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By Van Waffle


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The Academy of Nutrition and Dietetics has released a new Certificate of Training (COT) in Treating Gluten-Related Disorders, designed for registered dietitians to help patients navigate the gluten-free diet. It sets the standard of knowledge for any dietitian treating people with celiac disease. Funded in part by a grant from the Celiac Disease Foundation, the COT consists of five two-hour recorded webinars from experts in the field. Dietitians may choose to complete one or more modules and earn continuing education units for each.

Now that celiac disease is becoming more widely diagnosed and the challenges of avoiding gluten are better understood, more physicians are asking for nutritional guidance to treat and follow up new patients, says Pam Cureton, RD, Clinical and Research Dietitian for the Center for Celiac Disease Research and Treatment, Massachusetts General Hospital for Children. Many celiac patients never visit a dietitian, and are vulnerable to misinformation published online or from uninformed health providers. The COT is designed to train dietitians in nuances of the gluten-free diet so they can provide the best information available.

In an effort to increase the pool of dietitians skilled in celiac disease nutritional therapy, the Celiac Disease Foundation through the generosity of Proud Sponsor Schar is providing reimbursement grants to dietitians who complete all five COT modules. Eligible candidates must complete an application available here.


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“The COT was written by expert dietitians and gastroenterologists and provides information that all dietitians practicing in this realm should know.”

“Newly diagnosed patients must be referred to a dietitian well-versed in gluten-free diets,” says Tricia Thompson, RD, Founder of Gluten-Free Watchdog, which tests food products for gluten-free safety. “The only treatment for celiac disease is a gluten-free diet. If we want folks with celiac disease to follow a strict gluten-free diet, then the importance of a referral to a specialist dietitian shouldn’t be up for debate.”

She adds, “The COT was written by expert dietitians and gastroenterologists and provides information that all dietitians practicing in this realm should know. Some dietitians may see only a handful of patients with celiac disease each year. The COT provides an inexpensive opportunity for dietitians to come up to speed on celiac disease and the gluten-free diet.”

Cureton, who led and coordinated development of the COT, says it is vital for dietitians to have the right information about the diet, but also to help patients manage it. The need to follow a strict, gluten-free diet has so much impact on the patient’s family, social events, and emotional health that support from a knowledgeable nutrition expert is essential.


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Anne Lee, RDN, Assistant Professor of Medicine at the Celiac Disease Center, Columbia University, New York, gives the example of a patient who came to her, who traveled with a suitcase full of pots, pans, dishes and utensils, everything needed for a kitchen, because a dietitian had told her she could not use anything that had touched wheat.

Lee says, “We know it’s not true. Dishes are washed, pots and pans are washed. We do teach our patients about avoiding chance gluten exposure. But the burden on this family, and the burden that isolated the individual child as being the one causing all this commotion, is huge. It has a huge moral and social impact on the child. And it’s all unnecessary. If they had come to someone who knew and understood exactly what the issues of chance exposure are, they would not have had to endure this.”


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"The COT provides an inexpensive opportunity for dietitians to come up to speed on celiac disease and the gluten-free diet.”

Amy Keller, RD, Clinical Nutrition Manager at Mary Rutan Hospital, Bellefontaine, Ohio, together with Lee wrote the COT module on quality of life in celiac disease, covering topics like eating in restaurants, religious customs that affect diet, travel, and participating in support groups.

Keller says, “It would have been wonderful to have something like this 10 years ago,” when she encountered her first celiac patient at a small community hospital. She adds the COT will be vital for assisting patients at facilities like hers that have only one or a handful of dietitians who need to get up to speed.

Keller supports the Celiac Disease Foundation providing reimbursement grants for the COT in Treating Gluten-Related Disorders: “I think it’s the most worthwhile thing they can do with their money, in terms of making sure that this is accessible.”

Keller, like many dietitians, must pay her own continuing education costs. She says the offer of reimbursement will encourage more individuals to complete the COT.


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