Often thought of as a food allergy to wheat, Celiac Disease is actually a genetic disorder where individuals have an immune system reaction to gluten (a protein found in Wheat, Rye, Barley, and Oats). Gone undetected, Celiac Disease can lead to damage of the small intestine and eventually malnourishment. Since gluten is so prevalent in our food supply and in non-food items (like medications), becoming a food label expert is essential.

Unfortunately, the new FDA food label requirements for listing potential food allergens covers wheat, but not rye, barley or oats. You may find some manufacturers will list rye, barley, and oats are also found in their product-although it is not required. When it comes to Celiac Disease, preventing possible ingestion of food that trigger reactions is the best treatment. Having a list of potential harmful ingredients on hand during grocery shopping is a must for individuals with Celiac Disease. Here is a list of additional food items and ingredients you want to stand clear of if you have Celiac Disease:
Wheat Germ
Wheat Bran
Semolina Flour
Graham Flour
Gluten Flour
Durum Flour
Spelt
Kamut
Couscous
Triticale
Farina
Bulgur
Einkorn
Starches- unidentified starch and modified food starch
Hydrolyzed vegetable protein - HVP
Hydrolyzed plant protein - HPP
Texturized vegetable protein - TVP
Binders
Fillers (commonly found in processed meats)
Thickeners and emulsifiers (frequently found in salad dressings)
Malt (found in malted beverages/flavoring such as beer, coffee flavorings, malted milk, and instant cocoa mixes)
Soy Sauce
Soft cheeses and cheese spreads
Licorice
Cough drops, pills, and other medications


There are in fact “Gluten Free” versions of traditional foods on the market- although the term “Gluten Free” has not been officially defined by the FDA (they plan on making a proposal by this summer and hopefully have a final definition by 2008). Without an official definition for how a food label may use the term “Gluten Free” , products may be free of gluten without you knowing it (unless you read the ingredients list or the manufacturer has made such a claim). For example, although you want to be diligent about reading labels for food products listed above, there are manufacturers out there that do make such items free of gluten (i.e.: instant cocoa mix).

There are many resources out there to help make gluten free living even easier. Three helpful internet websites are www.csaceliacs.org, www.celiac.com, and www.gfcfdiet.com. Cook books focused on making gluten free cooking fun and tasty are a necessity for any family that gluten is an issue. Here are a few good titles to start with:

Kid Friendly Food Allergy Cookbook
By: Leslie Hammond and Lynne Marie Rominger

The AiA Gluten and Dairy Free Cookbook
Compiled by Marilyn Le Breton

The Gluten, Wheat and Dairy Free Cookbook
By: Nicola Graimes


This question was featured in the April 12, 2006 Springfield Republican Plus Paper.

Cholesterol is found both in our body and in the food we eat. We make cholesterol for use in our cells, hormones, as well as to aide in digestion. Although this is true, too much cholesterol traveling in our blood is not a good thing. For this reason, it is recommended to consume a diet that is moderate in cholesterol (300 milligrams or less) as well as rich in plant food (which are naturally cholesterol free).

Since food can directly affect the fats in our blood, use the following as a guide for healthful choices:

LDL cholesterol, or “bad” cholesterol, tends to increase when we eat foods higher in saturated fats. These kinds of fats are solid at room temperature and can be found in food like butter, cream based soups, meats, and baked goods. Choose lower fat (skim milk), lean (chicken), or plant oil (cook with oil versus shortening) based options.

LDL cholesterol can also increase by eating food high in trans fats. Trans fats may also be a double whammy for heart health since they can lower HDL cholesterol levels as well. These fats are listed as “partially hydrogenated” oil on food labels, and are abundant in our food supply (ie: deep fried food, baked goods, crackers, margarine, and frozen meals). Since they are now listed on the Nutrition Facts label, compare shop to ensure you are choosing trans fat-free food.

HDL cholesterol, or “good” cholesterol, appears to help protect against the effects of LDL cholesterol- so the higher your level, the better! When substituted for saturated fat in your diet, unsaturated fats have been shown to help lower both total and LDL cholesterol while possibly raising HDL cholesterol. These fats are liquid at room temperature and can be found in plant based oils (ie: soy, corn, canola, and olive oil), seeds, seafood, nuts, and avocados.

Triglycerides are the form excess nutrients (excess calories from protein, fat, and carbohydrates) take in our body when being stored as fat. Researchers have found that individuals with high levels of these fats tend to have high cholesterol levels as well. To reduce your level of triglycerides, eat a low-fat, low-sugar, calorie controlled diet. This simply means choose food that are nutrient dense (whole grains, vegetables, and fruits) when working towards your designated calorie goals. Also, some individuals can reduce triglyceride levels by substituting a small number of calories from carbohydrates with unsaturated fats.

To help maintain healthy cholesterol levels, eat a low-fat, fiber rich diet. Choose:
Unsaturated fats over saturated and trans fats
At least a total of 7-9 servings of fruits and vegetables every day
High fiber food to help meet the recommended 25-35 grams of total fiber each day
Make soluble fiber food part of your daily intake (fruits (apples), vegetables (potatoes), legumes (beans), and grains (barely, oat bran, oatmeal)

This question was featured in the Springfield Republican Plus Paper on March 29, 2006.

Summer sun means swimsuit fun which can cause chills for many of us. If you want to lose weight, there are a couple of key questions to ask yourself:

Why? Make sure you figure out exactly why you want to lose the weight- it should be for you and no one else.

How much? Don’t sabotage your efforts by holding yourself to an “ideal” weight based upon what others look like or what you looked like in high school. Set a weight that is realistic, healthy and comfortable for you.

How fast? This is a big one- the slower you lose the weight, the easier it will be to maintain. Losing 2-3 pounds per week is the fastest you should go. Any faster than that and you are losing water as well as not eating enough calories to maintain your body’s protein stores.

How? When it comes to weight loss, lifestyle changes are what works- not a diet! Though progressing slowly can be discouraging, setting short-term, achievable goals are the best bet for achieving and maintaining your weight loss.

Losing weight is a matter of burning more calories then you eat in through food. Be careful though, if you cut your calories back too far you could send your body into “survival” mode (which could cause your body to store what you eat as fat). To estimate how many calories you need, take into consideration:

How many calories you currently eat- If you are overeating calories, cutting daily calories back by 300-500 is an option. If you are eating enough calories, you may just need to add in exercise.

How active you are- If you can do it, exercise is the perfect second arm to a healthy lifestyle and weight loss plan. You don’t have to become a marathon runner, but the more you move, the more you lose. Plus, the more calories you burn, the more calories you can eat!


To figure out how many calories you need for weight loss, you are going to need to do a little bit of math. Start by converting your current body weight in pounds into kilograms. To do this, simply divide your weight in pounds by 2.2 (140/2.2= 64 kg). Then, multiply your weight in kilograms by 25 (64 * 25 = 1600 calories). As you lose weight, you’ll need to recalculate your calorie needs the same way. Do not eat less than 1500 calories per day without the supervision of a registered dietitian and physician.

Your greatest tool for loosing weight is the USDA’s MyPyramid website (www.mypyramid.gov). This is a wonderful website that shows how to eat your way through each food group while meeting your calorie goals. To find out the best eating pattern for your calorie level, visit the following page from the MyPyramid website:
http://www.mypyramid.gov/professionals/pdf_food_intake.html. To learn more about how to successfully meet your calorie needs, the website provides examples of servings and foods for each food group.


This question was featured in the March 16, 2006 Springfield Republican Plus Paper.

Dietary Fiber is the fibrous component of the plant foods we eat that are resistant to breaking down during digestion. There are a number of different molecules that make up what we generally label “fiber” in our foods. With that said, fibers do tend to be divided into two categories- insoluble fiber and soluble fiber. Insoluble fibers are usually the components of fruits, vegetables, and grains (like cereal bran) that add weight to stool. These are the fibers one thinks of when they are looking to promote a healthy colon by “increasing their fiber intake” to have regular bowel movements. Soluble fibers are primarily thought to be more viscous in nature than insoluble fibers (although not all insoluble fibers are viscous). Viscous fibers help reduce blood cholesterol levels (by-way of reducing the amount of “bad” cholesterol in our blood) and for individuals with diabetes, promote blood sugar control (due to reducing the amount of glucose dumped into our blood after eating). Soluble fibers can be found in fruits (apples), vegetables (potatoes), legumes (beans), and grains (barely, oat bran, oatmeal).

The role specific (soluble or insoluble) fibers play in disease risk is open for discussion. Both large population and small group observational studies seem to indicate diets high in fiber can reduce the risk of cancer, heart disease, and diabetes. When smaller clinical studies are conducted, researchers find it harder to support such observed cause and effect relationships. This simple deviation between observational studies and clinical trials is a very important piece to understanding nutrition science- the overall relationship between the foods we eat and how they work together may be the power of prevention for diseases rather then specific, isolated nutrients and molecules. Therefore, not one food component is ever working alone! What a great reason for eating all foods in moderation.

The average American diet falls 10-20 grams shy of the daily recommended amount of fiber. Hence, the American Dietetic Association recommends following a diet with a modest increase in fiber through fruits, vegetables, whole- and high-fiber grains to work towards the daily recommended 25-35 grams of dietary fiber. As a bonus, diets higher in fiber also tend to be greater in volume (i.e.: large quantity of foods), but lower in calories, fat, and simple sugars. These secondary benefits of following a high fiber diet may also help with weight management because you would find yourself feeling more satisfied and full of energy while consuming a lower amount of calories. As you work on increasing your fiber intake, just remember to do so slowly while increasing your fluid intake to help prevent against both diarrhea (too much fiber) and constipation (too little water).


This question was featured in the February 22, 2006 Springfield Republican Plus Paper.

Reported to effect up to one million Americans, inflammatory bowel disease is quite a common, incurable condition. Inflammatory bowel disease (referenced as IBD or IBS) is an umbrella term for those diagnosed with Crohn’s disease or chronic ulcerative colitis. The difference between these two conditions is which part of the digestive tract is affected. Crohn’s disease usually affects the end of the small intestine, but may also affect the colon. Chronic ulcerative colitis solely affects the colon. Due to the inflammation that occurs during IBS, both Crohn’s disease and chronic ulcerative colitis often results in unintentional weight loss from a loss in appetite and decreased absorption of nutrients due to diarrhea. The effects of IBS can become so severe that it could lead to malabsorption and iron deficiency anemia.

What to eat and drink all depends where you are in the cycle of your IBS. If you are having a flare up, then the first recommendation is to rest your bowel and slowly progress to a low residue diet (soft and bland foods) under the supervision of your physician or dietitian. For all other times, there are a few things you need to keep in mind:

 Unless you suffer from lactose intolerance, there really aren’t any typical food culprits that could “spark” a flare up. What causes a flare up for you may not cause a flare up in another person with IBS. As an added bonus, what causes a flare up for you one time may not cause a flare up for you at some point down the road! Therefore, following an overall healthy diet that is varied in foods from all of the food groups and keeping track of what you eat is recommended for individuals with IBS.

 Due to the fluid imbalance that can persist with IBS, make sure you properly replenish fluids and electrolytes (sodium, potassium, etc). Water and drinks that contain electrolytes play key roles in the daily intake for an individual with IBS-especially during flare ups.

 Since IBS is a digestive tract disease, proper absorption of nutrients can be affected. With this in mind, and the fact that the chronic nature of IBS also heightens energy needs, many individuals with IBS need to follow a high calorie, high protein, low fat diet. Your specific needs should be analyzed and calculated by a registered dietitian through one-on-one counseling.

 Eat smaller, frequent meals. This will help minimize an overload to your already sensitive digestive tract. Also, it can make keeping a record of foods that cause flare ups easier to do!

If you have been diagnosed with IBS, request a referral to a Gastroenterologist if you haven’t met with one already. Gastroenterologists are the specialists when it comes to conditions of the digestive tract. They may also have a dietitian on staff that you can meet with to discuss your specific food and beverage needs. If you do not receive an automatic referral to a dietitian, ask for one (this is true for ANY health condition directly impacted or impacting your nutrition).

To learn more about IBS, visit the Crohn’s and Colitis Foundation of America website for more information, tips, and resources at www.ccfa.org.

This question was published in the May 31st Living Well Eating Smart Column of the Springfield Republican Plus Paper.

Protein is often discussed but easily misunderstood. Traditionally, American’s tend to over meet their protein needs through every day food choices (see the example below). Once an individual decides to lose weight or gain weight is when they begin to think about their protein intake. Why is this? More and more research is being done on the benefits of protein and weight loss. Since scientist’s are learning that protein may aid in weight loss by making us feel fuller longer, making sure you choose lean protein foods at meals and snacks is a good thing when you’re trying to cut calories but curb hunger!

What role does protein have in gaining weight? Many people mistakenly believe if they eat more protein, they’ll gain more protein as muscle mass. This simply is not the case. Regardless if you are trying to lose weight, gain weight, or just want to know how much protein you personally need- our body can only use a specific amount of protein. It is true that your protein need will increase slightly when you are physically active, but not as much as most would think.

When it comes to protein, more is not necessarily better. Once you meet your protein needs through diet choices, whatever protein is left over is broken down and excreted as amino acids through urine. Hence, if you eat more then you need, it is going to waste. Also, if you are prone to kidney or liver issues, the extra load of amino acids on these organs could be quite detrimental.

To answer the question of how much protein you would need depends on each person’s situation and health status. Overall though, the recommendation from the 2002 Dietary Reference Intakes for Amino Acids is that we need 0.8 grams of protein per kilogram of weight (about 0.36 grams of protein per pound of weight). What this means is that the average adult males need about 56 grams of protein each day while non-pregnant adult females need about 46 grams per day.

The American Dietetic Association’s Sports, Cardiovascular, and Wellness Nutritionists practice group sites that even with rigorous* physical exercise, protein needs only increase to 1.2-1.7 grams per kilogram of weight (about 0.54-0.77 grams of protein per pound of weight). This would increase an adult man’s protein needs to 75-103 grams and a non-pregnant adult woman’s needs to 65-93 grams each day. Do you need to take a protein supplement to meet these increased needs? No, this slight need to increase your protein can be sufficiently met through traditional food choices (see the example below).

Wonder how easy it is for adults to over meet the 46-56 grams of protein each day? Here’s an example of how it could be done:

Breakfast
8 oz glass of low-fat milk= 9 g
¾ cup of dry cereal= 3 g
2 Tablespoons of Walnuts= 2 g
Total=14 g

Lunch
2 oz of Tuna Salad= 14 g
2 slices of whole wheat bread=7 g
A small salad= ~3 g
Total=24 g

Dinner
3 oz of Baked Chicken Parmesan with Mozzarella Cheese= 33g
1 cup of Whole Grain Blend Pasta= 7 g
¼ cup of Tomato Sauce= ~2 g
Total=42 g

Total for the day= 80 g

And if you are a competitive athlete, you would add in a snack or two throughout the day to easily meet the higher end of the protein recommendations listed above.

Always remember-a calorie is a calorie- if you tend to eat more calories then you burn, regardless of where those calories come from [protein, carbohydrates, or fat], you are going to gain weight!

*Rigorous physical exercise would be participating in a high-intensity sport (i.e.: hockey, basketball, soccer) as a competitive athlete or training as an elite runner.

This question was featured in the February 1, 2006 Springfield Republican Plus Papers.

Tea, especially green tea, has received a lot of press recently. From treating arthritis to maintaining gastrointestinal health, teas have been suggested to help with a number of different health conditions. Early studies looking at the biological mechanism of tea appear promising for tea’s potential role in preventing various types of diseases. While researchers extend such studies into larger, population based trials, results have been mixed- keeping the tea discussion open.

So what is it exactly that makes tea so healthy? All teas-- black, oolong, green, or white-- have antioxidants called flavonoids. Levels and types of flavonoids in each kind of tea vary, albeit insignificantly. Whether they come from black, oolong, green or white tea, scientists are working hard to identify if these flavonoids have any role in protecting against diseases such as heart disease, cancer, high blood pressure, osteoporosis, dental health and weight management. The answer for what health implications teas play is “stay tuned”. The number and strength of studies need to increase in order for a consensus to be met in the science community.

Herbal teas like chamomile, peppermint or hibiscus, are a mixture of herbs and flowers. Therefore, the antioxidant content of herbal teas differs from traditional teas that come from Camellia sinensis plant leaves. Due to their complimentary and alternative medicine status, the health benefits of the herbs and flowers found in herbal teas tend to be more controversial and less supported by research. As with traditional teas, the possible impact these tinctures have on various health conditions has increased the amount of studies being charted on their behalf. And as with traditional teas, only time will tell what to make of the role for herbal tea on disease prevention.

With that said, even though it may be early in the game to pinpoint what role teas have for protecting against disease, the potential positive impacts of tea are still there. Therefore, I do recommend adding tea to your daily beverage choices. Just remember, unless indicated on the packaging, assume all teas contain caffeine (in smaller amounts than other caffeinated beverages). If you are sensitive to caffeine and want the potential benefits of having tea antioxidants in your diet, simply choose a decaf version!

Here are a few pointers on making the best of your tea selections:
The form of tea you consume will dictate the amount of natural antioxidants you’ll get. As you go down the list, the concentration of naturally occurring flavonoids decrease:
Hot Tea
Cold Brewed Tea
Instant Tea
Bottled Tea
Researchers have found steeping bags in hot water for at least 3-5 minutes gives you a much higher level of antioxidants then a 1-2 minute steep.
Just keep in mind that the longer you steep your bag of tea, the stronger the flavor will be!

This question was featured in the March 2, 2006 Springfield Republican Plus Paper.

Living in a world of weight loss can be quite discerning for those trying to add more weight to their naturally lean build. Just as people who are overweight may be genetically predisposed to being overweight, so are those with smaller frames.

To gain weight, it is a matter of eating more calories through food than you burn through activity. To gain a pound a week, you would have to consume about 500 extra calories each day than your body requires for meeting its daily needs. If you are already an active person, your calorie goals for weight gain would be even greater. For example, the calorie needs for an active adult male is about 2,600. If that same man is trying to gain weight, he would want to begin following an eating plan that consists of 3,000-3,200 calories.

There is a healthy and unhealthy way to meet your weight gain goals. If you are overeating high calorie foods like fried foods, pastries, and sugary treats or increased your protein intake-stop what you are doing! Focus on gaining weight in a healthier and safer way with the USDA’s MyPyramid (www.mypyramid.gov). The MyPyramid website will explain how to eat your way through each food group while meeting your calorie goals. To calculate what your current needs are, simply start by entering your age, gender, and activity level on the main page of MyPyramid.gov. To find out the eating pattern needed for weight gain, add about 500 calories to amount calculated by MyPyramid. With this new calorie goal, visit the following page from the MyPyramid website and locate your new recommended eating pattern:
http://www.mypyramid.gov/professionals/pdf_food_intake.html. Our example man above would now follow the 3,200 calorie meal pattern versus the 2,600 calorie meal pattern.

Here are some general tips to help meet increased calorie needs without feeling overstuffed:

Add strength training exercise to your activities. Strength training will help you gain muscle-which weighs more than fat.
Plan ahead- eating just three meals isn’t going to cut it for weight gain. Plan on eating about 5-6 times each day with meals and snacks. Use your food group goals to plan what and when you are going to eat.
Increase your serving sizes of food at each meal. Make your portions slightly bigger though being mindful not to overeat till you are uncomfortable.
Drink fluids after your meal so you have more room for food. Yes, Mom was right!
Choose nutrient dense foods- like avocados, nuts, salmon, milk, cheese, yogurt, dressings, and granola.
Add in unnoticeable calories. Powdered milk, beans, cheese, meat, wheat germ, and plant oils can be added to casseroles, soups, and sauces without much thought.
Enjoy your shake! Do you have to buy a mega dose protein powder mix? No. Mixing together your favorite ice cream with items from your kitchen- like fruit and graham crackers- will help meet your calories without over taxing your kidneys and liver with too much protein!

This question was featured in the Springfield Republican Plus Paper on March 22, 2006.