Kune Varwere Avo Vasina Kurumbidzwa-Mahara, Kupa Mazano Kunyanzvi Ndiko Kunokosha
Vanhu vane chirwere chechiliac vanosangana nezvinetso zvakakomba zvekudya, kunyange kana vari kutevera kudya kweguten-pasina. Kutanga, vanofanira kudzoka (zvakanyanya zvichibvira) kubva kune marabiorption yakakosha iyo yakaitika pavakanga vachiri kudya gluten, izvo zvingave zvakakonzera chirwere chemafupa, pasi pemafu emagetsi uye osteoporosis , kushaya mavitamini, uye mamwe matambudziko .
Sezvo dai izvozvo zvakanga zvisina kukwana, kusiyana nemakemikari ane gluten muchitorosi, mashoma emabhizimisi e-gluten-asina zvekugadzirwa anoshandiswa kana kuvakwa mavhitamini akawanda, zvichiita kuti zviome kune vanhu vane chirwere chechiliac kuti vawane mavitamini ekudya.
Zvigadzirwa zveG Gluten zvinowanzosara muB mavitamini, calcium, vitamini D, iron, zinc, magnesium, uye fiber. Ichokwadi, kutsvakurudza kwakaratidza kuti vanhu vane chirwere chechiliac vari pangozi yemigumisiro yakawanda yezvokudya zvisina-gluten, kusanganisira kuwedzerwa kwekuwedzera kwekuneta.
Chikonzero nei Dietitian Inokosha Muhutano Hwako
Nemhaka yezviitiko zvose izvi zvinokonzera kudya, American Celiac Disease Alliance, Digestive Disease National Coalition, Gluten Intolerance Group yeNorth America, uye vanachiremba vakawanda vanokurudzira kuti munyori wezvokudya akarembera anofanira kuva chikamu cheboka rezveutano rinotarisa mamiriro ekurapa kwevarwere uye kutevedza nekudya.
Uyezve, zvidzidzo zvinoratidza kuti kune vamwe vanhu vane chirwere chechiliac, chikonzero chikuru nei vasingakwanisi kugara gemen-pasina kuti havanzwisisi kudya. Hazvingave zvinyaradzo here kuwana rubatsiro kubva kune unyanzvi?
Ndeupi musiyano pakati peNutritionist uye Dietitian, uye Ndeipi Ndinofanira Kuona?
MuUnited States, vanhu vane chirwere chipi nechipi, kusanganisira chirwere chechiliac, vanoda ruzivo rwekudya kunofanirwa kunzverana neDecetitian Dietitian (inonziwo RD).
RDs dzakapedza zvidzidzo uye zvido zvezviitiko zvakasimbiswa neAmerican Dietetic Association's Commission pamusoro pekunyora Dietetic, kusanganisira zvishoma pachikoro chebhizimisi kubva kune imwe yekoroji yakagamuchirwa kana yunivhesiti uye chirongwa chinogamuchirwa chiitiko chekutanga. RDs inofanirawo kupedza kuongorora kwakanyatsogadzirisa unyanzvi uye kubatanidzwa muzvirongwa zvinoenderera mberi zvedzidzo zvekudzidzira kuchengetedza zvigwaro.
Mamwe maRS anobata zvidzidzo zvepamusoro uye zvidzidzo zvepamusoro munzvimbo dzakasiyana dzekuita. Nekukosha kune vanhu vane chirwere chechiliac, National Foundation for Celiac Awareness inobvumira vanyori vakanyoreswa sechikamu cheGituten-Free Resources, Education, uye Training (GREAT) chirongwa. CHIKURU kune Dietitians is Continuing Professional Education (CPE) Mvumo yakagamuchirwa neKomisheni yeDhietetic Registration. (Kunewo maGERAT certification programs for chefs, vashandi vekudya, uye vamwe vanogamuchira mucherechedzo vemabhizimisi.)
Kusiyana neCreditential RD, hapana maitiro ehurumende uye chirevo chinosanganiswa nemazita e "dietitian" (pasina shoko rokuti "kubhadhara") kana "nutritionist" uye hapana chivimbo chokuti munhu anoshandisa iyo mazita ane dzidzo yepamusoro mune zvekudya uye kudya .
Dzimwe nguva Dietitian yakanyorwa inopiwawo zita re "Nutritionist" (somuenzaniso, mune hutano hwevanhu, zvipatara zvezvipatara, uye masangano ezvidzidzo). Dzimwe nguva, zvisinei, mazita aya anoshandiswa nevanhu vasingaiti kudzidziswa. Kunze kwekuti unyanzvi wezvokudya ane yekutanga "RD" mushure mezita rake, unofanirwa kuongorora zvakajeka zvemunhu wacho.
Maererano neBhood of Labor Statistics yeUnited States of Labor, makumi maviri nemitemo ine mitemo inodzora dietetics, nyika 35 dzinoda kuti vashandi vabvumirwe uye 12 vanoda kuti ivowo vabvumirwe nehurumende, vasingagoni kudzidziswa nemamwe masangano emagetsi.
Iva nechokwadi chokuti unyanzvi hwako hwezvokudya hwakazadzisa zvinodiwa zvehurumende (kana nyika) kwaanoita.
Ndekupi Kwandiri Kuwana Dietiti Yakanyorwa?
MuUnited States, unogona kushanyira American Dietetic Association's Find A Nutrition Professional site kuti utsvake chireyiro pedyo newe. Zvechokwadi, unogonawo kubvunza chiremba wako, kana nhengo dzechirwere chako chechiliac chechikwata, kana vachigona kukurudzira unyanzvi hwekudya.
MuAustralia, shanyira myDR.com.au; muCanada, Dietitians yeKanada; muHong Kong, Hong Kong Dietitians Associated Limited; muIreland, yeIrish Nutrition uye Dietetic Institute; muNew Zealand, New Zealand Dietetic Association; muUnited States, Nutri-People kana kuBritish Nutrition Foundation.
Ko Inishuwarenzi Yangu Inobhadharwa Nezvokurapa Zvokurapa Therapy yeCeliac Disease?
Maererano neshoko rinowirirana rinobva kuAmerican Celiac Task Force (iro zvino rinonzi American Celiac Disease Alliance), Digestive Disease National Coalition, uye Gluten Intolerance Group yeNorth America, "Chirwere chekurapa kwakagadzirirwa chete kurapwa kwechirwere chechiliac ... dambudziko rekudya rinobatanidzwa nechirwere chechiliac, chiremba chekudya chinyoreswa chinofanira kuva chikamu cheboka rehutano hwehutano rinotarisa mutevedzeri wehutano hwemutano nekuteerera nguva dzose. "Zvichibva mumitemo iyi, makambani einishuwarenzi anofanira kubhadhara kubvunzurudzwa kwezvirwere zvechiliac neRSs.
Kunyange zvakadaro, pane mukana wakaisvonaka waunoda kuti uite kuti inshuwarisi yako ikwanise kuti iwe unoda kutarisirwa kubva kune vekudya. Kunze kwevamwe vaswere vane chirwere chechiliac uye chirwere cheshuga. Nemhaka yokuti Medicare yakatonga kuti varwere vane chirwere cheshuga vanoda chirongwa chekurapa kwezvokurapa, mamwe makambani einishuwarenzi achabvumira kurapa kwekudya kune vane chirwere cheshuga .
Kana iwe unotarisana nechinetso chokugutsikana nekambani yako ye inshuwarisi kuti ipe chibvumirano chake, unofanirwa kuratidza kuti kurapwa kwezvokurapa kwezvokudya kubva kune zvakanyorwa zvakanyoreswa (1) zvinotarisirwa mumutambo wako uye (2) mutemo wekutarisira varwere vane celiac chirwere . Mazano anotevera angabatsira:
- Edza kuva ne "hurukuro" yakawanda mukunyora sezvaunokwanisa. Kana iwe uchitaura nemumiririri wekambani yemishuwarenzi, mumiririri wefoni, nyora pasi zita remunhu wawakataura naye uye musi, uye utore zvinyorwa pane zvakataurwa.
- Pachishoma, tumira kambani yeinishuwarenzi mishonga yekurapa kwekudya kubva kuchiremba wako, kana kutumira. Kunyangwe zviri nani, bvunza chiremba wako-uye uyo ane chikafu chekudya, kana iwe wakatotanga kubvunzurudza-kunyora tsamba kune kambani yveshuwarensi iwe uchitsanangura kuti sei kubvunzurudza kuri kudiwa mune zvemishonga uye kuti kurapa iyi ndiyo inogamuchirwa zvinoenderana nekutarisira . Kana uine mamwe mamiriro ezvinhu anogona kutaridzirwa nezvinetso zvekudya, zvakadai seanemia kana mavitamini kukanganisa, taura kuti mune tsamba yako nekambani ye inshuwarisi nekuyeuchidza chiremba wako uye chikafu chekudya kuti ataure nezvazvo mune tsamba dzavo, zvakare. Kana vakatumira tsamba, vawane makopi uye muvadzikidze netsamba yenyu kune inshuwarisi yako, zvakare.
- Kuzviratidza kuti kupa mazano kubva kune unyanzvi hwezvokudya ndiko muitiro wekutarisira varwere vane chirwere ichi, kunobatsira kutumira makopi emashoko anokosha kubva mumabhuku ekurapa anotsigira pfungwa iyi. Pachinyore, shandisa zvinyorwa kubva pamapepa anokosha. Mamwe mashoma anooneka pasi apa, pakuguma kwechinyorwa ichi.
- Chero pose paunopinza chero mapepa ane tsamba yako (makopi matsamba, migumisiro yechipatara, zvinyorwa, nezvimwewo), iva nechokwadi chekutaura mumutsamba yako zvawakapinda.
- Nguva dzose paunotumira chinhu chipi nechipi nekutumira tsamba kune inshuwarisi yako yekambani, vadana vhiki imwe gare kuti vaone kuti zvinyorwa zvakapinda mu "system" yavo.
- Kana kambani yako ye inshuwarisi inoramba kubvumidzwa kusati kwabvumirwa kana kuti inoramba kubvuma kwako, tsvaga zvaunoda kuita kuti upe rufuro rwechirevo chirevo chacho. Paunenge uchiita chikumbiro chako, tumira makopi emakamba ako ose pamwe chete navo kusvika panguva iyoyo uye chero magwaro anotsigira, kunyange iwe wakatumira kare.
- Kana iwe inshuwarisi yako inopiwa neunoshandira, bvunza iwe mushandi wekubatsirika mutariri kuti aite. Mutungamiri wekubatsira anotakura humwe huwandu nekambani yeInishuwarenzi kupfuura iwe iwe semunhu.
Zvinyorwa kuti zvivhare (kana kuti kudzokorora) mune tsamba neye inshuwarisi yako kambani:
- Leffler DA uye al. A inogona kuenzanisa nekuongorora zviyero zvishanu zvekudya zvisina kuwanikwa kweguten kune vanhu vakuru vane chirwere ichi. Alimentary Pharmacology & Therapeutics 2007; 26: 1227-1235
- "Kunyange zvazvo maitiro e-serologic aripo iye zvino ane manzwiro akakwirira uye zvakasiyana-siyana zvekuongororwa kwechirwere ichi, haagoni kutora nzvimbo yekudzidzira chikafu chezvokudya mukutarisa kwekutengesa kudya kweguten."
- Niewinski MM. Kufambira mberi mune chirwere chechiliac uye kudya kwema gluten. Nyaya yeAmerica Dietetic Association 2008 Apr; 108 (4): 661-72
- "Kudzokorora uku kunonyanya kujeka pamusoro pekudya kusina gluten uye kukosha kwehutano hunyanzvi hwekupa mazano kune vose varwere vane chirwere chechiliac ... Kudya pasina gluten kwakaoma uye varwere vanoda dzidzo yakakwana yezvokudya kubva kune unyanzvi hwezvokudya."
- Green PHR uye Cellier C. Chirwere cheCeliac. New England Journal of Medicine 2007; 357: 1731-43.
- "Bato rekuchengetedza hutano rinofanira kusanganisira munhu ane unyanzvi hwekurapa uyo anotarisa mutevedzeri wezvokudya uye chirongwa chekudya nguva dzose ... .Zvikudya zvekudya zvakajeka zvinodiwa kuti uone kukosha kwekuteerera [kune zvokudya zvisina kudya] uye zvikonzero zvinokonzera kusava nehanya. .. "
- Pietzak MM. Kuitevera kwevarwere vane chirwere chechiliac: kubudirira kutevedza nekurapa. Gastroenterology 2005; 128: S135-41
- "... kutarisana ne-gluten-isina kudya, kunyanya muUnited States, inonetsa kwazvo ... .Zvirokwazvo, nzira yeboka kune yekutevera kwechirwere chinenge chachangobva kuongororwa inofanira kusanganisira ... kurapwa kwezvokurapa kwemazuva ano nemunhu anozivikanwa sefatician ..."
- Mariani P et al. Zvokudya zveGluten-Zvisina Kuwanda: Chimwe Chinhu Chinokonzera Nengozi Yevana Vari Kuyaruka neCeliac Disease? Zvinyorwa zveMwana Gastroenterology & Nutrition 1998; 27: 519-523
- "Kunyange zvazvo mumakore apfuura pane kuve nekuvandudzwa kwakakura mune zvishandiso zveDCD, tinotenda kuti nguva yasvika pakupa zvakanyanya matambudziko pamusoro pekutevera kwakakwana kweCD, kwete kungoenderana nekudya chete asiwo kurara kwezvokudya yezvokudya pachayo. "
- Hallert C et al. Uchapupu hwehutachiwana husina hutachiwana hwevatachiona vecyacac pane kudya kwejuten kwemakore gumi. Alimentary Pharmacology & Therapeutics 2002; 16: 1333-1339.
- "Takawana zviratidzo zvinoratidzirwa nehutachiwana hwemavitamini mu 56% hwevarwere vakuru vechireli vakura, kusanganisira vatanhatu pa folate supplementation. Izvi zvinowedzera humwe uchapupu hunoratidza kuti varwere vanonamatira kudya kwakasimba kweGluten kwemakore zvinowanzoita kukura kwevhitamini yakasiyana-siyana kushayikwa kunoreva, kunyanya kushayikwa kwevanhu. "
> Sources:
> American Celiac Task Force, Digestive Disease National Coalition uye Gluten Kusagadzikana Boka reNorth America. Zvokudya zvinorayira uye kushandiswa kwechirwere ichi. Gastroenterology 2005; 128: S121-S127
> US Dept of Labor Bureau of Labor Statistics
> The American Dietetic Association
> Southern Illinois University Didactic Program muDeetetics
> Leffler DA uye al. A inogona kuenzanisa nekuongorora zviyero zvishanu zvekudya zvisina kuwanikwa kweguten kune vanhu vakuru vane chirwere ichi. Alimentary Pharmacology & Therapeutics 2007; 26: 1227-1235
> Niewinski MM. Kufambira mberi mune chirwere chechiliac uye kudya kwema gluten. Nyaya yeAmerica Dietetic Association 2008 Apr; 108 (4): 661-72
> Green PHR uye Cellier C. Chirwere cheCeliac. New England Journal of Medicine 2007; 357: 1731-43.
> Pietzak MM. Kuitevera kwevarwere vane chirwere chechiliac: kubudirira kutevedza nekurapa. Gastroenterology 2005; 128: S135-41
> Mariani P et al. Zvokudya zveGluten-Zvisina Kuwanda: Chimwe Chinhu Chinokonzera Nengozi Yevana Vari Kuyaruka neCeliac Disease? Zvinyorwa zveMwana Gastroenterology & Nutrition 1998; 27: 519-523
> Hallert C et al. Uchapupu hwehutachiwana husina hutachiwana hwevatachiona vecyacac pane kudya kwejuten kwemakore gumi. Alimentary Pharmacology & Therapeutics 2002; 16: 1333-1339.