Izigulane ezingenazo i-Gluten-Free, Ukucebisa ngeZondlo kubalulekile
Abantu abanezifo ezinqabileyo bajongene nocelomngeni obunzima, nokuba ngaba balandela ukutya okungekho gulen. Okokuqala, kufuneka bafumane (kubangangoko kunokwenzeka) ukusuka kwi- malabsorption yezondlo ezenzekayo ngelixa besidla i-gluten, enokuthi ibangele i-anemia, i-bone mineral osensity and osteoporosis , i-vitamin defence, kunye nezinye iingxaki .
Njengokuba oko kwakungekho ngokwaneleyo, ngokungafani nemveliso ye-gluten kwivenkile, iimveliso ezimbalwa zentengiso ye-gluten ziphuculwa okanye ziqiniswe ngeevithamini ezongezelelweyo, okwenza kube nzima kubantu abanezifo ezinqabileyo ukuba bafumane amavithamini okwaneleyo ekudleni kwabo.
Imveliso engekho iGluten ihlala iphantsi kuma-vithamini e-B, i-calcium, i-vitamin D, isinyithi, i-zinc, i-magnesium kunye ne-fiber. Enyanisweni, uphando lubonise ukuba abantu abanezifo eziqhelile besengozini yemiphumo emibini ye-gluten-free diet, kubandakanywa nesiganeko sokwanda kunene.
Kutheni i-Dietitian ibalulekile kwimpilo yakho
Ngenxa yezo zonke izingozi zondlo, i-American Celiac Disease Alliance, i-Digestive Disease National Coalition, iGlinten Inxerance Group yaseNyakatho Melika, kwaye oogqirha abaninzi bancomela ukuba i-dietitian ebhalisiweyo kufuneka ibe yinxalenye yeqela lokunakekelwa kwezempilo elijongene nesimo sengondlo sesigulane kunye nokuthotyelwa kokutya.
Ukongezelela, uphando lubonisa ukuba kwabanye abantu abanezifo ezingapheliyo, isizathu esikhulu sokuba bangakwazi ukuhlala bengenanto ye-gluten kukuba abaqondi ukutya. Ngaba kwakungayi kuba lukhululo lokufumana uncedo kwi-professional?
Yintoni eyahlukileyo phakathi kwesondlo kunye neDetitian, kwaye yintoni efuneka ndiyibonayo?
E-US, abantu abanaso nasiphi na isifo, kubandakanya isifo se-celiac, abadinga ukucebisa isondlo kufuneka badibane neDetetitian Dietitian (ebizwa ngokuba yi-RD).
Ii-RD zigqibile iimfuno zezifundo kunye namava asekwe yiKhomishini ye-American Dietetic Association kwi-Dietetic Registration, kubandakanywa ubuncinci be-degree-bachelor degree ukusuka kwikholeji eyamkelwe okanye eyunivesithi kunye neprogram eqinisekisiwe yezobugcisa. I-RDs kufuneka iphinde iphumelele uvavanyo oluqinileyo lweengcali kwaye ithathe inxaxheba kwiinkqubo eziqhubekayo zemfundo eziqhubekayo zokugcina iinkcukacha zazo.
Amanye ama-RD aphethe ama-degree aphezulu kunye neziqinisekiso ezongezelelweyo kwiindawo ezizodwa zemisebenzi. Ngokubaluleka kubantu abanezifo eziqhenqileyo, iSiseko seSizwe soKwazisa okuCeliac siqinisekisa abadli bezithuthi ezibhalisiweyo njengenxalenye yeProgram ye-Gluten-Free, yeMfundo, noQeqesho (GREAT). ABAKHULU kwi-Dietiti baQeqesho oluQhubekayo lwezeMfundo (CPE). (Kukho neeprogram ze-GREAT zokuqinisekisa abapheki, abasebenzi bezokutya, kunye nezinye izigulane zezibhedlele.
Ngokungafani ne-RD engqiniswangayo, akukho mgangatho wesizwe kunye neengqinisiso ezihambelana nezihloko ze "dietitian" (ngaphandle kwegama elithi "ukubhaliswa") okanye "isondlo" kwaye akukho siqinisekiso sokuthi umntu usebenzisa ezo zihloko uye waba nemfundo emiselweyo yokutya kunye nokutya .
Ngamanye amaxesha iDetetitian Dietitian inikezwa ngesihloko esithi "Isondlo" (umzekelo, kwimpilo yoluntu, kwii-specialist clinics, nakumaziko emfundo). Ngamanye amaxesha, nangona kunjalo, ezi zihloko zisetyenziswe ngabantu akukho qeqesho olusemthethweni. Ngaphandle kokuba isondlo sezondlo sinama-initials "RD" emva kwegama lakhe, kufuneka uqinisekise ngokuqinisekileyo iziqinisekiso zomntu.
Ngokwe-Bureau of Labor Statistics kwiSebe lezeMisebenzi yase-United States, ama-48 anemithetho elawula iidloetetics, amazwe angama-35 afuna ukuba abasebenzi babe neelayisenisi kwaye 12 bafuna ukuba baqinisekiswe ngurhulumente, abazimeleyo ngesatifikethi nangayiphi na imibutho yobungcali.
Qinisekisa ukuba uqeqesho lwenzululwazi lwakho luhlangabezane neemfuno zorhulumente (okanye ilizwe) apho akwenza khona.
Ndifumanaphi iDetetitian Registered?
E-US, unokutyelela i-American Dietetic Association Yifumana isayithi yeNgcali yeZondlo ukufumana isondlo esithile kufuphi nawe. Ngokuqinisekileyo, unokubuza ugqirha wakho, okanye amalungu eqela lakho lokuxhasa isifo se-celiac, ukuba ngaba unokuncoma umqeqeshi wezondlo.
E-Australia, tyelela i-myDR.com.au; eCanada, iiDetiti zaseKhanada; e Hong Kong, eHong Kong Dietitians Associated Limited; e-Ireland, i-Irish Nutrition kunye ne-Dietetic Institute; eNew Zealand, i-New Zealand Dietetic Association; e-UK, kwi-Nutri-People okanye kwi-British Nutrition Foundation.
Ngaba Inqwelo-mali yam iya kuhlawula unyango lwezonyango kwi-Celiac Disease?
Ngokomgaqo odibeneyo ovela kwi-American Celiac Task Force (ngoku i-American Celiac Disease Alliance), i-Digestive Disease National Coalition, kunye neGluten Intolerance Group yaseMntla Melika, "Ulwaphulo lwezonyango lwonyango luphela lonyango olwamukelweyo lwezifo eziphefumlelweyo ... Ngenxa izingozi zokutya okunxulumene nesifo esiqhoqhoqho, isitya se-dietarian esibhalisiweyo kufuneka sibe yinxalenye yecandelo lokunakekelwa kwezempilo elijongene nesimo sengondlo kunye nokuthotyelwa rhoqo. "Ngenxa yezi khokelo, iinkampani ze-inshorensi kufuneka zihlawule ukubonisana nezigulane zezifo zeliliac kunye ne-RDs.
Sekunjalo, kukho ithuba elihle lokuya kufuneka liqinisekise inkampani yakho yomshuwalense ukuba ufuna unonophelo kwi-dietitian. Iziganeko kuphela zezigulane ezinezifo eziqhekezayo nesifo sikashukela. Ngenxa yokuba i-Medicare iye yalawula ukuba izigulane ezineesifo sikashukela zidinga ukunikwa ngcebiso ngezokwelapha, ezinye iinkampani zomshuwalense ziya kuvuma ukuncediswa kokondla kwabashukela besifo sikashukela .
Ukuba ujamelene nomngeni wokukholisa inkampani yakho yenkampani yomshuwalense ukuba ivume, kufuneka uqinisekise ukuba unyango lwezonyango oluvela kwi-dietitian lubhalisiwe (1) oluyimfuneko yonyango kwimeko yakho kunye (2) nomgangatho wokunyamekela izigulane ezinokwakheka isifo . Iziphakamiso ezilandelayo zinokukunceda:
- Zama ukuba "nencoko" eninzi ngokubhaliweyo. Ukuba uthetha nenkampani yomshuwalense ummeleli wefowuni, bhala igama lomntu othetha naye kunye nomhla, uze uthathe amanqaku kwizinto ezithethwa.
- Okona ubuncinci, thumela inkampani yomshuwalense umyalelo wonyango olululisayo kumgqirha wakho, okanye ukuthunyelwa. Kulungile, buza ugqirha wakho - kunye nesondlo sokutya, ukuba sele sele ucebisane nawe-ukuba ubhale ileta kwinkampani yomshuwalense egameni lakho ichaza ukuba kutheni ukubonisana kuyimfuneko yonyango kwaye ukuba le nyango yimiqathango yokunakekelwa njengamanje . Ukuba unayo nayiphi na iimeko ezinokuthi ziqwalaselwe iingxaki zondlobungqina, ezifana ne-anemia okanye i-vitamin deficiencies, khankanya ukuba kwincwadi yakho kunye nenkampani yomshuwalense kwaye ukhumbuze ugqirha wakho kunye nesondlo sokutya ukuze ubhekise kwiileta zabo, nazo. Ukuba bathumela iileta, thola iikopi uze ubafake kunye neenkcukacha zakho kwi-inshorensi yakho.
- Ukubonakalisa ukuba iingcebiso ezivela kumfundi wezondlo ngumgangatho wokunyamekela izigulane ezinezifo ezinqabileyo, kunceda ukuthumela iikopi zamanqaku athile avela kwiincwadi zonyango ezigxininisa le ngongoma. Kancinci, zibandakanya icatshulwa kumaphepha abalulekileyo. A bambalwa abonakala ngezantsi, ekupheleni kweli nqaku.
- Nanini na xa ufaka khona nawaphi na amaxwebhu kunye neenkcukacha zakho (ikopi zeencwadi, iziphumo zovavanyo lwezonyango, amanqaku, njl.), Qi ni sekise ukuba ubhale kwileta oko udibeneyo.
- Njalo xa uthumela nantoni na ngeposi kwiinkampani yakho yomshuwalense, ubabize ngeveki kamva ukuqinisekisa ukuba amaxwebhu afakwe "kwinkqubo" yawo.
- Ukuba inkampani yakho yomshuwalense iphika ukuvunywa kwangaphambili okanye iphika ibango lakho, thola oko kufuneka ukwenze ukuze ubhenele ngokusemthethweni isigqibo. Xa ukwenza isibheno sakho, thumela ikopi yazo zonke iibhalelwano kunye nabo kunye nawaphi na amaxwebhu axhasayo, nokuba ngaba uyithumele ngaphambili.
- Ukuba i-inshurensi yakho inikezwa ngumqeshi wakho, cela umphathi wakho weenzuzo zokuqeshwa. Umphathi weenzuzo ubeka ubunzima obukhulu kunye nenkampani yomshuwalense kunokuba uyenze njengomntu.
Amanqaku okufaka (okanye ukucaphula) ngeenkcukacha kunye nenkampani yakho yomshuwalense:
- Leffler DA kunye no-al. Ukufunda okuthelekisayo malunga neendlela ezintlanu zokunamathela kokutya kwe-gluten-ezamahala kubantu abadala abanezifo ezinqabileyo. I-Pharmacology ne-Therapeutics e-2007; 26: 1227-1235
- "Nangona iimvavanyo ze-serologic zangoku zinemvakalelo ephakamileyo kakhulu kunye neenkcukacha zokuxilongwa kwezifo ze-celiac, azikwazi ukufaka indawo yokuhlolwa kokutya okunomsoco ekuhloleni ukunyanzeliswa kokutya kwe-gluten."
- Niewinski MM. Ukuqhubela phambili kwisifo se-celiac kunye ne-gluten-free food. Umbhalo we-American Dietetic Association 2008 Apr; 108 (4): 661-72
- "Olu hlalutyo lugxininisa iinkcukacha kwi-gluten-free food and the importance of experting intensive advice counseling kuzo zonke izigulane ezinezifo ezinqabileyo ... I-gluten-free food is complex and patients need a comprehensive diet nutritionist.
- I-PHR ebanzi kunye neCellier C. Izifo zeCeliac. I-New England Journal of Medicine 2007; 357: 1731-43.
- Iqela lezononophelo lempilo kufuneka libandakanye isondlo sokutya esinezixhobo ezijongene nesimo sengondlo kunye nokunyanzeliswa kokutya rhoqo rhoqo .Umntu ojongene nesondlo kufuneka ahlole izinga lokunamathela [kwi-gluten-free diet] kunye nezizathu ezinokungaboni. .. "
- Pietzak MM. Ukulandelwa kwezigulane ezinezifo eziqhekezayo: ukufezekisa ukuthotyelwa kwonyango. Gastroenterology 2005; 128: S135-41
- "Ukuthotyelwa kwe-gluten-free-food, ikakhulukazi e-United States, kuyinselele kakhulu ... .Kunjalo, indlela yeqela ekulandeleni isigulane esandul 'ukufumana isigxina kufuneka ifake ... isiluleko sezonyango ezibhaliswe ngumculi we-dietician ..."
- Mariani P et al. I-Gluten-Free Simahla: Isisombululo Somngcipheko Wezilwanyana Ngezifo Zama-Celiac? Umbhalo we-Gastroenterology & Nutrition 1998; 27: 519-523
- "Nangona kwiminyaka edluleyo kukho ukuphucula okukhulu kwizixhobo zokuxilonga kwi-CD, sikholelwa ukuba ixesha lifikile ukunikela ingqalelo ngakumbi kwiingxaki malunga nokulandelelana okufanelekileyo kweCD, kungekhona nje ukuthotyelwa kokutya kodwa kunye nesondlo sokutya yokutya. "
- Hallert C et al. Ubungqina bendawo engama-vitamin ehluphekileyo kwizigulane eziqinileyo kwi-gluten-free diet for 10 years. I-Pharmacology & Therapeutics ka-2002; 16: 1333-1339.
- "Sifumene iimpawu ezibonakalisa isimo se-vitamin esimpofu kwi-56% yezigulane ezingamalungu angama-celiac aphezulu, kuquka ezintandathu kwi-supplementation ye-folate." Oku kubonisa ubungqina bokuba izigulane ezinamathele ekudleni okungenasiphelo kwe-gluten kwiminyaka zixhomekeke ekuphuhlisweni kwevithamini ezahlukahlukeneyo ukungabikho kwemfuno, ngokukodwa ukulahleka komntu. "
> Imithombo:
> I-American Celiac Task Force, i-Digestive Disease National Coalition kunye neGluten Inxerance Group yaseMntla Melika. Izikhokelo zeesondlo kunye nokuphunyezwa kwezifo ezingenazo. I-Gastroenterology 2005; 128: S121-S127
> I-US Dept yeBasebenzi kwiBusiness Statistics Statistics
> I-American Dietetic Association
> Iprogram yaseYunivesithi yaseMelika yase-Illinois kwiDeetetics
> Leffler DA kunye al. Ukufunda okuthelekisayo malunga neendlela ezintlanu zokunamathela kokutya kwe-gluten-ezamahala kubantu abadala abanezifo ezinqabileyo. I-Pharmacology ne-Therapeutics e-2007; 26: 1227-1235
> Niewinski MM. Ukuqhubela phambili kwisifo se-celiac kunye ne-gluten-free food. Umbhalo we-American Dietetic Association 2008 Apr; 108 (4): 661-72
> I-PHR yeGreen kunye neCellier C. Izifo zeCeliac. I-New England Journal of Medicine 2007; 357: 1731-43.
> Pietzak MM. Ukulandelwa kwezigulane ezinezifo eziqhekezayo: ukufezekisa ukuthotyelwa kwonyango. Gastroenterology 2005; 128: S135-41
> Mariani P et al. I-Gluten-Free Simahla: Isisombululo Somngcipheko Wezilwanyana Ngezifo Zama-Celiac? Umbhalo we-Gastroenterology & Nutrition 1998; 27: 519-523
> Hallert C et al. Ubungqina bendawo engama-vitamin ehluphekileyo kwizigulane eziqinileyo kwi-gluten-free diet iminyaka eyi-10. I-Pharmacology & Therapeutics ka-2002; 16: 1333-1339.