ARE GLUTEN-FREE DIETS HEALTHIER FOR YOU?
By: Dr. Joan Marie Pellegrini
People who have celiac disease (CD) cannot eat gluten without it causing damage to their intestines. For an unknown reason, their immune system in the intestinal tract turns on itself when it is exposed to gluten. This disease is rare and affects only 2-3 million Americans according to the National Foundation for Celiac Awareness. It used to be quite difficult to diagnose because there were no blood tests available. Now that it is easier to diagnose, more physicians and patients are becoming aware of its existence.
One of the problems with diagnosing CD is that the symptoms are similar to other diseases. Bloating, headaches, migraines, joint pains, fatigue, “brain fog”, diarrhea, and anemia can all be very nonspecific symptoms and caused by several other illnesses. People with Irritable Bowel Syndrome, other food allergies, bacterial overgrowth, other autoimmune illnesses, and inflammatory bowel syndrome can also have many of these symptoms.
CD is caused by an autoimmune response against gluten which is a group of proteins found in wheat, rye, and barley. Gluten is what gives bread its characteristic texture. In order to treat CD, a patient must maintain a gluten-free diet (GFD) for the rest of their life. Patients who are more likely to develop CD are those with a family history, those with other autoimmune diseases, and diabetics.
When someone has symptoms suggestive of CD, many doctors and patients may simply try a GFD to see if their symptoms improve. However, this is not adequate for making the diagnosis. In order to truly make the diagnosis, a patient must be on a diet containing gluten and then have blood work that confirms the presence of certain antibodies. Once this is done, many patients will then need an endoscopy and multiple small bowel biopsies in order to confirm the diagnosis.
Doctors have known about CD for many years even though it may have been difficult to diagnose. A more recently recognized condition is gluten sensitivity. This is not a true allergy. These patients have the same symptoms but do not have any autoimmune disease that causes damage to the intestinal lining. It is not completely known why they have bloating and diarrhea and why they feel better with less gluten in their diet. Even gluten sensitivity is not that common and is estimated to affect only 18 million Americans.
CD patients almost always have nutritional deficiencies because of chronic malabsorption. However, even with strict adherence to a GFD, they often have problems obtaining enough calories because of limited food options depending on where they live and what they can find in their local grocery store. The good news for patients with CD is that there are now many more options at the market for them. There are breads, pastas, cookies, etc. that are made with rice or oats or other grains that do not contain gluten. Because of this, GFD has become more popular. It has been touted as a “healthier” diet and as a “quick weight loss” diet. A brief Google search revealed many sites even by famous TV doctors recommending GFD as a healthy diet. However, the science does not support this. Processed GFD foods that are available at the market are higher in lipids, trans fats, sugar, salt, and cost. A medical journal called Gut Microbe published a study in 2010 that looked at healthy volunteers (they did not have CD) that were put on a GFD. These study subjects on a GFD had a decrease in the healthy bacteria in their intestines and had an increase in the unhealthy bacteria. They also developed decreased immune function. None of this is good for the person who does not have CD.
Recommendations: if you have symptoms of CD you should discuss this with your doctor and get tested for CD. If you cannot afford to see a doctor, there are direct to consumer tests for CD available on the market but they are not yet approved by the FDA. If you do not have CD you may still have gluten sensitivity. Many patients with irritable bowel syndrome have gluten sensitivity. If you have been diagnosed with CD or gluten sensitivity, you should be referred to a nutritionist that is knowledgeable about GFD so that you do not develop any of the complications of being on a GFD long term. If you do not have CD, remember, there are other conditions which may cause similar symptoms and you will need to continue to work with your doctor to make a diagnosis. If you are just looking to lose weight, avoiding bread may be beneficial because of the extra calories and carbohydrates but you do not need a gluten free diet per se. In fact, there are many better and easier diet plans available to you for weight loss.
Kimberly Merrifield, Race Director of the Pants on Fire 5K Beer Run and Walk, came into the studio on Friday to talk about the fundraising event this Saturday, June 28th.
Cathy Billings, Associate Director for Communications and Development at Lobster Institute, came into the studio on Wednesday to talk to Wayne about the fourth annual ALS Calendar Raffle to fund the Bangor Walk to Defeat ALS coming up August 23rd.
Memory Decline With Aging: Can It Be Prevented?
Healthy Living – June 24, 2014
Dr. David Prescott – Eastern Maine Medical Center Behavioral Medicine
In about 15 years, twenty percent of the American population will be over 65 years old. One of the most common concerns about aging is memory and whether memory difficulties are inevitable as we grow older. In addition, seniors want to know what, if anything, they can do to prevent memory loss.
Amy Badger of Bodies by Badger was in the studio for another Fitness Friday this week. She stopped in to speak to Wayne about sweating during your exercises, and how to effectively replenish yourself.
Amy Badger from Bodies by Badger was back in the studio on Friday for Fitness Friday. This week she was teaching Joy and Wayne some exercises you can do with gliders in your living room.
FDA Warning on Tanning Beds
Amy Movius MD
Late last month the FDA issued a Black Box warning requirement on sun lamps products – which include tanning beds. The FDA is tasked with protecting public health in different ways, including by assessing the safety of medical devices. A Black Box warning is the strictest warning label available.
This warning states:
Tanning bed use is contraindicated in anyone less than 18yrs
Tanning beds must not be used by people with skin lesions or open wounds
Tanning beds should not be used by people with skin cancer or a history of skin cancer
People who are repeatedly exposed to ultraviolet radiation require regular evaluation for skin cancer
Ah, the prostate…A curious gland that boys under 15 are not aware of, and men over 50 can be all too aware of. In a recent study looking at how frequently men over 50 report having prostate problems, researchers at the University of Maryland found that 42% have some abnormality of urinary function attributed to an enlarging or inflamed gland. And symptoms that include frequent or painful urination, waking up at night to urinate, loss of urinary force to the point of occasionally becoming unable to urinate will increase in as men age, eventually affecting 80% of men over 70. The last symptom is particularly vexing, often require catheter placement and surgical procedures to overcome.
Amy Badger of Bodies by Badger was in the studio for another Fitness Friday this week. She stopped in to speak to Wayne about dealing with the soreness you can experience after a good workout.
Amy Badger from Bodies by Badger was back in the studio on Friday for Fitness Friday. This week she was teaching Joy and Wayne the correct posture and movements for lunges.
Summertime and the berries are out: Is there a reason you should not eat them?
In general, health providers and nutritionists recommend eating many fruits and vegetables as part of a healthy diet.
The Mental Health Parity Law:
Making Mental Health and Substance Abuse Treatment more Affordable
Healthy Living – May 27, 2014
Dr. David Prescott – Eastern Maine Medical Center Behavioral Medicine
Amy Badger from Bodies by Badger was back in the studio for Fitness Friday. This week she talked to Wayne about the growing trend of adventure races around the country, and what you should be prepared to do when getting ready for one.
Amy Badger from Bodies by Badger was back in the studio on Friday for Fitness Friday. This week she was teaching Joy and Wayne some simple shoulder exercises using resistance tubes and low weight dumbbells.
Why do we always ask for the Kids’ Menu?
(AKA: Why do we “dumb down” our kids’ food choices?)
By: Dr. Joan Pellegrini
Food left out can grow bacteria and become a source of illness anytime of the year. However, summertime is a particularly vulnerable time because there are more picnics and gatherings and the temperatures are warmer. There are three problems with food borne illness: 1) improper food preparation, 2) susceptible foods, and 3) improper food storage.
Amy Badger of Bodies by Badger was in for this week’s Fitness Friday talking to Joy about a ZUMBATHON fundraiser hapenning Friday night, and gives you an idea of what to expect at your first ZUMBA session.
Amy Badger from Bodies by Badger was in for another Fitness Friday, this time teaching Joy and Wayne some quick and easy exercises you can do with resistance tubes.
Alternative Models of Care Delivery — ‘May You Live in Interesting Times’
William A. Sturrock, MD
While scholars may argue whether this purported Chinese proverb is a blessing or a curse, no one could dispute that the American medical marketplace today is seeing great and interesting changes in how care is delivered. All across the landscape, providers, patients and insurers are wrestling with a new world of increasing numbers of older (and sicker) individuals needing care, combined with fewer healthcare dollars to accomplish the task. Indeed, we cannot continue on the same path medicine has been on since the 1950’s with a patchwork system of 3rd party insurers, Federal, State, employer-based organizations, and patients’ own pocketbooks trying to foot an ever increasing bill for medical care that is not meeting society’s healthcare needs. Almost all stakeholders are in agreement that the venerable ‘Fee-for-Service’ model needs to change because it has left us in the unenviable position of being first in the world in per capita healthcare spending while being embarrassingly 2nd rate when it comes to accepted definitions of good health outcomes such as longevity and infant mortality. Most public health experts advocate that it is time to evolve from the ‘high-production/dubious quality’ model to one focused on delivering better population health outcomes.
Now exactly what that new system will look like is still an open question. The Affordable Care Act, (aka Obamacare) is really just a stepping stone in the evolution of the American medical marketplace. Regardless of whether individual patients are ready, most major injurers and large employers are already implementing new care systems that are rewarding providers not for how many services they provide but whether they are providing measurable good outcomes for the large number of individuals and families in their care. Indeed the ACA allows for and encourages the development of alternative payment models to reward providers who have better immunizations rates, chronic disease outcome, lower complication rates, and a variety of other measures designed to improve the overall population health. EMMC is currently partnered with Medicare and other payers to form an ACO (Accountable Care Organization) for eligible patients in northern and eastern Maine, in which medical care dollars will be spent on activity that will improve the health of this population rather than simply reward the providers that see the most patients or do the most procedures.
By: Amy Movius MD
Becoming an organ donor isn’t a pleasant idea for anyone. It requires active consideration of our mortality and vulnerability to tragic events. However, it is a choice. Like most choices, it is best made with the benefit of accurate information.