I have long been concerned about the nutritional adequacy of the diets of most of our senior citizens whether resident in their own homes or in various forms of care. Very often, when left to their own devices many older people cannot be bothered to prepare proper meals and many of them fall into a toast and tea or coffee regime: they do what is easiest without recognising or realising the longer term consequences of this behaviour. They often become seriously under nourished. Many do not maintain an adequate intake of fluids,  particularly water, sometimes due to fear of incontinence or of inability to get to the toilet in time, even when they have dementia. Dehydration may cause brain shrinkage, headaches, memory loss and an inability to think clearly and logically. It can also cause serious kidney malfunction.

As we age, we often become less active physically and stress levels should diminish all of which reduces our energy intake requirements. A situation which, in combination with a declining digestive system, amplifies the requirement to maintain a nutritionally adequate and balanced diet. This also maintains the immune system, body warmth, energy levels, mental activity and the body’s natural healing and repair functions. Almost conversely, it becomes more critical that as the food quantity diminishes the need for appropriate fundamental quality and adequate nutritional balance increases. To avoid doing the elderly a grave disservice we need to better understand and provide for their nutritional needs taking into account the issues that also arise from their aging metabolisms.

I also believe that it is important for the elderly to remain as physically active as possible in order to maintain bone and muscular strength as well as their balance and blood circulation. Sadly, there are many older men in nursing homes, and elsewhere, who appear to be losing weight and muscle tone through being inadequately fed: quantity and quality wise. There are also increasing numbers of elderly women with open, ulcerated sores on their shins that will not heal: due often to the combined lack of an adequate diet and physical activity regime causing poor blood circulation. They all require quality sources of protein and vegetables in their diets not snacks, convenience foods, bread, cakes and biscuits etc.

The maintenance of good nutritional status in this group is critical. The elderly have the right to enjoy healthy, productive and fulfilling lives. Better nutrition will ensure greater independence for longer, better quality of life, higher immunity, lower mortality and less need to progress to higher, more expensive forms of care.

All human beings need to eat their body weight in quality food per month if they are to maintain body weight and good health. This requirement is inescapable. If there is insufficient food the outcome is loss of weight, malnutrition and a declining immune system leading to poorer quality of life, ill health and reduced life expectancy.

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Last week I mentioned in High Sodium Levels Linked to Cancer, how Dr. Max Gerson provided us all with valuable information about the health benefits of eating high proportions of fresh fruit and vegetables, instead of foods high in acidity and sodium. This week I will build on this by looking at several long lived populations from history. By studying the diets of these long lived populations, the benefits of reducing foods with high proportions of acid and sodium from our diets are evident. Three long lived populations we should study the diet’s of are: the Hunzas in the Himalayas, Peruvian natives living in the high Andes and the Okinawans of Northern Japan.

Both lots of mountain dwellers lived into active, healthy old age (110 -120 years) on an essentially alkaline diet of fresh, seasonal fruit and vegetables watered by glacier induced mineral rich irrigation water. Both the Hunzas and the Peruvian natives in the high Andes, consumed alcohol and animal proteins and fats, milk etc sparingly. The Okinawans also live into healthy old age on a traditional diet of mineral rich seafood and seaweed, tofu, miso, rice, fruit and vegetables. Similarly, their traditional diet is also more alkaline than the typical Western diet.

Quite obviously in Western communities, the combination of constipation, excess acidity and sodium levels, lack of exercise and the consumption of energy dense, mass produced and often over-processed and nutritionally deficient convenience foods high in fat, salt and sugar is proving to be a disaster. Heart disease, cancer, diabetes, macular degenerative eye diseases, Coeliac Disease, asthma, osteoporosis, obesity and declining life expectancy, under our regime, are all on the rise: a very sad reflection and commentary upon our dietary and lifestyle choices. A situation, which despite our knowledge, we appear reluctant to address.

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It should surprise you to learn that going on a gluten free diet can reduce or eliminate Rheumatoid Arthritis symptoms.

For example: in 2001, one US study confirmed that going gluten free clinically benefits rheumatoid arthritis patients. In this study 66 patients with active rheumatoid arthritis were randomly assigned to either a vegan gluten free diet (38 patients) or a well balanced non-vegan diet that included gluten (28 patients). The tests subjects participated in the study for 12 months and were assessed at the start of the test, as well as at 3, 6, and 12 month intervals. Researchers also measured levels of antibodies against gliadin.

These were individuals who had rheumatoid arthritis. Prior to the study none of them had been diagnosed with gluten sensitivity. The results of the study showed that, 22 patients in the gluten free group and 25 in the non gluten free group completed 9 months or more on the diet regimes. Of those who completed the study 40.5 % (9 patients) in the gluten free group experienced significant improvement in their rheumatoid arthritis symptoms, compared to 4 % (1 patient) in the non gluten free group. Also the anti-gliadin antibody levels decreased in the gluten free group but not in the other group.

Going gluten free may also help individuals who have osteoarthritis the most common and oldest type of arthritis. Osteoarthritis exists as two different types: primary osteoarthritis and secondary osteoarthritis.

Primary osteoarthritis is the “wear and tear” form of osteoarthritis. As each of us gets older, it is likely that we will have some degree of primary osteoarthritis. Although osteoarthritis is widespread and can be traced to the dawn of human kind (Ice Age skeletons showing osteoarthritis have been found), its causes are not known. It is thought to be genetically linked, and some researchers speculate it could also be autoimmune in origin.

Secondary osteoarthritis is arthritis that has an apparent cause, such as an injury, heredity, obesity or something else. That “something else” might easily be gluten sensitivity.

Whatever researchers have to say, individuals with osteoarthritis who have tried a gluten free diet give testament to its effectiveness.

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Autoimmune diseases such as rheumatoid arthritis can cause osteoporosis, so can gluten sensitivity. In a 2005 study, researchers evaluated 266 individuals with osteoporosis, along with 574 without the condition, to identify the prevalence of coeliac disease. They discovered that close to 5 % of people with osteoporosis had a positive blood test for coeliac disease, which is significantly higher then in the individuals without osteoporosis who only had 1% that tested positive for coeliac disease. These finding are clear enough that the researchers recommended blood tests for gluten anti-bodies in all patients with osteoporosis.

As amazingly high as this statistic is, we need to keep in mind that blood testing for coeliac disease misses a significant number of individuals who are gluten sensitive; it is these individuals that may already be on the way to losing bone density.

Osteopemia and osteoporosis can often be reversed, but the condition must be treated correctly. This does not always happen due to misdiagnosis, as the following case suggests.

Willow, a post menopausal woman had her first bon scan in 1991 because osteoporosis ran in her family and because she was thin and small boned. She was not surprised when she was diagnosed with osteoporosis. In an attempt to stop and reverse the disorder her rheumatologist tried the medications available at that time Fosamax and Actonel, both of which failed to help Willow.

Several years passed and the disease progressed. In 2003 Willows osteoporosis specialist prescribed a new medication. Despite her diligence in taking this course of treatment, it also failed to stop the degeneration of her bones. It was by either luck or instinct that Willow demanded to be tested for coeliac disease. Her husband had been diagnosed with coeliac disease in 1982, so she had kept up to date on coeliac disease research. Although she had not suffered from any symptoms of coeliac disease, she did not have diarrhoea, weight loss, anaemia or other symptoms, she asked her doctor to run a tissue transglutaminase blood test (a test for gluten sensitivity). The doctor and laboratory were unfamiliar with the blood test, but they learned how to do it. To everyone’s surprise, except possibly Willow’s, the tests came back positive. She went on a gluten free diet, gained over 6kg and has continued to see an improvement in her bone density. A gluten free diet came to her rescue.

Willow’s experience is not an anomaly. As far back as 1996, research has shown that going on a gluten free diet would reverse bone density loss, even in patients who showed no symptoms of malabsorption, normally the primary reason why osteoporosis occurs in people with coeliac disease ( In cases of malabsorption, the body does not absorb minerals and other nutrients necessary for bone growth. Porosity then results). In that study of 63 patients, every patient improved when they followed a gluten free diet.

These improvements are not short term only. Authors of a 5 year follow up study of coeliac disease patients who adhered to a gluten free diet said, “According to our results, bone disease in coeliac patients is cured in most patients during 5 years on a gluten free diet. The improvement in BMD (bone mineral density) mostly occurred already within the first year after the establishment of a gluten free diet”.

The lesson to be learned: if you have been diagnosed with osteopemia or osteoporosis and you haven’t seen improvement with all you have tried, go gluten free. The diet may save you from pain and suffering.

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Coeliac Disease and Gluten Sensitivity may come from genetic pre-disposition, long term deterioration of the digestive system and general ageing.

Sometimes a severe viral infection and /or its treatment may trigger the condition.

People often mention a severe illness and anti-biotics in association with the onset of their condition: that their immune system has been severely stressed in some way.

I do not know whether this is coincidental or not.

I often meet mature people who are unhappy, aggrieved, confused and sorely challenged about the fact that ‘suddenly’ they can no longer eat wheat or dairy products or whatever.

Their view is that they have been eating them all their life without a problem – why do or should they have a problem now? They just don’t want to know about or have to deal with it.

Celiac on mature people

There are others who are thrilled to have found a solution to their debilitating health problems.

Some parents reported they had gone on a gluten free diet in support of two of their four children who were coeliac.

Although not coeliac themselves they had, in the process, discovered they were both gluten sensitive and were in raptures about the benefits of their newly adopted gluten free diets: both had lost weight, had more energy and the mother’s chronic conjunctivitis problem had cleared up without any treatment or medication.

Previously, the conjunctivitis had not responded to treatment.

Another young man in his mid thirties had suffered from undiagnosed coeliac disease, severe depression, psychotic episodes and mild eczema from the age of nine.

On a gluten free diet since he was thirty-two, his gut had healed, his depression lifted and he was enjoying life and cooking: it was good to be alive and he was glad to have found a solution in gluten free food and our products.

Unfortunately, whether you want to know about it or not, once you’ve become a coeliac or gluten sensitive the only sensible answer is to totally exclude gluten from your diet.

There is no option to this lifetime commitment: you have to come to terms with your health condition. If you don’t, you risk, at best, continually feeling slightly off colour or, in a worst case scenario, becoming seriously and, perhaps, life threateningly ill.

There is a danger of serious weight loss, lack of energy, osteoporosis, depression, various immuno and nutrition deficiency issues and the risk of contracting various cancers of the bowel, lymph system and/or of the throat at much higher rates than for the general community.

As a mature person, you may have been mildly gluten sensitive or Coeliac and felt vaguely uncomfortable and think that is how life is.

You get used to it, you live with it and soldier on regardless. But in other instances you can be or become chronically ill.

The good news is, that if you adopt a strictly gluten free diet your health and quality of life will often improve dramatically and your general risks of illness will match those of the broader community.

While at first the change to gluten free foods and meal preparation may seem a bit daunting it soon becomes second nature.

It is fairly simple and, if approached in the right manner, even fun and creative: all that is required is a sense of humour, patience,curiosity and some persistence.

A small price to pay to be free of any chronic or debilitating illness.

Regards

Paul Smith

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