This video is for general information and support purposes only and is not intended as a substitute for medical advice from your doctor or other healthcare provider. If this video raises questions for you, please discuss with your treating specialist.
Presenter: Professor Evan S. Dellon
Epidemiology of EGIDs
This talk reviews the epidemiology of eosinophilic gastrointestinal diseases (EGIDs). It first discusses in general how epidemiology can and has been applied to EGIDs, including characterization of the number of cases and trends in the number of cases, description of the natural history of disease, and investigation of risk factors. Next, it reviews the available data on the epidemiology of the non-EoE EGIDs. Then, it reviews the data on the epidemiology of EoE, which is more extensive than for the non-EoE EGIDs. These data include patient characteristics, incidence and prevalence, and risk factors (which can help to increase the understanding of why EoE may be increasing).
Evan S. Dellon, MD, MPH, is a Professor of Medicine and Adjunct Professor of Epidemiology at the University of North Carolina School of Medicine in Chapel Hill. He performed a clinical and a research fellowship in Adult Gastroenterology at UNC, during which he also received a Masters of Public Health degree in Epidemiology from the UNC School of Public Health. Dr. Dellon is currently the Director of the UNC Center for Esophageal Diseases and Swallowing (CEDAS) and serves as an Associate Editor for Clinical Gastroenterology and Hepatology. His main research interest is in the epidemiology, pathogenesis, diagnosis, treatment, and outcomes of eosinophilic esophagitis (EoE) and the eosinophilic GI diseases (EGIDs). The goal of his research is to improve the lives of patients with EoE and EGIDs by learning how to better diagnose, treat, and monitor the condition
11 Game-Changing Tips For Eating Out With Food Intolerances
I have intolerances, how do I eat out?
We are lucky that in today’s society we are becoming more adaptive to the constant changes within our health. Gone are the days where you would be looked at with a funny face if you told the waiter you were gluten–free or vegan. Gone are the days where you would feel embarrassed for asking for alternative milks or asking if they have nut-free options. This has become the new norm and our community could not be happier about it!
Of course there are some restaurants or cafes that either refuse to adapt. Some may not acknowledge or recognise the wide variety of intolerances or allergies people deal with daily. It is often a process of educating café and restaurant owners about allergies and intolerances, and at the start that can seem really daunting, especially when you’re hangry!
We understand that it can feel uncomfortable asking questions about the menu, that you may feel like you’re being ‘difficult’ or a burden to the waiter. It is important to note you should not feel ashamed. You should not feel embarrassed. You are doing the best you can in living with your allergies and intolerances, and you’re making healthy choices with the food you eat and the food you avoid. At the end of the day, you are paying for a service and simply need to grow your confidence about asking questions to ensure you don’t get sick or sit in discomfort for the whole night. Food is life and you want to enjoy eating out, no matter if you have 1 intolerance or 50!
Here are some handy tips to squash your fear and replace it with rock solid confidence to speak to any waiter, barista or food truck server!
1- Call Ahead
This is a quick, simple, effective method you can do to alleviate the pressure beforehand. By ringing up the place and asking if they cater for your specific intolerances or dietary requirements you can feel at ease when you are there. You then know you do not have to worry about ’trying’ to find something that is friendly to you or opting for (drumroll please) yet another side-salad-as-main-course.Look we all love a salad, but without the dressing and added ingredients they don’t seem as fun or interesting.
2- Make the Suggestion
Do you have a go-to restaurant you know that caters to your dietary requirements? A place where you know the service is amazing and they don’t make you feel like a burden when asking questions about the menu? Making the suggestion for dinner dates can alleviate the fear or worry about whether a restaurant can cater to your needs. If you have a go-to place and know the food is of a high standard, the staff are friendly and they go out of their way to accommodate you, why wouldn’t you go support them?
3- Eat Simple
If you like a dish full body in flavour and spices, it may be useful to note that some of those flavours have hidden ingredients in them that may step outside of yourdietary requirements. A lot of flavorsome dishes have various dressings that can have hidden gluten, soy and dairy in them. If you are unsure, opt for the simpler dish or ask for the dressing on the side so you can see if it will upset your stomach or if you want to pose the risk of trying it. The control is back in your hands and you can decide what you want to do (no judgment on our end if sometimes you give in or want to deal with the pain later… we have all been there).
4- Always Take Your EpiPen with You
Sometimes we can be guilty of forgetting to take our EpiPens with us. We think, “No I won’t need it. I will be ok. What is the worst thing that could happen?”Having an allergy means we must own our actions and be aware of the protocols we must take to look after ourselves and those around us. It is our responsibility to treat our allergy with importance and not put ourselves in danger or create potentially scary situations for people around us if something were to happen and we did not have our EpiPen. Do not be ashamed or embarrassedabout the allergy that you have. It is not your fault. Treat this with importance, take it on board and take it seriously to ensure you look after yourself and those around you. So next time you leave the house, remember your little partner in crime aka your EpiPen. It always has your back. 😉
5- Own Your Allergy. Own Your Intolerance.
Do not feel embarrassed about your allergy or intolerance. OWN IT. You cannot get rid of it (in most cases) so you need to learn to accept and respect it.It is a part of you, and we can guarantee it will teach you a lot in life.
There is a period of denial or avoidance that most people in our community go through. Some people even LIKE their intolerance now because it kickstarted a healthier lifestyle for them. Others have gone on to study nutrition and health – not just seeing the silver lining in a diagnosis, but truly unlocking a brand-new life that all started with OWNING their intolerance.
6- If Staff Are Not Taking You Seriously, Say You Have an Allergy
Sometimes when you mention an intolerance to a waiter, they do not take you seriously. They think “it’s not life or death” or “it’s just a preference” and may not treat it with as high importance than if you were to say you had an allergy. A little handy tip to avoid confusion or worry is to say you have an allergy to the ingredient/s you are intolerant to, in order to ensure your food will come without it. It may seem a little cheeky, but in the interest of clear communication it’s a quick food ordering hack.
7- Plan Ahead
Technology has become our best friend. A little tip is too scope out the menu online to ensure you are across what they offer and that they can accommodate to your needs. Head over to Instagram to look at their presentation and food quality (warning this may result in🤤…) Look at reviews online and see if others have mentioned anything about accommodating to intolerances or allergies.
8- Touch Test
If you are skeptical of a dish that is presented to you, trust your intuition. Sometimes waiters forget things and despite them reassuring you they have accommodated to your dietary requirements; something could havehappened in the interim. Use the touch test as an added safety check. Put a small amount of the food on your outer lip. If you get a tingling, swelling, burning or chilli-like feeling — it is safer not to eat that food.The touch test does not guarantee that food is safe, however, it is an extra check you can use.
9- Safe Snacks
Sometimes despite the amount of prior research we do, restaurants can change their menus without having time to upload or communicate to their community. Our suggestion is to take safe snacks with you, just in case you find your options are limited or eat something prior to your reservation to avoid taking a risk later on due to hunger cravings bypassing you (no one needs a hangry person…)
10- Chef Cards
Chef cards are a handy tool to have when you want to communicate in a concise way to the chef. Sometimes we don’t want to feel like a burden or the message from the waiter to the chef is not passed on correctly (haven’t you ever played Chinese whispers before? Sentences can easily be mixed up). Take personalised chef cards that you can pass onto the chef explaining your food allergy and the need to be cautious. Allergy & Anaphylaxis Australia has chef cards you can print off or order online.
11- Reporting Reaction
If you have an allergic reaction to a food after checking the ingredients list, it’s important to report your reaction to protect others and avoid someone else experiencing this. After you have managed your reaction and recovered, you should report the reaction to the health department. Information about who to contact can be found here.
Remember, you are not alone. We understand that you may feel apprehensive about how to live with your intolerances and allergies. There is no reason to feel embarrassed about taking steps to ensure you live a happy, healthy life. Join ourFFACOMMUNITY to interact with others who may have similar experiences to you and share resources, lessons learned and supportone another. We are all on this journey together.
In this video, gut health dietitian and nutritionist, Rebecca Ponsford from FODMAP Nutrition & Dietetics breaks down what Coeliac Disease and IBS are- the differences and similarities between them.
She describes the process of testing and diagnosis for coeliac disease and the importance of the “Gluten Challenge”. Finally, she explains the FODMAP component of wheat which can trigger IBS-type symptoms.
Rebecca is an Accredited Practising Dietitian (APD). She completed her Bachelor Degree in Nutrition and Dietetics (Hons) from Monash University in Melbourne, Australia. Rebecca supports her clients with individualised nutrition advice to find relief from digestive health issues such as Irritable Bowel Syndrome (IBS), SIBO and coeliac disease, so they can get back to enjoying life again!
Rebecca has additional training in the low FODMAP diet, and healthy body image for adolescence. She has a passion for environmental sustainability and much experience in plant-based nutrition. She also has a strong interest in the connection between mental health and gastrointestinal health, environmental sustainability and women’s health.
When working with clients she uses evidence-based nutrition and lifestyle approaches to nourish their bodies and achieve sustainable results.
Rebecca strives to educate her clients by translating evidence into practical real-life strategies for her clients to implement. She works with an individualised client-centred focus, providing clients with tools to enjoy food, take ownership of their food choices and fit food into their lives around other priorities.
Rebecca is available for one-on-one nutrition and dietetics consultations at FODMAP Nutrition & Dietetics.
Dakota Rhys-Jones is a Research Dietitian working between the Department of Gastroenterology and Hypertension Research Laboratory at Monash University. Dakota works across many of our FODMAP team projects, including the management of our online tools that researchers use. She also coordinates clinical trials that are aiming to reduce blood pressure through fibre and its effects on the gut.
Jessica Fitzpatrick is an Accredited Practising Dietitian and PhD Candidate, at Monash University, who has a special interest in providing evidence based care to patients who live with gastrointestinal disorders such as Inflammatory Bowel Disease, Irritable Bowel Syndrome and Coeliac disease.
Food Chemicals or FODMAPs, What’s Your IBS Trigger
Research indicates 50-80% of people get an improvement on the low FODMAP Diet. But, what if you’re one of the 20-50% that don’t? Food chemicals are different from FODMAPs, theyoccur naturally in many foods or can be added in food processing. For some people these cantrigger IBS symptoms. Learn about the differences between FODMAPs and food chemicals and how to determine which approach is best for you.
Joanna is a dietitian, who loves food. Her passion for digestive health comes from her own life long battle with IBS. This has taught her both how hard it is to live with an unpredictable gut and how life changing it can be when food sensitivities are well managed.
Although based in Melbourne, Joanna consults virtually via Everyday Nutrition and loves working with people around Australia and Worldwide helping them to identify their triggers and learn to love food and life again.
In addition to this, Joannais on the advisory board for the Master of Dietetics degree at Deakin University and a member of Food Allergy and Intolerance Interest Group with Dietitians Australia. She provides resources for dietitians and presented at seminars in Australia and the USA.
Joanna is a regular contributor to FODMAPPER magazine and has also written for Healthy Food Guide, Australian Gluten Free Life and Nursing Review.
With many naturally gluten free options, Japanese food can be agreat choice when dining out. However, although sushi is often safe, there are other places where gluten lurks.
In addition to the obvious gluten unfriendly dishes such as dumplings and noodles, check for the following when confirming which options are gluten free.
1.Soy sauce and wasabi
This is basic but very important to know and keep in mind – standard soy sauce contains wheat! Gluten-free soy sauce and tamari are great substitutes that taste incredibly similar. Some Japanese restaurants may have GF soy sauce available if you ask, but always double-check when dishes are made with soy sauce. In addition, some packaged wasabi uses wheat starch as a thickener.
Not only is there wheat flour in batter used for tempura dishes, but tempura flakes (also known as “crunch”) that are used as a topping on sushi rolls have wheat as well. In addition, keep in mind that if a restaurant offers tempura, there’s a good chance they are using the same fryer for tempura as well as other dishes, so be sure to ask about potential cross-contamination.
3. Imitation Crab
Imitation crab (also known as “crab stick”) almost always contains wheat starch as a binding agent. This is why California rolls – which usually use imitation crab – are almost never gluten-free. Always ask about ingredients if there is any sort of imitation crab or fish in a dish.
4.Sauces and Dressings
Soy sauce and wheat starch are often in dressings and sauces. Watch out for seaweed salad especially – it almost always has soy sauce in the dressing.
Some fish roe (e.g., those orange fish eggs used as a sushi topping) have an added wheat thickener to help bind the eggs together. This isn’t always for the case, but it’s worth checking.
Believe it or not, some restaurants use steam from boiling wheat-based noodles to cook edamame and other vegetables. This can potentially cause cross-contamination. While this practice won’t be used at all Japanese restaurants, it is worth double-checking to be sure.
Born and raised in New York, I relocated to Sydney, Australia in 2018 for work. I love exploring the incredible gluten free food scene in Sydney as well as experimenting with gluten free cooking and baking.
I was diagnosed with Celiac when I was 12 years old and in the 14ish years since my diagnosis, I‘ve maintained a strict gluten free diet. I love sharing tips and tricks I’ve learned through my experience and showing how a GF diet can be exciting and delicious.