Whenever I meet a patient who is new to starting a gluten-free diet, the first food I hear they are eating is rice. Rice cereal for breakfast, rice cakes for lunch, white rice for dinner. It's safe, it's bland, it's the perfect food for going gluten-free.

The problem is, you can get tired of rice pretty quickly.

Besides, regular white rice and white rice products are low in fiber, and if they are replacing foods like whole grain cereal and whole wheat bread, you may be eating a diet much lower in fiber than before you started this gluten-free journey.
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What is fiber and why is it important? 
 
Dietary fiber is a substance found in plant products that gives the plant structure. Foods high in fiber, then, have more bulk and structure than foods low in fiber. This is good for the human body because you cannot digest it; instead, your digestive tract sends it on through to the large intestine and out with waste products, or stays and ferments in the large intestine, adding healthy bacteria to your system.
 
Dietary fiber benefits can be summarized as helping to:

1. Prevent or treat constipation
2. Improve your intestinal health to prevent colorectal cancer, hemorrhoids and diverticular disease
3. Lower cholesterol levels
4. Control blood sugar levels
5. Manage weight filling you up sooner and longer

 
You can find more good information about fiber benefits here from the Mayo Clinic  and here from The Nutrition Source at Harvard. 
 
What does this have to do with non-celiac gluten sensitivity? A gluten-free diet can potentially be low in fiber. As mentioned, white rice is a common substitute for wheat in the diet, and is also a common ingredient in gluten-free products such as breads, crackers, cereals, and snack foods. That often leads to a very low fiber intake. Most Americans already eat less than half of the recommended amount of fiber daily, so taking away whole wheat and whole grain products in your diet will only make the problem worse.  
 
Of course, fiber is not found just in whole wheat products, so the solution is easy. Fiber is found in a wide variety of fruits, vegetables, beans, nuts, and seeds. A plant-based diet filled with these food groups can contain the 20-30 grams of fiber you need per day. Try these great high fiber foods!
 

• Cereals and grains: oatmeal, barley, quinoa, brown rice and popcorn
• Legumes: black beans, lentils, split peas, navy beans, pinto beans, red beans
• Nuts and seeds: peanuts, almonds, walnuts, pumpkin seeds, sunflower seeds
• Vegetables: broccoli, carrots, spinach, Brussel sprouts, cauliflower, green peas, turnip greens
• Fruits: berries, pear, apple, banana, raisins

 
Sometimes it helps to have a tangible example. Here’s what a day might look like with adequate fiber:

• Breakfast: ½ cup GF oats with ½ cup berries
• Snack: ¼ cup almonds and 2 tablespoons raisins
• Lunch: 1 cup spinach salad with ¼ cup carrots, ¼ cup tomatoes and ¼ cup garbanzo beans
• Snack: yogurt with ½ banana and 2 tablespoons flax seeds
• Dinner: baked fish with ½ cup Brussel sprouts and ½ cup brown rice

 
As always, make sure your oats, nuts, and seeds are gluten-free. Then, start to add fiber-rich foods slowly, one serving at a time, until you are eating fiber at every meal. Be sure to increase your water intake as well, drinking about ½ cup with each meal and 8 cups per day.
 
Gluten-free and high fiber can both be a manageable part of your life!

​As you continue to avoid gluten, read labels, and monitor your gluten-related symptoms, eating can get overwhelming. How about taking a break from thinking about food and your illness? Self-care is a somewhat new buzzword for initiating deliberate care of yourself, whether to reduce stress or reduce negative symptoms of fatigue or pain. It is important for both physical and mental health!
 
These are my favorite areas of self-care.
 
Physical activity: I have my smart watch set to notify me when it is ten minutes before the hour, every hour. Whatever I am doing, I get up and stretch, walk around the block or the house, go up and down the stairs a few times, and/or do a few calisthenics at my desk. I even have an RBG calendar on my office wall that shows activities I can do if I run out of ideas :)
 
Exercise: In addition to bits of physical activity throughout the day, I make sure I get at least 30 minutes daily of uninterrupted higher intensity exercise, such as a brisk walk, bike ride, hike, time on an elliptical, etc. This reduces the stress hormone cortisol and helps fight chronic diseases. You do not have to start training for a marathon; just find something you enjoy that raises your heart rate a bit.
 
Stress management: Physical activity and exercise are major stress busters. Other great habits are meditation (which I am terrible at) and yoga (which I love), as well as journaling, reading, listening to music, and spending time in nature.  Surely there is something you can do for 10 minutes a day that is just for you. 
  
Sleep: You’ve heard the advice: get eight hours of sleep every night. While the optimal sleep time varies, I know I feel better with eight hours, and I have to fight the urge to stay up late to enjoy a book or movie or NCIS episode on TV. It’s worth it to set a regular bedtime, make sure it’s dark and cool in your room, and avoid blue lights/screens for the half hour before.
 
Mindfulness: Mindful eating, especially, is a habit that can leave you feeling more fulfilled and nourished than speed eating while working at your computer or watching TV. Eat meals at the table with a placemat and even a candle.
 
Social support: A friend, partner, family member, neighbor, or online community can help you feel connected. Reach out to others, and cultivate only the relationships that feel positive.
 
Spiritual self-care: Remember your spiritual side, which  needs nurturing along with your body and brain. Spiritual values may include religion, the environment, social justice and peace, or believing in anything else that is greater than yourself.
 
I often combine these habits, such as walking my dog (exercise) through the woods (stress management) while reflecting (spiritual) or inviting my partner along (social). Do I always follow my own recommendations? Maybe not, but it’s an ongoing effort!
 
Today, give yourself the care and compassion you give others; you deserve it.
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​Have you ever realized how many foods have gluten? For such a little protein, it seems to show up in a wide variety of places. My last blog highlighted oats, spices, nuts, seeds, alcohol, and coffee - - be sure to view that if you haven’t already.
 
There are many other hidden sources of gluten, and some of them may surprise you! Let’s walk through increasing your chances of avoiding them.
 
①
First, be sure to recognize all the grains and pastas that are actually WHEAT, including bulgur, semolina, durum, spelt, kamut, graham, einkorn, farina, couscous, orzo, seitan, matzah (or matzoh or matzo) and cake flour to name a few. I had a client tell me she eats spelt because she read somewhere that it isn’t really wheat. It is!
 
②
Second, my ongoing recommendation is to read all INGREDIENTS on food labels. Some food packages make it easy for us by stating “gluten-free”; this is a voluntary claim that can be used by food manufacturers on food labels if they meet all the requirements of the regulations. A symbol is not required. If the food package does not say “gluten-free”, then we need to look at the list of Ingredients. Food manufacturers are required to list all ingredients in order from highest to lowest amount. Here are a few ingredients to avoid:

• barley, rye, and wheat
• ingredients with the words barley, rye, or wheat in the name or after the name
  • For example: “wheat starch” or “dextrin (wheat)”
• any of those grains listed above in step 1
• malt, malt flavor, malt extract, and malt vinegar
• brewer’s yeast
• soy sauce

 
Unfortunately some ingredients can be listed as “flavors” or “spices” without naming each one, making your symptoms journal all the more important. For example, I had a client who was symptom-free and doing well, so he purchased a new type of rice, a flavored mix to add variety to his diet. It turned out to cause him quite a bit of bloating and pain, and he realized the source of the problem was the spice mix it contained.
 
Food labels do have to list wheat, thanks to the federal Food Allergen Labeling and Consumer Protection Act (FALCPA). Any packaged food regulated by the FDA must state that it contains wheat; furthermore, it may also have the statements “may contain wheat” or “made in a facility with wheat”, which are voluntary statements. These come in very handy for me when I am choosing nuts.
 
③
My third suggestion is to take a second look at the MEAT, FISH and POULTRY you are eating, as processed versions may contain gluten. Starting with meat and poultry, it is good to know that plain beef, chicken, turkey and pork do not naturally contain gluten. But when they are packaged or processed in any way, they may contain additional ingredients, or if they are sliced in the deli they may come into contact with gluten from other foods. The more the meat or poultry strays from its origin, say into the form of bologna or salami, the more likely it is to have outside ingredients. Your safest approach is to look for those clearly labeled “gluten-free”. These are helpful lists of brands of gluten-free deli meat and gluten-free sausages.
 
In addition to deli meat, beware of hot dogs, self-basting turkey or seasoned chicken breast. Even rotisserie chicken may have gluten; when roasted in the store, flour is often added to the skin to make it crisper, and there are also many spices and sauces that are used that may contain gluten. Also, as if that isn’t all worrisome enough, the rotisserie chicken may be exposed to gluten when it is packaged, since fired chicken is usually prepared right next to it. Look for “gluten-free” rotisserie chicken.
 
Meat substitutes are not necessarily a safe replacement, as there may be gluten in veggie burgers and other meat alternatives products (veggie bacon, sausage, burritos, etc.). Seitan is a common meat substitute, but is almost completely wheat gluten. Soy and bean products may have gluten-containing ingredients added. As always, read labels or call the manufacturer if you are not sure.
 
As for fish, seafood itself is naturally gluten-free and a wonderful source of nutrients, but processed fish such as imitation crabmeat usually contains wheat. Also, seafood that has been pre-seasoned, breaded, or packaged with a sauce are risky. I recommend you stick to plain fish that you can season and prepare yourself. This is a good overview of choosing safe seafood.
 
④
Another popular food is PIZZA. I know it seems obvious that pizza with a wheat crust has gluten and should be avoided. But also be careful with other pizzas, as sometimes they have a gluten-free crust but contain gluten in the cheese (shredded cheese may be mixed with a gluten-containing starch to prevent sticking and clumping) or the toppings (such as pepperoni). Read, call, ask, become informed. Whether you are buying a pizza from a grocery store or ordering pizza from a restaurant, use the same rules.
 
⑤
SAUCES, GRAVIES AND SPICE mixes may contain gluten from wheat or other culprits because they provide thickening (think roast beef gravy made from a roux) or stability (e.g. a package of fajita seasoning may have wheat added to prevent caking). Or they may be made of wheat; for example, soy sauce is a mixture of soy and wheat fermented together.
 
⑥
SOUPS from a manufacturer (premade) often contain pasta, barley, or spices that potentially contain gluten. Some brands are great about using the “gluten-free” designation on the label, but others just provide the list of ingredients, so you have to read carefully. If in doubt, don’t buy it; if you already bought it, call the manufacturer to check.
 
⑦
SALADS can be a nutrition dream of a variety of colorful greens and other fresh vegetables like tomatoes, cucumbers, peppers, carrots and mushrooms. As is, these are all naturally gluten-free ingredients. Make your own dressing or simply toss with vinegar, oil, salt and pepper for one of my favorite lunches and side dishes. Be careful, though, with store bought and restaurant salad dressing as well as croutons and other toppings that may have gluten containing elements.
 
⑧
Between meals, SNACK BARS can give you a boost but could also make you sick, so be sure to know what you are getting. With over 100 different brands and even more flavors, they also come with a variety of names: protein bars, energy bars, granola bars, health bars, and cereal bars. Start by eliminating those with wheat, rye and barley, then study the ingredient list. Avoid any that say “may contain” or “processed in a facility with” wheat. Bars often contain oats that are not gluten-free, wheat starch, rice syrup, yeast extract, and natural flavors. Some also contain dextrin and maltodextrin, which may or may not be made from wheat. If the bar is labeled “gluten-free”, of course, you do not need to worry, but if it is not, you should probably avoid or call the manufacturer to check.
 
⑨
SWEETS such as cookies and cake are probably obvious to you has potential sources of gluten. But what about ice cream, candy, candy bars and even cheesecake filling? All potential sources of gluten due to wheat and other gluten containing ingredients that are added. For example, vanilla ice cream is gluten-free while cookies and cream flavor is not; plain M&M’s are gluten-free but pretzel and crispy M&M’s are not; cheesecake is sometimes thickened with wheat. Other times, the product comes into contact aith gluten during processing. If you have celiac disease, you must carefully avoid all of these. If you have non-celiac gluten sensitivity, you may tolerate a product that has only slight exposure to gluten. Your symptom journal will help you. And fortunately for us, the most trusted celiac and nonceliac gluten sensitivity expert sites list gluten-free candy sources every Halloween and Easter; start with this one: Gluten and Candy. 
 
That is a lot of information and there is so much more out there! I don’t attempt to list all the brand names of what does and does not contain gluten because there are other sites that serve that purpose. My favorites are www.celiac.org and www.beyondceliac.org.
 
If you are doing your elimination diet, you can start to add them back foods in just a few weeks to identify which are bothersome to you. Until then, continue to keep a symptoms journal, read food labels and watch for those gluten sources.

After reading my previous blog, you hopefully started your Gluten-free Elimination Diet. Some experts recommend you follow an elimination diet for three to four weeks; I did it for eight weeks because I had little setbacks along the way, and many of my clients have as well, so here is some advice for navigating this phase!
 
ELIMINATION
First, you eliminate all obvious sources of gluten. To review, obvious sources of gluten include:

• Wheat and all its forms, such as whole grain, multigrain, enriched, graham, semolina, and self-rising flour. These are found in bread, pasta, bagels, frozen waffles, flour tortillas, cookies, crackers, pretzels, pizza dough, and many breakfast cereals.
• Rye
• Barley
• Oats (more below)

 
At this point in your journey, I recommend you keep your meal plan / dietary intake as simple as possible with mostly whole foods - foods that you recognize in their original form, not processed, such as fruits, vegetables, beans (dried or canned such as black, pinto, kidney, and navy beans), meat, fish, eggs, milk, and yogurt. See my meal plan here.
 
If you are craving carbohydrate foods like pasta, turn to potatoes, rice and quinoa instead. You should also stick to salt and pepper for seasonings unless the label clearly says gluten-free (more on that in a minute). You will be reintroducing all your favorite flavors soon. By keeping your intake simple for now, you are most likely to avoid all gluten and start to feel better.
 
That said, it is easy to encounter gluten in hidden places!  After my previous blog, you are paying attention to processed foods that may contain gluten, such as beer, malt, modified food starch, soups, seasoned snack food, some cereals, soy sauce, spices, and seasoning mixes. It sounds straightforward until you are actually trying it. I started to expand my diet after about four weeks because I wanted more variety, and I realized how it important it was to continue keeping a Symptom Journal! Let’s look at a few of the hidden gluten sources I encountered.  
 
HIDDEN SOURCES OF GLUTEN
 
Oats

• Oats are a wonderfully delicious and nutritious whole grain that can be made into oatmeal, baked into granola, and used in a variety of recipes. They are naturally gluten-free, but unfortunately are often contaminated with wheat and other gluten-containing products. How? They are often grown next to wheat in the fields or exposed to gluten in the facilities where they are packaged. So, you need to buy and eat only oats that are labeled “gluten free”. Popular brands include Bob’s Red Mill, Arrowhead Mills, Nuts.com, and Thrive Market; even Quaker has a select gluten-free variety  now. Read the label and make sure it says certified gluten-free, gluten-free, or pure/uncontaminated.

• Do not buy oats from a bin - you know, those bulk bins in grocery stores where you scoop your own. The container or scoop may have been contaminated by gluten and there is no way to know.
• Do not eat oatmeal flavored with molasses or brown sugar flavorings, which may have caramel coloring that contains wheat.

 
Spices

• Ground spices are sometimes contaminated with gluten in a facility that processes other foods, or they are sometimes intentionally processed with wheat to keep them from clumping. I discovered that my favorite ground cinnamon contained gluten. I was four weeks into my elimination diet and felt great, then added cinnamon to my safe foods. I felt those old familiar symptoms the next day - fogginess, headache, blurred vision, and fatigue. I quickly wrote out a symptom journal since I had stopped keeping one, and the only food item that was new was the cinnamon. I tried it again with the same results. After another week of my original elimination diet and back to feeling great, I tried a different brand of cinnamon with the same results. I finally found a brand that was gluten-free and have been successfully enjoying cinnamon with no problems.
• Other possible contaminated spices are ground paprika, turmeric, curry powder and spice mixes. Read labels and experiment carefully.
• One website that lists a variety of gluten-free spices and seasonings is www.verywellfit.com. I would add Savory Spice to the list.

 
Nuts and Seeds

• Like spices, nuts and seeds are sometimes processed or contaminated with gluten. Who would have thought? Fortunately, these are a little easier to catch because their food labels have to say if they were processed in a facility that also processes wheat. I discovered store brands of peanuts and walnuts from two of my favorite stores were contaminated with flour, so I had to search for others.
• Read labels and avoid nuts or seeds processed in a facility that processes wheat.
• Do not buy nuts and seeds from bulk bins.

 
Beverages

• Beer is often a source of gluten because it is usually made from malted barley and hops, and sometimes wheat. During the first few weeks of your elimination diet, I recommend you steer clear of all beer. Once you are feeling well, it is safe to try gluten-free beer. Do not drink “gluten-removed beer” if you have celiac, as it is not necessarily safe. Good gluten-free beer options are now fairly widely available, with some good options identified in this Gluten-Free Beer Roundup.  

• Other alcoholic beverages such as wine, hard cider, and distilled alcohol are usually safe. Wine is made from fruit, so no worries there. Hard cider is also made from fruit, but sometimes barley is added so ask or read the label. Most spirits, hard alcohol, or distilled alcohol are made with a process that removes any potential gluten proteins; this means vodka, tequila, whiskey, rum and gin are okay for you, but do read this informative article to tease out the details before taking a sip: Gluten-Free Alcoholic Beverages.
• Flavored coffees and teas, as well as specialty drinks that contain added flavors (such as a vanilla latte) may contain gluten. Explore websites or call the manufacturer if you aren’t sure.

 
 
That’s a lot of information for one read! To recap, if you have symptoms despite carefully choosing gluten-free foods, consider the hidden sources discussed here. And keep going with your Symptom Journal so you can go back and identify the culprits.
 
Be kind to yourself as you continue this journey. Get some fresh air every day and treat yourself to regular physical activity, like walking around the block or stretching every hour.
 
Best of health!
 
Resources in today’s blog include

• https://health.clevelandclinic.org/spot-secret-sources-gluten-infographic/
• https://www.verywellfit.com/gluten-free-spices-562362
• https://www.uchicagomedicine.org/-/media/pdfs/adult-pdfs/conditions-and-services/gastrointestinal-disease/celiac-impact-beer.pdf
• https://www.glutenfreeliving.com/gluten-free-foods/diet/gluten-free-beer-roundup/
• https://www.celiac.com/articles.html/gluten-free-alcoholic-beverages-r218/

 
UP NEXT… More hidden sources of gluten: I will look at protein foods, pizza, and a variety of
​S foods: sauces, sweets, snacks, soups, and salads.
 
 
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​Now that you have used your Symptom Journal to identify potential triggers, you should avoid those foods or drinks, then eventually reintroduce them, with an Elimination Diet. As the name implies, this is a meal plan that eliminates or removes certain foods and drinks. The idea is to remove your symptoms, too! That said, it is important to follow an Elimination Diet for 3 to 4 weeks, or until you have do not feel symptoms anymore and you feel good. (I like to say “health” is not just the absence of illness, but a feeling of physical and emotional wellbeing).   Then you will gradually reintroduce one at a time to see if it creates symptoms again.
 
Before I go on, please know that you should do this with the help of a dietitian or specialist in integrative medicine for several reasons:

1. Guidance in creating a meal plan that give you a variety of nutrients. If you simply cut out everything gluten and just eat gluten-free crackers for a month, you will likely develop other problems such as constipation and fatigue due to lack of fiber and vitamins.

2. Moral support. An experienced health expert knows this can be a frustrating period of time, and she/he can help you know what to expect.

3. Adding foods back to your intake should be slow and systematic. It is important to introduce one gluten-containing food at a time, in a small amount. If that does not cause problems, you can increase it to what you consider a normal serving size the next day. Some practitioners say to add something new every two days, but I recommend (and used myself) a more cautious and informative approach: add back one gluten-containing food (let’s say one piece of wheat bread) and otherwise follow your elimination diet. If you feel old symptoms returning (I felt bloated and brain fog in just a few hours), spend the next day on your full elimination diet again then add the bread again on the third day. This helps make sure you are not having a placebo effect or imagining the symptoms. It can be tricky and it really does help to work with someone.
 
The key to this phase of your health journey is patience.
 
And of course knowledge. How do you know what to eliminate? Let’s start here…
 
What and Where is Gluten?
Gluten is a protein found in many grains, including wheat, barley, rye and triticale (a cross between wheat and rye). Gluten is also often found in oats. While oats are naturally gluten-free, they may be contaminated during production with wheat, barley or rye. Oats and oat products labeled gluten-free have not been cross-contaminated. Some people with gluten sensitivity or celiac disease, however, cannot tolerate the gluten-free-labeled oats, so avoid them for now.
There are different names for wheat flour depending on how it is processed, so look for and avoid these:

• enriched flour with added vitamins and minerals
• farina, milled wheat usually used in hot cereals
• graham flour, a course whole-wheat flour
• self-rising flour, also called phosphate flour
• semolina, the part of milled wheat used in pasta and couscous

 
There are also other varieties of wheat to know and avoid:

• durum
• einkorn
• emmer
• kamut
• spelt

 
Lastly, many processed foods and drinks contain gluten (even foods you don’t really think of as processed). some to watch for and carefully read labels on:

• beer, malt, modified food starch, soups, seasoned snack food, some cereals, soy sauce, spices, seasoning mixes.

 
I know it is a long list. The easiest way to start an elimination diet is to stick to naturally
gluten-free foods! This list is pretty great – lots of variety, color, and nutrients. I found it satisfying and sufficient for my four week trial:

• fruits and vegetables
• unflavored dairy products (milk, plain yogurt)
• beans and legumes
• eggs
• unprocessed meats, fish and poultry

 
My first week, I admit to looking for gluten-free breakfast cereals, snack foods, and baked goods; just knowing I couldn’t have gluten made me crave carbs. But I soon found I didn’t feel great because they ended up giving me more sugar and less fiber than I was used to. So here is what I ate…

• Breakfast: plain Greek yogurt + berries or a banana + flax seed*
• Lunch: large tossed salad of dark greens, carrots, cucumbers, tomatoes, peppers and a protein (canned drained tuna, leftover chicken breast, and garbanzo beans were my favorite)
• Dinner: steamed/grilled/roasted vegetables like green beans, Brussel spouts or broccoli + a protein (fish, turkey breast, chicken and black beans were my favorite)
• Snacks: apple slices with peanut butter; nectarine with almonds*; melon with cottage cheese**; popcorn; smoothie of fruit + Greek yogurt + almond butter

 
*some nuts and seeds are processed with flour so check the label to make sure it says gluten free. Imagine my surprise when I felt great until I ate a handful of store brand peanuts; not good!
**most cottage cheese if safe but some are processed with modified food starch.
 
Do you love cheese and want more information? I love this website: Beyond Celiac.
  
Up next... Hidden Sources Of Gluten: Improving Your Elimination Diet
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You’ve realized that your stomach aches, pains and processes are not “normal”. What next? It’s time to keep track of your symptoms in an organized manner over a specific period of time – using something we call a Symptom Journal, Patient Log, or Medical Diary. For consistency, I’m going to call it a symptom journal in this blog.
 
A symptom journal is all about identifying the what, when, why, and how of your gastrointestinal (GI) issues.

• What: What exactly are you experiencing? Bloating? Pain? Gas? Cramps? Nausea? These obviously are your symptoms.
• When: Are you having symptoms when you first wake up, during a meal, immediately following a meal, an hour after eating or drinking? These can be identified as timing and duration of symptoms.
• Why: Do you tend to have symptoms with certain foods, such as bread? Certain spices, such as cinnamon? Certain beverages, such as soda? These can be identified as triggers.
• How: How are symptoms improved? Do they go away if you don’t eat or drink for two hours? Do they go away with rest, with exercise, with a gas-relieving medication like Gas-X? These are your alleviating factors.
• What else: I think it is also important to record lifestyle considerations. Are you feeling stressed, sleeping poorly, or dehydrated? And maybe you want to record positives, like when you get fresh air, stretch, listen to good music, or have a good video chat. 

 
Keeping this journal for at least a week will give you a clearer picture of what is going on with your body. You know your body better than anyone, and this allows you to know it even better. You will be more mindful and knowledgeable instead of just guessing or assuming.
 
This symptom journal can also provide information for your physician or dietitian, as it takes much less time for your healthcare provider to review your diary than to gather a verbal report.
 
There are several ways to start this journal. Some of my clients use a composition notebook, a legal pad, or printed form where they can fill in the blanks. Others like a document, template, or spreadsheet they can keep open on their laptop or phone. Do what is most likely to work for you. Here are just a couple of examples (I do not get any kickbacks by recommending these; please find ones that you like.)
1. Digital Tracker
2. iPhone App
3. Example (if you use this example, be sure to customize to include how long symptoms last as well as alleviating factors and any other details that might help):

Up next: The Elimination Diet!

Happy New Year to followers, friends and colleagues!

Like you, I had a very unusual 2020. My travel plans were all cancelled, work shifted to remote only, and health was of utmost importance. I was fortunate to continue to teach online courses as well as counsel clients via video chat. At the same time, though, I struggled to feel well, brushing it off for months as the fatigue of all things pandemic-related. But medical visits and paying closer attention to my body helped me determine that I could not tolerate gluten.

Having to follow a gluten-free diet was never something I aspired to. Raised on spaghetti and bread, I love carbs more than anyone I know. And as a dietitian, I have warily watched the trend of going gluten-free for all the wrong reasons (weight loss, improved athletic performance, cleaner eating – none of which are scientifically supported) but have also worked with many clients suffering from gluten-related disorders, namely Celiac Disease and Non-Celiac Gluten Sensitivity.

My mission for 2021 is to focus on this topic while sharing my journey with you. Together we will explore the latest research, examine different gluten-related disorders, figure out steps for diagnosis, look at how to improve quality of life, and of course, manage a gluten-free diet. I cannot wait to continue this conversation with you and connect you with all kinds of other resources. Until then, get plenty of fresh air, sleep well, be mindful, maintain your physical activity, and eat lots of fruits and vegetables.

​Best in health,
Melissa

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