The impact of what you eat

Imagine purposely infecting yourself with hookworms – all in the name of good health. Most people would squirm at the thought of it but 20 volunteers with celiac disease opted for the unusual treatment (The Australian 2009). People with celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley. The digestive disorder damages the small intestine and interferes with nutritional absorption.

 Queensland-based Dr James Daveson is trialling the use of hookworms which burrow through the skin before travelling via the bloodstream to live in the gut. Dr Daveson says people with the worms have given celiac disease patients an improved tolerance for bread than those without the worms (Guest 2009). He thinks the immune system may function better with “friendly” organisms such as hook worms. “We have co-evolved with them … (yet) we’ve cleaned up our world so well that we no longer have worms in our guts,” says Dr Daveson. He says some experts believe this is one of the reasons there is an increase in auto-immune disorders such as celiac disease.

 Although celiac disease is on the rise it is not clear if it is due to an increased awareness about the disease and doctors are more likely to test for it. New research from the Mayo Clinic in Rochester, Minnesota, USA suggests the disease is four times more common today than in the 1950s, and not just because doctors are looking for it (Lapid 2009). Some experts believe the increase can be partially blamed on the hygiene hypothesis and the increasingly germ-free environment of modern life contributes to an increase in abnormal immune system reactions and allergies and asthma (Lapid 2009).

 Celiac disease is often associated with children and young people but new research has found it can strike someone for the first time later in life (Reuters 2009). The disease commonly goes undiagnosed in people for many years and researchers investigated whether some elderly people had actually developed the disease later in their lives, or the disease had simply gone undetected. They looked at 2,815 people over 55 years of age who had undergone blood tests for celiac disease in 2002, 2,216 of whom were screened again in 2005. In 2002, 2.13% of the study participants had biopsy-confirmed celiac disease, while 2.34% did in 2005. There were five new cases among people whose blood tests had initially been negative for the disease suggesting it is possible for celiac disease to strike older generations (Reuters 2009).

 People with celiac disease also face an increased risk of osteoporosis. It was previously thought that this was because they cannot properly absorb nutrients, including calcium and vitamin D from their diet. New research from the University of Edinburgh (2009) shows 20% of celiac patients actually produce antibodies that attack the body and limit its ability to digest calcium which results in severe osteoporosis. Although this form of osteoporosis does not respond to calcium and vitamin D supplements, drugs can be used to prevent bone destruction.

 New Zealand has one of the highest rates of food allergies in the world and Stuff (2009) says a leading international allergy expert warns the rates will only increase if preventative strategies are not put in place immediately. Paediatric Gastroenterologist and Allergist Dr Ralf Heine says the number of infants being diagnosed with food allergy and early on-set eczema is on the rise. Dr Heine who works at the Department of Allergy and Immunology at the Royal Children’s Hospital, University of Melbourne made a visit to New Zealand to present new research to GPs and paediatricians in a series of seminars throughout the country. Mr Heine told Stuff (20009) more than 60% of moderate to severe eczema in infants under the age of six months is due to food allergy which often goes unrecognised. Dr Heine says an integral part of the treatment of eczema in infants is dietary modification (Stuff 2009).

 How can people make better food choices?

 European Food Information Council director general Josephine Wills says putting high fat labels on food products is not the answer to improving healthy food choices (Knight 2009). Ms Wills who spoke at NZ Nutrition Foundation’s annual meeting says labelling efforts are pointless without supporting education and advertising campaigns. Research shows consumers can identify healthy foods, but they choose not to act on it. “Taste and price are the strongest drivers when it comes to food choice. Nutrition is a little bit lower down” says Ms Wills as reported in the Sunday Star Times (2009). Nutrition labels are only a small part of the answer and New Zealand needs to build a culture of healthy eating she says (Knight 2009).

 As the third fattest nation in the world New Zealand has a long way to go to creating a healthy eating culture. We follow Mexico and America as the world’s heaviest nations. Obesity kills 8000 Kiwis a year and costs $900 million a year in healthcare (TVNZ 2009). New Zealanders are divided over what should be done about this healthcare time-bomb. Diabetes specialist and spokeswoman for Fight the Obesity Epidemic Dr Robyn Toomath told The Press (2009) the government has actually reversed minimal nutritional guidelines in schools. “Obesity rates go up and the response from Government is one of complete denial. All we’ve seen is an unravelling of efforts designed to stop obesity” she says.

 Health Minister Tony Ryall said the government planned to announce programmes “around physical activity” and sports “in due course” (Eleven 2009). Greens MP Sue Kedgley told TVNZ (2009) the Government has scrapped almost all obesity initiatives. Obesity Action Coalition executive director Leigh Sturgiss agrees and says the government needs to tackle obesity in a similar way it approached the anti smoking campaign (Eleven 2009). She says there needs to be tough regulation of what can be advertised to children. “Foods that are heavily promoted come in huge portion sizes and are high in salt, sugar and fat” she says to Eleven (2009). “More money should be spent on preventing people getting into the hospital system in the first place” say Ms Sturgiss.

 A new British study reported in the BBC (2009)  has shown a strong link in obesity between mothers and daughters and fathers and sons, but not across the gender divide. Obese mothers are 10 times more likely to have obese daughters. For fathers and sons the increase is six times. In both cases children of the opposite sex were not affected. Researchers say the findings mean policy on obesity should be reconsidered. They believe the link is behavioural rather than genetic, suggesting it was probably a form of “behavioural sympathy” in which daughters copy their mothers and sons their fathers (BBC 2009). It is commonly thought that obese children become obese adults; however, researchers say this assumption ignores the fact that eight in 10 obese adults were not severely overweight when they were children. Researchers say the opposite is true, obese adults led to obese children. Study leader Professor Terry Wilkin told the BBC (2009) “we should be targeting the parents and that is not something we have really done to date.”

 Doctors tracking the swine flu pandemic have linked obesity with serious swine flu complications say Brown and Shulman (2009). The worldwide pattern shows people infected with swine flu who have a body mass index greater than 40, classed as morbidly obese, suffer respiratory complications that are difficult to treat and can be fatal. the Centers for Disease Control and Prevention, U.S. Department of Health and Human Services epidemiologist Anne Schuchat says she is surprised by the findings and they are looking into the possibility that obese people should be a top priority for swine flu vaccines (Gale 2009).

 Capital and Coast District Health Board deputy chairman Ken Douglas paid $20,000 for a private gastric bypass in 2003 (Hill 2009). He used to weigh in at 151kg and now sits at 83kg. Mr Douglas told the Dominion Post (2009) it was the best investment he ever made and is now an advocate for publicly funded weight-loss surgery. “As far as I’m concerned, it’s a no- brainer – putting money into this now will save millions of dollars in the long run. It’s unfair that those who are most badly affected by obesity – Maori and Pacific people – have the least access to it.” Medical ethics professor Grant Gillett says many people assume morbidly obese people lack of self-control and only have themselves to blame. “Slim people, often educated, middle- class people, feel somehow morally superior about this. But not everyone has the same meaningful choices in life . . . obesity is a life-threatening disease and it’s our social duty to treat those individuals who need help” says Mr Gillett (Hill 2009). Professor of human nutrition and medicine at Otago University Jim Mann was initially sceptical about the value of weight-loss surgery but now believes for some patients that it’s the only answer as many weight-loss drugs available have so far turned out to have serious side- effects: “We treat cancer in smokers – so why not treat the morbidly obese?” (Hill 2009).

 Over the past two years publicly funded weight-loss operations have more than tripled according to figures obtained by The Dominion Post (2009) under the Official Information Act. The Ministry of Health says the direct cost to the health sector from obesity is about $460 million a year (Hill 2009).

 Women’s Health Action Trust policy analyst Christy Parker told Hill (2009) weight-loss surgery is invasive and expensive, and prevention and early intervention should be the first approach. She says “ultimately we are concerned that we are living in a social context which pathologises and stigmatises fatness, and that it is this which is overly influential in people’s decisions to undergo this surgery – particularly women who tend to be more affected by the slenderness ideal.”

 Eating Difficulties Education Network co-ordinator Maree Burns says surgery does not fix the underlying problem for most people, which is “disordered eating”. For some people, overeating – especially of comfort foods – is their only coping strategy for dealing with stresses in their lives (Hill 2009). She says for some people surgery could cause eating disorders by disrupting their natural relationship with their bodies.

What we choose to eat can have a lasting impact on our bodies. Many New Zealanders have food allergies and face difficulties just trying to eat simple foods such as bread. Yet others over eat and consequently face increased health problems. It is not as black and white as simply telling people to eat less and exercise more. Disordered eating is complex and there is no one size fits all answer.

Reference list:

BBC, July 12 2009. “Obesity ‘link to same-sex parent’”. Internet. http://news.bbc.co.uk/2/hi/health/8144376.stm. BBC

Brown D and Shulman R, May 20 2009. “Survey Finds Link Between Obesity and Flu Severity”. Internet. http://www.washingtonpost.com/wp-dyn/content/article/2009/05/19/AR2009051902609.html. The Washington Post.

Eleven B, September 13 2009. “Hefty price as Kiwis get too fat”. Internet. http://www.stuff.co.nz/the-press/news/2587321/Hefty-price-as-Kiwis-get-too-fat. The Press.

Gale J, July 10 2009. “Obese Exposed as Swine Flu Collides With Fat Epidemic”. Internet. http://www.bloomberg.com/apps/news?pid=20601124&sid=a0DakJmBpgrc. Bloomberg.

Guest A, October 22 2009. “Worms get their hooks into coeliac sufferers”. Internet. http://www.abc.net.au/worldtoday/content/2009/s2721104.htm. ABC.

Hill R, September 26 2009. “Obesity: A heavy burden”. Internet. http://www.stuff.co.nz/national/health/2906517/Obesity-A-heavy-burden. The Dominion Post.

Knight K, September 27 2009, “Food labelling won’t work without education: expert”. Internet. http://www.stuff.co.nz/national/health/2907275/Food-labelling-won-t-work-without-education-expert. Sunday Star Times.
 
Lapid N, July 10 2009. “Cases of celiac disease up dramatically: report”. Internet. http://www.reuters.com/article/idUSTRE5694O320090710. Reuters.

Reuters, July 24 2009. “Celiac disease may strike elderly, too”. Internet. http://www.reuters.com/article/idUSTRE56N6BZ20090724. Reuters.

Stuff, August 12 2009. “More kids developing food allergies”. http://www.stuff.co.nz/life-style/2744817/More-kids-developing-food-allergies.  Stuff.co.nz

The Australian, October 22 2009. “Parasitic worms to treat auto-immune”. Internet. http://www.theaustralian.com.au/news/breaking-news/parasitic-worms-to-treat-auto-immune/story-fn3dxiwe-1225789774686. The Australian.

TVNZ, July 13 2009. “Kiwis are fatties, report shows”. Internet. http://tvnz.co.nz/health-news/kiwis-fatties-report-shows-2841411/video. TVNZ.

University of Edinburgh, October 8 2009, “New Link Found Between Osteoporosis and Celiac Disease. Internet. http://www.sciencedaily.com/releases/2009/10/091007171735.htm ScienceDaily.