Daily Diet: Increase in Incidence of Celiac Disease

Apparently you are never too old to be diagnosed with celiac disease, and new findings challenge the notion that it is something that you develop in childhood. A study published in the latest issue of the Annals of Medicine has found not only an increased incidence of the disease, but that the incidence (or risk) of celiac disease rises with age.

Researchers found that the incidence of celiac disease has doubled in the United States every 15 years since 1974. The number of individuals with celiac disease blood markers rose from 1 in 501 in 1974 to 1 in 219 in 1989, and then to 1 in every 133 people in 2003. Results also confirmed previous research that elderly people are twice as likely to develop the disease compared to the general population.

Celiac disease is an inherited digestive system disorder caused by an intolerance to gluten that affects the digestive process of the small intestine. Once thought to be a rare condition, research shows that it affects about 3 million people. The disease often goes undiagnosed because there are as many as 300 different symptoms, many of them subtle and seemingly unrelated. In fact, it is sometimes confused with irritable bowel syndrome, iron-deficiency anemia, Crohn’s disease, diverticulitis, intestinal infections, and chronic fatigue syndrome.

When a person who has celiac disease eats foods containing gluten, a protein found in wheat, barley, and rye, their immune system responds by attacking the small intestine, destroying the intestinal villi, thus inhibiting the absorption of vital nutrients into the body. Left untreated, the disease may increase the risk of many other conditions, including hepatitis, thyroiditis, lymphoma, diabetes, and rheumatoid arthritis.

Although genetic markers for celiac disease have been identified, the actual trigger that causes an individual to lose gluten tolerance is unknown. Study leader Alessio Fasano, M.D., director of the University of Maryland's Center for Celiac Research, said, “Even if you have these genetic markers, it's not your destiny to develop an autoimmune disease. Our study shows that environmental factors cause an individual's immune system to lose tolerance to gluten, given the fact that genetics was not a factor in our study since we followed the same individuals over time.”

The only treatment for celiac disease is a gluten-free diet. But despite the fact that manufacturers are required to label food that contains gluten, adhering to a gluten-free diet can be tricky business. In addition to the obvious places gluten can be found in a normal diet, such as breads, cereals and pasta, there are many hidden sources of gluten. Everyday products such as medicines, vitamins and even lip balms contain gluten, as does thickening agents, emulsifiers, fillers, flavor enhancers, and food stabilizers.

Obesity Surgery Tied to Lower Diabetes Risk in Pregnancy

NEW YORK (Reuters Health) - Severely obese women who undergo weight-loss surgery may have a decreased risk of developing diabetes during future pregnancies, a new study suggests.

Researchers found that among 700 women who had undergone obesity surgery, those who'd had the procedure before becoming pregnant were 77 percent less likely to develop pregnancy-related diabetes than those who'd had a pregnancy before their surgery. They also had a lower rate of cesarean section.

The findings, published in the Journal of the American College of Surgeons, add to evidence of the potential health benefits of weight-loss surgery.

Research has shown that the surgery, which restricts the amount of food a person can eat, can spur substantial weight loss and help control obesity-related conditions like type 2 diabetes.

Studies have come to conflicting conclusions, however, regarding the effects on gestational diabetes, a form of the disorder that arises during pregnancy.

While gestational diabetes usually resolves after childbirth, during pregnancy it may cause the fetus to grow abnormally large, which can make a C-section or forceps necessary and raise the risk of postpartum bleeding. Women who develop gestational diabetes are also at increased risk of type 2 diabetes later in life.

For the new study, Dr. Anne E. Burke and colleagues at Johns Hopkins University in Baltimore reviewed insurance records of 23,594 U.S. women who had undergone obesity surgery between 2002 and 2006.

Of those women, 346 had given birth during that same time period, but before having the surgery; another 354 had given birth after the surgery—typically about 20 months later.

Most had undergone gastric bypass, in which the upper portion of the stomach is stapled off to create a small pouch that restricts the amount of food a person can eat at one time. The surgeon also creates a bypass around the rest of the stomach and a portion of the small intestine, which limits the body's absorption of food.

A minority—42 women overall—had undergone gastric banding, where an adjustable band is used to create the pouch at the upper part of the stomach.

Burke's team found that among women who had delivered before weight-loss surgery, 27 percent developed gestational diabetes during the pregnancy. That compared with eight percent of those who'd delivered after their surgery.

Similarly, the rate of C-section was lower in the latter group: 28 percent versus 43 percent.

The researchers then factored in two other variables: the women's age and whether they had ever had a C-section in the past, which raises the odds of having one in subsequent pregnancies. With those factors considered, obesity surgery was linked to a 77 percent reduction in the risk of gestational diabetes and a 52 percent decrease in the odds of C-section.

The findings "add to a growing body of evidence in favor of a protective effect" of weight-loss surgery against gestational diabetes and C-section, Burke told Reuters Health.

However, she added, "I do not think this is saying that obese women need to delay pregnancy until after having this surgery."

For one, only certain, severely obese women would be candidates for the procedure. Moreover, Burke pointed out, women should first try to shed weight through diet and exercise before turning to surgery.

The study has limitations, the researchers acknowledge. Chief among them is the fact that it was a review of insurance records, rather than a controlled study where women were recruited and then followed over time to compare the pregnancy outcomes of those who had obesity surgery with those who did not.

According to Burke, it would be difficult, for both practical and ethical reasons, to conduct a randomized, clinical trial -- in which women would be randomly assigned to have weight-loss surgery either before or after a pregnancy.

But, she noted, it would be more feasible to do a study where women were followed over time to look at the pregnancy outcomes of women who chose to have weight-loss surgery and those who did not.

In general, weight-loss surgery may be an option for people with a body mass index (BMI) of 40 or higher, which puts them in the category of severe obesity. It may also be an option for people who are less severely obese but have chronic medical conditions like type 2 diabetes or high blood pressure.

The risks include short-term complications from surgery, like serious bleeding, infection and blood clots; longer-term risks include vitamin and mineral deficiencies and hernia development. And an estimated 10 percent of patients have an unsatisfactory weight loss or eventually regain much of the weight they had shed.

An estimated 220,000 Americans underwent some form of weight-loss surgery, most often gastric bypass, in 2009, according to the American Society for Metabolic & Bariatric Surgery.

On average, the procedures cost about $20,000 to $25,000. Whether surgery is a cost-effective way to prevent gestational diabetes is a question for future research, according to Burke's team.

A study published last month found that weight-loss surgery may curb the costs of managing type 2 diabetes.

The study, which examined insurance claims of more than 2,200 weight-loss surgery patients, found that among those with diabetes before the surgery, only 15 percent were still taking diabetes medications two years after the procedure. (See Reuters Health story of August 16, 2010.)

Diabetic patients' yearly healthcare costs averaged nearly $6,400 in the two years before surgery; the typical cost of the surgery plus hospitalization was almost $30,000.

The researchers concluded that because the weight loss won by surgery can be maintained for years, the procedure could be cost-saving in the long run for people with type 2 diabetes.

SOURCE: http://link.reuters.com/kub83p Journal of the American College of Surgeons, August 2010.

The Clean Diet: Newest Celebrity Fad?

It’s no secret that celebrities feel the pressure to look beautiful, to be thin and smart and the best at what they do. Many mere mortals share that trait, and both groups often jump in headfirst to diets and weight loss programs outside the standard norm. It’s considered newsworthy to highlight the latest fast and diet trend, particularly in products that lack any celebrity endorsement.

While Jenny Craig has its Valerie Bertinelli, Nutrisystem has Marie Osmond, and Jennifer Hudson is touting Weight Watchers, there are hundreds of diet systems that lack star power, and will work all the angles to garner publicity. Two weeks ago Master Cleanse jumped on the bandwagon when Demi Moore mentioned trying the liquid-only detxing cleanse. (Trying being the operative word as she admittedly lasted less than a week on the program.) This week it’s the Clean diet that is making news, again with Ms. Moore providing the buzz. (Although in all fairness Gwyneth Paltrow has endorsed this product in the past and Debra Messing and Mariska Hargitay have used the program.)

Clean: Remove, Restore, Rejuvenate is the brainchild of Dr. Alejandro Junger, a New York City cardiologist and practitioner of integrative medicine. This 21-day detox program is designed to remove toxic chemicals that have invaded the body. According to Clean literature, “As the toxicity of modern life increases and disrupts our systems on a daily basis, bombarding us through our standard American diet and chemical-filled environments, our ability to handle the load hasn’t accelerated at the same rapid pace.” Hence, the Clean detox system to the rescue.

The Clean program has a cost of $350, which includes everything you need for the three-week program except for your daily lunch meal. The kit includes brown-rice based shake powders that contain “nutrients, vitamins, minerals, antioxidants, and phytonutrients,” fiber powder, probiotics, herbal antimicrobials (used to treat gut bacteria), and an herbal supplement.

Ordering the Clean kit allows you to join the Clean community online where there are educational videos and forums. During the 21-day program you use the products to make one shake in the morning and one shake in the evening. You also take supplements that are supplied. You get one meal per day, best eaten at mid-day. In addition to eating these three meals, there are specific guidelines for the detox program:

Follow the Elimination Diet guidelines for everything you consume. [There are specific foods you need to remove from your daily diet during this time.]

Leave a twelve-hour window between the last meal of one day and the first meal of the next. Try not to snack in between. [Water is suggested to reduce hunger pangs.]

Make sure you have a bowel movement before the end of the day. If this doesn’t happen spontaneously, make it happen with laxatives or castor oil.

Drink enough pure water to cause you to pee often. If more than one hour has gone by without peeing, you are not drinking enough.

Move. Walk. Take the stairs. Jump. Incorporate more movement into your day, as often and for as long as you possibly can. Park your car two blocks away from your destination. Get off the subway or the bus a stop before you should and walk the rest of the way.

Rest. Get enough sleep. And breathe deeply all day long.

There is little scientific evidence or research studies behind the Clean program. It is based on Dr. Jung’s own experience and experimentation. It does, however, seem to have caught the eye of Hollywood and will no doubt be more visible in the future, meaning more “regular folks” will attempt to use the program.

As with any diet program, do your research first. Go to the library, search the internet, and above all, consult your doctor about any diet regimen that you are contemplating.

Top 10 Most Popular Weight Loss Diets

Obesity is a costly issue, but weight loss can be just as expensive. Trying diet after diet after diet not only takes money out of your pocket, it can lead to frustration, binge eating, and depression. It’s important to find a diet that is not only proven, but one that fits your needs, budget, and lifestyle. To find the right one takes more than a friend’s reference; it takes some investigation and planning.

With that in mind, along with the hundreds of diets that have been developed over the past few decades, there are a number of diets that consistently land in the Top 10, according to a variety of ranking systems. The ones included in this list are certainly not inclusive but are meant to give consumers an idea of what works for the majority of people. Each one should still be examined for the appropriateness as it pertains to each individual.

1. Jenny Craig


2. Mediterranean Diet


3. Zone Diet


4. Weight Watchers


5. Volumetrics


6. Flat Belly Diet


7. NutriSystem


8. South Beach Diet


9. Atkins Diet


10. Sugar Busters Diet

Jenny Craig, NutriSystem, and the Zone Diet all require the purchase of food from the companies themselves to assure caloric intake and portion control. All of the plans can be expensive, though if substituted for a lifestyle that used to include dining out and fast food meals, it may not be that much of a financial burden. All three do have the benefit of teaching portion control for those who use the diets for awhile and venture out on their own, but staying on the plans allows the added benefit of meeting with counselors, having calories counted by the company tracking food intake, and keeping to a strict regimen.

Weight Watchers is also a popular diet that promotes its own meals for purchase, but more emphasis is put on the points system of counting calories. Customers pay for meetings, but the knowledge gained about spacing out meals and watching the nutritional intake involved is a tool that can be used well beyond the time spent as an official member.

Several diets focus on the abdominal region, which is one of the most problematic for many seeking weight loss advice. Stomach fat is the easiest to gain and toughest to lose, making diets like the Flat Belly Diet and Abs Diet popular. The first is geared toward females and concentrates on eating monounsaturated fatty acid-based foods with few calories per meal but meals every four hours. The latter—Abs Diet—focuses mainly on ab-centered exercises mixed with a diet similar to the other with more frequent but smaller meals.

The South Beach and Atkins diet plans have increased in popularity in the last decade due to results that show consumers lose initial weight quite quickly. That happens, though, due to the strict nature of the diets and the focus on proteins.

The Mediterranean Diet, Volumetrics, and Sugar Busters Diet each take unique approaches to their diet suggestions, which work only if the consumer has a penchant for that particular lifestyle change. The Mediterranean, for example, concentrates on cheap and easy meals with an emphasis on vegetables, whole grains, nuts, fish, poultry, dairy, and olive oil. Volumetrics focuses on fiber-heavy foods and a watchful eye on various vitamins and minerals, and it eliminates all packaged foods and sugar/fat-based items. Sugar Busters reduces carbohydrates in the diets with the exclusion of potatoes, white bread, and sugar.

Most weight loss programs incorporate or encourage exercise, some have monthly fees or mandatory food-purchase requirements. HealthNews editors have reviewed many of the aforementioned diets, along with many others, to help make your research just a little bit easier. So, if you are in the market for a weight loss plan, take the time to check each out and find out which is right for you.

How to Gain Weight Eating Healthy Foods

It may feel pretty lonely out there when everyone you know is trying to shed pounds and you are trying to put some on. However, your goals are exactly the same as those trying to lose some weight: To eat a healthy diet, and reach a normal body weight. It’s just as much of a challenge for the overweight person to lose pounds, as it is for you to gain them.

The good news is that it’s possible for all of you to sit at the same table, with the same menu, enjoy each other’s company, and reach your goals. You will be choosing a few things that they may be avoiding, but generally, eating healthy to gain weight involves eating the same variety of foods as your friends.

Whether you are underweight because of a recent illness, an eating disorder, or simply because your sense of taste declined as you grew older, the way to increase your weight is to increase the calories in your diet. To do this in a healthy way, you will not want to just add more junk foods to your diet. Junk foods don’t offer much nutritionally, and are loaded with unhealthy saturated fats and sugar.

Eating fish, nuts, and even seeds, routinely throughout the week will provide you with needed healthy fat and calories. Because red meat has a high saturated fat content, meals of this type would best be limited to one or two times a week.

Black beans, kidney beans, pinto beans, dried peas, and soy beans are all good sources of protein and calories. A delightful snack is easy to make by placing beans and cheese on a tortilla; roll it up, and microwave until it’s hot, enjoy.

Powdered milk added to soups, sauces, and smoothies, is a relatively effortless way to get bonus calories and protein.

Olive oil is a healthy diet choice because this monounsaturated fat will add calories to your diet, and help keep your cardiovascular system in good shape. For healthy salad dressings and mayonnaise, choose those made with canola or safflower oil.

The carbohydrates found in vegetables, fruits, and whole grains, infuse energy and nutrients into your daily diet. The USDA recommends that our daily diet include lots of grains and cereals; and that at least three servings a day are from whole gain breads, cereals, or and pastas. Whole grain carbohydrates provide calories, fiber, nutrients, and some protein in a healthy diet.

More Time Needs to Be Spent on Exercising to Lose Weight

With more and more developing nations adopting the Western lifestyle, they are also exposing themselves to the plight of that lifestyle—namely obesity. Obesity-related ailments including diabetes, stroke, gallbladder, and heart disease are responsible for over 300,000 deaths each year in the United States alone. The Surgeon General reports that about one-third or over 68 million Americans age 20 and older are overweight, while another 64 million are classed as obese.

Current data, showing that over one-third of American women are now considered obese, has given cause for a new study led by John Jakicic, chairman of the Department of Health and Physical Activity at the University of Pittsburgh. It appears that the American Heart Association's current guidelines of at least 30 minutes of moderately intense activity five days a week (150 minutes per week) falls short-by almost half-of what the new study recommends. After following 200 women considered being overweight or obese for a two-year period, Jakicic's team found that in order to take of weight and keep it off that the study group needed to exercise about 275 minutes a week, which translates to 55 minutes, five times a week or 40 minutes a day.

For the study, the women were divided into four groups, each with a different calorie intake restriction between 1,200 and 1,500 per day, and each group was assigned moderate to vigorous physical activity with varying levels of duration requiring a calorie burn of 1,000 to 2,000 per week. After six months, all of the women had lost weight; averaging between 8 and 10 percent of their starting weight-but only 47 women were able to sustain that weight loss at the two-year mark. These women exercised the most, burnt the most calories, and reported eating less food in general and decreasing dietary fat. The lead author of the study, John Jakicic, stated that people need to exercise more to keep losing weight, especially if they are already obese or overweight.

The study was supported by grant funds from the National Institutes of Health and the National Heart, Lung, and Blood Institute and reported in the journal Archives of Internal Medicine.

It is hard for many people to find time for this kind of exercise with today's hectic life style, but there are ways to add more activity to your day that doesn't require much extra time. Try walking or biking to work, take the stairs, do leg lifts while sitting at your desk, wear wrist or leg weights during exercise or all day, be creative and make-up some of your own. Anything that keeps you moving helps to burn calories, and that is what it takes to get the weight off and keep it off.