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Gluten-free ways to boost your fibre intake – The Globe and Mail

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Gluten is a protein found in the grains of wheat, barley and rye. In traditional bread made from wheat flour, gluten forms a protein network that makes dough cohesive and stretchy and gives bread that quintessentially satisfying, chewy texture.Aileen Son/The New York Times News Service

Q: I avoid eating gluten for health reasons. Without wheat, how can I get enough fibre?

Fibre can be a harder-to-get nutrient from a gluten-free diet. That’s because gluten-containing whole grains, such as wheat, rye and barley, are excellent sources of fibre.

As well, many processed gluten-free breads, crackers, cereals and snack foods are made with fibre-poor flours and refined tapioca, corn, rice and potato starches.

Removing gluten, though, doesn’t have to lead to a deficit of beneficial fibre. Here’s a guide to getting plenty of roughage from a gluten-free diet.

Why a gluten-free diet?

A gluten-free diet is a necessity for people with celiac disease, a lifelong genetically-based disorder that occurs when gluten triggers the body’s immune system to attack and damage the lining of the small intestine.

People who don’t have celiac disease but react poorly to gluten also benefit from a gluten-free diet. Non-celiac gluten sensitivity can cause symptoms such as bloating, gas, abdominal pain, fatigue, joint pain, brain fog and headache.

Other people may drop gluten because they perceive a diet without it to be healthier than one which contains gluten. (Not necessarily true.)

Reasons to focus on fibre

A high-fibre diet is tied to a lower risk of heart disease, stroke, Type 2 diabetes and colorectal cancer. Fibre-rich foods may also assist in weight control by helping you feel satiated longer.

Getting enough fibre benefits digestive health, too, by helping prevent constipation and reducing the risk of diverticulitis. Diverticulitis occurs when small balloon-like pouches in the wall of the large intestine, called diverticula, become inflamed.

Eating lots of fibre also supports a healthy gut microbiome, the community of microbes that reside in our large intestine.

Daily fibre recommendations, established by the U.S.-based National Academies of Medicine, are 25 g for women ages 19 to 50 and 21 g for older women. Men, ages 19 to 50, are advised to consume 38 g of fibre each day; older men should aim for 30 g.

Fibre-packed, gluten-free foods

Whether you avoid gluten or not, the following fibre-rich foods are worthy additions to your diet. While not listed below, fruits and vegetables are, of course, gluten-free sources of fibre.

Gluten-free whole grains. Brown rice and quinoa are go-to gluten-free grains, each supplying 3 g and 5 g of fibre per one-cup cooked, respectively. There are other whole grains, though, that deliver even more fibre.

Sorghum, an ancient grain that looks like a tiny ball, delivers 9 g of fibre per one-cup cooked. It’s also a good source of iron, vitamins B6 and niacin and magnesium.

Teff, a type of millet, provides 7 g of fibre per one-cup cooked, along with 10 g of protein, plenty of magnesium and more than a day’s worth of manganese, a mineral needed for immune function and bone health.

Other high-fibre gluten-free grains include amaranth, buckwheat, millet and oats.

Enjoy cooked gluten-free grains as a hot cereal or add them to smoothie bowls. Blend cooked grains into muffin and pancake batters, toss into salads, add to grain bowls, stir into soups, stews and curries or use as a stuffing for bell peppers.

High-fibre flours. Use gluten-free flours made from amaranth, teff, quinoa, chickpeas, coconut, buckwheat and almonds for baking and cooking.

Chickpea flour offers 20 g of fibre per one-cup, as well as folate, calcium, magnesium and potassium. Amaranth flour, at 16 g of fibre per one-cup, is also a good source of protein (20 g per one-cup), iron and calcium. One-cup of almond flour has 12 to 16 g of fibre (depending on how finely the almonds are ground) and supplies iron, calcium and brain-friendly vitamin E.

For comparison, one-cup of whole wheat flour as 12.8 g of fibre.

Each gluten-free flour has its own properties when it comes to baking, so you may need to experiment to get the ratios right.

Pulses. Beans (e.g., black beans, pinto beans, chickpeas), lentils and dried peas deliver a hefty amount of fibre, 14 to 16 g per one-cup. So do soybeans, though technically they’re not a pulse. Serve pulses in salads, soups, chilis, stews, curries and tacos.

Alternate lower-fibre brown rice and quinoa pastas (3 g fibre per 85 g dry) with pasta made from lentils, black beans, chickpeas or edamame (9 to 20 g fibre per 85 g).

Chia seeds. All nuts and seeds provide fibre, but chia seeds stand out: 10 g per two tablespoons. Add chia to smoothies, mix into yogurt, bake into muffins, sprinkle over oatmeal and salad or make chia pudding.

Leslie Beck, a Toronto-based private practice dietitian, is director of food and nutrition at Medcan. Follow her on Twitter @LeslieBeckRD

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Some in B.C. cross U.S. border for their next COVID-19 vaccine – Global News

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Global News Hour at 6 BC

There is evidence of the lengths some British Columbians will go to get a second booster dose of the COVID-19 vaccine — crossing the border to Point Roberts, WA for a shot. The movement comes thanks to the different approach to the fourth shot south of the border. Catherine Urquhart reports.

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Unknown hepatitis in children: Will it become a pandemic too? – CGTN

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03:56

The number of cases of a mysterious acute hepatitis in children continues to increase worldwide, with most cases occurring in Europe. As of May 10, 348 suspected cases had been reported in at least 20 countries. Information and data have pointed to an adenovirus called adenovirus-41 (HAdV-41) as the possible culprit. Does it have anything to do with COVID? Will it become a pandemic? How do we protect ourselves from it?

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Study tracks hospital readmission risk for COVID-19 patients in Alberta, Ontario – CBC.ca

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A new study offers a closer look at possible factors that may lead to some hospitalized COVID-19 patients being readmitted within a month of discharge.

At roughly nine per cent, researchers say the readmission rate is similar to that seen for other ailments, but socio-economic factors and sex seem to play a bigger role in predicting which patients are most likely to suffer a downturn when sent home.

Research published Monday in the Canadian Medical Association Journal looked at 46,412 adults hospitalized for COVID-19 in Alberta and Ontario during the first part of the pandemic. About 18 per cent — 8,496 patients — died in hospital between January 2020 and October 2021, which was higher than the norm for other respiratory tract infections.

Among those sent home, about nine per cent — 2,759 patients — returned to hospital within 30 days of leaving, while two per cent — 712 patients — died. The deaths include patients who returned to hospital.

The combined rate of readmission or death was similar in each province, at 9.9 per cent or 783 patients in Alberta, and 10.6 per cent or 2,390 patients in Ontario.

For those wondering if the patients were discharged too soon, the report found most spent less than a month in hospital and patients who stayed longer were actually readmitted at a slightly higher rate.

“We initially wondered, ‘Were people being sent home too early?’ … and there was no association between length of stay in hospital and readmission rates, which is reassuring,” co-author Dr. Finlay McAlister, a professor of general internal medicine at the University of Alberta, said from Edmonton.

“So it looked like clinicians were identifying the right patients to send home.”

Examining the peaks

Craig Jenne, an associate professor of microbiology, immunology and infectious diseases at the University of Calgary who was not involved in the research, said the study suggests that the health-care system was able to withstand the pressures of the pandemic. 

“We’ve heard a lot about how severe this disease can be and there was always a little bit of fear that, because of health-care capacity, that people were perhaps rushed out of the system,” Jenne said. “There was a significant increase in loss of life but this wasn’t due to system processing of patients.

“Care was not sacrificed despite the really unprecedented pressure put on staff and systems during the peaks of those early waves.” 

The study also provides important insight on the power of vaccines in preventing severe outcomes, Jenne said.

Of all the patients admitted with COVID-19 in both provinces, 91 per cent in Alberta and 95 per cent in Ontario were unvaccinated, the study found.

The report found readmitted patients tended to be male, older, and have multiple comorbidities and previous hospital visits and admissions. They were also more likely to be discharged with home care or to a long-term care facility.

McAlister also found socio-economic status was a factor, noting that hospitals traditionally use a scoring system called LACE to predict outcomes by looking at length of stay, age, comorbidities and past emergency room visits, but “that wasn’t as good a predictor for post-COVID patients.”

“Including things like socio-economic status, male sex and where they were actually being discharged to were also big influences. It comes back to the whole message that we’re seeing over and over with COVID: that socio-economic deprivation seems to be even more important for COVID than for other medical conditions.”

McAlister said knowing this could help transition co-ordinators and family doctors decide which patients need extra help when they leave the hospital.

‘Deprivation’ indicators

On its own, LACE had only a modest ability to predict readmission or death but adding variables including the patient’s neighbourhood and sex improved accuracy by 12 per cent, adds supporting co-author Dr. Amol Verma, an internal medicine physician at St. Michael’s Hospital in Toronto.

The study did not tease out how much socio-economic status itself was a factor, but did look at postal codes associated with so-called “deprivation” indicators like lower education and income among residents.

Readmission was about the same regardless of neighbourhood, but patients from postal codes that scored high on the deprivation index were more likely to be admitted for COVID-19 to begin with, notes Verma.

Verma adds that relying on postal codes does have limitations in assessing socio-economic status since urban postal codes can have wide variation in their demographic. He also notes the study did not include patients without a postal code.

McAlister said about half of the patients returned because of breathing difficulties, which is the most common diagnosis for readmissions of any type.

He suspected many of those problems would have been difficult to prevent, suggesting “it may just be progression of the underlying disease.”

Looking at readmissions is just the tip of the iceberg.-Dr. Finlay McAlister-Dr. Finlay McAlister

It’s clear, however, that many people who appear to survive COVID are not able to fully put the illness behind them, he added.

“Looking at readmissions is just the tip of the iceberg. There’s some data from the [World Health Organization] that maybe half to two-thirds of individuals who have had COVID severe enough to be hospitalized end up with lung problems or heart problems afterwards, if you do detailed enough testing,” he said.

“If you give patients quality of life scores and symptom questionnaires, they’re reporting much more levels of disability than we’re picking up in analyses of hospitalizations or emergency room visits.”

The research period pre-dates the Omicron surge that appeared in late 2021 but McAlister said there’s no reason to suspect much difference among today’s patients.

He said that while Omicron outcomes have been shown to be less severe than the Delta variant, they are comparable to the wild type of the novel coronavirus that started the pandemic.

“If you’re unvaccinated and you catch Omicron it’s still not a walk in the park,” he said.

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