611740
Dietary Treatment
- 1. Lifelong strict Gluten Free diet: to normalise mucosa for improved nutrient absorption.
- Reduces anemia risk
- Prevent long term complications eg oesteoperosis.
- Osteoperosis: Inc PTH and Inc Ca+i in blood = bone loss.
- Lack Ca intake following diagnosis
- Poor compliance with GF diet
- Poor compliance with GF diet
- Need 1500mg Ca/day (BSG 2010)
- DXA Bone Density Scan
- DXA Bone Density Scan
- Lack Ca intake following diagnosis
- Intestinal Malignancy: Stick to GF diet, risk of cancer after 5yrs same as general popn
- Osteoperosis: Inc PTH and Inc Ca+i in blood = bone loss.
- Reduces anemia risk
- Life-long GF diet means :
- Exclude Rye/wheat/barley
- Oats controversal- mix with wheat flour at mills.
- Found in foods containing wheat or wheat flour
- bread, cakes, biscuits, pasteries, pies
- Processed Foods- Wheat used for dusting/ breadcrumbs
- Processed Foods- Wheat used for dusting/ breadcrumbs
- bread, cakes, biscuits, pasteries, pies
- Oats controversial: contaminated with wheat from factory process. Reintroduce 6-12months
- Oats controversal- mix with wheat flour at mills.
- Exclude Rye/wheat/barley
- Can enjoy balanced diet with GF foods
- Natural foods: fruits/ veg
- Meat / fish
- Meat / fish
- Potato/ rice
- GF bread, cake, pasta mixes
- Available on prescription:
- Important as fortified with ca, fibre, B viitamins + give variety to diet
- Issue: Consider storage, organised for repeat prescriptions
- Need cooking skills - baked from scratch
- Time consuming- interfere with compliance
- Time consuming- interfere with compliance
- Need cooking skills - baked from scratch
- Issue: Consider storage, organised for repeat prescriptions
- At diagnosis check for malnutrition + anaemia: need supplementation for Fe, Vit D, Ca due to malabsorption
- Important as fortified with ca, fibre, B viitamins + give variety to diet
- Available on prescription:
- Dairy products + Eggs
- Butter/ marg/ oils
- Butter/ marg/ oils
- Safe cereals: Sorghum, Maize, Rice
- For inc fibre: use rice Bran
- Natural foods: fruits/ veg
- Other issues patients need to know:
- Package food labelling: GF not same as zero gluten.. Codex standards
- contains <20ppm safe amount of gluten to eat
- Very low gluten products contain 21-100ppm [not GF]
- Hidden gluten in pre prepared meals, sauces, beer/larger
- contains <20ppm safe amount of gluten to eat
- Coeliac UK: Info and Food + Drink Directory
- Practical Issues: Refreshing bread in toaster or oven to release moisture and improve taste/ seprate toasters
- Consider needs of age groups!:
- Preschool Kids: PlayDoh, playgroups/nurseries, parties, eating same meal as a family
- Children: ensure parents cope with parties, school dinners. Child need to take own GF bread- routine
- Children: ensure parents cope with parties, school dinners. Child need to take own GF bread- routine
- Teenagers: Less adult supervision, eat out more need knowledge and snack more
- Adults: Be prepared at work etc, aware of work canteen
- Elderly: Support to change habit of a lifetime
- Depression and low mood common
- Preschool Kids: PlayDoh, playgroups/nurseries, parties, eating same meal as a family
- Package food labelling: GF not same as zero gluten.. Codex standards
- Main Nutritional Issue
- Malabsorption: impaired macronutrient absorption
- Negative calorie +pr balance= catabolic response + lose weight
- Negative calorie +pr balance= catabolic response + lose weight
- Nutrient deficiency of Fe,folate, B12, fat soluble vits EDK
- oesteoperosis
- Malabsorption: impaired macronutrient absorption
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