Coeliac disease is an autoimmune disease to gluten. This means that eating gluten damages the lining of the small intestine. Other parts of the body may be affected. If gluten is not avoided, this can result in nutritional deficiencies, osteoporosis, infertility problems and bowel cancer.

Coeliac disease is common, affecting 1 in 100, but only 10-15% have actually been diagnosed. Symptoms are often similar to irritable bowel syndrome or wheat intolerance.

Possible symptoms may include:

• diarrhoea, excessive wind, and/or constipation
• persistent or unexplained gastrointestinal symptoms, such as nausea and vomiting
• recurrent stomach pain, cramping or bloating
• any combination of iron, vitamin B12 or folic acid deficiency
• tiredness and/or headaches
• weight loss (but not in all cases)
• mouth ulcers
• hair loss (alopecia)
• skin rash (dermatitis herpetiformis (DH))
• osteoporosis
• depression
• infertility
• repeated miscarriages

If you think you or your child has coeliac disease, you must keep eating gluten and speak to your GP for advice. GPs can do a simple blood test, and if positive a referral to a gastroenterologist will be made.

A dietitian can advise on the elimination of gluten from the diet. Following a life-long gluten-free diet is a major task. Provision of dietetic support is essential to assess and review nutritional issues or possible nutritional deficiencies, as well as promoting an overall balanced diet.

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It appears that our summer here in the UK is well and truly over. Today I had my winter coat on, it seems strange that just 2 weeks ago we were in shorts and sunglasses. It’s as if September flicked the sunshine ‘off’ switch, which is a shame because that’s the best source of Vitamin D.

I don’t take many supplements as a varied, healthy diet will provide most of what the body needs, however, when there’s no sun and the days are getting shorter, vitamin D is on my essential supplement list. Unfortunately, it is very difficult to get enough vitamin D from food sources. Increasing numbers of scientific studies are showing the importance of maintaining good levels in the body.

I usually buy vitamin D drops, as these are easy to put in the children’s porridge in the morning, but unfortunately they were out of stock. I came across a spray version, how novel! Tried it on the brood this morning and they loved it. I tell them it only works if they’ve eaten their breakfast (not true!)

Studies have shown that about 50% of people in the UK have vitamin D insufficiency. In ethnic populations, deficiency can be up to 90%!

5 reasons why Vitamin D is important:

1. needed to absorb calcium (deficiency causes rickets in children, osteomalacia and osteoporosis in adults)
2. deficiency can cause loss of muscle mass and muscle weakness
3. helps the immune system – may increase tolerance to immune diseases and increase antibacterial defences
4. cancer – link between deficiency and breast, prostate and colorectal cancer
5. metabolism – implicated in insulin resistance, obesity and blood pressure

Can’t I get all I need from the sun?

The best source of vitamin D is sunlight. In the United Kingdom there is insufficient light of the correct wavelength between October and March to generate vitamin D. The summer months is the time to expose our arms for about 20 minutes a day to get the vitamin D needed, however using sun protection of factor 15+ blocks 99% of vitamin D production.

There are just a few foods containing vitamin D e.g. oily fish, margarine, egg yolks, fortified breakfast cereals. It is difficult to get enough from food alone.

Who is at risk of deficiency and should take a vitamin D supplement?

• babies and young children
• pregnant women and breastfeeding mothers
• people over 65
• people with darker skin living in the UK
• people who don’t go outside very much, especially the housebound, office/shift workers

The Department of Health recommends that these people take a vitamin D supplement. Current dose recommendations are 200IU (5 micrograms) per day, however up to 1000 (25 micrograms) micrograms per day is quite safe. In the USA, recommended intakes are much higher (400-800IU). Supplements are in liquid and tablet form.

If you are concerned that you may be vitamin D deficient, your GP can test your blood. Supplements can be prescribed or bought from pharmacies and health food shops.

N.B. very high doses (over 10,000IU) of vitamin D supplements can be toxic, and should not be taken by those with hypercalcaemia or metastatic calcification, or where there may be significant interactions with other medications. Supplements of vitamin D containing vitamin A should not be prescribed in pregnancy as excessive vitamin A doses.

This information should not take the place of medical advice. You should talk to your doctor, registered dietitian, pharmacist, etc. about your interest in, questions about, or use of dietary supplements and what may be best for your overall health.

A very large study followed people for between 17 and 19 years to see if maintaining ideal levels of seven health factors promoted cardiovascular health and reduced the risk of cancer.

5 out of the 7 factors are directly related to diet……..

The seven health factors and their ideal levels are:

1) physical activity – at least 75 minutes per week of vigorous physical activity, or 150 minutes per week of moderate or moderate plus vigorous activity

2) healthy body mass index (BMI)

3) healthy diet – good intakes of fruit & veg, fish, nuts, seeds, legumes, high fibre. Low salt, saturated fat, sugar and processed meats.

4) cholesterol – total cholesterol less than 200mg/dl
5) blood pressure – less than 120mm Hg systolic and 80mm diastolic
6) blood sugar – fasting levels of glucose less than 100mg/dl
7) smoking – never smoking, or quitting more than 12 months ago

The message is clear!

The BBC recently reported that lorry drivers who drink coffee cut their crash risk. It came from a large study of 530 Australian long distance drivers.

Caffeine consumption may be associated with safer driving as the headlines imply, but this study does not prove it. There are other explanations to the findings of this particular research, and the limitations suggest it would be wise to interpret the findings with caution.

While caffeine consumption may give you a short-term boost to attention – excessive consumption can lead to lack of concentration, restlessness and irritability, which could adversely impact your driving ability.

If you are planning to drive long-distance, it is recommended that you take a 15-minute break every two hours. You should not rely on coffee alone to ‘get you through’.