Milk. It used to be so simple. Milk came from cows.

Not any longer….oat milk, rice milk, cashew milk, almond milk, soya milk, coconut milk, hazelnut milk…it goes on and on..

World Milk Day – not what it used to be. Dairy farmers must be raging.

Calcium

The significance of cow’s milk (and milk products like cheese and yoghurt) in our diet has mainly been to provide calcium.

Animal milk is often heavily promoted as being our main source of calcium.

This is misleading and often gets wrongly interpreted as meaning that animal milk contains more calcium than most other foods.

But this is not necessarily the case. Milk and milk products are simply one of a number of calcium sources – just ask your vegan friend.

Why do I need calcium anyway?

Calcium has several functions in the body. You probably already know that most of our body calcium is used for bone structure* and teeth but calcium is also needed for muscle contraction including heartbeat, nerve function, hormone functions and blood clotting.

*Calcium does not work alone – other bone healthy nutrients are vitamin D, vitamin K, boron, copper, magnesium, silicon, zinc….case closed regarding eating as wide and varied a diet as possible.

How much do I need?

Most adults need an average daily intake of 700mg of calcium, with some exceptions – breastfeeding mothers and postmenopausal women need more at 1200mg per day.

[There are also a number of medical conditions that may require higher calcium intakes eg osteoporosis, coeliac disease, or inflammatory bowel disease.  Check with your health professional]

Where can I get it?

Yes, dairy foods are a good source of calcium, but it is also found in many non-dairy foods.  Find a list of good calcium sources here.
(Derived from information available at National Osteoporosis Society)

Final word

Drink animal milk, eat cheese and dairy yoghurt ‘til the cows come home if you like and tolerate them.

Just don’t think you must eat them for adequate calcium.

Enjoy a wide variety of other calcium containing foods, safe in the knowledge that vegans have a skeleton too.

The days of being ‘entertained’ by Gillian McKeith collecting poo in tupperware may be over but, like it or not, she had a point! Not the ‘putting it in a tupperware’ bit, but the ‘getting familiar with it’ bit!

Some of us have a chance to get acquainted with our waste matter daily, and it’s a comfortable and reliable relationship. For others, it can get prickly and punctuated with strain or pain. Who has time for constipation these days? Move proceedings along with fibre.  Therapy for your bowel.

Not for everyone

High fibre may not be advisable if you have IBS or other medical condition that has reduced fibre as part of the treatment plan – speak to your GP or dietitian if you are unsure if you should increase or decrease your fibre intake.

How much do I need?

The recommended fibre intake for adults is 30g per day (this must be alongside a good fluid intake). Current UK national average fibre intake is 15-21g per day so eat up!

Where can I find fibre?

20 High Fibre Foods

This is NOT a complete list of high fibre foods. All fruit, vegetables, beans, legumes, pulses, nuts, seeds and wholegrain products will contain useful amounts of fibre.
Fibre SourceFibre (g) per 100g
Linseed / Flaxseed (ground)41.2
Chia seeds37.5
Linseed / Flaxseed (whole)28
Legume pastas (varies)23
All Bran15
Branflakes14.7
Shredded Wheat10.1
Oats9.8
Pumpkin8.3
Muesli / Granola (varies)8
Sesame seeds7.9
Prunes7.1
Raspberries6.5
Peanuts6.3
Yellow split peas5.9
Wholemeal bread5.8
Sunflower seeds5.7
Almonds5.6
Kidney beans5.5
Brazil nuts5.4

There is probably no need to count grams of fibre – if you are eating enough fruit and vegetables, choosing wholemeal / wholegrain versions of breads, cereals, rice and pasta, enjoy eating nuts, seeds and pulses, then you are likely getting enough fibre – but ultimately, your bowel movements will be your best indicator.

(For reference, a food can be considered high fibre if it contains 6g (or more) of fibre per 100g. You will find this information on food labels).

And by the way…

The benefits of fibre do not end with keeping you “regular”. Fibre is also important for control of:

  • Cholesterol
  • Blood pressure
  • Blood glucose
  • Colorectal cancer risk
  • Weight

So why wouldn’t you eat more?

Final word

In honour of World Digestive Health Day 2018, resolve to improve your relationship with your bowels, keep them happy with more fibre if necessary, and get familiar with your ‘output’.

But don’t put it in a tupperware.

Going too far.

Coeliac Awareness Week 14-20th May 2018

What is Coeliac Disease?

NHS Choices provides a comprehensive outline of what coeliac disease is, the symptoms, diagnosis and treatment.

Coeliac UK provide comprehensive information regarding the gluten free diet.

This short article covers some of the more obscure questions about coeliac disease and the gluten-free diet.

Incidence of Coeliac Disease

According to Coeliac UK, 1 in 100 people have coeliac disease.

Across the UK, only 24% of people have been diagnosed.

Here in Northern Ireland, the diagnosis rate is higher at 39% (as per 2014 data). However this also means 61% are undiagnosed – SO OVER 11,000 PEOPLE IN NORTHERN IRELAND DON’T YET KNOW THEY HAVE COELIAC DISEASE.

Who should get checked for coeliac disease?

See your GP for a coeliac screen if you have:

  • the common symptoms
  • a first degree relative (parent, sibling, child) with coeliac disease.

Non-coeliac gluten sensitivity

If you experience the symptoms of coeliac disease but testing has excluded this diagnosis, you may have non-coeliac gluten sensitivity. Your symptoms will improve on a gluten free diet. This is an emerging area of research and you can find out more at Coeliac UK.

Irritable Bowel Syndrome (IBS)

There is overlap between the symptoms of coeliac disease, non-coeliac gluten sensitivity and IBS.

  • Treatment for coeliac disease and non-coeliac gluten sensitivity is a gluten free diet.
  • Treatment for IBS is often the low FODMAP diet.

The low FODMAP diet coincidently excludes many gluten sources. So if you feel better, it’s impossible to know whether that is because of reducing FODMAPs or cutting out gluten.

No condition can be managed well without knowing what is causing the problem.

Get the diagnosis right, and the right treatment will follow.

I’ve cut out gluten already – can I still test for coeliac disease?

No – coeliac disease cannot be diagnosed if you have been avoiding foods containing gluten.

  • NICE (National Institute of Health and Care Excellence) advise that before being tested, people need to follow a diet containing gluten for at least 6 weeks.
  • Coeliac UK recommend “to eat some gluten in more than one meal every day for at least 6 weeks before testing”.

What is not helpful is that no specific advice is given regarding quantity – “some” does not suggest the need for large amounts so eating a bowl of gluten containing cereal and a slice of gluten containing bread may be sufficient, provided this is included daily over the recommended 6 week period.

This reinforces the importance of being tested for coeliac disease BEFORE avoiding gluten.

Should I use a home testing kit?

That depends on your reason for doing so.

If you’re considering a gluten free diet for general health reasons, and have no troublesome symptoms or signs of coeliac disease, then a negative result from a home testing kit may give you some re-assurance that should you occasionally, or accidently, eat a gluten containing food you will not be causing any gut damage.

If the home test kit suggests a positive coeliac outcome, see your GP for a formal test BEFORE you proceed to cutting out gluten.

If you have suspicions that you may have coeliac disease, it is in your best interests to take advantage of the full range of support available on the NHS. You will have annual review of your symptoms, blood retests, and access to other services if required – for example, scans to check bone density.

If you self-diagnosis and self-manage, you may be inadvertently overlooking other problems.

Take home messages

Are you one of the undiagnosed 11,000? See your GP. Get tested.

Does your parent, sibling or child have coeliac disease? See your GP. Get tested.

Thinking of trying a gluten free diet? If you have any suspicions that gluten may be causing a problem…See your GP. Get tested.