Staying Healthy

No money to run coeliac disease tests

Because of budget constraints, a hospital in Ireland has had to cut back expenditure.  An internal memo (according to the Irish Times) indicates that the hospital executive have decided to cancel all non-urgent elective work until the end of September, to bring its expenditure back to 2006 levels.

One of the doctors, Dr Varadkar, said the measures meant that patients would suffer and there was a risk that serious illness would not be detected at an early stage.

“The cutbacks are the second set of cutbacks at Blanchardstown Hospital this year and are by far the most savage. Essentially, the hospital has been forced to reduce its service back to 2006 levels in order to break even by the end of the year …

“Investigations requested by GPs to detect bowel and stomach cancers, Crohn’s and coeliac disease will be pushed back, reducing the likelihood of early diagnosis and intervention.”

Of course, everyone thinks that their own case is urgent, but this does seem short-sighted to me … surely early diagnosis and intervention is cheaper, in the long run, than letting these problems continue, and increasing the ill-health of the patients?

Pregnant and gluten free? Eat more spinach

spinach - folic acidPregnant, or hoping to be? And gluten free?

Thanks to Melissa on the message-board, I’ve been made aware of this, from the British National Formulary:

Folic acid for the prevention of neural tube defects

Folic acid supplements taken before and during pregnancy can reduce the occurrence of neural tube defects. The risk of a neural tube defect occurring in a child should be assessed and folic acid given as follows:

Women at a low risk of neural tube defects should be advised to take folic acid as a medicinal or food supplement at a dose of 400 micrograms daily before conception and until week 12 of pregnancy. Women who have not been taking folic acid and who suspect they are pregnant should start at once and continue until week 12 of pregnancy.

Couples are at a high risk of conceiving a child with a neural tube defect if either partner has a neural tube defect (or either partner has a family history of neural tube defects), if they have had a previous pregnancy affected by a neural tube defect, or if the woman has coeliac disease (or other malabsorption state), diabetes mellitus, sickle-cell anaemia, or is taking antiepileptic medicines (see also section 4.8.1).

Women in the high risk group who wish to become pregnant (or who are at risk of becoming pregnant) should be advised to take folic acid 5 mg daily and continue until week 12 of pregnancy (women with sickle-cell disease should continue taking their normal dose of folic acid 5 mg daily throughout pregnancy).

I’ve put the key phrases in bold above. (The BNF is responsible for advising healthcare professionals here in the UK on medicines).

We all know that folic acid is important in pregnancy, and here in the UK, breakfast cereals are usually fortified. In the US, I understand that flour has been fortified with folic acid since 1996, though this probably doesn’t apply to gluten free flour. The Food Standards Agency here is recommending the fortification of bread flour, though there is some debate about the health risks to the general population. Quoted in the Telegraph:

Dr Sian Astley from the institute [of Food Research] said: “Fortifying UK flour with folic acid would reduce the incidence of neural tube defects (such as spina bifida).

“However, with doses of half the amount being proposed for fortification in the UK, the liver becomes saturated and unmetabolised folic acid floats around the blood stream.

“This can cause problems for people being treated for leukaemia and arthritis, women being treated for ectopic pregnancies, men with a family history of bowel cancer, people with blocked arteries being treated with a stent (an internal splint) and elderly people with poor vitamin B status.”

She said it also increased the likelihood of multiple births for women undergoing IVF treatment.

While this debate is likely to continue for a while here, the key point is that if you have coeliac disease and are trying to conceive (or are in the very early stages of pregnancy) you should be increasing your intake of folic acid. Unless you decide to live on spinach, in which case you’ll have other problems, you will need to ask your doctor for a prescription for 5g/day (here in the UK, anyway).

Live gluten free – because you’re worth it

Diagnosed as coeliac?

Don’t be tempted by people who suggest that ‘a little bit won’t hurt’, urge ‘just this once’, or say ‘go on – I won’t tell anybody’, while offering you a plate of gluten-full food.

Your health is worth more than the moments pleasure that a proper croissant might give. Yes it is! Even if you don’t suffer any symptoms in the next few days, you will have done yourself some internal damage, and it will take much longer for that damage to heal than it did for you to eat that tempting treat.

Not only that, but your self-esteem might drop too. Are you really the sort of person who can’t say no? And if you give in this time, you are setting yourself up to be tempted by these people again, as they won’t understand that gluten free is for life if you don’t explain it to them clearly enough.

So – health, self-esteem and an easier life? I’d say you were worth it!

Not yet diagnosed?

Perhaps you’ve not been diagnosed as coeliac, but do think that gluten is your problem. Perhaps you’ve been diagnosed as having irritable bowel syndrome, but you’re not convinced that this is the right diagnosis, or perhaps your symptoms are continuing …

If you still have concerns about your health, go back to the doctor. Or ask for a second opinion. Even change your doctor. You are worth it.

Are you deficient in vitamin B6?

Is your tongue sore? Have you got sores around your mouth?

Inflammation of the tongue and sores around your mouth (especially in the corners) may be a sign of chronic Vitamin B6 deficiency – as can anaemia, pins-and-needles or numbness in hands or feet, dermatitis, depression, confusion and even convulsions.

Bananas are a good source of B6

Why do I need vitamin B6?

B6 is essential for the production of haemoglobin, and for the nervous system and immune system. It also helps maintain your blood sugar levels within a normal range. It is important in preparation for pregnancy, and rumour says that it can help with PMT, too. Vitamin B6 deficiencies have also been linked to heart disease and cancers of the breast, uterus and prostate.

So it is an important vitamin!

Severe deficiency is rare, though you might be deficient in B6 if you have undiagnosed coeliac disease, or malabsorption for other reasons. Even just a poor quality diet can lead to deficiency. People who drink too much alcohol may be deficient, because alcohol promotes the loss of B6 from the body. Women taking the contraceptive pill tend to have a low level of B6 too.

Note that if you are diagnosed with celiac disease, and maintain a strict gluten free diet, you may be low in other vitamins, but you are less likely to be low in B6 – as long as you maintain a healthy diet. A recent study showed that coeliacs are more likely to have poor vitamin levels than the rest of the population – but not of B6 – even after 10 years on a gluten free diet. Do you suppose celiacs eat more bananas – the gluten free snack that comes in its own packaging?

More than one million people take B6 here in the UK to fight stress and increase energy, and it is used in conjunction with magnesium to treat autism. Other suggested reasons to maintain a good level of B6 are: a family history of heart disease; nausea in pregnancy; to try to prevent osteoporosis; if you have sustained serious burns; depression; PMS; diabetes; HIV; ADHD; rheumatoid arthritis.

How much do I need?

Children

  • Under 6 months: 0.1 mg
  • Infants 7 months to 1 year: 0.3 mg
  • 1 to 3 years: 0.5 mg
  • 4 to 8 years: 0.6 mg
  • 9 to 13 years: 1 mg
  • Males 14 to 18 years: 1.3 mg
  • Females 14 to 18 years: 1.2 mg

Adult

  • 19 to 50 years: 1.3 mg
  • Men over 50: 1.7 mg
  • Women over 50: 1.5 mg
  • In pregnancy: 1.9 mg
  • When breastfeeding: 2.0 mg

Note that this is the recommended daily dose. The dose given for autism is significantly higher than this, as it is for other treatments – ask your doctor for advice. Note, too, that there can be a clash with other medicines, for example, B6 reduces the effectiveness of Levodopa, used to treat Parkinson’s disease, so if you are taking medicines, and decide to increase your B6 with a supplement, do check that they don’t counteract each other.

Where can I get it?

You can buy a supplement, but why not just check that you eat the right variety of foods?

This important vitamin is found in most food, but especially in poultry, fish and pork, whole grains (this includes brown rice, which is good if you’re coeliac and can’t eat other grains), bananas and avocados, carrots, seeds, pulses and nuts. Examples of good sources of B6 include:

  • Fortified cereals (not likely to be OK for coeliacs) – could be up to 100% of RDA (recommended daily allowance)
  • Baked potato (but you must eat the skin as well) – 34% RDA
  • Garbanzo beans (1/2 can) – 30% RDA
  • Chicken breast – 25% RDA
  • Oatmeal (only if you are OK with oats, and only if they are non-contaminated with gluten) – 20% RDA
  • Pork loin (3 oz) – 15% RDA
  • Sunflower seeds (1 oz) – 10% RDA
  • Salmon (3 oz) – 10% RDA
  • Tuna (tinned, 3 oz) – 10% RDA
  • Peanut butter (2 tablespoons) – 8% RDA

You can see that a normal gluten free diet could easily contain enough B6 to keep your levels up. Tuna and bean salad with a baked potato? You’re nearly there …

Smart, healthy and gluten free – by an alchemist and a believer

Anne, the Creativity Alchemist at Smart Foods Healthy Kids emailed me this week, to explain about their ambition to help families wanting to be healthier, and dealing with food allergies.

Smart Foods Healthy KidsCreativity Alchemist – isn’t that a fabulous job title? I so want to be an alchemist when I grow up. Their CEO’s title is Chief of Belief, and that’s pretty wonderful too.

Do go and look – this does look like it is a great resource, and the fairly new blog is entertaining – pooping on Batman, anyone?

They argue that fruit and vegetables shouldn’t be hidden in foods, and I agree absolutely. It’s never worked for me anyway (just makes my children look really closely at all homemade cakes to check for things that shouldn’t be there – and refuse anything they have doubts about), and I would like my children to be able to identify fruit and vegetables, to know what they taste like, and to actively enjoy them.

I’d like that to happen … not saying it is. Did you see the group of schoolchildren on the Jamie Oliver programme about school meals who couldn’t identify any of the fairly ordinary vegetables he showed them? Shocking.

Another shocking fact is one commented on by Smart Foods Healthy Kids, which I wasn’t aware of: that in the US, 1,358 pesticides and herbicides can legally remain as food residue. To see the Maximum Residue Levels for pesticides in the UK, see the Pesticides Safety Directorate documents, which provides maximum levels for 295 pesticides. To think I didn’t even know there was a Pesticides Safety Directorate … Note, though, that this UK list is for pesticides only, and doesn’t include any residues left from herbicides, fertilisers or any other additions, so the UK number will almost certainly be a lot closer to the 1,358 quoted by the Environmental Protection Agency in the US.

Scary.

Smart Foods, Healthy Kids offers an monthly newsletter, so if you’re interested, this might be a good way of staying up to date.

Footnote:

The 2007 Weblog AwardsIf you haven’t voted in the 2007 Weblog Awards today, please consider voting for Free From … I’d really like not to be the last blog over the line in my category, and they must be closing the voting very very soon.