Manage Stress to Better Manage Irritable Bowel Syndrome (IBS)
What is Irritable Bowel Syndrom (IBS) and How Does Stress Impact It? Irritable Bowel Syndrome (IBS) is a common disorder of the gastrointestinal tract that affects an estimated 10-15% of people worldwide. Stress has been identified as a major factor in the onset and exacerbation of IBS symptoms and it is definitely a trigger for the patients I see at my clinic when attending one of our super successful gut health programmes. This month has been awareness month for both IBS and Stress, so I thought I would bring the two together in my final blog for this month. As previously mentioned in my previous blogs IBS and Probiotics Irritable Bowel Syndrome is characterized by abdominal pain, bloating, and changes in bowel habits. How does stress affect digestion? Studies have shown that stress can affect the way our bodies process food and how our digestive system functions, leading to an increase in abdominal pain and other IBS symptoms. Additionally, stress can cause changes in hormone levels which can further exacerbate IBS symptoms. It is important for people with IBS to take steps to reduce stress levels in order to manage their condition more effectively. The relationship between our brains and the digestive system is powerful, so it is not uncommon for changes in our emotional or psychological state to affect the way our gut works and could explain why we often feel ‘butterflies in the stomach’ when feeling anxious or stressed. The communication and feedback between the gut and the brain is known as the gut-brain axis. This network consists of two parts: The sympathetic nervous system, which manages fight-or-flight responses; and the parasympathetic nervous system, which controls repair, rest and digestion. It is believed that the enteric system functions as a third part to control the digestive system. This communication between the brain and the gut is referred to as ‘the gut-brain axis’, which helps connect emotional processes in the brain to the physical operations of our digestive system. Recent research has been able to establish the gut-brain axis, which is the connection between the two systems. Emotions can affect how your gut functions and vice versa. It’s important to note that although many digestive problems are related to mental health, not all of them are caused by Irritable Bowel Syndrome (IBS). Anxiety can manifest in various physical symptoms, such as stomach aches or changes in bowel movements. Gut Bacteria and Stress Did you know that having an imbalance in your gut bacteria is having an impact on your mental health? This is sadly not that well known, but with years of research and practice it is a major area that I have built into our programmes and is an important part of successful treatment. Certain bacteria can affect levels of anxiety or stress through activities in the digestive tract. A healthy balance of the ecosystem is necessary for our mental health and well-being, however when it is not balanced (dysbiosis) organisms like bacteria can lead to negative consequences. A recent large, most comprehensive and best-validated association study to date provides further evidence for an association between gut microbes and blood metabolites (generated by host and by microbes) in patients with Major depressive disorder (MDD). (1) They observed “that the genera Sellimonas, Eggerthella, Hungatella, and Lachnoclostridium were more abundant, while genera Ruminococcaceae…, Coprococcus, Lachnospiraceae…, Eubacterium ventriosum, Subdoligranulum, and family Ruminococcaceae were depleted in the guts of individuals with more symptoms of depression. Of these, genus Eggerthella showed statistical evidence of being involved in the causal pathway.” These microbes are involved in synthesising important neurotransmitters, such as gamma-aminobutyric acid, butyrate, glutamate, and serotonin. It is known that Butyrate can influence depression through several routes — ie, via immune regulation, genomic transcript/translation, and/or affecting energy metabolism. So this is really critical for health to ensure these pathways are optimised. 3 Tips for Identifying & Reducing Sources of Stress in Your Life Stress is a natural part of life and we all deal with it at different times in our day, week or life. It is normal and should not cause us problems. It can however become overwhelming if left unchecked. Identifying and reducing sources of stress in your life is essential for maintaining mental and physical health. There are many levels of stress and many ways to address. Here are 3 simple tips to help you identify and reduce the sources of stress in your life. One way is to take time to reflect on what is causing you stress. This could be anything from work or family pressures to financial concerns or relationship issues. Once you’ve identified the source, think about how you can reduce it. This could involve making lifestyle changes. Such as exercising more or taking up a hobby, or seeking professional help if needed. Second, get into the habit of practising mindful living by being aware of how your thoughts and actions affect your emotions and overall well-being. Taking regular breaks throughout the day to relax and refocus will help keep stress levels low. Third, set realistic goals for yourself that are achievable within a reasonable timeframe. Setting unrealistic expectations will only add more pressure and increase feelings of helplessness. Dietary Changes & Supplements that Can Help with Stress & IBS Symptoms Making changes to your diet can not only help reduce stress levels but also lessen the severity of IBS symptoms. Eating a nutrient-rich diet, and limiting processed fat and sugars is important as well as avoiding specific trigger foods. These can help reduce stress levels and improve digestion. Our 6 week elimination programme combines these all for excellent results. Additionally, certain supplements such as probiotics, omega-3 fatty acids, magnesium, vitamin B12 and zinc may be beneficial for those suffering from stress or IBS. By making key dietary changes and taking the right supplements specifically for you, you can experience improved overall health and well-being. We do a deep dive assessment for each patient that attends our practice. This allows 121 Dietitian programmes to be designed specifically for you, ensuring physical and mental health are addressed. Stress Management
The Health Benefits of Eating Eggs and How to Incorporate Them into Your Diet
What are the Health Benefits of Eating Eggs? If you don’t already know, eggs are a great source of nutrition and provide a variety of health benefits. They are high in protein, contain essential vitamins and minerals, and can help reduce the risk of certain diseases. Eating eggs regularly as part of a varied and nutritious diet can help improve your overall health and well-being. In this blog, you will learn of the health benefits of eating eggs and why they should be part of your diet. Firstly why were Eggs considered bad for us? For decades, eggs have been the subject of controversy and debate. In the 1970s and 80s, they were linked to high cholesterol levels and salmonella poisoning, leading to a wave of negative press and public advice to avoid eating eggs. However, more recent research has revealed that eggs are actually a healthful food with numerous benefits for our bodies. In 1999, a groundbreaking study published in the Journal of the American Medical Association (JAMA) sought to challenge the long-held belief that egg consumption was linked to an increased risk of cardiovascular disease. The results of this study found no such link, leading to a paradigm shift in how eggs were viewed by medical professionals and the general public alike. This shift in attitude towards egg consumption has continued over two decades later, with many health organizations recommending moderate egg consumption as part of a balanced diet. In 2020 an observational study has stirred the pot again and has not been so favourable regarding eggs and heart disease! Many experts are sceptical due to the methods of data collection so it will be interesting to see what researchers come up with next! For now, Eggs are definitely on the 121 Dietitian yum list, read on to find out why.. Egg Nutrition Eggs are packed with essential vitamins and minerals including calcium, iron, potassium, zinc, manganese, vitamin E, folate and many more, as well as being a great source of protein. They contain all nine essential amino acids, making them a complete protein source. Additionally, eggs are loaded with choline, an important nutrient that can help support many bodily functions including cardiovascular health and the yolks are one of the best sources of lutein, a pigment that has been linked to better eyesight and lower risk of eye disease. With their powerhouse of nutrition, eggs make a great addition to any healthy diet. For the protein and nutrients they provide, they are an inexpensive food group. If you are already a Boiled egg eater you will be delighted to know the following: Eating just one large boiled egg can give you 8% of your daily value (DV) of vitamin A, as well as 6% DV of folate, 14% DV of pantothenic acid (vitamin B5), 23% DV of vitamin B12, 20% DV of riboflavin (vitamin B2), 7% DV of phosphorus and 28% DV selenium. Eggs are an excellent source of several essential vitamins and minerals. 78 calories, 6 g of protein and 5 g of fat can be found in each egg, as well as trace nutrients which are important for overall health. Nutrients found in eggs include vitamin D, vitamin E, vitamin B6, calcium, zinc. How to Choose the Right Type of Egg for Your Diet Choosing the right type of egg for your diet can be a tricky task. With so many options available, it can be difficult to know which type of egg is best for you. Organic eggs, regular eggs, free-range eggs, cage-free eggs, pasture-raised eggs and omega-3 enriched eggs are some of the main types of eggs available in the market today. Each type of egg has its own unique benefits and drawbacks that should be taken into consideration when making a decision about which one to buy. Organic eggs we know are a healthier and more sustainable alternative to regular eggs. Eggs that come from hens are fed organic feed and are allowed to roam freely in their natural environment. These hens have access to fresh air, sunlight, and plenty of space for foraging. As a result, organic eggs contain higher levels of essential vitamins and minerals than regular eggs. Additionally, organic egg production is more humane and does not involve the use of antibiotics or hormones. For those looking for a healthier option that is also better for the environment, organic eggs are a good choice if you are able to spend the money as this can be prohibitive if consuming large amounts. Omega-3 enriched eggs are a type of egg that has been enhanced with additional omega-3 fatty acids. These eggs are produced by feeding chickens a diet that is rich in omega-3 fatty acids, such as flaxseed, fish oil, and algae. The resulting eggs have higher levels of omega-3 fatty acids than regular eggs and can be used as an alternative to traditional sources of dietary omega-3s. Omega-3 enriched eggs have been shown to have health benefits such as improved heart health, reduced inflammation, and improved brain function. They also provide an excellent source of protein and essential vitamins and minerals so a win-win. Caged eggs, also known as battery eggs, are eggs laid by hens that are kept in a cage. The cages used for caged eggs are typically small and restrict the hens’ movement. This type of egg production is controversial due to animal welfare concerns. Caged eggs have been banned in some countries, while others have implemented regulations to ensure that the hens receive adequate space and enrichment activities. It is good to know that more is being done to stop hen cruelty and to assist this further – selecting alternatives where possible is a good start. How to Incorporate Eggs into Your Diet Eggs are not only a super choice nutritional but so versatile and can be cooked in many different ways to create delicious dishes that are both nutritious and satisfying. From omelettes to frittatas, quiches to salads, and the infamous cloud bread!
Waist Hip Ratio Measurement are you familiar with this?
Waist Hip Ratio. I released a recent blog highlighting the positives and negatives of the BMI calculation and wanted to follow up on this with another measurement that you may find useful. Just to recap, BMI (Body Mass Index) is a well-known measurement that checks weight against height to select a number that you then can plot in a range for health. You can check yours here on our BMI calculator. This unfortunately in some circumstances can be misleading, and my BMI blog covers this in more detail. One example is if you have a high muscle mass, you may see your BMI number to be ‘overweight’.. What to use instead of BMI? The measurement that is now recommended as standard by the British Diabetes Association is the Waist : Hip Ratio This is a simple and quick-to-do measurement that just requires a tape measure. The tape measure below is designed to assist you to be more accurate as it holds the tape in place as required so you can record your numbers.. How to take your own Waist-Hip Ratio Start with the tape around your tummy, this should be the smallest part of the waist. Record this number. Next, drop the tape down around the hips, you need to measure the widest point across your bottom. Take down this number. Next, you need to divide the waist measurement by the hip measurement this will give you another number called the ratio. You use this number to check against the guidelines below. Waist Hip Ratio Guidelines The following are the recommended parameters: What does the Waist Hip Ratio number show? In simple terms the nearer this ratio you have recorded is to 1, the more likely you are to be insulin resistant and at risk of developing Type-2-Diabetes. If you have a high waist-hip ratio you may notice you have more of an ‘apple’ body shape. This body shape means you are carrying excess abdominal fat. Why does this matter? Health risks rise significantly with increased abdominal fat as many of our vital organs like your liver and pancreas are located here, if these organs are restricted by excess fat they are put under extra pressure. What can you do to lower your Waist Hip Ratio? Thankfully you can assist your waist-hip ratio by taking action in several ways. What to do next about your Waist Hip Ratio or anything else.. If you are unsure of how to increase or decrease your weight, change your eating habits or need help optimising the foods you eat and are not sure what programme to select please do contact us. We would love to help you or your family and friends with any nutrition-related queries big or small. If you want to book your programme TODAY we would love to help you. You can book a 121 Dietitian Programme today by clicking on the link below If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Do visit our YouTube Channel for more on keeping your health optimal. If you are interested in how I overcame my Thyroid Autoimmune Condition do check out the About section below Before you go please check out our 121 Dietitian Shop created specifically for optimising your health. Gillian x
PCOS -Weight Loss Diet
PCOS – Weight Loss Management (Fertility Programme) PCOS – Polycystic ovary syndrome is the most common hormonal disorder in women of reproductive age. It affects about one in 10 women and usually starts from puberty and can continue through to menopause. PCOS can cause multiple problems, including infertility, acne, excess hair growth, period irregularity and excess weight. Why does PCOS make it difficult to lose weight? PCOS has a link to multiple issues. What does the clinical evidence say for PCOS and Fertility? Many large studies across the world have shown that women who were overweight were able to lose weight before getting pregnant significantly improved both their fertility treatments and pregnancy outcomes. This is why international guidelines have recommended that weight loss should be the first line treatment for women living with obesity before undergoing fertility treatment or planning a family. How can a 121 Dietitian weight management programme help you? There is no one size fits all regime for losing weight, nor is there one specific fertility diet. Furthermore, women who are overweight with conditions such as polycystic ovary syndrome can find weight loss particularly difficult.All of the recent evidence has indicated that crash diet/exercise regimes tend not to work and can even cause harm, in other words, weight management does not mean starving yourself! The best approach is to have a sensible and achievable long-term plan to reduce weight and keep it off for GOOD. Who is this plan for? • Women with polycystic ovary syndrome (PCOS) experiencing difficulty losing weight• Women who are over or underweight experiencing a delay in achieving a pregnancy• Women who want to achieve weight and lifestyle improvement before trying for a baby• Men who have modifiable risk factors with diet and weight. Weight management for PCOS The aims of the weight management and or fertility programmes we offer are: • To achieve a realistic goal. We, therefore, focus on a 5-10% body weight loss over 4-6 months as this has been shown to improve fertility treatment outcomes.• To achieve sustainable weight loss – not just short-term gain• To provide a personalised dietary and exercise programme with appropriate psychological support – this has been shown to be the most effective way to achieve sustainable weight loss as well as improve quality of life – helping you to feel good about yourself• To empower you to help you feel more in control of everyday life so that you can avoid returning to unhealthy lifestyle behaviours. We haven’t forgotten the men in your lives…. Men can contribute to infertility issues also. Our programmes allow for both or either partner to be treated for infertility. How does our PCOS and Fertility plan work? You will meet a specialist dietitian throughout a period of a minimum of 6 months….Prior to an appointment, you will be asked to complete a 121 Dietitian – 7 Day Food Diary and Diet Plan Questionnaire. These will be assessed by Gillian Killiner RD, specialist Dietitian, and an appointment will be arranged to discuss the findings and begin the best nutritional programme bespoke to you. This can be via our online secure portal or face-to-face at our Holywood clinic. Week 1 – At this initial appointment Gillian will include nutritional information, motivation and lifestyle changes. A nutritional programme, recipes and shopping list will be written up for you to follow with SMART goals. Nutritional optimisation is the goal and this will include assessment of gut health/mental health/bloods and corrected with diet and supplements as required. Week 4 –6 – at this dietetic review Gillian will reassess the recommendations and assist you with setting further achievable goals. If you are wishing for a reduction in weight you will be aiming for 1kg/2lb weight loss as a steady and manageable reduction each week. Week 12-15 – Review with Gillian – you will be asked to forward a new food diary prior to this, the appointment is online/phone call &/or email. Week 22 -28 – Final appointment with Gillian – reassessment of weight and medical and general health parameters in conjunction with your fertility team. Partners together weight management fertility package £800 Either Partner weight management fertility Individual programme £600 Weight Loss for PCOS For women with PCOS who wish to lose weight only, our programmes will be tailored specifically to your requirements. PCOS weight management programme £500
Gallstones Diet: What to Eat and What to Avoid
How common are gallstones? Gallstones are very common and there are many gallstones diets out there. It’s estimated more than 1 in every 10 adults in the UK has gallstones, although only a smaller number develop unpleasant symptoms. Here at 121 Dietitian we see and assist patients each week with gallstones. This blog is to help you if you have symptoms and are needing trusted advice for a gallstones diet. What are Gallstones? There are two types of gallstones: The most common are cholesterol gallstones, made up of excess cholesterol in the bile. Less common pigment gallstones are made up of excess bilirubin. The processing of these stones being made takes place in the gallbladder which is a small sac below the liver. The stones can be very small like gravel to single large stones. Interestingly gallstones can cause no symptoms in two out of three people who have them. If you do experience symptoms you may find problems such as upper right abdominal pain, yellowing of the skin or the whites of your eyes (jaundice), inflammation of the pancreas (pancreatitis), and gallbladder inflammation with paler stools and diarrhoea. Surgery is the treatment offered for people whose gallstones cause symptoms. A combination of diet and lifestyle factors and genetics are likely the cause of gallstone formation. Who is at risk of Gallstones? Women people over 40 overweight people Gallstones are also more likely if: Your bile contains too much cholesterol The outlet from your gallbladder is blocked or infected You have an underlying health condition – diabetes, liver disease, or sickle cell disease You have a family history of gallstones What can flare up a gallbladder? When we eat food, our digestion requires the gallbladder to actively squeeze bile salts, phospholipids, cholesterol, conjugated bilirubin, electrolytes, and water out of the gallbladder and down the bile duct to the small intestine. If you have an inflamed gallbladder anything in the stomach can trigger this action and irritate it. We know the gallbladder has to squeeze harder when there is fat in the stomach so anything fried, greasy, fatty, pizza, pastries, will upset the gallbladder. Symptoms of a Gallbladder attack Gallstones may lead to your gallbladder becoming inflamed (cholecystitis), which can cause: Pain below your ribs on the right-hand side Pain in your back and right shoulder Fever Nausea Biliary colic If gallstones pass down your bile duct into your duodenum, you will experience a painful condition known as biliary colic. The pain is usually felt in the upper part of your abdomen, in the centre, or a little to the right, and often occurs about an hour after a meal that has a particularly high-fat content. The pain can be so severe that some people report they feel like they’re having a heart attack. Also, people can feel sick and may vomit. Gallbladder and Obesity If you are overweight or obese, losing weight will be really beneficial. Avoiding highly restrictive plans when you have gallstones is essential, as rapid weight loss has been associated with developing more gallstones. A safe weight loss of 1-2 lbs(0.5 to 1 kg) per week is what you want. 121 Dietitian’s specialist programmes provide you with a personal, safe and enjoyable lifelong plan. What diet can I eat when I have gallstones? It is best to have smaller, more frequent meals and best not to fast for long periods. Choosing small amounts of fats like olive oil can assist the smooth regular contractions of the gallbladder. Eat more foods that are high in fibre these can be fruits and vegetables, lean meats and fish and wholegrain carbohydrates like Brown Rice and Quinoa, and lower-fat dairy products. Avoid refined carbohydrates and sugar. What foods to avoid if you have gallstones? Avoid eating too many foods with a high saturated fat content as cholesterol is involved in forming gallstones. These include: meat pies. sausages and fatty cuts of meat. butter, ghee and lard. cream. hard cheeses. cakes and biscuits. food containing coconut or palm oil. What is best to drink with gallstones? Water is ideal for drinking as it dilutes and detoxifies impurities that impact your gallbladder. If you are experiencing an attack and you are not eating, drinking some protein water can assist with additional plant-based protein. Alcohol is very interesting in regard to gallstones. Research has found that a moderate alcohol intake may help reduce the risk of gallstones, although researchers aren’t sure how this happens. It is always necessary to note that even though it is thought drinking in moderation may lower the risk of gallstones, excess alcohol consumption can increase the risk of many health conditions. What foods help heal gallstones? Fresh fruits and vegetables. Whole grains (whole-wheat bread, brown rice, oats, buckwheat flakes) Lean meat, poultry, and fish. Low-fat dairy products. Finally on the natural options Getting active when you can is really important. Regular exercise is beneficial for your overall health. It can also help you maintain a moderate weight and prevent gallstones. Ensuring you keep stress to a minimum and sufficient sleep are both important for assisting or reducing gallstone formation, attack, weight and health. Our 121 Wellness shop provides essentials to help you. Medical treatments for gallstones If natural recommendations do not treat gallstones effectively, then medications or surgery may be required. Medication for gallstones Ursodeoxycholic acid and chenodeoxycholic acid may be used to treat smaller gallstones. These medications can take time to work (up to 2 years) and if stopped gallstones may return. Surgery for gallstones Cholecystectomy is the name for gallbladder removal surgery. Removing the gallbladder ensures that the gallstones cannot re-form. 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 please check out our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your
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
