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There is mounting evidence that many of us are increasingly deficient in Vitamin D. While there is some controversy about the health impact of this it seems that changes in our diet in the last few years towards fewer foods rich in Vitamin D has led to a much lower intake.

Taking Vitamins to Prevent Cancer or Heart Disease
In my practice we ask our patients to bring all of the medications they are taking, including vitamins and herbs or supplements, to every office visit. This is so that if a patient is seeing more than one doctor - maybe a cardiologist in addition to visiting me, an internist - we can make sure that none of the medications they are taking will interact with each other in negative ways. 

Vitamin Supplements and Mental Function in the Elderly
There's been a few conflicting studies regarding vitamin supplementation in the elderly and its effects on mental function. They've been pretty narrowly focused, however: some studies supplemented with only B vitamins, while others focused on antioxidants.


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Are those on a Gluten-Free Diet Eating Healthy?

Celiac Disease causes damage to the villi (think tiny fingers) that line the small intestine. These villi are responsible for your body absorbing many nutrients, so many Celiac patients are nutrient-deficient. When a Celiac patient goes on a gluten-free diet, their villi slowly return (for the most part) and they are again able to absorb the nutrients from the food they eat. This is often cited as a reason that many Celiac patients gain weight after their diagnosis.

It's natural for Celiac patients to focus on simply avoiding gluten-containing products in their diet. Researchers in the United Kingdom, however, looked beyond simply treating Celiac Disease with a gluten-free diet and wondered if the gluten-free diet was actually nutritionally sound (Aliment Pharmacol & Ther 2010;32(4):573-581). Are those with Celiac Disease getting enough calcium, Vitamin D or other macro- and micronutrients in their gluten-free lifestyle?

They recruited 93 adult men and women with confirmed Celiac Disease who had been following a gluten-free diet for at least six months, and asked them to submit a detailed food diary that included five days: three weekdays and two weekend days. Each participant's height and weight was assessed in order to calculate their Basal Metabolic Rate and by extension their daily caloric needs.

These detailed food diaries were then analyzed to find their average daily caloric and nutrient intakes.

As a basis for comparison, the researchers utilized dietary data gathered in two large studies of the UK population. They limited that data to those who did not follow a gluten-free diet and otherwise matched the profiles to the same ages and genders of the Celiac patients. They also matched the profiles to those who lived in the same general area of the country.

They found that those on a gluten-free diet tended to get less fiber in their diets, and women were particularly prone to being low in folic acid and iron, along with other minerals. Male Celiac patients tended to be particularly low in magnesium and selenium. This isn't too surprising, as wheat flour is often enriched with these nutrients, while non-wheat flours are typically not enriched in this way.

What's particularly interesting, however, is that those following a gluten-free diet tended to get more of their carbohydrates from sugars, especially added sugars. Female Celiac patients typically consumed about 17% more calories than their gluten-eating counterparts, while male Celiac patients ate about 11% more calories. This is likely to be a factor in the post-diagnosis weight gain.

What this means for you

If you have Celiac Disease, you may find it helpful to meet with a dietitian to make sure that you're getting all the vitamins and minerals you need. You can get more fiber by eating gluten-free pasta (the quinoa pastas are great!), yams and brown rice, to suggest just three foods. Here's a list of gluten-free starch side dish recipes to help you get started.

First posted: March 16, 2011