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I – for Sep. 6, 2010

receive questions about diet and special dietary needs. Here’s some of the most frequently asked ones.

Q.:What can I eat on a gluten-free diet?

A.:People with celiac disease need to have a gluten-free diet. This condition occurs in those who are “intolerant” to gluten and the symptoms include diarrhea, flatulence, abdominal distention, weight loss and weakness. The gliadin portion of gluten causes damage and inflammation to the lining of the small intestine resulting in various nutrients not being absorbed, resulting in deficiencies of iron, calcium, folate and, in some cases, vitamin B12. These deficiencies can lead to osteomalacia and anemia. So, the prescription is to avoid foods that contain (or may contain) gluten. Gluten is a protein found only in the grains of wheat, oats, rye and barley. Seems simple enough to avoid these foods, doesn’t it? Except that so many commercially prepared foods use emulsifiers, thickeners and other additives obtained from gluten-containing grains. Someone with celiac disease should consult with a registered dietitian for a complete list of “safe” foods. There is now available a “pure oats” product (manufactured by Cream Hill Estates and called Lara’s Pure Rolled Oats) that both Health Canada and the Canadian Celiac Association have declared appropriate for those on a gluten-free diet.

Note:Regular oats are still a no-no for those with celiac disease — it’s only the “pure oats” product that is considered safe.

Q.:My doctor tells me that while my total cholesterol and LDL levels are acceptable, my HDL levels are low. What can I do to raise my HDL cholesterol?

A.:HDL refers to High Density Lipoprotein, the so-called “good” cholesterol. Most experts now feel that a low HDL level is more indicative of subsequent heart disease than is a higher-than-desirable level of LDL (Low Density Lipoprotein — the “bad” cholesterol). Recent research has shown that LDL can be further categorized into good and bad LDL — the good being the “large, fluffy particles” and the bad being the “small, dense particles.” There are only two dietary components that have been shown in the research to raise HDL levels — booze and saturated fats. This is hardly advice that a heart association is about to dole out since too much alcohol is obviously a bad thing and most health agencies have spent the last 30 years or so railing against saturated fats. But the fact remains that certain saturated fatty acids (myristic acid for one) have been shown absolutely to raise HDL levels. Another problem is that diets rich in vegetable oils like corn oil, safflower oil or sunflower oil have been shown to lower HDL levels. Operating under the notion that vegetable oils are “good” for us, many have consumed them in excessive amounts leading to lower HDL levels. So, my advice would be to use olive oil or canola oil for baking/sautéing (since these oils contain fewer polyunsaturates) and to go easy on commercially prepared salad dressings. And, oh yes, a glass of wine with meals is not a bad idea.

Q.:I’ve been diagnosed with lactose intolerance. Does that mean I must avoid all milk and milk products?

A.:An intolerance is different than an allergy. An allergy requires that the sufferer avoid any food that might contain the offending substance. With lactose intolerance, those afflicted simply produce no, or insufficient amounts of the enzyme lactase. In the “normal” individual, lactase breaks down the milk sugar lactose and the symptoms of bloating, flatulence and gastric distress don’t occur when milk is consumed. The presence of this condition, however, does not mean that all milk products are out of bounds. In fermented products like yogurt the “friendly” bacteria will break down the lactose, and products like hard cheese and butter contain lactose in such negligible amounts as to pose no problem. In addition, there are lactase-containing capsules that are taken before milk is consumed, and they will aid in the digestion of lactose.

HelenBishopMacDonaldisaconsulting nutritionistintheagriculturalindustry.

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