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Coeliac Disease & Iron Deficiency: Understanding the Connection

This year, Coeliac Awareness Week is running from 13th-20th March and is putting a spotlight on the connection between iron deficiency and coeliac disease.

Iron Deficiency

Did you know that iron deficiency is the most common nutritional deficiency in Australia? It is estimated that one in three women of child-bearing age experience iron deficiency. Iron is a necessary component of heamoglobin contained in red blood cells and is required for the transport of oxygen around the body. Therefore, iron deficiency and iron deficiency anemia can have significant health implications, including symptoms such as;

HeadachesFatigueDizzinessShortness of breathFeeling cold easilyInability to concentrate

Whilst iron deficiency is commonly attributed to inadequate dietary iron intake, issues of poor iron absorption (e.g. coeliac disease) are often overlooked.

Coeliac Disease

Coeliac disease is an autoimmune condition in which the body's immune system attacks the intestinal lining when exposed to gluten. This results in chronic damage to the walls of the small intestine, whereby the villi (small finger-like projections on the intestine wall) become flattened and can no longer effectively absorb nutrients (such as iron, B12 and calcium). Coeliac disease is estimated to account for approximately 1 in 20 cases of iron deficiency, however, many individuals are not aware of the connection between iron deficiency and coeliac disease. Healthcare providers do not always undertake further investigations, meaning that ceoliac disease continues to be under-diagnosed.

What to do if you think you have Coeliac Disease?

It is estimated that 4 in every 5 individuals with coeliac disease in Australia are undiagnosed, which can severely impact quality of life and heightens the risk of long-term complications such as infertility and osteoporosis. It is for this reason, that iron deficiency should ALWAYS be investigated further by your GP or other healthcare provider, as it can be an important warning sign of coeliac disease. We encourage all patients to advocate for their own health and prompt further investigation by healthcare professionals if you are experiencing chronic iron deficiency with no other apparent cause. This is particularly important if you have additional symptoms of coeliac disease such as;

Abdominal pain and crampingBloatingDiarrhoea Unintentional weight loss FatigueBrain 'fog' 

How can your healthcare provider help?

If you or your healthcare provider has reason to suspect that coeliac disease may be present, the following testing can be undertaken; 

Coeliac serology: Blood test is performed to test for the presence of ceoliac antibodies which suggest an active autoimmune response. Note: coeliac disease should not be diagnosed on serology alone. A small bowel biopsy should subsequently be done to confirm the diagnosis. Small bowel biopsy: gastroscopy is performed in which tiny samples (biopsies) of the small intestine are taken and tested for signs of damage to the villi caused by coeliac disease. 

If presence of coeliac disease is confirmed, dietary management involves complete removal of ALL gluten containing foods and beverages from the diet to prevent continued immune activation. This includes avoiding any risk of gluten contamination when eating out or sharing utentils (e.g. toasters). A dietitian can help provide guidance regarding how to adjust to dietary changes, including label reading and avoidance of cross-contamination. Once gluten is removed from the diet, the gut lining will begin to repair, allowing for a return to normal gut function and nutrient absorption with symptom resolution.

So this Coeliac Awareness Week (13-20th March 2022), we encourage everyone to spread the word about iron deficiency and coeliac disease and advocate for your own health if you are concerned about chronic iron deficiency. If you are someone who has been diagnosed with coeliac disease, we also encourage you to speak to an Accredited Practising Dietitian (APD) for personalised support with dietary management.

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Heart Disease Prevention

Cardiovascular disease (CVD) affects over four million Australian's and unfortunately, over three quarters of Aussies are at risk of CVD. However, the good news is most of these risk factors are treatable!

With today being 'Wear Red' Day (February 14th) it is the perfect time to put the spotlight on CVD and raise awareness for this condition. We thought we’d talk about some factors that affect our heart health and ways to prevent CVD!

Common risk factors of CVD:

High blood pressureHigh cholesterol levelsBeing overweight/obesePhysical inactivitySmokingAlcohol consumptionDiet 

Diet  

Eating habits alone can impact four of the seven risk factors listed (amongst other factors like genetics). With diet having such a strong link to heart health, we have listed our top nutrition tips to help you stay heart healthy.  

Vegetables 

Did you know only seven per cent of Australian's are eating the recommended five serves of vegetables daily? Research shows us that eating all five serves per day can reduce your risk of CVD by up to sixteen per cent! That’s powerful stuff. We know it’s dry information but vegetables don’t have to be boring! By including one cup of salad at lunch, whether it be in a sandwich, wrap, or on its own, along with two cups of cooked vegetables at dinner (e.g. one roasted potato, half cup pumpkin, one cup mixed broccoli and cauliflower) can easily bring you to the five serves per day.

Mixing up your protein sources

You’ve probably heard that red meat isn’t the best for a healthy heart but that really doesn’t stop us, does it? (And to be honest we don’t blame you). So rather than removing red meat entirely, just focus on including a variety of different protein options. For example, fish! Oily fish in particular, is an excellent source of Omega-3's which are incredibly good for our heart health. In fact, just three serves of oily fish per week gives us enough omega-3's to have a cardio-protective effect.

You could also consider boosting your intake of plant-based proteins (and we aren't meaning the fake meat range). This could include options such as beans, lentils, chickpeas, tofu, nuts and seeds. For example, using black beans for your taco filling, having baked beans on toast, adding marinated tofu to a stir-fry or cooking up some lentil soup!

Opt for healthy fats and reduced fat dairy options  

There are two main types of healthy fats (mono and polyunsaturated). These work by not only lowering bad cholesterol, but also raising good cholesterol! Great ways to boost your healthy fat intake include cooking with olive oil, swapping butter for margarine, adding avocado to salads, snacking on a handful of nuts, or simply enjoying some free-range eggs.  

Choosing low fat dairy will also help to reduce saturated fat intake. This is important as high saturated fat typically increases LDL (‘bad’) cholesterol. You could also try a range of calcium fortified non-dairy alternatives such as almond or soy milk for something different!  

Limit discretionary foods  

Discretionary foods are those ‘extras’ that are (unfortunately) a lot of the yummy foods like chocolate, ice cream, crisps, chips, pastries and deep-fried foods. Keep in mind, the key message here is LIMIT not completely remove these foods. Whilst these foods aren't great for our health, particularly heart health, they still play a fundamental role in enjoying food. A good rule of thumb is to save them as occasional foods rather than everyday staples (for example limiting them to 1-2 times per week).  

Seeing a dietitian  

If you have been identified by your doctor as being at risk of heart disease, seeing a dietitian is a great way to get personalised advice on what dietary changes you can make to better support your heart health.  

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A Dietitian's Guide To Building A Healthy Lunchbox

It's the start of a new year and with the school term approaching, it's back to packing lunches! For many parents, having the time and resources to prepare nutritious and delicious lunches every morning is a daunting task. This is particularly challenging here in the Top End, where the heat and humidity makes keeping food fresh a very difficult feat. So we have put together our top dietitian tips to help take the guess work out of lunch box preparation! Ditch the guilt and go stress-free with our lunchbox guide below.

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