Article: Nutrition and autoimmune diseases
March 13th, 2012 | by Pam Stuppy
Printed in Seacoast Online
There are more than 80 autoimmune-related diseases or conditions that affect a wide range of body tissues. This implies that numerous people are at risk or have already experienced the onset of some type of autoimmune issue. Interestingly, although the percentages vary depending on the specific condition, in general about 75 percent of people with autoimmune diseases are female.
What does the term “autoimmune” mean?
Our bodies need to have a strong defense system in place to fend off numerous “foreigners” that try to invade and cause problems. What happens in an autoimmune situation is that the body mistakes a body tissue as foreign and begins to self-destruct or has an exaggerated immune response.
An example of an autoimmune disease is celiac disease where the target is the villi lining the intestinal wall, resulting in reduced uptake of nutrients and energy sources. Another is rheumatoid arthritis where joints are attacked. Other more familiar autoimmune diseases include type 1 diabetes, lupus, multiple sclerosis, a form of thyroid disease and Sjogren’s syndrome.
There are a number of theories as to what causes autoimmune disease. The most accepted information is that their development is related to both genetic and environmental factors. When looking at family medical history, there may or may not be a clear line of people with one specific autoimmune disease. Instead, there may be genes that predispose families to autoimmune diseases in general. In this case, the family tree may be sprinkled with a wide range of autoimmune diseases. A single individual may also experience more than one autoimmune disease — like having celiac disease and type 1 diabetes.
There appears to be a connection with inflammation in most autoimmune diseases. The question is which comes first — the disease or the inflammation. Is the inflammation a cause or effect of the disease? Inflammation may also be related to greater intensity of symptoms.
Dietary factors are still being studied with regard to their possible impact on autoimmune diseases. Because of the connection with inflammation, omega three fatty acids may be of benefit in reducing symptoms. Anecdotally, people with conditions like rheumatoid arthritis have noted some improvement in symptoms with the addition of fish oil supplements.
Vitamin D is also being studied with regard to autoimmune disease. The incidence of some of these diseases appears higher in the more northern latitudes, implying that sun exposure/vitamin D status may play a role. The thought is that adequate vitamin D may reduce the risk and improve the symptoms of some autoimmune diseases. Again, more studies need to be done to confirm the relationship and the target blood levels of vitamin D. In any case, making sure vitamin D levels are adequate based on current guidelines cannot hurt and can possibly help.
Other areas of study involve the condition of the intestinal tract. This system is one of the largest lines of defense in the body. The beneficial bacteria and other microbes that live there assist in protecting the body from foreigners. Disruption of the balance between the “good” and “bad” microbes in residence there may be related to the risk of disease. The typical American diet, which is high in processed foods, animal proteins, sugar, and saturated fat, while low in fiber, fruits and vegetables can contribute to this imbalance. A higher fiber, less processed, more plant-based diet encourages the growth of the “good” microbes. Probiotics from food sources or supplements may prove helpful as well.
During an immune response, tissue is often damaged by “free radicals.” Antioxidants are being explored for their potential benefit of reducing tissue breakdown. Dietary sources of antioxidants from a wide range of healthy foods are suggested rather than supplemental forms. Think foods like fruits, vegetables, whole grains, nuts, seeds, beans, plant-based oils, tea, etc.
In people with diagnosed autoimmune disease, the medications used to treat the disease may have some dietary relationships as well. Corticosteroids, like prednisone, that are often used to reduce inflammation, can have a number of negative side effects. An example is the loss of bone density that can happen even when this medication is used for only a short period of time. Although it will not totally protect bone from loss, adequate nutrient intake (including slightly higher intakes of protein, calcium, and vitamin D) can help somewhat. If possible, however, getting off the medication or taking a lower dose is the best protection for bone.
Although more studies need to be done with regard to autoimmune disease, the dietary interventions noted above are not harmful and could prove very helpful for reducing the risk of autoimmune disease occurrence and reducing symptoms. They are also consistent with the general dietary recommendations for overall health. In summary, the goals are to consume a healthy, less processed, more plant-based diet that is moderate in animal protein, saturated fat and sugar, with the addition of omega three fatty acids and adequate vitamin D.
Pam Stuppy, MS, RD, CSSD, LD is a registered, licensed dietitian with nutrition counseling offices in York, Maine, and Portsmouth. She is also the nutritionist for Phillips Exeter Academy. Visit www.pamstuppynutrition.com for more nutrition information, some healthy cooking tips, and recipe ideas.
Article: Convenience foods versus convenient foods
March 1st, 2012 | by Pam Stuppy
Printed in Seacoast Online
As our lifestyles have become busier, there has been an increasing demand for quick and easy foods from the grocery store.
Everyone seems to be in a hurry and one of the short-cuts happens in the kitchen. Unfortunately, the “convenience foods” that arose out of this trend were not always on the positive side of health. Many were more highly processed (often resulting in fewer nutrients), high in preservatives and other additives, high in sodium, higher in calories, low in fiber, high in saturated and/or trans fat, or high in sugar.
Besides the potentially negative impact on health, studies looking at the efficiency of using these foods did not always show a significant amount of time-saving when compared to lesser use of these products. Cost was often higher as well.
Rather than choosing “convenience foods,” a solution might be to stock up on “convenient foods.” These would be food items that retain much of their nutritional value without all of the less healthful negatives of processed foods, while still contributing to time efficiency. These foods can be added to a family’s standard grocery list so that they are always available, reducing the need for extra trips to the grocery store.
In looking for convenient foods to add to your shopping cart, reading food labels can help you to choose those that are lower in sodium, saturated or trans fat, and sugar. Watch out for “flavor packets” as these tend to include a lot of sodium and other food additives. You may want to use only minimal amounts of the contents of these packets, or omit them. You can also omit or minimize any added butter called for in the directions.
Time-saving but healthy items for breakfast might include unsweetened oatmeal packets, eggs, whole grain bread products, or high fiber/low sugar cereals. Frozen fruit without added sugar is perfect for a quick fruit and yogurt smoothie or for making fruit sauces to top french toast, waffles, pancakes, hot cereal, yogurt, or pudding.
Canned or vacuum sealed tuna or salmon are quick and easy lunch ideas. Sometimes a little higher in price, but definitely healthy convenient foods for lunches or snacks, are the individual packets of peanut butter, hummus, guacamole, or pureed fruit (like unsweetened applesauce).
Some other meal and snack ideas that are ready-to-eat without any preparation (except maybe portioning them out for individual serving sizes) are nuts, seeds, and soy nuts. Many people would benefit from the unsalted versions of these.
Dried fruit in moderation is another option. The smallest boxes of raisins count as a single serving. The “yogurt-coating” added to some dried fruit adds no nutritional benefit but does add extra sugar.
Be cautious with store-made trail mixes, as many contain a lot of high sugar ingredients and sodium in addition to the healthful nuts and seeds. Low-fat, low-sodium popcorn is another easy, high-fiber snack.
Numerous fresh fruit and vegetables make grab-and-go snacks. Bananas, apples, grapes, most berries, and pears require no prep, while oranges and clementines, are almost as easy. Many stores sell the ready-to-eat containers of cut-up fresh fruit as well.
Baby carrots, pea pods, and grape tomatoes just need to be rinsed and tossed into a bag as part of a meal or snack. Some raw veggies are now individually packaged with no prep required. Bagged salad-ready fresh spinach and lettuce can help families reach the goal of making at least half of their plate vegetables (remember — the darker the leaves, the more nutrients).
Individual yogurts are a great source of calcium and protein, but look for the ones without a lot of added sugar. Low-fat cheese is available in portion-sized packages, like string cheese, or pre-grated for use in recipes.
For your dinner side dishes, consider purchasing the parboiled bagged brown rice that can be heated in boiling water or microwaved. Other grain items might be whole grain pasta or quinoa (which cooks like rice but in less time).
When it comes to jarred or canned items, buy the lower sodium tomato sauces, low sodium cooked canned beans, low sodium canned tomatoes products, and salsa.
Frozen foods vary in their nutritional quality. Added sodium and high calorie/high fat sauces can be a problem. Frozen vegetables retain much of their nutritional value and are already cut to size. Choose those packaged without anything else added. These are great for a quick stir fry, soup, or vegetable side dish. Frozen, shelled edamame (fresh soy beans) make a quick protein option for use in these dishes as well.
Frozen veggie burgers can be part of a healthy meal, too. Precooked frozen shrimp is another easy protein to add to a whole grain pasta dish, a stir fry, or a soup. Frozen whole grain bread dough or premade whole grain pizza crust is available in some stores. It makes a homemade veggie pizza an easy meal.
Besides the choices made at the grocery store, making meals in bulk for use over several meals is another time-saving hint. This means home-cooked meals with minimal time spent for each meal.
So to boost your nutrient intake while still reaping the benefits of convenience and time-saving, choose “convenient foods” over the more processed “convenience foods” most of the time.
Pam Stuppy, MS, RD, CSSD, LD, is a registered, licensed dietitian with nutrition counseling offices in York, Maine, and Portsmouth. She is also the nutritionist for Phillips Exeter Academy. Visit www.pamstuppynutrition.com for nutrition information, some healthy cooking tips, and recipe ideas.