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Saturday, May 30, 2015

Health Canada Identification of Oats for Gluten Free Diets

Health Canada considers "gluten-free oats" as those that do not contain more than 20 parts per million (ppm) of gluten from wheat, rye, barley, or their hybridized strains.
A typical serving would be 1/3 cup dry oats.  For those who are very sensitive to gluten, too much could create a problem. eg small children or others who have had repeated high TTG with very good diet compliance. Gluten Free Oats are a great source of soluble fibre and iron but be aware of the potential  issues with large portions.

Schneider Presents paper at the Dietitians of Canada in Quebec City

The Effect of a FODMAPs Diet on Symptom Production and the Gut Microbiome in Patients with IBS.
June 4, 2015 in Quebec City

Keith McIntosh, MD, FRCPC,
Theresa Schneider BASc, MPH, RD, Hotel Dieu Hospital Kingston
Ian Spreadbury PhD, GIDRU Queen’s University
Stephen Vanner, MD, FRCPC, Queen’s University
Francis Dang
Objective: With increasing evidence that the gut microbiome and foods such as fermentable oligo, di, and monosaccharides and polyols (FODMAPs) contribute to symptoms in patients with irritable bowel syndrome (IBS),  this study set out to determine if FODMAPs modulates symptoms in patients with IBS Methods: This prospective, randomized trial comparing the effect of low-FODMAP and high-FODMAP diets on IBS patients (ROME III diagnostic criteria), randomized subjects to either diet for a total of 3 weeks, regardless of their previous reported fodmap intake. A RD taught the diets in a 30 min session: with a booklet, food diary, foods to choose and avoid lists and menu choices. The low diet contained 2 servings of wheat/day. The previously validated IBS Symptom Severity Questionnaire measured symptoms. The gut microbiome was assessed indirectly by measuring H2 production as the change in the area under the curve (AUC) of H2 ppm for a 5 hour, 10g Lactulose Breathe Test (LBT). The Dietitian developed a Dietary Fodmap Code (DFC) (intake over a 7 day period using Canada’s Food Guide and Estimates of Food Frequencies) to verify dietary compliance. Results: 40 patients were enrolled with 20 randomized to the low FODMAPs and 20 to the high FODMAP diet. For the analysis, 16 and 18 respectively were used.  Baseline symptom scores and LBT H2 AUC were similar between groups.  At the end of the study, symptom scores had decreased by 31.1% in the low FODMAP group (p < 0.0001), versus no change in the high FODMAP group (+4.48%, p = 0.58). Neither diets produced any significant changes in H2 AUC (-12.12%, p = 0.39 and +4.8%, p = 0.75 respectively). Conclusions: The analysis shows a low FODMAP diet taught by an RD leads to a significant reduction in IBS symptom severity after 3 weeks. 

Monday, April 27, 2015

Is There Vitamin C in Apples?

Recently I provided a nutrition assessment for a mother of a young child.  The two year old liked apples and ate 1/2 an apple every day.  I asked the Mom if she had a source of Vitamin C in her child's diet and she insisted that the apples had Vitamin C in them.
Was she right?
Vitamin C needs (DRI) are 15 mg per day in a 2 year olds and go up to 90 mg per day in an adult male.
A whole Macintosh Apple in Canada has 6.3 mg of Vitamin C.
This is why local fruit juices in Canada are fortified with Vitamin C.
 If you are not willing to use juice in your child's diet or your diet then you should take an orange a day. For all families adults and children I recommend 4-8 ounces of orange juice per day which will provide Vitamin C, folic acid and potassium. Orange juice is also the most tummy friendly juice being low in fructose compared to other juices.

The Dietitians of Canada discusses food fortification.
Fortification means adding vitamins and minerals to foods. The government regulates the addition of certain nutrients to foods to ensure Canadians do not fall short. Some examples include:
  • Adding vitamin D to milk  
  • Adding iron to cereal
  • Adding folic acid to flour
  • Adding iodine to salt
  • Adding Vitamin C to apple juice
  • When we eat some organic foods we miss some of these things.  Read your labels.