Weight Management

Labeling the Food Label

The New Year gives rise to new resolutions, but many have grown tired of attempting unsuccessful diets and seeing numbers on the scale crawl up, year after year. Although there is no magic bullet for weight loss, it is possible to reach your health goals by lifelong commitment to a healthy and balanced diet.

Making healthy choices isn’t as difficult or intimidating as it may seem: one useful strategy is to take advantage of the Nutrition Facts Label (Figure 1). Found on most prepackaged foods, the table is designed to inform consumers about the nutritional content of the food they are purchasing. Read below for a summary of the components:

  • Figure 2: Side-by-Side Comparison of current and new food labels Source: U.S. Food and Drug Administration

    Figure 2: Side-by-Side Comparison of current and new food labels
    Source: U.S. Food and Drug Administration

    Serving size determines the nutrition information you receive—including calories and nutrients—of a food. The amount of each nutrient consumed will change relative to eating more or less than the serving size provided. Serving size and portion size are not the same! The next you eat a meal, try comparing serving size to the amount you actually eat.

  • Calories correspond to the amount of energy by any given food. Consuming excess calories results in unintended weight gain. You are more likely to keep your weight in check by tracking the number of calories you consume. Contact a Registered Dietitian Nutritionist (RDN) or visit www.myplate.gov to calculate individual calorie needs.
  • Percent Daily Value (%DV) can be used to evaluate whether a food is low (5% DV or less) or high (20% DV or more) in a specific nutrient. Although the Food and Drug Administration (FDA) recommends choosing foods providing 20% DV or more of vitamins and minerals, and providing 5% DV or less of sodium and saturated fat, the average American consumes excess sodium and saturated fat, and consumes inadequate amounts of key nutrients.
  • The Ingredient List itemizes ingredients by greatest to least weight, and allows consumers to identify the contents of a food product For example, you can use the ingredient list to determine whether a bread has been made from whole or refined wheat.
Figure 2: Side-by-Side Comparison of current and new food labels Source: U.S. Food and Drug Administration

Figure 2: Side-by-Side Comparison of current and new food labels
Source: U.S. Food and Drug Administration

Nutrition recommendations for American have changed considerably since the introduction of the current food label in 1994. To better reflect these changes, the FDA approved a number of revisions on the current food label (Figure 2). The new label is scheduled to launch in 2018, and will feature a more prominent placement of serving sizes and calories, issue a mandatory % Daily Value for added sugars, and introduce values for potassium and vitamin D. Serving size will also change, and will be measured based on the amount American actually consume, versus what they “should” consume: for example, a 20 ounce sports drink will be designated as being one serving, rather than two (or three!).

The Nutrition Facts Label is intended to inform and assist consumers when they are selecting foods, and can become a valuable tool when used to your advantage. Paying attention to the foods you purchase and choose to eat brings you one step closer to achieving your health goals.
References

Emory Bariatric Center

If your resolutions include improving your health and weight loss, let Emory Bariatric Center help you. We offer both surgical and non-surgical weight loss programs. View our website www.emoryhealthcare.org/bariatrics for program options or call 404-778-7777 for more information.

Resources

  1. “Food Labeling Guide”. U.S. Food and Drug Administration. N.p., 2013. Web. 6 Jan. 2017.
  2. “Report Index – 2015 Advisory Report”. Office of Disease Prevention and Health Promotion. N.p., 2015. Web. 6 Jan. 2017.
  3. V. R. Delgado, RDN, LD, M. Moyer, MPH, RDN, LD, and E Lin, DO FACS. “The Food Label: A Guide To Educating Bariatric Patients”. Bariatric Surgical Practice and Patient Care 10.3 (2015): 87-92. Web.”Changes To The Nutrition Facts Label”. N.p., 2016. Web. 9 Jan. 2017.

Experiencing FOHO? Fear of the Holidays

hanukkah-2-fbDo you experience stress hosting that annual dinner party, seeing those long-lost relatives, or fear of gaining weight with it all?

It is true that the holidays can make it more difficult to manage all of life’s responsibilities including weight management. Pressure of weight loss can add to your stress level during the holiday. Perhaps your holiday weight goal this year should be to maintain your current weight. Don’t let the holidays set you back. Creating a realistic and attainable goal can set you up for success.

Here are several tips that can help you fight your food FOHO:

  • PLAN ahead— Be sure to plan how you will eat at the holidays in a way that works best for you. The more you prepare, the easier it will be to succeed at weight maintenance through the holidays. Don’t throw in the towel to just start over again in January 1.
  • Use a smaller plate at holiday parties. This creates the illusion of having more than you really are consuming.
  • You CAN leave the table if your plate is not clean. Try to eat slower at meal times to allow your body to send “fullness” signals to your brain to avoid overeating.
  • Eat only the dishes and treats you know you won’t get any other time of the year. Don’t waste calories on store bought items that you can get anytime. Savor the moment!
  • At dinner parties, sip on a non-alcoholic drink, like seltzer with lime so that one of your hands is occupied holding a drink rather than reaching for food. **Steer as clear as you can from alcohol, especially those creamy eggnog drinks that are loaded with unwanted calories.
  • Watching the big game? Throw a football outside with your family or friends during halftime.
  • Watch your portions and don’t over indulge. **Remember the first bite tastes the best.
  • Do some research. Check out which traditional holiday dishes have less calories. For instance, pumpkin pie tends to have less calories than other desserts.
  • Look to make healthy substitutions when making your holiday dish. Try using plain Greek yogurt instead of sour cream, or applesauce in place of oil or butter.
  • Lastly, don’t SAVE UP your calories. It’s a bad idea to starve yourself all day until the big holiday dinner. Why? You will likely eat too much and consume too many calories.

You don’t have to fear the holidays in terms of weight gain. If you know your triggers that lead to overindulgence and follow these tips where fit, it’ll make for an easier, more joyful NEW YEAR!

Takeaways from Emory Bariatrics Live Chat, ‘New Year, New You: Successful & Lasting Weight Loss in 2016’

weightloss2016-cil638Thank you to everyone who joined us on Tuesday, January 19th, for our live online chat titled “New Year, New You: Successful & Lasting Weight Loss”, hosted by Emory Bariatrics registered dieticians, Victoria Delgado, RD, and Kasey LaPointe, RD.

During this live chat, Victoria and Kasey provided healthful living tips to lasting weight loss for those who have made weight loss a part of their New Year’s resolution. They also answered questions about surgical and non-surgical weight loss.

We were thrilled with the number of people who registered and were able to participate in the chat. The response was so great that we had a few questions we were not able to answer so we have answered them below for your reference.

Question: Does wrapping your body with Saran wrap while you work out help shed inches/pounds? If so, how does it work?
Answer: No, this is a myth. It may increase sweat which can result in water loss, but not fat loss. To lose inches and pounds, we must combine physical activity with a healthy eating plan.

Question: Am I too old to go on Optifast (a liquid meal replacement program) to reduce my weight?
Answer: Due to risk of losing muscle mass, we encourage our patient who are 70 year or older to follow a Partial Meal Replacement Meal Plan instead of the Full Meal Replacement Meal Plan. The partial plan includes using Optifast and whole foods, while the full plan consists of using only Optifast products for a short period of time. All patients are assessed individually by a physician prior to getting started.

Question: I am interested in learning more about the lap band surgery to help with weight loss.
Answer: I recommend clicking on this link to learn about lap band surgery. Once you decide which Emory location is more convenient to you, you will find details about each of the surgical weight loss options we offer. You may also register for a seminar. Our video seminars define the three procedures we perform: the band, sleeve and bypass. There is also contact information and other resources at these sites.

Question: Can I go from the lap band to the gastric sleeve?
Answer: Absolutely. The surgeon can remove the band and convert to the sleeve all during the same procedure. You may click on the following link to choose a location and get started: http://www.emoryhealthcare.org/emorybariatrics/index-nav.html.

If you missed out on this live chat, be sure to check out the full list of questions and answers on the chat transcript. You can also visit emoryhealthcare.org/emorybariatrics for more information.

Also, if you have additional questions for our registered dieticians, Victoria Delgado, RD, and Kasey LaPointe, RD, please feel free to leave a comment in our comments area below.

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New Year, New You: Successful & Lasting Weight Loss in 2016 Live Chat- January 19th

weightloss2016-cil638Is weight loss part of your New Year’s resolution? Let Emory Bariatrics help you make 2016 the year you commit to getting healthy through weight loss.

Please join us for a live chat on Tuesday, January 19, 2016 at 12:00 p.m. EST with Emory Healthcare registered dietitians, Victoria Delgado, RD, and Kasey LaPointe, RD. They will discuss healthful living tips to get you on the path to lasting weight loss and answer your questions about surgical and non-surgical weight loss. Weight loss can be a big challenge, both physically and mentally, but with hard work, a strong support system and a positive outlook, you can achieve better health in 2016. Register here for this chat!

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Understanding Some Basics of Mindful Eating

mindful-eatingEating mindfully is not something we learn as a child. As a matter of fact, we are often taught the exact opposite. As children, how many of you were told by your parents “Clean your plate!”? This idea can actually lead to a lifetime of overeating, as many of us feel guilty leaving food on our plate, especially when there are “starving children” in the world. But the concept of mindful eating can lead to healthy habits and lead to less waste.

So what is mindful eating? Simply put, it is eating with awareness. Your focus is on your food, your body, and your body’s response to the food you eat. We put forth time and effort when we review bills and bank statements or when we plan a meeting, but when it comes to eating, we do so absent-mindedly. Even when we are in the act of eating, our minds drift or we are in the midst of conversations with others, that we don’t focus on how much food we put in our mouth, the texture of the food or the taste.

So how can mindful eating help with weight loss? Many of us struggle with food. We react mindlessly to it. We eat when we are not hungry. We continue to eat even though we have eaten enough already. And often, we do not use food for its intended purpose – to nourish our bodies. With that being said, if we started asking ourselves, “Is this food I am about to eat nourishing to my body?” our response to food would likely be much different. If you answer truthfully, you may find yourself choosing a healthier option altogether.

Another great question to ask yourself before eating is, “Am I hungry?” We find ourselves eating whenever it is convenient or whenever food is present, regardless of whether we are hungry. And when you ask yourself that question, you open the door to other mindful questions which, when answered truthfully, can impact your eating habits and food choices tremendously.

The great thing about mindful eating is it is a way of life – a lifestyle. It is not a diet. It is just you treating your body, and the food you allow to enter your body, with respect. It increases your awareness and attitude toward food without judgement. It allows you to think, and not react, to food.

Moving forward, consider the following choices in planning your meal: the type of food you eat or drink; where you eat; when you eat; how often you eat; the amount of food you eat; the size of the bite you chew; how fast or slowly you chew; how thoroughly you chew; when you swallow; how much time you take between bites; and when you stop eating . The list can go on and on – go ahead and add some of your own thoughts or questions. And let’s begin the practice of mindful eating today.

For more information or questions about weight loss services offered at Emory Healthcare, call 404-778-7777 or visit http://www.emoryhealthcare.org/emorybariatrics/.

Reference:
Fletcher, Megrette, MEd, RD, CDE; Frederick Burggraf, MEd; Discover Mindful Eating, 2010
http://amihungry.com/what-is-mindful-eating/

Power Up with Breakfast

oatmeal-breakfastYes, the old adage is true…breakfast really is the most important meal of the day. Why is that? Research has shown breakfast eaters are more alert during the day, perform better at work and school, and are more likely to exercise. Eating breakfast can also help trim your waistline. When we eat breakfast, our metabolism is given a boost that last throughout the day. Eating in the morning also helps us to not overeat at lunch and dinner. Some people even feel less hungry at night when they eat breakfast compared to when they don’t.

The two most common reasons people don’t eat breakfast is: 1.) “I don’t have time.” and 2.) “I’m not hungry in the morning.” The answer to prevent number 1 is to plan ahead. Have “grab and go” foods in the house as you run out the door. Do any prepping or cooking the night before so you don’t have to in the morning. Try cooking a large batch of steel cut oatmeal on Sunday night and keep it in the fridge. Scoop out a serving each morning during the week, and then heat and eat.

Addressing number 2 is a little trickier. The reason most people are not hungry in the morning is that they have trained their bodies to not expect food (or they may have eaten too much the night before). Our bodies are meant to have food in the morning; therefore, it is up to us to train our bodies back. Try eating something light like low-sugar yogurt or a homemade fruit smoothie until your body gets used to eating in the morning again.

Here are some quick and easy breakfast ideas:

  • Oatmeal with dried fruit and nuts
  • Low-fat yogurt with granola
  • Whole-wheat pita with hard boiled egg and spinach
  • Whole-wheat tortilla, peanut butter and banana wrap
  • Leftovers from last night’s dinner

Below is a recipe to one of my favorite “grab and go” breakfast items. It is full of protein and will give you plenty of energy to get you through the morning:
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Overnight Peanut Butter, Banana and Honey Oats

Ingredients:
– ¼ cup steel cut oats
– 1 cup light vanilla soy milk
– 2 tbsp natural peanut butter
– ½ tbsp honey
– Dash of cinnamon
– ½ banana, sliced

Directions:
Mix together all ingredients and place in an air-tight container in the refrigerator. Let sit overnight and enjoy in the morning. You can heat it in the microwave or eat it cold.
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Reference:
Lombardo M, Bellia A, Padua E, et al. Morning meal more efficient for fat loss in a 3-month lifestyle intervention. J Am Coll Nutr. 2014;33(3):198-20

Takeaways from Emory Bariatrics’ Successful & Lasting Weight Loss Live Chat

successful-weight-loss-cilThank you to everyone who joined us on Tuesday, August 11th, for our live online chat on “Successful & Lasting Weight Loss: Strategies for Reaching Your Goals”, hosted by Emory Bariatrics registered dieticians, Megan Moyer, RD, and Kasey LaPointe, RD.

For the millions of Americans who diet, stop dieting and then promise to diet again, the constant struggle to lose weight and keep it off can be exhausting, not to mention discouraging. During this live chat, Megan and Kasey discussed strategies for long term weight loss success. They offered healthful living tips to get you on the path to lasting weight loss and provided successful strategies to help make this time the one that leads to a healthier, happier lifestyle. Here are just a few highlights from the chat:

Question: What’s the best way to keep on track: daily weigh-ins? listening to tapes?

Meagan Moyer, RD: The best way to stay on track really depends on the person. Some people choose to weigh themselves everyday, but that can take a mental toll if they beat themselves up every time they step on the scale. That’s why I recommend not weighing yourself more than once a week. It’s also helpful to have a person you can call when you need support and in moments of “weakness.” Some people also choose to track what they eat using a website or app.

Question: Does eating before bedtime make you gain weight? What time should I stop?

Meagan Moyer, RD and Kasey LaPointe, RD: It’s a misconception that the metabolism stops at a certain time during the night. Usually the problem lies more with eating later in the night after your calories have been consumed for the day. Late night eating can be out of boredom or habit. One thing I suggest is asking yourself the reason you are eating, whether it’s out of boredom or actual hunger. Try to occupy your time with something else to keep you from snacking late at night. I keep a crossword puzzle next to my bed if I feel my mind wandering towards hunger.

Question: After months of steady weight loss, I feel like I might be at a plateau. My weight loss has been incredibly slow for the past few months. Any suggestions on how to adjust my diet to see better results?

Meagan Moyer, RD and Kasey LaPointe, RD: Reaching a plateau is completely normal when it comes to weight loss. The body gets used to your behaviors and habits, so it’s good to adjust your routine and diet. Try incorporating new activities into your work outs in order to continue to see results.

Also, while you may reach a plateau when it comes to the scale, the body often continues to change in other ways. Try to focus on other non-scale victories to measure your weight loss success. You can focus on how your clothes fit, seeing a decrease in inches using a tape measure, having more energy, sleeping better and other noticeable changes is a good way to measure your success.

Question: How do I know if I’m a candidate for Bariatric surgery?

Kasey LaPointe, RD: If your body mass index is greater than 40 or if your body mass index is greater than 35 and you have weight related health issues, you are a candidate for bariatric surgery. You also have to be ready to commit to a lifelong healthy lifestyle and be mentally prepared for these changes.

If you missed out on this live chat, be sure to check out the full list of questions and answers on the chat transcript. You can also visit emoryhealthcare.org/emorybariatrics for more information.

Also, if you have additional questions for our registered dieticians, Megan Moyer, RD, and Kasey LaPointe, RD, please feel free to leave a comment in our comments area below.

Bariatric Surgery: What are the Differences in Surgical Options?

bariatric-appleLosing weight with diet and exercise can work for many individuals. However, for some, diet and exercise may not be enough causing individuals to be at high risk for disease-related complications due to obesity. In these cases, weight loss surgery may be an option.

The decision to have weight loss surgery should never be taken lightly. Contrary to popular belief, it is not “the easy way out” and won’t instantly cure the emotional and physical issues which lead one down the path to obesity.

Emory Bariatrics performs three types of weight loss surgery. Below is a brief description of each type offered.

  •  Roux-en-Y, also know as “gastric bypass”, is a combination procedure. It is a restrictive procedure and a malabsorptive procedure. The surgery reduces the size of your stomach, therefore limiting the amount of food you can eat at one time. A malabsorptive procedure means your intestines are rerouted so that your body does not absorb as much nutrients from food. Lifelong vitamin and mineral supplements must be taken to avoid deficiencies.
  • Sleeve gastrectomy, also known as “sleeve”, is a restrictive procedure. About 80% of your stomach is removed, leaving a tube-like pouch that resembles a banana. The stomach and intestines are not rearranged, but since you are eating less, there may be vitamin & mineral deficiencies if the recommended supplements are not taken throughout life.
  • Adjustable gastric banding or “band” is a restrictive procedure. An inflatable band is placed around the upper portion of the stomach, therefore making you feel full on less food. Tubing connects the band to a port under the skin, and the band is inflated or deflated using a needle, as needed. You may have to visit your physician’s office several times for as long as you have the band. Vitamins & minerals must also be taken when you have the band to prevent malabsorptive issues.

All three procedures have pros and cons. Your doctor will recommend a procedure based on many things such as your medical history, your weight, and past surgeries. The most important thing to remember is that weight loss surgery will help you lose weight, but maintaining this loss for years to come is up to you. Weight loss surgery is a tool. Making healthy food choices and exercising regularly are essential to maintaining weight loss. If behavior changes are not embraced, weight loss is not guaranteed. Attending support groups and seeing a psychologist or mental health counselor will help you with these behavioral changes. Remember, it is a “journey”, not a sprint.

For more information about bariatric surgery options offered at Emory Bariatrics, call 404-778-7777 or visit emoryhealthcare.org/emorybariatrics.

Recommended readings:

  • “Weight Loss Surgery for Dummies” by Mariana S. Kurian, Barbara Thompson and Brian K. Davidson
  • “The Emotional First Aid Kit – A Practical Guide to Life After Bariatric Surgery” by Cynthia L. Alexander, PsyD
  • “Eat It Up! by Connie Stapleton
  • “Emotional Eating Toolbox” by Melissa McCreery, Ph.D
  • “Dying to Change” by Katie Jay
  • “Eating Well After Weight Loss Surgery Cookbook” by Patt Levine, Michele Bontmpo-Saray, William B. Inabnet and Meredith Urban-Skuros

Understanding Nutrition Facts Labels

Nutrition LabelCalories? Fat? Sodium? Carbohydrates? What do you look for on a nutrition facts label? Food labels tell you a lot about what’s in the foods you choose to eat. But they can be hard to decipher. Follow these simple steps to help you make the best food choices for what your body needs.

Step 1: What’s the serving size?
One of the most important pieces of information is also the most ignored! How many times have you eaten an entire package, thinking it’s one serving, just to turn it around and see that it’s actually two servings! That means you have to double all the numbers on the label. Instead of 150 calories, you ate 300. Instead of 7 grams of fat, you ate 14, and so on. Always check the serving size before portioning out your food.

Step 2: How many calories?
This section is helpful to look at if you are working on losing, gaining or maintaining weight. “Calories” listed on the left side are the number of calories for one serving. “Calories from Fat” tell you how many calories come from the fat in the food for one serving. Balance how many calories you eat with how many calories your body uses to maintain weight. Eat more calories than you burn to gain and less calories than you burn to lose.

Step 3: Nutrients to Limit
Choose foods with lower numbers of the following nutrients: Total Fat, Saturated Fat, Trans Fat, Cholesterol, and Sodium. Eating too much of these nutrients may increase your risk for heart disease, some cancers, or high blood pressure.

Step 4: Get More of these Nutrients
Most Americans don’t get enough fiber, vitamin A, vitamin C, calcium, and iron from the foods they eat. Eating more of these nutrients may improve your health and help reduce the risk for some diseases and health conditions.

Step 5: What are Percent (%) Daily Values?
The percentages listed on the right side of the label tell you whether the food gives you a lot or a little of that nutrient. Five percent (5%) or less gives you a “low” amount of that nutrient. Twenty percent (20%) or more gives you a “high” amount of those nutrients.

The Gluten Free Diet: Is It for Me?

Gluten FreeThere has been a lot of hype around “gluten-free” diets in recent years. While thousands tout the benefits of going gluten-free, many people aren’t exactly sure what it is or if it’s the right diet for them. If you’re unsure of what “gluten-free” really means or if you should give it a try, here’s a quick and dirty rundown of things you should know:

  • The first thing you should know is that a gluten-free diet is used to treat celiac disease.
  • So what is celiac disease? Celiac disease is an autoimmune disorder in which the small intestine is sensitive to the protein gluten, often found in wheat, rye and barley.
  • What are the symptoms of celiac disease? It’s a digestive disease, and symptoms include abdominal bloating and pain, chronic diarrhea, constipation, fatigue, iron-deficiency anemia, osteoporosis, missed menstrual periods and numbness in the hands and feet.1
  • How does an allergy cause such a wide array of symptoms? The effect of celiac disease is twofold. First, when gluten is ingested by a person with celiac disease, it can damage the lining of the small intestine, causing uncomfortable digestive symptoms. Secondly, due to the damage of the small intestines, crucial vitamins and minerals don’t get absorbed properly, leading to malnutrition and long-term negative health effects.
  • How do I know if I have it? Celiac disease is genetic, so if anyone in your family has tested positive, it’s probably a good idea for you to get checked, too. The disease can occur at any age, and affects people in all parts o f the world. You can get tested for celiac disease with a simple blood test. People with the disease will probably have higher levels of certain autoantibodies that your doctor will be able to identify.
  • What if I don’t have celiac disease? Can I still do a gluten free diet? Gluten free diets are only necessary for individuals with celiac disease or a wheat allergy. Before going gluten free, take a closer look at your diet- Is your diet balanced? Are you eating a variety of fruits, vegetables, legumes/beans, nuts/seeds, whole grains, and lean meat/low fat dairy? Often, when someone goes from a diet high in processed foods to “gluten free” they end up increasing other foods groups. This increase in fruits, vegetables, legumes/beans, nuts/seeds which may actually be reliving the symptoms, not the avoidance of gluten. If you’re not convinced, make any appointment with your gastroenterologist and discuss how to determine food allergies or sensitivities.
  • Will eating gluten-free help me lose weight? Not necessarily. Don’t fall prey to the idea that “gluten-free” equals “healthy” or “low-fat.” Some processed gluten-free foods are low in fiber so you won’t stay full as long, and they’re often stripped of important nutritional elements. In one case study, the vast majority of participants that adhered to a gluten-free diet gained significant weight.3 And since gluten-free foods often carry a heftier price-tag, you might want to think twice about going free just for weight-loss’ sake.

Takeaways: The gluten-free diet is really only necessary for people who have celiac disease or gluten sensitivity. Don’t get sucked in to the mindset that gluten-free equals a healthier diet. If you want to improve your health choose a variety of fruits, vegetables, beans/legumes, nuts/seeds, lean meats, low fat dairy, and whole grains.

Related sources:

References:

1. National Digestive Diseases Information Clearinghouse, a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Institutes of Health (NIH) . http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/#1
2. Antonio Di Sabatino, Gino Roberto Corazza. “Nonceliac Gluten Sensitivity: Sense or Sensibility? Annals of Internal Medicine. 2012 Feb;156(4):309-311.
3. T. A. Kabbani, A. Goldberg, C. P. Kelly, K. Pallav, S. Tariq, A. Peer, J. Hansen, M. Dennis andD. A. Leffler. “Body mass index and the risk of obesity in coeliac disease treated with the gluten-free diet.” Alimentary Pharmacology & Therapeutics. 35:.6; 625-744, March 2012.
4. Biesiekierski JR, Muir JG, Gibson PR. “Is gluten a cause of gastrointestinal symptoms in people without celiac disease?” Curr Allergy Asthma Rep. 2013 Dec;13(6):631-8.