Staying Healthy

Winter Flu, Pneumonia and Coeliac Disease

Winter is coming…

We visited the medical practice yesterday for some travel inoculations. That was fun, as you can imagine: me, plus three large teenagers, in a small nurse’s office, each receiving a variety of jabs in both arms…

Anyway, as we were wrapping up (and retrieving one feeling-faint daughter from the floor) the nurse said something in passing about coeliac daughter.

Has she had her pneumonia jab?

Um… no? What pneumonia jab? We decided long ago that we wouldn’t take up the winter flu vaccination, as coeliac daughter is very healthy; she just needs a special diet.

The nurse dug around in her paperwork, and found our daughter on a list of people to be called in. Apparently, these days, infants all receive a pneumococcal vaccination as part of the routine series of inoculations. Because of their ages—born long before 2006—my children did not receive the pneumococcal vaccine: too old.

And now, it turns out, it is recommended that coeliacs (especially those whose spleens are not working well – fortunately, this doesn’t apply to us) should receive this jab, no matter what their age. And, we should be reconsidering our views on the winter flu jab.

The pneumococcal vaccine will protect her against pneumonia for 10 years, apparently; the winter flu jab against influenza, but only for one season.

Have you had this vaccine? What do you think? Find out more at Coeliac UK.

Are You Deficient in Minerals?

Here’s a very informative quiz about your mineral intake, provided by Goodness Direct.

Take the Quiz

It’s very revealing – we could probably all do better! How did you score?

Glad to be coeliac: osteoporosis, the hidden threat

dairy productsWe caught the end of a programme on Radio 4 this afternoon, while driving, which caught my daughter’s attention. “Like me!” she said, when the speaker revealed that she’d been diagnosed with coeliac disease.

The programme was actually about new treatments for ostoporosis, but – helpfully – the risks of developing osteoporosis as a result of undiagnosed coeliac disease were clearly stated.

Luckily, the woman speaking on the radio had been diagnosed with coeliac disease, and as a result, was automatically sent for a bone scan, which caught the osteoporosis. She’d never broken a bone and had no idea she had osteoporosis. As a result, she was delighted to have been diagnosed as coeliac!

The problem with undiagnosed coeliac disease is that valuable nutrients are not being absorbed, with the resulting damage to bone. Coeliacs who’ve been gluten free for long enough will in most cases be absorbing these nutrients again, because the lining of their small intestine will have healed. My daughter’s risk of bone damage is minimal – she’s had years to rebuild her bone strength. But there it is: one very good reason not to cheat. As if you needed any more reasons…

If you’ve recently been diagnosed as coeliac, and you’ve not had a bone scan to check for osteoporosis, then perhaps you should ask for one. As well as remembering to eat calcium and do some exercise!

If you’re interested in the osteoporosis programme, you can find it on the BBC website at the moment, and it will probably be there for a while longer: http://www.bbc.co.uk/programmes/b00q3gjn.

Also available via the BBC site is the FRAX risk assessment tool to assess the probability that you’ll suffer a broken bone in the next decade, based on gender, BMI and medical history. Definitely worth a look.

Preventing Osteoporosis

I recently invited Linda Simon, a registered dietitian and certified personal chef, to advise us on how best to avoid osteoporosis. Linda blogs at blog.kitchentherapy.us, where she posts delicious – and healthy! – recipes and advice. Over to you, Linda…

Thanks Lucy, for asking me to write about preventing osteoporosis. This is a topic important to all folks with gluten intolerance. Specific U.S. and U.K. recommendations may be different. And like nearly every topic, not everyone agrees with the consensus. But we are all people, and I think general recommendations would apply to most of us.

milk and sunshineOne of the many serious complications of celiac disease and gluten intolerance is osteoporosis. In fact, diagnosis of osteoporosis early in life can be a tip off to test for celiac disease. But then it may be too late to prevent a hip fracture or broken wrist. We want to build maximum bone by during childhood and adolescence.

Prevention is the name of the game, so how can we prevent it?

Follow a gluten free diet.

The gut needs to heal to absorb nutrients effectively. Unhealthy villi cannot absorb bone-building nutrients. We hear about calcium all the time, and it is important. But healthy bones also require many nutrients, these range from boron to zinc. See the U.S. Surgeon Generals report for an easy to read chart on all nutrients that that are beneficial in bone health (PDF). A truly gluten free diet is the first priority, to have a healthy gut and absorb everything we need.

Eat enough calcium.

One to two percent of our weight is calcium, mostly in our bones. The recommendation for “enough” varies with age and sex. U.K. DRV (dietary reference value) for calcium is 450-1000 mg per day.

Dairy products are the best natural source of calcium. One serving of milk or yogurt is 250 ml. They contain about 300 to 450 mg calcium. A 30 gm piece of cheese has about 150 to 250 mg calcium. Getting the recommended amount of calcium is a challenge for most people, celiac or not.

And many folks with gluten intolerance are also lactose intolerant. They may tolerate low lactose dairy products like hard cheeses, yogurt and kefir. Or they may be able to use non-dairy products fortified with calcium. In the U.S., soymilk and some orange juice have added calcium.

Healing the gut may cure lactose intolerance. The enzyme that digests lactose is produced at the very end of healthy villi. So healing the gut and growing longer villi may allow one to enjoy milk again. A young celiac friend says he is very proud of his new “hairy” villi. Though it will not work in every case, you might be able to drink milk after successfully following the gluten free diet long enough to heal and feel well.

Canned fish, with the bones, are also excellent sources of calcium. These include salmon, sardines and anchovies. A 100gm serving averages about 200 mg of calcium.

Other good natural sources of calcium are greens, such as turnip greens, collards, spinach, and kale. A 50 gm serving of cooked greens averages about 100 mg of calcium.

Or you might consider calcium supplements. Some people find them constipating though. That might be helpful for some, a problem for others.

Get enough vitamin D, the sunshine vitamin.

This is very hard to do with diet and sunlight alone. Few foods have natural vitamin D. They are limited to oily fish like herring, salmon, tuna, mackerel and eel. A 100 gm serving averages about 200 IU vitamin D.

Cod liver oil is especially rich in vitamin D, 15 gm has 1350 IU. But it tastes worse than terrible. And it also contains vitamin A, so much you might overdose on it.

Few of us spend enough time in the sun to meet our vitamin D needs. I think of misty gloom rather than warm sunshine in the U.K. Most people will need to take a supplement.

The current U.S. recommendations are 200 to 600 IU per day, depending on your age. I could not find a U.K. DRV. But many experts believe it should be raised for adults to 1000 IU D3 per day. D3 is the active form of vitamin D. See Grassroots Health for a thorough review of current research and their recommendations. I take 1000 IU D3, most days, when I remember it.


Step away from the TV and the computer and get out of the house! Walk, jog, run, dance, and take the stairs instead of the elevator. Or skip rope, jump on a trampoline, do Pilates or yoga, play soccer or tennis, skate, ski… Use those bones, get moving!!

Enjoy a healthy lifestyle

Limit alcohol, do not smoke and get rid of soft drinks. The smokes and soft drinks are contributing nothing, I will repeat, nothing to your health.

Thanks Linda – good advice for all of us.

Safety Tips for Gluten Free Cooking

trivetOne of the biggest risks in gluten-free cooking is cross-contamination from products containing wheat. In households where some people have gluten allergies and others don’t share the same dietary needs or concerns, it just takes a bit of work and organization to keep things safe for everyone.

An easy step to keeping things separate is purchasing separate cookware sets, utensils, and storage containers for cooking gluten-free. You can use color-coding so that there will be no confusion as to which cookware is for which diet. For baking trays you can use disposable liners, so you can bake separate cakes and breads using the same pans. It’s important to keep any cooking implements very, very clean, whether you’re using separate sets or not.

Cookware and utensils aren’t the only concern for gluten-free cooking; cooking surfaces should be very thoroughly cleaned, and separate cutting boards should be used if possible. It’s a good idea to have separate toasters for regular bread and gluten-free bread, and separate flour sifters for the different types of flour that you use.

Food storage should be handled carefully. Make sure to purchase good quality air-tight containers to keep flours separate. Cross-contamination can happen if crumbs get into shared butter or jams, so be careful about sharing condiments and using a very clean knife for each serving.

Keeping things well-organized, separate and clean in your kitchen is the key to maintaining a safe eating environment for gluten-free cooking.