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
FODMAP – all you need to know to get results..
Here, Gillian Killiner, Principal Dietitian at 121, discusses the Low Fodmap Programme and in particular, why seeking the help of a qualified and experienced Dietitian is key to implementing it successfully. The Low Fodmap Programme has been around for over 10 years. I heard about it in its infancy and thought: “Wow! This is excellent for gut dysfunction and IBS”. And so in 2010/2011, I packed my bags and returned from Belfast to London on three separate weeks to go back to my training hospital, Guys and St Thomas’s to learn all about it – the first course of its kind outside of Monash University, Australia. The work load was intense but exciting. After qualifying with my certificate in Low FODMAP practice, I took my first guinea pigs patients and we followed the information I had learned from the course. I can’t lie. It was hard work. Now over the 7 years I have been practicing the Low FODMAP programme daily, much has changed in the way I deliver, advise and support because everyone is different. My high success rate of 97% is due to my expertise of using the programme daily. The gut is not just about absorption. It’s microbiota has a complex network of links to emotions, stress, activity, genetics, medical history, medication, lifestyle, food and fluids… We as individuals are not all uniform. We do not all follow the same diet and lifestyle. This is the basis of my increasing frustration and the fiasco I find myself in. People are coming to me more and more in desperation, telling me they have tried the Low FODMAP programme and it hasn’t worked. AhhHHHHH!! Another emotional boundary to cross. I have found that with the programme’s popularity and success has come the internet dippers. They take a bit from one website that they like and mix it with another and believe they have completed the programme. Wrong… The other – and most frustrating way that these people are not succeeding. They are being handed a “sheet” from their Consultant or GP and left to get on with it. Excuse me… WHAT??? A little more respect to the programme please! A sheet or a smorgasbord will not get results but in fact dangerously add to people’s fears around food and restriction is dangerous in the wrong hands. Low FODMAP Dietitian -why use one? A patient came to me recently and had been told by a local health food shop to avoid a major list of foods. She did so and over two years of carefully following the advice she to me gravely ill, malnourished, depressed and still her stomach issues continued. Appalling. If you have a gut health problem that has not resolved with medication, dietary changes, or visiting a health shop to pay and hold two balls in the air and told to eat very little, don’t despair – do get in touch. Gillian Killiner is an expert in all areas of Gut Health. 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 our 121Dietitian Shop which has been expertly created especially for you. If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed]
Gluten free dairy free chocolate cake
We recently celebrated my birthday & my daughter Laura very kindly baked a delicious chocolate cake. As the recipe is for a Gluten free dairy free chocolate cake, it means our entire family can enjoy it. Knowing how hard it can be to get a good recipe for a dairy free, gluten free chocolate cake, Laura wanted to share this tried & tested recipe with you. We hope you like it as much as we did. Ingredients for Gluten free dairy free chocolate cake 75g cocoa powder 137ml boiling water 150g softened butter (Dairy free) 400g caster sugar 262g self raising flour 1 1/2 tsp baking powder 1/4 tsp xanthan gum 4 eggs, beaten 187ml almond milk For the icing 150g dark chocolate 250g butter (dairy free) 250g icing sugar Pinch of salt Method for making Gluten free dairy free chocolate cake Pre-heat oven to 170°c Grease 2 round baking tins Sift cocoa into a large bowl. Add boiling water and butter, mix until smooth Pour in the caster sugar, self raising flour, baking powder & xanthan gum Mix the eggs & milk into the dry items, making a smooth batter Pour into cake tins Bake for approximately 40 mins Remove from the oven and allow to cool While your cake is cooking prepare the icing – begin by putting chocolate into bowl over a pan of boiling water to melt In a large bowl, place butter and icing sugar and mix well until combined Add melted chocolate and mix Once cake is cooled, spread between layers, top as desired and enjoy 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 our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help with healthy Gluten and Dairy free foods Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed] Information checked & correct on 16th May 2018 and 1st January 2023.
Gluten and Dairy free chocolate cake recipe-low FODMAP
Gluten and Dairy free chocolate cake recipe – low FODMAP Well today my eldest daughter sat the 1st of her 3 transfer exams to senior school. She came out happy in the knowledge that we had a fun day ahead planned! So all was good. It started with concocting some yummy home-made; tuna, chilli, spring onion greens, pepper, caper, cheese on corn tortilla pizza’s for lunch followed by a trip in the winter sunshine to the park for some monkeying around. We returned with a hunger for chocolate cake so we experimented with this simple recipe and I thought it was so good I should share it with you, especially as it is made with a healthy fat choice; olive oil, and it is also low FODMAP and gluten free, dairy free too…. 80g cocoa 130ml boiling water 150g ground almonds 1/2 tsp bicarbonate of soda pinch of salt 200g brown/caster sugar 150ml olive oil Eggs x 3 whisked Blend thoroughly together the sugar, olive oil and 3 whisked eggs to create a creamy ‘mayo’ Mix the boiling water with the cocoa to a paste Weigh the almonds, bicarb of soda, and salt in a bowl, add the cocoa paste and the dry ingredients to the ‘mayo’ mix and blend. Pour into a cake tin. Depending on the size of the tin cook for 30 – 45 minutes till the cake is soft and squidgy on the top. dust with icing sugar. Voila. We got a photo of the last slice!! Enjoy! How we can help you…. Need help optimising the foods you eat or unsure of how to change your eating habits? We are experts in making “bad food” into healthy delicious tasty everyday alternatives. If this is what you need, 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 our 121Dietitian Shop for specially selected choices for you. If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. We are on Instgram and Facebook. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed] Information checked & correct on 16th May 2024.
