Coeliac disease – how a dietitian can help
COELIAC DISEASE How can a specialist dietitian help optimise people diagnosed with coeliac disease? This is a great question and one that is asked every day by enquiring patients. Here at 121 Dietitian we have helped thousands of people, many diagnosed with coeliac disease. It can be overwhelming to learn of such a diagnosis and it can be difficult to know who to turn to. Thankfully we are the experts in optimizing health for all conditions and we have a dedicated programme that takes all the worry and stress away! WHAT IS COELIAC DISEASE? Coeliac disease is an autoimmune disease triggered in those people who are genetically at risk. This trigger causes your immune system to attack your own tissues when you eat gluten. The gastrointestinal tract is the targeted organ for this attack and the consequences are many. Interestingly 35-40% of the general population have the genes that predispose a person to celiac disease, but only around 1% of the general population develop the autoimmune disorder. SYMPTOMS There are several classical symptoms and a few more not so common, so if you feel you have an issue with Gluten you may find this helpful in getting a diagnosis. The most well-known symptoms of coeliac disease include diarrhoea (pale foul smelling fatty stools) fatigue bloating weight loss stomach ache Other not so well know coeliac disease symptoms include: indigestion constipation itchy rash nerve damage (B vitamin deficiencies) malnutrition – not getting enough nutrients from food, infertility problems – women with coeliac disease can have difficulty becoming pregnant disorders that affect coordination, speech, and balance (B vitamin deficiencies) Children with coeliac disease: have all the above symptoms along with nausea and vomiting may not grow at the expected rate and may have delayed puberty. And some people do not have any notable symptoms and this diagnosis comes as a complete surprise. IMPORTANT COELIAC STATISTICS 1 in 100 -people worldwide are affected by coeliac disease In Europe: Germany, The Scandinavian countries, Ireland, and the United Kingdom population have a higher prevalence of coeliac disease ~ 1000 to 1500 per 100,000 individuals Women to men ratio 3:1 Of patients diagnosed with Coeliac disease 50% still report symptoms while following a gluten-free diet (this is where 121 Dietitian can help) Family members 1 in 10 also have coeliac disease If you are diagnosed with coeliac disease you have a x 2 increased risk of coronary artery disease You have an increased risk of small bowel cancers x 4. COELIAC DISEASE TESTING Coeliac disease diagnosis can be made by your GP. They will take a history of your symptoms and arrange a blood test to check for antibodies that are present in the blood of people with coeliac disease. You need to keep eating gluten foods otherwise you may have an inaccurate blood test result. If this is +ve you will then be referred to a gastroenterologist to confirm this with an endoscopy and a biopsy. They will also be looking for blunt villi. Villi are finger-like projections in the gastrointestinal tract required for nutrient absorption, and when flattened do not have enough surface area to absorb sufficient nutrients. COELIAC DISEASE TREATMENT As this is an autoimmune disease – Gluten a protein found in grains is the trigger, coeliac disease is treated with a gluten-free diet. If you have been experiencing symptoms for a while with malabsorption you may need vitamins and minerals to be replaced. A specialist Dietitian who is trained in gastrointestinal diseases is the best person to assist you with optimising your diet and health for the long term. COELIAC MEDICAL TREATMENTS Coeliac disease unfortunately does not have a cure. So a strict gluten-free diet will help control symptoms and prevent long-term complications. What can often be a problem is when people have none to mild symptoms, or their symptoms go away within a few weeks of the diet, they can continue to eat or sneak some gluten and over time if not addressed serious complications can occur. Many years ago my patients often presented as very underweight, anaemic, exhausted, and having multiple nutrient deficiencies. Today this is not always the case. Many people are now being diagnosed who come to see me eating an unhealthy poor quality diet. Some carry excess weight and are nutrient deficient from this and less so from malabsorption. The worst for these people is that, if not educated in the right choices, they replace their poor gluten diet with gluten-free processed unhealthy choices. Unhealthy choices lead to the consumption of insufficient nutrients causing the patient to feel poorly and gain further weight. It is really important to therefore ensure that your gluten-free diet is designed to suit you and is wide in variety, healthy and balanced. Overall it has been fantastic that there has been an increase in the range of available gluten-free foods in the past 10 years. But the negative to this is that it is now possible to eat a diet full of unhealthy choices instead of focusing on a healthy and varied gluten-free diet. WHAT FOODS TRIGGER COELIAC DISEASE? Foods and fluids that contain Gluten include: Wheat and derivatives of wheat such as: Durum Emmer Couscous Semolina Spelt Farina Farro Kamut Einkorn wheat Rye Barley Triticale Malt including, malted milk, milkshakes, malt extract, malt syrup, malt flavouring, malted barley flour, malt vinegar Brewer’s Yeast Wheat Starch that has not been processed to remove gluten to below 20ppm Oats are contaminated in processing and packaging so are not allowed even though they do not naturally contain gluten. GLUTEN FOOD EXAMPLES The following are examples of popular foods containing gluten -so these are no longer suitable to eat – lifelong. bread pasta cereals cakes and pastries biscuits or crackers pies gravies, stocks and sauces beer WHAT HAPPENS IF SOMEONE WITH COELIAC DISEASE EATS GLUTEN? I advise and treat hundreds of newly diagnosed and refractory Coeliac patients. It is a common fear that when not in control of the cooking they are going to
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Essential kitchen utensils for stress-free cooking
Whether your aim is to get healthy by ditching the processed meals in favour of home cooked goodness. Or you simply want to get more adventurous in the kitchen. The best place to start is with the right essential kitchen utensils. It has been said that ‘a poor workman blames his tools’. So the easiest way to ensure your cooking process is as a stress-free and fast as possible is to ensure you are armed with the correct utensils. Here, we share our essential kitchen utensils that Gillian Killiner has personally used for several years and can promise will help ensure your cooking experience is a breeze. The aim to help get you healthier in the process! Measure it out Most recipes will include measurements for ingredients either in grams and ounces or millilitres and pints, not to mention tablespoons, teaspoon and dessertspoons, So a good place to start is with all the right measuring tools. I find the following set mega helpful with measuring oils, coffee, stock powder. Owning a set of weighing scales is a great start but for easy reading and accurate reading of wet and dry ingredients. Our favourite choice would be hassle-free electronic scales. You can add ingredients to the bowl, zero the scale and add again – super handy. You’ll also need a measuring jug or jugs. Choose with both the metric and imperial markings. measuring spoons are highly practical especially when using recipes from around the world. Essential kitchen utensils to chop With fresh cooking comes prep. This involves chopping so you’ll need good surfaces to chop food on, while keeping your kitchen surfaces scratch free. Chopping boards are necessary for this. Ideally, you should have separate boards to avoid cross-contamination between raw meat, poultry, seafood, and eggs. Thankfully, chopping boards range in price many are relatively cheap but if you invest in a good set they will last years. Graters & drainers A cheese grater isn’t just for grating cheese! It comes in so handy in the kitchen and can be used for grating things like garlic, ginger, fruit, vegetables, cheeses and even chocolate! You’ll also need a really good, sturdy colander, which can be used for draining foods such as wholemeal rice and pasta. as well as rinsing vegetables. The essential kitchen utensils -smaller tools It can be rather daunting when starting off as cooking requires many skills such as chopping, slicing, stirring, whisking and peeling. While none of these are difficult to do, having the correct tools like sharp knives are essential for speed and achieving the end result you desire. Again, each of these are readily available in the shops or online. They range from low cost to very expensive. Start off with a few and build your collection as your experience grows. This furi knife block was a personal purchase which I have been using for the past few years. They really do assist in all preping tasks. If you want to go BIG with an essential kitchen utensil! Not everyone likes being in the kitchen for hours. Time saving gadgets are a great way to cut down some of the work. I absolutely love my magimix and it was a personal purchase for me after many years of really, really wanting one. I have had it now for 10 years and it works like a dream when making soups, sauces, cakes etc. Storage saviours Finally you’ll need somewhere to store all your home cooked goods. This will keep them fresh as long as possible. Alternatively freeze so you can enjoy your hard work again at speed. Healthy eating requires a little planning so these boxes are a great way of storing any ingredients you’ve prepared in advance. Storage boxes are available in a range of sizes and styles so again, start with a few and add to your collection if you need to, a handy option is to clean out tubs that you buy food in and use these again – no cost and very effective. I do again have a set of storage containers and personally bought many years ago after I realised the risks of plastics, especially when heated or storing fats. They have been used over and over each day by all my family and far more durable than I imagined they would be. Definitely a little investment and making time to cook is the cornerstone to healthy eating. As experts in Diet and Nutrition for decades we know that pouring your money into quick fixes are not the answer – you need enjoyable nutrient rich meals and snacks lifelong. Our nutritional programmes are designed to help you. On-the-go While it isn’t an essential kitchen utensil, this is definitely one thing we’d recommend… A glass drinking bottle. These are great for helping you drink more water on-the-go. They are also useful for things like shakes, smoothies and even tea. We’d be lost without ours! The reason for using glass? Glass eliminates the leaching of chemicals you get from plastic bottles. Thus reducing health concerns and also ensures the water tastes great. Reusable glass bottles assists the environment and saves you a ton of money too. We would love to hear your top utensil choices and why. Visit our facebook page to share your thoughts and ideas. If you need help with putting together healthy ingredients then why not book an appointment here today. Need a recipe to get started? Check out our naughty but nice for special occasions, gluten free dairy free chocolate cake recipe here. If you are unsure of how to change your eating habits. Or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition related queries big or small. In the meantime do please check out more health and well-being choices specially selected for you on our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your family and
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