and to inform and educate consumers with data driven, medically reviewed content about celiac disease.

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Gluten-Free R E S O U R C E D I R E C TO RY

NUTRITION

M AY I S S U E / F O O D S O L U T I O N S M A G A Z I N E /

NUTRITION

Gluten-free “goodies” and classic gluten replacement foods are a blessing and a curse. They are fine on occasion, but eating them daily is a problem.

Imagine you’ve just been diagnosed with gluten sensitivity or celiac disease. You’ve been given the profound message that gluten can never cross your lips again. It’s scary and overwhelming. Or perhaps there has been no formal diagnosis but you have discovered for yourself that gluten isn’t your friend. Now what? What DO you eat? The natural first inclination is to begin the mourning process over your favorite bread, pasta, brownie, cookie, or croissant. Once something is taken away from us we tend to almost fixate on it. Okay, I give you permission - go out and eat some gluten-free goodies. It will help the transition and make you realize that an occasional cookie, cake, pizza or the like is still available. Give it a few weeks, a month tops and then implement what I’m about to tell you. I pride myself on telling my readers and my patients the unvarnished

/ F O O D S O L U T I O N S M A G A Z I N E / M AY I S S U E

truth. Granted, when you’re in the field of functional medicine and clinical nutrition, “truths” change as more is discovered as we learn more, but what I currently know as the “truth” is what I’ll share with you.

“GOOD” GLUTEN FREE AND “NOT-SO-GOOD” GLUTEN FREE FOODS

There are some foods that inherently are gluten-free and healthy for you. In this group you’ll find (Please try to opt for organic or minimally non-GMO in all categories.): • Fruits • Vegetables • Beans and legumes • Nuts and Healthy Oils (best oils: olive, avocado, coconut, almond, macadamia and hazelnut) • Eggs (pasture raised, organic please) • Honey, stevia, maple syrup • Herbs, salt, pepper • And, if you eat animal flesh, free-

NUTRITION

range, organic chicken, grass-fed beef, healthy fish that doesn’t tend towards high mercury content (avoid large fish, they accumulate heavy metals with age). The way to consume the above foods is in a state as close to naturally occurring as possible. Think of eating an organic strawberry vs. strawberry jam or eating a steamed new potato vs. eating potato chips.

WHAT ARE THE NOT-SO-GOOD FOODS?

Gluten-free replacements for classic foods like pizza crust, brownies, cookies and cakes, are fine on occasion but these foods in the diet daily can cause issues with staying healthy. While I’m thrilled when a patient follows gluten-free recommendations, I can never leave it at just that if I’m going to improve their health. Realize that gluten, in the celiac or gluten sensitive individual, does a lot of damage to the human body. Many

systems are affected and while removing gluten from the diet is the necessary first step, it is far from the only step.

for you personally. And, it requires good healing food.

Gluten was the flame of the destructive fire, but the destruction it left in its wake now has to be addressed. Removing gluten prevents further destruction; it doesn’t heal the damage that’s occurred. Shouldn’t the body be able to heal itself once the stressor (gluten) has been removed? In a perfect world, yes, and that it is the case for some patients, though not many. The vast majority of patients require help healing their gut, strengthening their immune system and other frequently “hit” systems such as the nervous system, endocrine and reproductive systems. What does it take to heal these body systems? It takes a clinician who understands the best diagnostic, dietary, lifestyle and nutritional tools available and tailor makes a program

The contents of pre-packaged, overly refined, high sugar, high starch gluten-free, desserts, crackers, breads and cakes are not on the nourishing list of foods. Quite the contrary, these

ABOUT THE AUTHOR DR VIKKI PETERSEN, DC, CCN, Certified Functional Medicine Practitioner, is founder of HealthNOW Medical Center in Sunnyvale, CA. She has been awarded Gluten Free Doctor of the Year and authored the critically acclaimed “The Gluten Effect”. HealthNOW Medical Center is a destination clinic and treats patients from across the country and internationally. If your health is not to the level you desire, consider contacting us for a FREE consultation – 408-733-0400.

M AY I S S U E / F O O D S O L U T I O N S M A G A Z I N E /

NUTRITION

overly refined, starchy, typically high in sugar, products act as a stressor to the body, resulting in an increased burden on the body systems we are trying to heal. They tend to result in weight gain, cravings, hormonal imbalance, an increased stress response and further inflammation of major body organs. Remember, inflammation is the enemy that causes degenerative diseases such as heart disease, cancer, diabetes and autoimmune disease. Inflammation must be avoided at all costs. I’m sorry but it’s the truth. It’s okay to gradually move in this direction but, once again, do not languor too long over gluten-free substitutes of unhealthy foods. Your body deserves to be treated to nourishing food that will heal it, not further inflame it.

5 TIPS TO KEEP IN MIND WHEN SHOPPING FOR GLUTEN-FREE FOOD:

1. Look at the ingredient list; if it’s more than 5 to 7 items long, probably

best not to buy it. Of course the best food is the one that doesn’t require an ingredient list: kale, an avocado, an orange. 2. If sugar is listed in the top 2 or 3 ingredients, walk away. 3. If there are chemicals, preservatives, dyes, colors or words you simply cannot pronounce, put the item back on the shelf. 4. Look for words like organic (or at least non-GMO) on the foods you purchase. The hazard of GMO is truly frightening and must be avoided at all costs. 5. Avoid any and all high fructose corn sweeteners, artificial sweeteners (stevia is fine, it’s a real plant) and any products containing vegetable oils such as corn oil, soybean oil, canola oil, safflower, sunflower or cottonseed. These substances are all toxic and cannot be part of a healing diet. While gluten must be a zero quantity for those sensitive, you can definitely work gradiently towards removing the

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above ingredients from your diet. The truth is that cooking will need to be a more integral part of your life if you’re going to enjoy good health. If you’re not the cooking type, work to encourage a close friend or family member who perhaps enjoys cooking to assist you. Believe me it would be worth it to make some arrangements to get some home cooked healthy food in order to know that you are consuming the nourishing nutrition you so desperately require to get healthy.

HINT: use the leftovers from dinner last night as today’s lunch. Grab some healthy fruit and nuts for snacks and you’re good to go. Start your day with a nice green smoothie and there you have it, a healthy day of eating! And if you want to learn to cook healthy, fast and delicious food, feel free to join me on YouTube (Dr Vikki Petersen) where I recently launched a series of cooking videos.

What If All My Symptoms Didn’t Improve A er Following a Gluten-Free Diet?

Eliminating gluten is o en just the first part of treatment and that alone can make a dramatic improvement in one’s health. But equently the improvement is only temporary—and symptoms start to return. This is due to gluten’s effect on the immune system, which may cause several problems to occur. We call these the “secondary effects of gluten”. Our doctors are the leading experts in treating gluten sensitivity and celiac disease. People travel to see us at our Destination Clinic om across the country and internationally due to our highly effective treatment protocols. Regardless of where you live, consider the first step of a FREE PHONE CONSULTATION. Call us to schedule yours. We are here to help!

Location: 1309 S. Mary Avenue, Suite 100 • Sunnyvale, California 94087

www.healthnowmedical.com

Call for a FREE PHONE CONSULTATION: (408) 733-0400

NUTRITION

We used to think that gluten problems or celiac disease were confined to children who had diarrhea, weight loss, and failure to thrive. Now we know you can be old, fat, and constipated and still have celiac disease or gluten sensitivity.

S O M E T H I N G Y O U ’ R E E AT I N G may be killing you, and you probably don’t even know it! If you eat cheeseburgers or French fries all the time or drink six sodas a day, you likely know you are shortening your life. But eating a nice dark, crunchy slice of whole wheat bread–how could that be bad for you? Well, bread contains gluten, a protein found in wheat, barley, rye, spelt, kamut, and oats. It is hidden in pizza, pasta, bread, wraps, rolls, and most processed foods. Clearly, gluten is a staple of the American diet. What most people don’t know is that gluten can cause serious health complications for many. You may be at risk even if you don’t have celiac disease.

The Dangers of Gluten

A recent large study in the Journal of the American Medical Association found that people with diagnosed, undiagnosed, and “latent” celiac disease or gluten sensitivity had a higher risk of death, mostly from heart disease and cancer. (i) This study looked at almost 30,000 patients from 1969 to 2008 and examined deaths in three groups: Those with full-blown celiac disease, those with inflammation of their intestine but not full-blown celiac disease, and those with latent celiac disease or gluten sensitivity (elevated gluten antibodies but negative intestinal biopsy).

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The findings were dramatic. There was a 39 percent increased risk of death in those with celiac disease, 72 percent increased risk in those with gut inflammation related to gluten, and 35 percent increased risk in those with gluten sensitivity but no celiac disease. This is ground-breaking research that proves you don’t have to have full-blown celiac disease with a positive intestinal biopsy (which is what conventional thinking tells us) to have serious health problems and complications–even death–from eating gluten. Yet an estimated 99 percent of people who have a problem with eating gluten don’t even know it. They ascribe their ill health or symptoms to something else–not gluten sensitivity, which is 100 percent curable. And here’s some more shocking news … Another study comparing the blood of 10,000 people from 50 years ago to 10,000 people today found that the incidences of full-blown celiac disease increased by 400 percent (elevated TTG antibodies) during that time period. (ii) If we saw a 400 percent increase in heart disease or cancer, this would be headline news. But we hear almost nothing about this. I will explain why I think that increase has occurred in a moment. First, let’s explore the economic cost of this hidden epidemic.

The most serious form of allergy to gluten, celiac disease, affects one in 100 people, or three million Americans, most of who don’t know they have it. Undiagnosed gluten problems cost the American healthcare system oodles of money. Dr. Peter Green, Professor of Clinical Medicine for the College of Physicians and Surgeons at Columbia University studied all 10 million subscribers to CIGNA and found those who were correctly diagnosed with celiac disease

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used fewer medical services and reduced their healthcare costs by more than 30 perecnt. (iii) The problem is that only one percent of those with the problem were actually diagnosed. That means 99 percent are walking around suffering without knowing it, costing the healthcare system millions of dollars. And it’s not just a few who suffer, but millions. Far more people have gluten sensitivity than you think–especially those who are chronically ill. The most serious form of allergy to gluten, celiac disease, affects one in 100 people, or three million Americans, most of who don’t know they have it. But milder forms of gluten sensitivity are even more common and may affect up to one-third of the American population. Celiac disease and gluten sensitivity masquerade as dozens and dozens of other diseases with different names.

Gluten Sensitivity: One Cause, Many Diseases

A review paper in The New England Journal of Medicine listed 55 “diseases” that can be caused by eating gluten. (iv) These include osteoporosis, irritable bowel disease, inflammatory bowel disease, anemia, cancer, fatigue, canker sores, (v) and rheumatoid arthritis, lupus, multiple sclerosis, and almost all other autoimmune diseases. Gluten is also linked to many psychiatric (vi) and neurological diseases, including anxiety, depression, (vii) schizophrenia, (viii) dementia, (ix) migraines, epilepsy, and neuropathy (nerve damage). (x) It has also been linked to autism.(ix) We used to think that gluten problems or celiac disease were confined to children who had diarrhea, weight loss, and failure to thrive. Now we know you can be old, fat, and constipated and still have celiac disease or gluten sensitivity. Gluten sensitivity is actually an autoimmune disease that creates inflammation

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NUTRITION

According to the New England Journal of Medicine, 55 diseases can be caused by eating gluten.

throughout the body, with wide-ranging effects across all organ systems including your brain, heart, joints, digestive tract, and more. It can be the single cause behind many different “diseases.” To correct these diseases, you need to treat the cause–which is often gluten sensitivity–not just the symptoms. Of course, that doesn’t mean that ALL cases of depression or autoimmune disease or any of these other problems are caused by gluten in everyone–but it is important to look for it if you have any chronic illness. By failing to identify gluten sensitivity and celiac disease, we create needless suffering and death for millions of Americans. Health problems caused by gluten sensitivity cannot be treated with better medication. They can only be resolved by eliminating 100 percent of the gluten from your diet. The question that remains is: Why are we so sensitive to this “staff of life,” the staple of our diet? There are many reasons …

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They include our lack of genetic adaptation to grasses, and particularly gluten, in our diet. Wheat was introduced into Europe during the Middle Ages, and 30 percent of people of European descent carry the gene for celiac disease (HLA DQ2 or HLA DQ8), (xii) which increases susceptibility to health problems from eating gluten. American strains of wheat have a much higher gluten content (which is needed to make light, fluffy Wonder Bread and giant bagels) than those traditionally found in Europe. This super-gluten was recently introduced into our agricultural food supply and now has “infected” nearly all wheat strains in America. To find out if you are one of the millions of people suffering from an unidentified gluten sensitivity, just follow this simple procedure.

The Elimination/ Reintegration Diet

While testing can help identify gluten sensitivity, the only way you will know if this is really a problem for you is to eliminate all gluten for a short period of time (2 to 4 weeks) and see how you feel. Get rid of the following foods:

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ABOUT THE AUTHOR • Gluten (including: barley, rye, oats that are not certified gluten-free, spelt, kamut, wheat, triticale, etc.) • Hidden sources (soup mixes, salad dressings, sauces, as well as lipstick, certain vitamins, medications, stamps and envelopes you have to lick, and even Play-Doh.) For this test to work you MUST eliminate 100 percent of the gluten from your diet–no exceptions, no hidden gluten, and not a single crumb of bread.

Consider trying an elimination diet eliminate gluten for 2 to 4 weeks - to see if your negative symptoms go away. If they do, you may need to eliminate gluten from your diet all the time.

Then eat it again and see what happens. If you feel bad at all, you need to stay off gluten permanently. This will teach you better than any test about the impact gluten has on your body. But if you are still interested in testing, here are some things to keep in mind.

Testing for Gluten Sensitivity or Celiac Disease

There are a variety of tests available that can help identify celiac disease or gluten sensitivity. They will look for: • IgA anti-gliadin antibodies • IgG anti-gliadin antibodies • IgA anti-endomysial antibodies • Tissue transglutaminase antibody (IgA and IgG in questionable cases) • Total IgA antibodies • HLA DQ2 and DQ8 genotyping for celiac disease (used occasionally to detect genetic susceptibility). • Intestinal biopsy When you get these tests, there are a few things to keep in mind.

MARK HYMAN, MD is dedicated to identifying and addressing the root causes of chronic illness through a groundbreaking whole-systems medicine approach called Functional Medicine. He is a family physician, a eight-time New York Times bestselling author, and an international leader in his field. Through his private practice, education efforts, writing, research, and advocacy, he empowers others to stop managing symptoms and start treating the underlying causes of illness, thereby tackling our chronic-disease epidemic. To learn more about Dr. Hyman and Functional Medicine, visit drhyman.com

In light of the new research on the dangers of gluten sensitivity without full blown celiac disease, I consider any elevation of antibodies significant and worthy of a trial of gluten elimination. Many doctors consider elevated anti-gliadin antibodies in the absence of a positive intestinal biopsy showing damage to be “false positives.” That means the test looks positive but really isn’t significant. We can no longer say that. Positive is positive and, as with all illness, there is a continuum of disease, from mild gluten sensitivity to full-blown celiac disease. If your antibodies are elevated, you should go off gluten and test to see if it is leading to your health problems. So now you see–that piece of bread may not be so wholesome after all! Follow the advice I’ve shared with you today to find out if gluten may be the hidden cause of

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NUTRITION

your health problems. Simply eliminating this insidious substance from your diet, may help you achieve lifelong vibrant health.

REFERENCES:

(i) Ludvigsson JF, Montgomery SM, Ekbom A, Brandt L, Granath F. Small-intestinal histopathology and mortality risk in celiac disease. JAMA. 2009 Sep 16;302(11):1171-8. (ii) Rubio-Tapia A, Kyle RA, Kaplan EL, Johnson DR, Page W, Erdtmann F, Brantner TL, Kim WR, Phelps TK, Lahr BD, Zinsmeister AR, Melton LJ 3rd, Murray JA. Increased prevalence and mortality in undiagnosed celiac disease. Gastroenterology. 2009 Jul;137(1):88-93 (iii) Green PH, Neugut AI, Naiyer AJ, Edwards ZC, Gabinelle S, Chinburapa V. Economic benefits of increased diagnosis of celiac disease in a national managed care population in the United States. J Insur Med. 2008;40(3-4):218-28.

(iv) Farrell RJ, Kelly CP. Celiac sprue. N Engl J Med. 2002 Jan 17;346(3):180-8. Review. (v) Sedghizadeh PP, Shuler CF, Allen CM, Beck FM, Kalmar JR. Celiac disease and recurrent aphthous stomatitis: a report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(4):474-478. (vi) Margutti P, Delunardo F, Ortona E. Autoantibodies associated with psychiatric disorders. Curr Neurovasc Res. 2006 May;3(2):149-57. Review. (vii) Ludvigsson JF, Reutfors J, Osby U, Ekbom A, Montgomery SM. Coeliac disease and risk of mood disordersâ&#x20AC;&#x201C;a general population-based cohort study. J Affect Disord. 2007 Apr;99(13):117-26. Epub 2006 Oct 6. (viii) Ludvigsson JF, Osby U, Ekbom A, Montgom-

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ery SM. Coeliac disease and risk of schizophrenia and other psychosis: a general population cohort study. Scand J Gastroenterol. 2007 Feb;42(2):179-85. (ix) Hu WT, Murray JA, Greenaway MC, Parisi JE, Josephs KA. Cognitive impairment and celiac disease. Arch Neurol. 2006 Oct;63(10):1440-6. (x) Bushara KO. Neurologic presentation of celiac disease. Gastroenterology. 2005 Apr;128(4 Suppl 1):S92-7. Review. (xi) Millward C, Ferriter M, Calver S, Connell-Jones G. Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev. 2004;(2):CD003498. Review. (xii) Green PH, Jabri B. Coeliac disease. Lancet. 2003 Aug 2;362(9381):383-91. Review.

NUTRITION

Being gluten free is a personal health and lifestyle choice â&#x20AC;&#x201D; and one that not everybody needs to make. In fact, some of us tolerate gluten quite well, while others do so poorly or not at all. In general, most Americans eat too much gluten at the expense of other healthy foods. Breads, pasta, and other wheat and gluten-containing products make up a large proportion of the US diet. And itâ&#x20AC;&#x2122;s just not that healthy. Further, diets lacking in variety are not optimal for our gut flora. Like in problems with the soil

from mono-agriculture, limited diets tend to deplete the good bacteria growing in our gut! So most of us can benefit from reducing our gluten intake. Some people are inherently gluten intolerant. In fact, according to celiac disease specialist Alessio Fasano, thatâ&#x20AC;&#x2122;s the case for at least 6% of us. Those folks are best just avoiding gluten altogether, or as Dr. Fasano suggested to my Harvard pediatrician daughter-in-law, avoid it like you should avoid texting while driving!

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Some people, however, are not inherently gluten intolerant, and do not necessarily always have to be 100% gluten-free. This is sometimes the case for folks who have developed intolerance due to leaky gut from another source, for example, lactose intolerance (way more folks are lactose intolerant than realize it!), medications, stress, or other causes. If this is the case for you, then healing your gut, which can take from 3-12 months of dietary changes and appropriate herbal and nutritional supplements, may

NUTRITION

restore gluten tolerance and allow you to include it in your diet. Testing for leaky gut (zonulin/occludin antibody testing, for example), the celiac genes (HLA DQ2 or HLA DQ8), and gluten intolerance with a functional medicine doctor may help you to differentiate between the reasons for gluten intolerance. If you were previously tested and found to be positive for the celiac genes, then you may be particularly susceptible to developing the health problems associat-

ed with eating gluten. If this is the case, and your symptoms have completely resolved since you’ve stopped eating gluten, then you might be someone who actually does better being gluten free, um, yup, sorry… forever. If you’ve had pretty serious symptoms in the past while you were eating gluten that are completely gone now, whether digestive problems, “brain fog,” joint problems, or even more importantly, autoimmune problems, then I’d stay

gluten free for about a year to let any inflammation in your gut and systems in general, have time to heal.

Test, Reintroduce, and Decide

If after a year your symptoms are still resolved, you could try introducing gluten and see what happens. Start with a small amount in the morning. A piece of wheat toast, for example. If nothing happens, then go on a gluten “bender” for 1-3 days. Eat something

M AY I S S U E / F O O D S O L U T I O N S M A G A Z I N E /

NUTRITION

Listening to your own body, and how it reacts to foods like gluten, is the key to knowing what is best for your health.

with gluten a few times each day – pasta, bread, etc. Loading up will be more likely to tip you back into symptoms if they are going to recur. If no symptoms return, then you might consider allowing small amounts of gluten into your diet on occasion. That means, for example, once a month or less. Don’t make gluten

ABOUT THE AUTHOR Aviva Romm, MD is a Yale-trained, Board Certified Family Physician, midwife, herbalist, and award-winning author. She is the internationally respected authority on botanical and integrative/functional medicine for women and children. Aviva combines her backgrounds to guide women in transforming their health and their lives, and do the same for their kids. Dr. Romm practices Functional Medicine at The UltraWellness Center with Dr. Mark Hyman in Lenox, MA. Visit her at her website www.avivaromm.com

a staple part of your diet. If at any time symptoms recur, then go gluten free again for a few months – or indefinitely. If in doubt, just leave gluten out! One approach to consider before reintroducing gluten is to get some Functional Medicine testing to determine whether you have positive antibodies to gluten. Cyrex Labs offers two test panels that look at both gluten antibodies and foods that cross-react with gluten. If these are very positive, then staying off of gluten for longer, or indefinitely, might be your best bet for staying symptom free and optimally healthy. Again, healing your digestive system of leaky gut may allow you to become more tolerant. Retesting after several months of being gluten free can help you to make a plan that is best for you. I also like to check in and find out why my patient wants to start eating gluten-containing products again. For some it’s carb cravings, in which case we work on getting to the bottom of that. (Is there stress, anxiety, or a relationship

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issue going on? Inadequate nutrition? Premenstrual? Disrupted gut flora?) For others it’s a matter of convenience (easier to eat out with friends, for example). For others, it’s lack of familiarity with the myriad other wonderful grains and foods that can make up a wonderfully taste-filled diet. And for others it’s a matter of missing childhood comfort foods – in which case finding healthy substitutes – or sometimes healing unresolved issues around food and relationship/family might be needed. And sometimes it’s a matter of pasta or joint pain? Take your pick…

No Rules, Just Personal Choices

I remind my patients that there really are no rules – just choices – unless of course they actually have celiac disease in which 100% gluten free really is the rule for maintaining health. Remember, your body is your best guide. If you’re feeling better – or even great – now that you’re off of gluten, that tells you something – your body is happier without it!

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Gluten Free Therapeutics was born out of need. Whether suffering from celiac disease, gluten sensitivity or electing to eliminate gluten, we understand firsthand the lack of essential nutrients in a gluten-free diet and the constant struggle with proper nutrition.

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Celi•Vites for Balanced Body Health is a superior supplement tailored to help replenish vital nutrients that are lacking in a gluten free diet. Body Health uses only patented chelated minerals for maximal absorption and utilization.

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AWARENESS

Celiac disease brings with it hundreds of symptoms, with more added to the list almost daily. However, there are categories of symptoms that seem to occur most often in those diagnosed with CD. Here, we share common gastrointestinal symptoms, related gastrointestinal disorders and some of the system-wide effects of CD on the body.

Gastrointestinal distress

• Diarrhea • Constipation • Bloating • Gas • Abdominal pain • Unexplained weight loss (but it is

also possible for individuals with CD to be overweight or even obese)

Related gastrointestinal disorders

• IBS • Crohn’s disease • Ulcerative colitis

Non-gastrointestinal symptoms

• Dermatitis herpetiformis • Iron deficiency anemia • Osteoporosis • Neurological disorders (peripheral neuropathy, ataxia) • Infertility • Nutrient deficiency

Autoimmune diseases occur more frequently (three to ten times more) in those with celiac disease than in the general population. Hernandez et al, Current Gastroenterology Reports.

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Gluten-Free just got a lot Easier

www.GlutenFreeResourceDirectory.com

AWARENESS

Left untreated, celiac disease can shorten your life. If you have celiac disease, you can heal your damaged small Celiac disease damages

intestine with a gluten-free

the small intestine.

diet. Individuals with celiac disease cannot eat gluten or use items with gluten in them. Celiac disease is

The only treatment for celiac disease is 100% avoidance of all gluten.

NOT a food allergy. Dermatitis herpetiformis is the skin manifestation of celiac disease.

You do not grow out of celiac disease, but you can control it with a lifetime 100% gluten-free diet.

People with untreated celiac

Celiac disease is an autoim-

disease are unable to get vital

mune disease just like diabetes

nutrients from the foods they eat.

or rheumatoid arthritis. Celiac disease is diagnosed by blood tests and a biopsy of the small intestine.

Without treatment, celiac disease leads to a variety of other health problems.

Celiac Facts to Remember 32

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1 2

“Gluten-Free just got a lot easier!”

GLUTEN-FREE R E S O U R C E D I R E C TO RY

INNOVATIVE EDUCATION + FOOD + HEALTHCARE

CeliacCentral.org the go-to place for information on celiac disease and the gluten-free diet

Recipe of the Week Ask the Dietician Science News Feed Free webinars archived for easy viewing F b Alternative Appetites gluten-free cooking videos Kids Central: blogs and games for kids, by kids (and some grown ups too) and for bi-weekly product reviews: GlutenFreeHotProducts.com The National Foundation for Celiac Awareness drives diagnosis of celiac disease and promotes quality of life for children and families maintaining a gluten-free diet. NFCA is a nonprofit organization. Your donation makes life better for thousands of people every year. www.celiaccentral.org/donate

Restoring Health. Reclaiming Lives.

AWARENESS

1 – There are more naturally gluten-free foods than there are foods with gluten.

2 – For someone with celiac disease, a

gluten-free diet is a healing way of life.

3 – Gluten-free living opens up new food

options for many individuals, encouraging them to try new fruits and vegetables.

4 – Gluten-free whole grains are in abun-

dance – try quinoa, amaranth, buckwheat, millet, sorghum, etc.

5 – A gluten-free diet forces you to read nutrition labels.

6 – Gluten-free baking is easier than

traditional baking in some ways – no worrying about disrupting the gluten in baked goods anymore!

7 – Omitting wheat flour from the diet

eliminates empty calories from the diet. Wheat flour is often used as a filler, with little nutrients.

8 – Healing your gut, if you have celiac

disease, can improve your health and even extend your life!

9 – Getting a grasp on your gluten-free

lifestyle as soon as you are diagnosed with celiac disease means your body heals faster.

10 – Awareness of gluten-free living is

growing by leaps and bounds, making this “special diet” more mainstream than ever.

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PRODUCT LIST

Great Gluten-Free Products to Add to Your Next Shopping List

01 4C Bread Crumbs

02 Cream of Rice

Cream of Rice is naturally cholesterol free, fat-free and gluten-free, with no salt or sugar. It’s a great choice for kids and adults alike living the gluten-free lifestyles - delicious, simple and an excellent source of iron!

4C plain or seasoned bread crumbs are made with wholesome ingredients, making them ideal for coating meats or vegetables for pan frying, oven baking or for topping your next casserole!

04 04 Ener-G Products

Bloomfield Farms

Founded by loving grandparents of a little girl diagnosed with gluten sensitivity and an egg allergy, Bloomfield Farms provides a full line of products from cake mixes to pizza dough so that no one has to miss out on delicious food again!

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Ener-G provides an extensive line of gluten, wheat and dairy free products to today’s consumer. Look for breads, cookies, crackers, snack bars, pretzels, croutons and more in your grocer’s gluten-free section or online.

PRODUCT LIST

Enjoy Life Foods

Perhaps best known for their top 8 allergen free chocolate chunks, mini chocolate chips and Choco Boom chocolate bars, Enjoy Life Foods carries a full line of cookies, bars, granolas and chips you can feel great about serving to anyone with food allergies!

Crunchmaster

Crackers are the name of the game at Crunchmaster and theyâ&#x20AC;&#x2122;re making them gluten-free and 100% whole grain, cholesterol free, low in sodium, low in saturated fat and with 0 grams of trans fat. Get your crunch on today!

Wise

While not all Wise snacks are gluten-free, they offer an extensive line of gluten-free products, ranging from potato chips to corn chips to dips. This mainstream brand is widely available in most major markets, so look for the Wise label the next time youâ&#x20AC;&#x2122;re shopping!

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F O O D / M AY

This month, celebrate Celiac Awareness Month with us as we pull out all the stops to show you just how delicious and healthy gluten-free eating can be! And with these tried and true recipes from our expert chefs and cooks, you’ll soon see how simple gluten-free living is. With plenty of appetizers and finger foods for your next neighborhood barbecue to how to cook with cast iron and a special feature on this month’s gluten-free grain of the month, amaranth, you’ll find a plethora of information to whet your appetite and recipes you’ll come back to again and again. We’ve got your warm weather healthy desserts, too – don’t miss the Quest Raspberry Cheesecake and the Spicy Paleo Brownies in this issue. It’s time to turn the page and turn on the gluten-free foodie fun!

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FOOD

Artichoke Dip

WITH RAW VEGGIES RECIPE COURTESY OF DR. MARK HYMAN

YIELD: 6 Servings PREP: 5 mins

Blended artichokes are the perfect way to indulge in a creamy and satisfying snack. They provide tons of blood-sugar-stabilizing fiber, magnesium, and potassium with little fat or calories. Enjoy with your favorite crunchy vegetables as a snack or at your next party.

INGREDIENTS

• 15 ounce can artichoke hearts, drained • 1 teaspoon extra virgin olive oil • 1 Tablespoon dried Italian herb blend or any combination of dried oregano, thyme, rosemary, and basil • 1 pinch sea salt • 4 cups mixed raw vegetables for dipping

INSTRUCTIONS

Place all of the ingredients except the raw vegetables in a food processor and blend until smooth, 30–60 seconds or until desired level of creaminess. Chill and serve the dip with the raw vegetables. Any leftover artichoke dip can be refrigerated for up to 5 days.

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FOOD

Using large leafy greens in place of tortillas is an excellent way to cut carbs and add nutrients to your diet!

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Black Bean Wraps FOOD

RECIPE COURTESY OF DR. MARK HYMAN

CHICKEN &

IN STEAMED COLLARD GREENS WITH AVOCADO AND SALSA

YIELD: 4 Servings PREP: 15 mins COOK: 10 mins READY IN: 25 mins

INGREDIENTS

FOR THE WRAPS:

• 1/2 Tablespoon ground cumin • 2 teaspoons paprika • 1 pinch cayenne pepper • 1 pinch sea salt • 1/2 pound skinless boneless chicken breast • 1 Tablespoon grape seed or extra virgin olive oil • 1 Tablespoon fresh lime juice • 2 cups water • 4 large collard greens • 1 can (15 ounces) black beans, drained • 1 ripe avocado, sliced • Hot sauce (optional) FOR THE SALSA

• 2 medium ripe tomatoes, diced • 1 Tablespoon red onion, diced • 1 Tablespoon garlic, minced • 1/2 Tablespoon olive oil • 1 Tablespoon fresh cilantro, chopped • 1 Tablespoon fresh lemon juice • 1 pinch sea salt

INSTRUCTIONS

In a large bowl, combine the cumin, paprika, cayenne, and salt. Slice the chicken into thin strips and coat in the olive oil or grape seed oil, then toss in the spices. Heat a large skillet on medium heat and lightly coat with additional oil as needed. Lay the chicken strips in the hot pan and sear on all sides until cooked through, about 5 minutes depending on the thickness of the chicken, sprinkle with lemon or lime juice, and set aside to cool. Place the water in a sauté pan and bring to a boil. Add the collard greens, cover, and cook for 1 minute, then remove and rinse under cold water to cool. To prepare the salsa, combine all the salsa ingredients in a small bowl and stir. To make the wraps, layer the chicken strips, black beans, avocado slices, and fresh salsa on the collard greens. Roll the greens, tucking in the edges. Add the hot sauce for extra heat.

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FOOD

Add sprigs of fresh herbs like thyme for a burst of flavor and nutrients!

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Quick Mexicana Chili FOOD

RECIPE COURTESY OF DR. MARK HYMAN

WITH QUINOA

YIELD: 8 Servings

PREP: 5 mins COOK: 25 mins READY IN: 30 mins

INGREDIENTS

• 2 Tablespoons extra virgin olive oil • 1 small onion, diced • 2 Tablespoons garlic, diced • 2 Tablespoons chili powder • 1 Tablespoon ground cumin • 1 Tablespoon paprika • 1/2 teaspoon chili flakes • 1 teaspoon dried oregano • 2 Tablespoons tomato paste • 1 Tablespoon red wine or water • 1/2 cup quinoa, rinsed • 1/2 green bell pepper, seeds removed, then diced • 1 small zucchini, diced • 1 can (15 ounces) black beans (do not drain) • 1 can (15 ounces) pinto beans (do not drain) • 4 cups water or vegetable stock • 1 can (8 ounces) tomato sauce • 1 teaspoon sea salt • 1 squeeze of fresh lime juice • Fresh cilantro, chopped for garnish (optional)

INSTRUCTIONS

In a large soup pot, heat the olive oil on medium heat. Add the onions and garlic and cook until they begin to sweat. Add spices and continue to sauté for two more minutes. Add the tomato paste and sauté another minute. Deglaze with water or wine, and then add the quinoa. Sauté until quinoa is browned. Add green pepper and zucchini and sauté a few minutes until they begin to soften. Add beans with their liquid, water or stock, tomato sauce, and salt. Bring to a boil, then reduce heat to low and simmer for 15 minutes. Garnish with lime juice and cilantro. Serve with gluten-free tortilla chips.

Adjust seasonings to suit your individual tastes, and change up the veggies with what’s in season and locally available.

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FOOD

Belgian Endive

BY LISI PARSONS

WITH SPICY ARTICHOKE HEART SALSA

A deliciously refreshing spicy salsa that pairs perfectly with crunchy cooling Belgian endive.

INGREDIENTS

• Several bunches of Belgian endive • 1 cup artichoke hearts cooked (or jarred artichoke hearts) • 1 cup cherry tomatoes • 1 small red scotch bonnet pepper (optional) • 1 tablespoon fresh cilantro • ½ teaspoon dried cumin • 1 tablespoon extra-virgin olive oil • 6 garlic cloves peeled • 1 teaspoon coconut or apple cider vinegar • 1 teaspoon sea salt • 1 teaspoon black pepper • Juice from one Lemon

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DIRECTIONS

1. Place all ingredients, except Belgian endive, into a food processor or blender and combine until all ingredients are well incorporated. 2. Separate endive into individual pieces and use endive petals to dip out salsa. Recipe Yields: 4 Servings Active Time: 20 minutes

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Plantain Bacon BY LISI PARSONS

FRITTERS

Recipe Yields: 4 Servings

DIRECTIONS

Active Time: 30 minutes

Mix together the mashed plantains, sea salt and bacon pieces in a bowl.

INGREDIENTS

Heat coconut oil in a skillet over medium heat.

• 3 yellow plantains peeled and mashed • 1 cup cooked bacon crumbled into small pieces • 4 tablespoons coconut oil • ½ teaspoon sea salt

Form plantain mixture into small patties and place in hot oil and pan sear for 4-5 minutes per side. Be sure not to overcrowd skillet or the fritters will not fry correctly & they will be soggy.

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A sweet and savory treat that will make the perfect addition to your breakfast or dinner table and they make a great after school snack.

PRODUCTS EDITOR’S PICKS

Simple Girl Dressings & Sauces These dressings, marinades and sauces may have simple, clean gluten-free ingredients and they may be simple to use (just open the bottle and pour!) but there is nothing simple about the flavor explosion you’ll get in every bite! These are by far the best bottled dressings I’ve tried to date, and the barbecue sauce, well, if you’re a BBQ lover like me, stock up now! This is our go-to sauce for summer grilling! Read more here.

Lovely Lady Solid Moisturizer In the beauty products and skincare department, I’ve not been so impressed with the “all natural” offerings. While organic, allergen-free skin care items are definitely something I want, I’m usually let down by the results I get with them. But that’s not the case with Lovely Lady products, particularly the solid moisturizer. I admit, at first, I just couldn’t wrap my mind around this product, but after using it for nearly a month, I am hooked and it’s going to be a staple in my skin care routine. I use the solid moisturizing stick daily now because of its long-lasting moisturizing effects. If you haven’t tried it, you must! Get yours here!

Schar Gluten-Free Baguettes Here in France, there is no shortage of gluten-free bread from which to choose and so far my top pick for a gluten-free baguette that tastes mighty close to the real thing (according to my gluten-eating friends here) is from Schar. Check out their entire line of gluten-free products, but if you can get the baguettes, by all means do so. They are par-baked and only need 10 minutes in a hot oven before your crusty gluten-free baguette dreams come true! Find Schar products near you here.

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Click here to get your copy now!

FOOD

Christophene TWICE-BAKED

BY LISI PARSONS

Squash

Recipe Yields: 4 Servings Active Time: 30 minutes

INGREDIENTS

A uniquely delicious Mexican side dish full of beautiful flavor that will surprise your dinner guests. This one will become a family favorite!

• 4 Christophene squash (aka Chayote Squash) • 1 small Vidalia onion chopped • 5-6 cloves garlic chopped • 2 tablespoons ghee or butter • 2 small green scotch bonnet peppers chopped (or favorite spicy pepper) • ½ teaspoon nutmeg • 1 teaspoon sea salt • 1 teaspoon black pepper • ¼ cup goat cheese mozzarella • 1 teaspoon Hungarian paprika for garnish

DIRECTIONS

Preheat oven to 400F. Slice squash in half lengthwise and place in boiling water until you can just pierce with a fork. Remove and allow to cool completely.

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Once the squash has cooled, gently scoop the meat of the squash out into a bowl being very careful to leave the outer shell intact. Mash the squash with a ricer or food processor. Heat a skillet over medium-high heat and add ghee, onion, garlic, sea salt and black pepper and cook just until onion is slightly soft. Add the mashed squash, scotch bonnet peppers, nutmeg and stir to combine and cook for 8 minutes. Remove from heat and place squash mixture back into the squash shell, top each with a little goat cheese mozzarella Bake for 15-20 minutes or until goat cheese is melted. Remove from oven and sprinkle with paprika.

FOOD

Chayote Squash (also known by many other names such as Christophene), are a tuberous root. If youâ&#x20AC;&#x2122;re fortunate enough to get the stems and leaves, too, those are also edible and make a great addition to salads.

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Raspberry Cheesecake QUEST

RECIPE COURTESY OF QUEST NUTRITION

INGREDIENTS:

PREP: 20 mins

FOR THE CRUST

COOK: 45 mins

• ½ White Chocolate Raspberry Quest Bar® • 1 bag Quest® Sea Salt Protein Chips • 2 tablespoons almond meal • 2 tablespoons zero-calorie sweetener • 3 tablespoons butter, melted • Nonstick cooking spray

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FOR THE FILLING

• 1½ White Chocolate Raspberry Quest Bars® • ½ cup Quest® Vanilla Milkshake Protein Powder • ¾ cup nonfat Greek yogurt • ¾ cup low-fat ricotta cheese • 4 ounces fat-free cream cheese, softened • 2 eggs • 2 egg whites • ¼ cup zero-calorie sweetener • ½ cup fresh raspberries • 8 fresh raspberries for garnish (optional)

FOOD

INSTRUCTIONS: FOR THE CRUST

1. Preheat oven to 400°F. 2. Unwrap and break half of the Quest Bar® into pieces. 3. Bake 3 to 4 minutes, or until lightly crisp. Set aside to cool. 4. Reset the oven to 325°F. 5. In a mini-blender, process Quest Protein Chips™ to very fine crumbs. 6. Add baked Quest Bar® pieces, and blend again to crumbs. 7. Add in almond meal, sweetener, and melted butter, pulse to combine. 8. Spray an 8-inch spring form pan with cooking spray. 9. Press dough into the pan’s base until covered. Set aside.

FOR THE FILLING

A S S E M B LY

1. Chop 1½ unwrapped Quest Bars® into small cubes. Set aside. 2. In a blender, combine Greek yogurt, ricotta, and cream cheese; blend until smooth. 3. Add Quest Protein Powder,® eggs, egg whites, and sweetener. Pulse several times until well mixed and set cheesecake filling aside. 4. Purée the ½ cup of fresh raspberries in a blender and set aside.

1. Pour half of the filling over the crust. Sprinkle in Quest Bar® cubes, and pour the remaining cheesecake filling on top. 2. Swirl raspberry purée on top. 3. Bake for 45 to 50 minutes, or until cheesecake is still slightly jiggly in the center. 4. Remove cheesecake and let cool for 1 hour. 5. Place in refrigerator for at least 4 hours. 6. Before serving, run a warm knife around the pan to loosen from pan. Garnish with a fresh raspberry.

YIELDS - 8 SERVINGS 1 SLICE PER SERVING Nutrition Facts per Slice: 7g NET CARBS 220 CALORIES 25g PROTEIN 10g FAT

Quest bars make this low-carb, lower sugar treat a possibility as a part of your healthy gluten-free diet.

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FOOD

Spicy Brownie

BY LISI PARSONS

WITH COCONUT BUTTER FROSTING

These unique brownies offer multiple levels of delicious flavor. The perfect amount of spicy finished off with the cooling coconut butter frosting will make these your familyâ&#x20AC;&#x2122;s favorite dessert.

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* * BoneSuckin.com | (919) - 833-7647 | Sales@BoneSuckin.com Gluten Free • Fat Free • *NON GMO • All Natural • No Preservatives • No MSG

*(The Bone Suckin’ line is NON GMO except our Steak Sauce & Mustards & we’re working on those.)

Spring 2015

FOOD

CO N T I N U I N G F R O M PAG E 5 6

Recipe Yields: 12 servings Active Time: 50 minutes

Sweet potatoes add a boost of antioxidants to these moist brownies, for a healthier treat!

INGREDIENTS

• 1 ½ cups mashed cooked sweet potatoes • 4 whole eggs (room temperature) • ¾ cup coconut oil • ½ cup honey • ½ cup canned coconut milk • 1 tablespoon coconut or apple cider vinegar • 1 cup almond or macadamia nut flour • ½ cup coconut flour • 1 ½ teaspoon cayenne pepper • 1 teaspoons baking soda • 1 ½ teaspoons baking powder • ½ cup Cacao Powder • ½ cup cacao nibs or chocolate chips

INGREDIENTS FOR COCONUT BUTTER FROSTING:

• 1 cup coconut butter melted slightly • ¼ cup coconut flakes

DIRECTIONS

Preheat oven to 375F Line a 13x9” baking pan with parchment paper. Mix together sweet potatoes, eggs, coconut oil, honey, coconut milk, and coconut vinegar in one bowl. In another bowl, mix together almond flour, coconut flour, cayenne pepper, baking soda, baking powder, cacao powder and cacao nibs Now, mix together contents of both bowls and pour into baking pan. Bake for 25-30 minutes or until brownies are fully cooked. Allow to cool completely before slicing or frosting. Prepare coconut butter frosting by thoroughly mixing together coconut butter and coconut flakes.

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NUTRITION

PROS Once hot, it stays hot, which is important when searing meat. Extremely versatile; can be used to cook in any medium, from stovetop to fire pit. Can use any type of utensil; metal utensils will not scrape the surface. Durable and inexpensive. Naturally non-stick if seasoned properly.

CONS Doesnâ&#x20AC;&#x2122;t heat very evenly. The best way to ensure an evenly heated pan is to preheat it for about 10 minutes, rotating it a quarter-turn every few minutes. Can also preheat cast iron in a hot oven for 20 to 30 minutes. Can rust, chip, and crack easily if it is not properly cared for. Follow instructions on how to season the pan, and there will be no issues. Reactive â&#x20AC;&#x201C; does not take well to acidic foods. Heavy. Takes effort to clean and maintain.

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NUTRITION

Remember, with porous cookware like cast iron, make sure you use dedicated pots and pans to avoid possible gluten contamination.

C AST I RO N I S O NE O F THE most versatile cooking materials. It’s durable, conducts heat very well, and can cook almost anywhere – from stove to oven and grill. Cast iron gets a bad rap because it is notoriously hard to take care of. Let us dispel the rumors: seasoning the cast iron by adding a layer of polymerized oil is pretty easy and protects the surface. The process consists of repeatedly rubbing the cast iron with oil, heating it up, and cooling it down. This process breaks down the oil into a plastic-like substance that bonds to the metal, creating a slick surface that’s perfect for cooking. A well-seasoned cast iron pan will be nearly non-stick. While iron is a reactive metal, it’s nothing to worry about. Reactive metals can cause off flavors and discoloring when mixed with certain foods, including anything very acidic or alkaline. However, if a cast iron pan is seasoned properly, the occasional run-in with a few tomatoes or a splash of lemon juice shouldn’t hurt, so long as they’re not simmering for hours on end.

Kate Morin is a freelance writer and editor with a passion for food. After being diagnosed with celiac disease in 2010, she developed a strong interest in health, and has been merging these two passions through her work ever since.

How to clean it: After cooling, clean cast iron gently with a bit of soap and water. Gently remove any stuck-on food with a plastic scrub sponge. Do not use steel wool, as this will ruin the seasoning. Immediately dry the pan. After each use, re-season: Place the clean pan over a burner on high. Heat until residual water dries up. Add a teaspoon or two of vegetable oil and rub it around the cooking surface using a paper towel. Heat until the oil starts to smoke. Once smoking, take the pan off the burner and rub the oil around once more. Let the pan cool, and store.

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B O N U S H E A LT H

During an endoscopy, doctors can take a tissue sample of the intestinal lining.

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B O N U S H E A LT H

Endoscopy allows doctors to see exactly what is going on inside the GI tract, helping determine an accurate course of treatment. IF YOU PRESENT WITH SYMPTOMS OF CELIAC DISEASE and your blood tests come back positive, your doctor may order an “Upper GI” or an upper gastrointestinal endoscopy to examine the lining of your small intestine. Here’s everything you need to know, courtesy of, and shared with permission from, the National Institutes of Health.

What is upper gastrointestinal (GI) endoscopy?

Upper GI endoscopy is a procedure in which a doctor uses an endoscope—a long, flexible tube with a camera—to see the lining of your upper GI tract. A gastroenterologist, surgeon, or other trained health care provider performs the procedure, most often while you receive light sedation. Your doctor may also call the procedure an EGD or esophagogastroduodenoscopy.

• nausea and vomiting • pain • problems swallowing • unexplained weight loss Upper GI endoscopy can also find the cause of abnormal lab tests, such as: • anemia • nutritional deficiencies Upper GI endoscopy can identify many different diseases: • anemia • gastro-esophageal reflux disease • ulcers • cancer • inflammation, or swelling • precancerous abnormalities • celiac disease During upper GI endoscopy, a doctor obtains biopsies by passing an instrument through the endoscope to obtain a small piece of tissue. Biopsies are needed to diagnose conditions such as: • cancer • celiac disease • gastritis Doctors also use upper GI endoscopy to: • treat conditions such as bleeding ulcers • dilate strictures with a small balloon passed through the endoscope • remove objects, including food, that may be stuck in the upper GI tract

Why do doctors use upper GI endoscopy?

Upper GI endoscopy can help find the cause of unexplained symptoms, such as: • persistent heartburn • bleeding

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How do I prepare for an upper GI endoscopy?

Talk with your doctor You should talk with your doctor about medical conditions you have and all prescribed and over-the-counter medicines, vitamins, and supplements you take, including • aspirin or medicines that contain aspirin • arthritis medicines • nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen • blood thinners • blood pressure medicines • diabetes medicines Arrange for a ride home For safety reasons, you can’t drive for 24 hours after the procedure, as the sedatives used during the procedure need time to wear off. You will need to make plans for getting a ride home after the procedure.

An endoscope is inserted through the mouth into the GI tract so that the intestine can be viewed via a tiny camera.

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B O N U S H E A LT H

has worn off, the doctor will share these results with you or, if you choose, with your friend or family member. A pathologist will examine the biopsy tissue to help confirm a diagnosis. Biopsy results take a few days or longer to come back.

What are the risks of an upper GI endoscopy? Do not eat or drink before the procedure The doctor needs to examine the lining of your upper GI tract during the procedure. If food or drink is in your upper GI tract when you have the procedure, the doctor will not be able to see this lining clearly. To make sure your upper GI tract is clear, the doctor will most often advise you not to eat, drink, smoke, or chew gum during the 8 hours before the procedure.

How do doctors perform an upper GI endoscopy?

A doctor performs an upper GI endoscopy in a hospital or an outpatient center. An intravenous (IV) needle will be placed in your arm to provide a sedative. Sedatives help you stay relaxed and comfortable during the procedure. In some cases, the procedure can be performed without sedation. You will be given a liquid anesthetic to gargle or spray anesthetic on the back of your throat. The anesthetic numbs your throat and calms the gag reflex. The health care staff will monitor your vital signs and keep you as comfortable as possible. You’ll be asked to lie on your side on an exam table. The doctor will carefully feed the endoscope down your esophagus and into your stomach and duodenum. A small camera mounted on the endoscope will send a video image to a monitor, allowing close examination of the lining of your upper GI tract. The endoscope pumps air into your stomach and duodenum, making them easier to see. 68

During the upper GI endoscopy, the doctor may: • perform a biopsy of tissue in your upper GI tract. You won’t feel the biopsy. • stop any bleeding. • perform other specialized procedures, such as dilating strictures. The procedure most often takes between 15 and 30 minutes. The endoscope does not interfere with your breathing, and many people fall asleep during the procedure.

What should I expect from an upper GI endoscopy?

After an upper GI endoscopy, you can expect the following: • to stay at the hospital or outpatient center for 1 to 2 hours after the proce dure so the sedative can wear off • bloating or nausea for a short time after the procedure • a sore throat for 1 to 2 days to go back to your normal diet once your swallowing has returned to normal • to rest at home for the remainder of the day Following the procedure, you—or a friend or family member who is with you if you’re still groggy—will receive instructions on how to care for yourself following the procedure. You should follow all instructions. Some results from an upper GI endoscopy are available right away after the procedure. After the sedative

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The risks of an upper GI endoscopy include: • bleeding from the site where the doctor took the biopsy or removed a polyp • perforation in the lining of your upper GI tract • an abnormal reaction to the sedative, including respiratory or cardiac problems Bleeding and perforation are more common in endoscopies used for treatment rather than testing. Bleeding caused by the procedure often stops without treatment. Research has shown that serious complications occur in one out of every 1,000 upper GI endoscopies.1 A doctor may need to perform surgery to treat some complications. A doctor can treat an abnormal reaction to a sedative with medicines or IV fluids during or after the procedure.

Seek Care Right Away

If you have any of the following symptoms after an upper GI endoscopy, seek medical care right away: • chest pain • problems breathing • problems swallowing or throat pain that gets worse • vomiting—particularly if your vomit is bloody or looks like coffee grounds • pain in your abdomen that gets worse • bloody or black, tar-colored stool • fever REFERENCES:

1Yusuf TE, Bhutani MS. Esophagogastroduodenoscopy. Medscape website. http://emedicine.medscape. com/article/1851864-overview #a17. Updated June 3, 2013. Accessed July 8, 2014.

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Food Solutions magazine (FSM) is published by Directory Media Group (DMG) a Country Club Media, Inc., company. FSM provides information of a general nature about health and nutrition, healthy living and all things gluten and allergen free. It is provided for EDUCATIONAL PURPOSES ONLY. This information in FSM is NOT a substitute for PROFESSIONAL medical advice, diagnosis, or treatment. Seek the advice of a physician or other healthcare professional if you have concerns or questions about your health. The information is provided with the understanding that neither FSM nor any of its affiliates are engaged in rendering medical advice or recommendations, and the information contained in FSM should never be considered a substitute for appropriate consultation with a licensed physician and or other healthcare provider. FSM, DMG, its affiliates, employees, contributors, writers, editors and its Board of Advisors (“Publisher”) accept no responsibility for inaccuracies, errors or omissions with respect to information and/ or advertisements contained herein. Publisher assumes no responsibility for the claims made by the Advertisers or the merits of their respective products or services advertised or promoted in FSM. Publisher neither expressly nor implicitly endorses such Advertiser products, services or claims, nor vouches for the accuracy of their effectiveness. Publisher expressly assumes no liability for any damages whatsoever that may be suffered by any consumer, purchaser or user for any products or services advertised or mentioned editorially in FSM and strongly recommends that any consumer, purchaser or user investigate such products, services, methods, and/ or claims made thereto. Opinions expressed in the magazine and/or its advertisements do not necessarily reflect the opinions of the Publisher. When choosing to follow any health related advice, consumers should always check with their personal healthcare professional to ensure it is appropriate

for them. The information on products and services as advertised in FSM are shown by Publisher on an “as is” and “as available” basis. Publisher makes no representations or warranties of any kind, expressed or implied, as to the information, services, contents, trademarks, patents, materials, or products included in FSM. To the full extent permissible by law, Publisher disclaims all warranties, expressed or implied, including, but not limited to, implied warranties of merchantability and fitness for a particular purpose. Publisher will not be liable for any type of damage arising from the use of any products or services advertised and/ or promoted in FSM. Certain state laws may not allow limitations on implied warranties or the exclusion or limitation of certain damages. In this case, some or all of the above disclaimers, exclusions, or limitations may not apply to you, and you might have additional rights. Be advised that some of the health information provided throughout this publication has been furnished to FSM and/or its affiliates for advertising in the form of display advertising or paid advertorials some of which may be featured within the magazine. Publisher neither endorses nor makes warranties of any kind regarding the quality, accuracy, ethics or validity of the information about or by the health related information, services and/or statements. All images and photos reproduced in FSM have been accepted by Publisher on the condition that such pictures are reproduced with the knowledge and prior consent of the photographer and any model concerned. As such, Publisher is not responsible for any infringement of the copyright or otherwise arising out of any publication in FSM. ALL MATERIAL PRESENTED in FSM IS FOR EDUCATIONAL AND INFORMATIONAL PURPOSES ONLY. BEFORE USING THE INFORMATION PROVIDED, CONSULT A PHYSICIAN REGARDING THE APPLICABILITY OF ANY IDEAS, OPINIONS OR SUGGESTIONS FOR YOUR UNIQUE SITUATION.

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