Meeting the Specific Needs of

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Sodium FreeGluten Free

Making Changes Making small changes to your diet or eating plan

can be exactly what you need for good health and healthy aging. Many diseases and conditions, including allergies, and/or your family history, can require changes in your diet to keep you feeling well and in good health.

Making Changes In many cases, a doctor will prescribe a modified

diet, along with exercise suited to your condition. Sometimes, this diet therapy is nothing more than a good, nutritious diet balanced in carbohydrates, proteins and fats, or one that requires frequent mini-meals. Most special diets can be just as tasty and easy to follow as traditional eating plans.

Celiac Disease What Is Celiac Disease? Celiac disease is a digestive disorder that occurs

in reaction to gluten, a protein found in rye, barley, wheat, and hundreds of foods made with these grains. The body's immune system reacts to the gluten and causes damage to the intestine. Celiac disease, also known as celiac sprue or gluten-sensitive enteropathy, is fairly common. One in 133 Americans has the disorder and needs to follow a gluten-free diet.

Celiac Disease Celiac Symptoms: Digestive Symptoms of celiac disease can vary from mild to

severe. Some people have no symptoms, although they still are developing intestinal damage. Celiac disease is sometimes misdiagnosed as irritable bowel syndrome, Crohn's Disease or gastric ulcers. Digestive symptoms may include:o Abdominal bloating and paino Diarrheao Vomitingo Constipationo Pale, foul-smelling stool

Celiac Disease Celiac Symptoms: Weight Loss Many adults with celiac disease don't have

digestive symptoms at all. But the failure to absorb nutrients may lead to other problems, including weight loss and malnutrition.

Celiac Disease Celiac Disease Trigger Foods Wheat is a staple in Western cultures, so many

common foods contain enough gluten to aggravate celiac disease -- breads, crackers, muffins, pasta, pizza, cakes, and pies. Fried chicken can be off limits, thanks to the breading. Chinese seitan and Japanese udon noodles come from wheat. Rye and barley also contain gluten, so pumpernickel bread, barley soup, and even beer can cause problems for those with celiac.

Celiac Disease Celiac or Wheat Allergy? Celiac disease and wheat allergy both involve the

immune system but the reaction within the body is different. Celiac disease is an autoimmune disease that causes damage to the lining of the intestine. It is a lifelong disorder. Symptoms of wheat allergy include a skin rash, wheezing, abdominal pain or diarrhea. Wheat allergy is often outgrown.

Celiac Disease Celiac Damage in the

Intestine In people with celiac, the

body's immune system is triggered by gluten in food. Antibodies attack the intestinal lining, damaging, flattening, or destroying the tiny hair-like projections (villi) in the small bowel. Damaged villi can't effectively absorb nutrients through the intestinal wall. As a result, fats, proteins, vitamins, and minerals get passed through the stool. Over time, this can lead to malnutrition.

Celiac Disease Gluten Sensitivity People with gluten sensitivity have similar

symptoms, such as abdominal pain, fatigue, or headaches, but they don't have the intestinal damage or more severe consequences of celiac disease. However, a gluten-free diet still will eliminate symptoms.

Celiac Disease Dangers of Untreated Celiac Disease Up to 60% of children and 41% of adults with

celiac disease do not have symptoms. With a damaged intestinal lining, they may not be absorbing nutrients properly and are at risk of malnutrition. People with celiac disease have a higher chance of developing osteoporosis, infertility, and some neurological problems.

Celiac Disease Home Care: Gluten-Free There is no cure for celiac

disease, but strictly avoiding gluten will halt the symptoms and allow the intestine to repair itself. In fact, you may feel better within days of removing gluten from your diet. The most common foods to avoid include pasta, baked goods, and cereal, but you must avoid even small amounts of gluten that could be in other products.

Celiac Disease Beware of Hidden Gluten A wide variety of foods contain gluten, including

processed meat, potato chips, French fries, breaded foods, sauces, and soups. It may be in lipstick or in medicines. You may be able to eat oats if they are not contaminated with wheat, but talk to your health care provider first. Wine and distilled alcohol are generally safe, but most beers are not. Beer is made from grains and does not go through a distilling process.

Celiac Disease Naturally Gluten-Free Many other starches can fill

your gluten-free diet, including potatoes, rice, corn, soy, flax, and buckwheat. Buckwheat is not a type of wheat at all, but a relative of rhubarb that is gluten-free. It's used for Japanese soba noodles, kasha, porridges, pancakes, and baking. Processed foods, such as corn chips, should be examined carefully to be sure they have not been prepared with a gluten ingredient, such as wheat flour.

Celiac Disease Living With Celiac Disease Meat, fish, rice, beans, fruits, and vegetables are

all fine for people with celiac disease, when prepared without ingredients that contain gluten. Some restaurants now offer gluten-free meals. And many stores carry gluten-free versions of pasta, pizza, and cookies. Strict adherence to the diet can prevent health problems. If you don't see improvement, you may need to look for hidden sources of gluten.

Celiac Disease There is a way to convert recipes that contain

gluten into gluten-free recipes. You will need to experiment with the ingredient substitution, length of time, and temperature used for baking. Here are some substitutions that you can make in your recipes:

For wheat flour, substitute one of these:o Cornstarch, potato starch, arrowroot starch, rice flour,

quick-cooking tapioca, plain cornmeal, potato flour

Type 2 Diabetes What Is Type 2 Diabetes? Type 2 diabetes strikes people of all ages, and

early symptoms are subtle. In fact, about one out of three people with type 2 diabetes don't know they have it. This chronic condition thwarts the body's ability to use the carbohydrates in food for energy. The result is elevated blood sugar. Over time, this excess sugar raises the risk for heart disease, loss of vision, nerve and organ damage, and other serious conditions.

Type 2 Diabetes Diabetes Warning Sign: Thirst People with type 2 diabetes frequently have no

symptoms. When symptoms do appear, one of the first may be an increase in thirst. This is often accompanied by additional problems, including dry mouth, increased appetite, frequent urination -- sometimes as often as every hour -- and unusual weight loss or gain.

Type 2 Diabetes Diabetes Warning Sign: Thirst People with type 2 diabetes frequently have no

symptoms. When symptoms do appear, one of the first may be an increase in thirst. This is often accompanied by additional problems, including dry mouth, increased appetite, frequent urination -- sometimes as often as every hour -- and unusual weight loss or gain.

Type 2 Diabetes Diabetes Warning Sign: Infections In most cases, type 2 diabetes is not discovered

until it takes a noticeable toll on health. One red flag is troubling infections, such as:

Cuts or sores that are slow to heal Frequent yeast infections or urinary tract

infections Itchy skin, especially in the groin area

Type 2 Diabetes Risk Factors You Can Control Some health habits and medical conditions

related to your lifestyle can increase the odds of developing type 2 diabetes, including:o Being overweight, especially at the waisto A sedentary lifestyleo Smokingo A diet high in red meat, processed meat, high-fat dairy

products, and sweetso Abnormal cholesterol and blood fats, such as HDL "good"

cholesterol lower than 35 mg/dL or a triglyceride level over 250 mg/dL

Type 2 Diabetes How Does Insulin Work? In a healthy person, insulin

helps turn food into energy -- in an efficient manner. The stomach breaks down carbohydrates from food into sugars, including glucose. Glucose then enters the bloodstream, which stimulates the pancreas to release insulin in just the right amount. Insulin, a hormone, allows glucose to enter cells throughout the body, where it is used as fuel. Excess glucose is stored in the liver.

Type 2 Diabetes Type 2 Diabetes:

Metabolism Mishaps In type 2 diabetes, the cells

cannot absorb glucose properly. That means glucose levels in the blood become elevated. If you've developed a condition called insulin resistance, the body makes excess insulin, but the muscle, liver, and fat cells do not use or respond properly to the insulin. With long-standing uncontrolled type 2 diabetes, the pancreas will reduce the amount of insulin it produces.

Type 2 Diabetes Managing Diabetes: Diet Fortunately, controlling blood sugar levels by

changing diet can also cut your risk of complications. People with type 2 diabetes should carefully monitor carbohydrate consumption, as well as total fat and protein intake, and reduce calories. Ask your doctor for a referral to a registered dietitian to help you with healthy choices and an eating plan that will work for you.

Type 2 Diabetes Managing Diabetes: Exercise Routine exercise, such as strength training or

walking, improves the body's use of insulin and can lower blood sugar levels in people with type 2 diabetes. Being active also helps reduce body fat, lower blood pressure, and protect against heart disease. People with type 2 diabetes should try to get 30 minutes of moderate exercise on most days of the week.

Type 2 Diabetes Long-Term Damage: Arteries Over time, untreated type 2 diabetes can damage

many of the body's systems. About two out of three people with diabetes die of heart disease. Having diabetes also puts you at a two to four times higher risk for stroke. People with diabetes are likely to develop plaque in their arteries, reducing blood flow and increasing risk of clots. This hardening of the arteries (atherosclerosis) raises the risk of heart attack and stroke.

Type 2 Diabetes Long-Term Damage: Kidneys The longer you have diabetes, the greater the risk

of developing chronic kidney disease. Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2008. Controlling risk factors such as uncontrolled diabetes, high blood pressure, and high cholesterol reduces your risk of developing this complication. Annual screening for kidney disease and medications, which slow the development and progression of kidney disease, are used to reduce your risk of kidney failure.

Type 2 Diabetes Long-Term Damage: Eyes High blood sugar can damage the tiny blood

vessels that bring oxygen and nutrients to the retina, a critical part of the eye. This is known as diabetic retinopathy, and it can cause progressive, irreversible vision loss. It is the leading cause of new cases of blindness in people between the ages of 20 and 74. Pools of blood, or hemorrhages, on the retina of an eye are visible in this image.

Type 2 Diabetes Preventing Type 2 Diabetes One of the most astonishing things about type 2

diabetes is that such a life-altering condition is often preventable. To lower your risk, follow the same guidelines for warding off heart disease:

Eat a healthy diet. Exercise for 30 minutes, five days a week. Maintain a healthy weight. Talk to your doctor about being screened for

prediabetes. In people with prediabetes, lifestyle changes and

medication can help prevent the progression to type 2 diabetes.

Type 2 Diabetes The Healthy Diet While you should be able to eat most of the same

things as everyone else, people with diabetes often have to limit the amounts they eat, prepare food in different ways than they may have been used to, and think about when they eat.

Another important element of a healthy diet is portion control. Your health-care team can help you learn to gauge correct portion sizes, which are often smaller than we've come to expect in the age of super-sizing. For example, one serving of meat is about the size of a deck of cards, and a serving of pasta is about the size of half a tennis ball.

Type 2 Diabetes Sugar: Most experts now agree that it's OK for people with

diabetes to have a little dessert now and then. Sugar is just another form of carbohydrate, so you can substitute a sweet for another starch (say, bread or pasta) in your eating plan. But keep in mind that most sugary foods have lots of calories, and few of the nutrients your body needs.

Fat: Too much fat is bad for anyone, but especially for people with diabetes. A high-fat, high-cholesterol diet increases your risk of heart and artery disease -- and people with diabetes already are more likely to get these diseases. And, of course, eating too much fat can make you fat. So choose lean cuts of meat, or fish or skinless poultry. Switch to skim or low-fat dairy products. Cut out butter, and substitute low-fat margarine or other seasonings such as broth, herbs, and fruit juices.

Type 2 Diabetes Salt: People with diabetes are at higher risk of high

blood pressure, which can be affected by the sodium in your diet. To cut down on salt, limit packaged convenience foods and fast food, as well as pickles and salty condiments like mustard. Use herbs, garlic, or fruit juices instead of table salt.

Fiber: Fiber is the non-digestible carbohydrate found in plant-based foods. It keeps you feeling full longer, and may also help lower blood sugar and blood fat levels. Choose whole grains and cereals, and eat lots of fruits and veggies, to help you reach a healthy goal of 25 to 35 grams of fiber per day.

Type 2 Diabetes Alcohol: If your doctor approves, you may include small

amounts of alcoholic beverages in your healthy eating plan. (The American Diabetes Association recommends no more than two drinks a day for men and no more than one a day for women.) If you do drink alcohol, never have it on an empty stomach. And remember that alcohol tends to be high in calories and has few nutrients. Choose light beer or dry wine, and sugar-free mixers.

Artificial sweeteners: Unlike sugar, artificial sweeteners have no calories, don't raise blood-sugar levels, and don't have to be counted as a starch in your meal plan. But don't overdo it: Many artificially sweetened foods still have plenty of calories and few vitamins and minerals.

Lactose Intolerance What is lactose intolerance? Lactose intolerance is the inability to digest and

absorb lactose (the sugar in milk) that results in gastrointestinal symptoms when milk or food products containing milk are consumed.

Lactose Intolerance What causes lactose intolerance? Lactose is a large sugar molecule that is made up of two

smaller sugars, glucose and galactose. In order for lactose to be absorbed from the intestine and into the body, it must first be split into glucose and galactose. The glucose and galactose are then absorbed by the cells lining the small intestine. The enzyme that splits lactose into glucose and galactose is called lactase, and it is located on the surface of the cells lining the small intestine.

Lactose intolerance is caused by reduced or absent activity of lactase that prevents the splitting of lactose (lactase deficiency). Lactase deficiency may occur for one of three reasons, congenital, secondary or developmental.

Lactose Intolerance What are the symptoms of lactose intolerance? The common primary symptoms of lactose

intolerance are gastrointestinal include:o Abdominal pain, diarrhea, and flatulence (passing gas)

Symptoms occur because the unabsorbed lactose passes through the small intestine and into the colon.

The severity of the symptoms of lactose intolerance varies greatly from person to person. One reason for this variability is that people have different amounts of lactose in their diet; the more lactose in the diet, the more likely and severe the symptoms.

Lactose Intolerance What are the sources of lactose in the diet? Although milk and foods made from milk are the

only natural sources of lactose, lactose often is "hidden" in prepared foods to which it has been added. People with very low tolerance for lactose should know about the many food products that may contain lactose, even in small amounts. Food products that may contain lactose include:o bread and other baked goods; processed breakfast

cereals; instant potatoes, soups, and breakfast drinks; margarine; lunch meats (except those that are kosher); salad dressings; candies and other snacks; and mixes for pancakes, biscuits, and cookies.

Lactose Intolerance How is lactose intolerance treated? Dietary changes The most obvious means of treating lactose

intolerance is by reducing the amount of lactose in the diet. Fortunately, most people who are lactose intolerant can tolerate small or even moderate amounts of lactose. It often takes only elimination of the major milk-containing products to obtain sufficient relief from their symptoms.

Most supermarkets carry milk that has had the lactose already split by the addition of lactase. Substitutes for milk also are available, including soy and rice milk.

Lactose Intolerance For individuals who are intolerant to even small

amounts of lactose, the dietary restrictions become more severe. Any purchased product containing milk must be avoided. It is especially important to eliminate prepared foods containing milk purchased from the supermarket and dishes from restaurants that have sauces.

Low Sodium Diet A low sodium diet is a diet that includes no

more than 1,500 to 2,400 mg of sodium per day. (One teaspoon of salt has about 2,300 mg sodium.)

The human minimum requirement for sodium in the diet is about 500 mg per day, which is typically less than one-sixth as much as many diets "seasoned to taste". For certain people with salt-sensitive blood pressure, this extra intake may cause a negative effect on health.

Low Sodium Diet A low sodium diet in Caucasians has a useful

effect to reduce blood pressure, both in people with hypertension and in people with normal blood pressure.

Low Sodium Diet High sodium content Sodium occurs naturally in most foods. The most common form

of sodium is table salt. Sodium is also added to various food products. Some of these

added forms are MSG, sodium nitrite, baking soda, and sodium benzoate.

These are ingredients are in condiments and seasonings such as Worcestershire sauce, soy sauce, onion salt, garlic salt, and bouillon cubes.

Processed meats, such as bacon, sausage, and ham, and canned soups and vegetables are all examples of foods that contain added sodium.

Fast foods are generally very high in sodium. Also, processed foods such as potato chips, frozen dinners and cured meats have high sodium content.

Low Sodium Diet Low sodium content Unprocessed, fresh foods, such as fresh fruits, vegetables,

lean meats, poultry, fish and unprocessed grains are low sodium.

The availability of low sodium foods is increasing; Due to the difficulty of finding low sodium versions of processed foods that are naturally high in, or contain medium levels of, sodium (such as cereals, soups, and canned seafood), food markets and distributors have recently started opening online businesses that focus on marketing low sodium products.

Just like low carb or low calorie products, low sodium products began to take their own place in food marketers’ shelves. Many low sodium products have crossed over from the hospitality industry and are now available online, such as low sodium soup bases.

Low Sodium Diet Other foods that are low in sodium include: Seasonings: Black, cayenne, or lemon pepper, mustard, some chili

or hot sauces Herbs: Dried or fresh garlic, garlic/onion powder (no salt), dill,

parsley, rosemary, basil, cinnamon, cloves, paprika, oregano, ginger, vinegar, cumin, nutmeg

Fresh fruits and vegetables (celery, carrots, beets, spinach) Dried beans, peas, rice, lentils Macaroni, pasta, noodles, rice, barley (cooked in unsalted water) Honey, sugar Unsalted butter Unsalted dry curd cottage cheese Fresh beef, pork, lamb, fish, shrimp, egg Skim milk, yogurt Hot cereals Club soda, coffee, seltzer water, soy milk, tea

Vegetarian A well-planned vegetarian diet can meet the

needs of people of all ages, including children, teenagers, and pregnant or breast-feeding women. The key is to be aware of your nutritional needs so that you plan a diet that meets them.

Types of vegetarian diets When people think about a vegetarian diet, they

typically think about a diet that doesn't include meat, poultry or fish. But vegetarian diets vary in what foods they include and exclude:

Vegetarian Lacto-vegetarian diets exclude meat, fish,

poultry and eggs, as well as foods that contain them. Dairy products, such as milk, cheese, yogurt and butter, are included.

Lacto-ovo vegetarian diets exclude meat, fish and poultry, but allow dairy products and eggs.

Ovo-vegetarian diets exclude meat, poultry, seafood and dairy products, but allow eggs.

Vegan diets exclude meat, poultry, fish, eggs and dairy products — and foods that contain these products.

Vegetarian Vegetarian diet

pyramid A healthy diet takes

planning, and a food pyramid can be a helpful tool. The vegetarian pyramid outlines food groups and food choices that, if eaten in the right quantities, form the foundation of a healthy vegetarian diet.