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Gluten and Celiac Disease
Celiac disease is characterized by the inability to tolerate gluten, the protein component present in wheat oats, rye and barley. One out of 133 Americans have been diagnosed with celiac disease. The cause is unknown but there is a genetic predisposition to developing the disease. Gluten is toxic to the inner lining of the intestines in individuals with celiac disease. When gluten is consumed, the the hair-like projections in the intestines responsible for the absorption of food are damaged. The body is unable to absorb nutrients leading to malnutrition. Celiac disease is detected by testing for specific antibodies in the blood. If antibody results are positive, the doctor will perform a biopsy of the small intestine to determine the extent of damage. Most people are not aware that they have celiac disease because the symptoms are generalized and vary from individual to individual. Gastrointestinal symptoms may include constipation, nausea, vomiting and an intolerance to dairy products. Poor absorption of nutrients can promote unexplained weight loss even with a high calorie intake. Vitamin and mineral deficiencies are common and can result in fatigue, confusion, muscle cramps, bruising, hair loss and tingling of the extremities. Vitamin and mineral supplements are often prescribed. There is no cure for celiac disease except for the implementation of a gluten-free diet. Wheat, oats, rye and barley products must be completely avoided. Compliance to a gluten-free diet can be challenging as gluten is often used in food processing as a stabilizer and listed on labels in many different forms. Unless labeled "gluten-free" all breads, pasta, cereals, commercial desserts, processed foods, gravies and sauces must be avoided. Foods that are naturally free of gluten are corn, rice, potato, arrowroot, fruits, vegetables, legumes, fresh meat, poultry and dairy but it is important to read labels to ensure that gluten is not a hidden ingredient. Manufacturers now make gluten-free products which are labeled as gluten-free. Many grocery stores have a gluten-free section and there is a wealth of nutrition and recipe information available. ...read more
By Diane Tomkin, MPA, MA, RD, CDN March 23, 2013
Do High Protein Low Carbohydrate Diets Really Work?
Contrary to popular belief, there is no long term scientific evidence to support the use of high protein low carbohydrate diets for effective long term weight loss. After 30 years of clinical nutrition practice, I have found that almost all of my patients have gained back lost body weight and then some. While there is some clinical evidence to support the use of a high protein low carbohydrate diet for weight loss, the long term prospects are grim. Most diets that restrict carbohydrates also significantly restrict food choices and variety. Restricted choice of any food will lead to weight loss. How much steak, meat, eggs and cheese can one eat before getting tired of it? At what point does one start craving comfort foods such as potato, pasta, pizza and icecream. While some are successful for a time, most are back to eating and in fact overloading on carbs within weeks. Many individuals following a high protein low carbohydrate diet will assert that they have a diminished appetite. This can occur due to a condition called ketosis. The brain, nervous system, and blood cells use carbohydrate as a source of energy. When the body is not getting enough carbohydrates it will break down body protein for energy. With prolonged carbohydrate fasting, fat is broken down into ketones resulting in a state called ketosis.The body also shifts into fasting mode which can further dull appetite. Initial use of these diets can result in rapid weight loss. Most of the initial weight loss is due to a considerable loss off body fluids. When the body breaks down protein for energy it results in an increase in ammonia levels which is then converted to urea in the kidneys. The kidneys now work hard to dilute the urea thus excreting large amounts of water through the kidneys. When ketone bodies start to build up in the boodstream from the breakdown of fat, the kidneys will flush them out by additionally excreting more water. Thus, much of the initial weight loss is due to fluid loss. In addition, there are numerous side effects from the long-term use of these diets. Successful weight management can not result from one single diet or one approach alone. It is the result of a life-long commitment to healthy eating practices, behaviors and lifestyle changes. It is best to visit with a Registered Dietitian for a healthy eating plan. Diane Tomkin, M.P.A., M.A., R.D., C.D.N. ...read more
By Diane Tomkin, MPA, MA, RD, CDN March 06, 2012
Lose Weight... Feel Great
Individualized nutrition counseling for weight loss and other health related diseases. Private counseling based on you personal needs, lifestyle, prefernces and habits. Most insurance accepted with sliding scale for out of pocket. Diane Tomkin, MPA, MA, RD, CDN 631-476-8766 ...read more
By Diane Tomkin, MPA, MA, RD, CDN January 14, 2011