Dietary Treatment

Description

ACD (Coeliac Disease) Mind Map on Dietary Treatment, created by SS_ on 07/03/2014.
SS_
Mind Map by SS_, updated more than 1 year ago
SS_
Created by SS_ about 10 years ago
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Resource summary

Dietary Treatment
  1. 1. Lifelong strict Gluten Free diet: to normalise mucosa for improved nutrient absorption.
    1. Reduces anemia risk
      1. Prevent long term complications eg oesteoperosis.
        1. Osteoperosis: Inc PTH and Inc Ca+i in blood = bone loss.
          1. Lack Ca intake following diagnosis
            1. Poor compliance with GF diet
            2. Need 1500mg Ca/day (BSG 2010)
              1. DXA Bone Density Scan
            3. Intestinal Malignancy: Stick to GF diet, risk of cancer after 5yrs same as general popn
          2. Life-long GF diet means :
            1. Exclude Rye/wheat/barley
              1. Oats controversal- mix with wheat flour at mills.
                1. Found in foods containing wheat or wheat flour
                  1. bread, cakes, biscuits, pasteries, pies
                    1. Processed Foods- Wheat used for dusting/ breadcrumbs
                  2. Oats controversial: contaminated with wheat from factory process. Reintroduce 6-12months
                2. Can enjoy balanced diet with GF foods
                  1. Natural foods: fruits/ veg
                    1. Meat / fish
                    2. Potato/ rice
                      1. GF bread, cake, pasta mixes
                        1. Available on prescription:
                          1. Important as fortified with ca, fibre, B viitamins + give variety to diet
                            1. Issue: Consider storage, organised for repeat prescriptions
                              1. Need cooking skills - baked from scratch
                                1. Time consuming- interfere with compliance
                            2. At diagnosis check for malnutrition + anaemia: need supplementation for Fe, Vit D, Ca due to malabsorption
                          2. Dairy products + Eggs
                            1. Butter/ marg/ oils
                            2. Safe cereals: Sorghum, Maize, Rice
                              1. For inc fibre: use rice Bran
                              2. Other issues patients need to know:
                                1. Package food labelling: GF not same as zero gluten.. Codex standards
                                  1. contains <20ppm safe amount of gluten to eat
                                    1. Very low gluten products contain 21-100ppm [not GF]
                                      1. Hidden gluten in pre prepared meals, sauces, beer/larger
                                      2. Coeliac UK: Info and Food + Drink Directory
                                        1. Practical Issues: Refreshing bread in toaster or oven to release moisture and improve taste/ seprate toasters
                                          1. Consider needs of age groups!:
                                            1. Preschool Kids: PlayDoh, playgroups/nurseries, parties, eating same meal as a family
                                              1. Children: ensure parents cope with parties, school dinners. Child need to take own GF bread- routine
                                              2. Teenagers: Less adult supervision, eat out more need knowledge and snack more
                                                1. Adults: Be prepared at work etc, aware of work canteen
                                                  1. Elderly: Support to change habit of a lifetime
                                                    1. Depression and low mood common
                                                  2. Main Nutritional Issue
                                                    1. Malabsorption: impaired macronutrient absorption
                                                      1. Negative calorie +pr balance= catabolic response + lose weight
                                                      2. Nutrient deficiency of Fe,folate, B12, fat soluble vits EDK
                                                        1. oesteoperosis
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