Kwa Odwala Amene Ali Opanda Ulemerero, Malangizo Othandiza Ambiri Ndi Ofunikira
Anthu omwe ali ndi matenda oopsawa amakumana ndi mavuto ovuta, ngakhale ngati akutsatira zakudya zopanda thanzi. Choyamba, iwo ayenera kuchira (monga momwe angathere) kuchokera ku malabsorption ya zakudya yomwe idacitika pamene adakali kudya gluten, zomwe zingayambitse kuchepa kwa magazi, kuchepa kwa minofu ndi osteoporosis , kuchepa kwa vitamini, ndi mavuto ena .
Monga ngati sizinalikwanira, mosiyana ndi mankhwala ogulitini m'sitolo, masewera ochepa a malonda a gluten amapindula kapena amathandizidwa ndi mavitamini owonjezereka, zomwe zimapangitsa kuti anthu omwe ali ndi matenda a soliac akhale ovuta kudya mavitamini okwanira.
Zakudya za Gluten nthawi zambiri zimakhala zochepa mu mavitamini a B, calcium, vitamini D, chitsulo, zinc, magnesium, ndi fiber. Ndipotu, kafukufuku wasonyeza kuti anthu omwe ali ndi matenda a leliac ali pangozi ya zotsatira zosiyanasiyana za zakudya zopanda thanzi, kuphatikizapo kuwonjezeka kwa kunenepa kwambiri.
Chifukwa Chakudya Chakudya Chamakono Ndi Chofunika Kwambiri pa Thanzi Lanu
Chifukwa cha zoopsa zonsezi, American Celiac Disease Alliance, Digestive Disease National Coalition, Gluten Intolerance Group ya North America, ndi madokotala ambiri amalimbikitsa kuti olemba zakudya ayenera kukhala mbali ya gulu lachipatala lomwe limayang'anira thanzi la wodwalayo komanso kutsatira zakudya.
Kuwonjezera apo, kafukufuku amasonyeza kuti kwa anthu ena omwe ali ndi matenda a leliac, chifukwa chachikulu chimene sangathe kukhalira opanda thowutu ndikuti samvetsa zakudya. Kodi sikungakhale mpumulo kupeza thandizo kwa katswiri?
Kodi pali kusiyana kotani pakati pa odyetsa zakudya ndi odwala, ndipo ndiyenera kuwona chani?
Ku US, anthu omwe ali ndi matenda alionse, kuphatikizapo matenda a celiac, omwe amafunikira uphungu wothandizira zakudya ayenera kufunsa Wolemba Dietitian (wotchedwanso RD).
RDs yatsiriza zofunikira za maphunziro ndi zochitika zomwe bungwe la American Dietetic Association la Commission on Registration Dietetic Register, kuphatikizapo digiri ya bachelor digiti ya koleji yovomerezeka kapena yunivesite komanso ndondomeko yovomerezeka yapamwamba. RDs iyeneranso kuyesa kafukufuku wogwira mtima ndikugwira nawo ntchito pulogalamu yopitiliza maphunziro yovomerezeka yopitirizabe zizindikiro zawo.
Ma RD ena ali ndi madigiri apamwamba komanso zovomerezeka zina m'madera apadera. Ponena za anthu omwe ali ndi matendawa, National Foundation for Celiac Awareness amavomereza zakudya zolembetsa monga gawo la Gluten-Free Resources, Education, and Training (GREAT). WAMPHAMVU kwa Odwala ndi Ophunzira Amaphunziro Ogwira Ntchito (CPE) Ovomerezedwa omwe ali ndi Komiti ya Kulembetsa Dietetic. (Palinso ndondomeko zazikulu zothandizira ophika, ogwira ntchito zodyera, ndi akatswiri ena ogwira ntchito zamalonda.)
Mosiyana ndi chidziwitso RD, palibe chikhalidwe cha dziko ndipo chidziwitso chimagwiritsidwa ntchito ndi maudindo a "dietitian" (popanda mawu "olembetsa") kapena "odyetsa" ndipo palibe chitsimikizo chakuti munthu amene akugwiritsa ntchito maudindowo ali ndi maphunziro apamwamba pa zakudya ndi zakudya .
Nthawi zina Wolemba Dietitian amalembedwanso mutu wakuti "Nutritionist" (mwachitsanzo, mu umoyo waumphawi, zachipatala, ndi maphunziro). Nthawi zina, mainawa amagwiritsidwa ntchito ndi anthu osaphunzitsidwa. Pokhapokha ngati wodwalayo ali ndi "RD" yoyambira dzina lake, muyenera kutsimikizira kuti munthuyo ali ndi ziyeneretso.
Malingana ndi Bungwe la Labor Statistics ku Dipatimenti Yogwira Ntchito ku United States, mayiko 48 ali ndi malamulo olamulira zamatsenga, mayiko 35 amafuna kuti olemba apatsidwe chilolezo ndipo 12 amafunikanso kuti apitirize kuvomerezedwa ndi boma, popanda kudziwitsidwa ndi bungwe lililonse la akatswiri.
Onetsetsani kuti katswiri wanu wamagetsi adakwaniritsa zofunika ku boma (kapena dziko) kumene iye amachita.
Kodi Ndingapeze Kuti Wolemba Dietitian Wolembetsa?
Ku US, mukhoza kupita ku America Dietetic Association kuti Pezani Malo Othandiza Opeza Chakudya Chakudya kuti mupeze odyetsa zakudya pafupi ndi inu. Inde, mukhoza kufunsa dokotala wanu, kapena mamembala a gulu lanu lothandizira matendawa, ngati angathe kulangiza akatswiri odwala zakudya.
Ku Australia, pitani ku MYDR.com.au; ku Canada, Dietitians ku Canada; ku Hong Kong, Dietitians Associated Limited ku Hong Kong; ku Ireland, Irish Nutrition and Dietetic Institute; ku New Zealand, New Zealand Dietetic Association; ku UK, Nutri-People kapena British Nutrition Foundation.
Kodi Inshuwalansi Yanga Idzapereke Chakudya Chakumankhwala Chithandizo cha Matenda a Kachilombo?
Malinga ndi mawu a mgwirizano wochokera ku American Celiac Task Force (omwe tsopano ndi American Celiac Disease Alliance), Digestive Disease National Coalition, ndi Gluten Intolerance Group ya North America, "Thandizo la mankhwala ndi mankhwala okha omwe amavomereza matenda a Celiac ... Chifukwa cha Nthendayi yomwe imayambitsa matenda odwala matendawa amafunika kukhala mbali ya gulu la thanzi limene limayang'anira thanzi la wodwalayo komanso kumatsatira nthawi zonse. "Chifukwa cha malangizowa, makampani a inshuwalansi ayenera kulipira maulendo a odwala matendawa ndi RDs.
Komabe, muli ndi mwayi wokwanira kutsimikizira kampani yanu ya inshuwalansi kuti mukufunikira kusamalidwa ndi odyetsa. Okhawo okha ndi odwala omwe ali ndi matenda a diabetes ndi matenda a shuga. Chifukwa Medicare yalamula kuti odwala matenda a shuga amafunika uphungu wokhudza zachipatala, makampani ena a inshuwalansi amavomereza uphungu wothandiza anthu odwala matenda a shuga .
Ngati mukukumana ndi vutoli pofuna kutsimikizira kampani yanu ya inshuwalansi kuti muvomereze, muyenera kutsimikizira kuti mankhwala ochiritsira zakudya kuchokera ku zakudya zolembedwera ndi (1) zofunikira m'thupi mwanu ndi (2) muyezo wa chisamaliro kwa odwala ndi laliac matenda . Mfundo zotsatirazi zingathandize:
- Yesetsani kukhala ndi "zokambirana" zambiri momwe mungathere. Ngati mukulankhula ndi kampani ya inshuwalansi ya foni, lembani dzina la munthu amene mumamuwuza ndi tsiku, ndipo lembani zolembazo.
- Pang'ono ndi pang'ono, tumizani kampani ya inshuwalansi mankhwala ochiritsa matenda kuchokera kwa dokotala, kapena kutumiza. Ngakhale zili bwino, funsani dokotala wanu - komanso odyetsa zakudya, ngati mwakhala mukukambirana kale - kulembera makalata kwa kampani ya inshuwalansi m'malo mwanu pofotokoza chifukwa chake kuyankhulana kuli kofunikira pa mankhwala komanso kuti mankhwalawa ndiwomwe amavomereza panopa . Ngati muli ndi zifukwa zina zomwe zingayambidwe ngati vuto la zakudya, monga kuchepa kwa magazi m'thupi kapena mavitamini, tchulani kuti mu makalata anu ndi kampani ya inshuwaransi ndikumbutseni dokotala wanu ndi odyetserako zakudya kuti mutchulepo makalata awo. Ngati atumiza makalata, tengani makope ndikulembera makalata anu kwa inshuwalansi yanu, inunso.
- Pofuna kutsimikizira kuti uphungu wochokera kwa akatswiri okhudzana ndi zakudya ndizofunikira pa chisamaliro cha odwala omwe ali ndi matendawa, amathandiza kutumiza makope okhudzana ndi zolemba zachipatala zomwe zimatsindika mfundoyi. Pang'ono ndi pang'ono, phatikizani ndemanga kuchokera pamapepala ofunikira. Ochepa amapezeka pansipa, kumapeto kwa nkhaniyi.
- Nthawi iliyonse mukamapepala malemba anu ndi makalata anu (makalata, zotsatira za mankhwala, mankhwala, etc.), onetsetsani kuti mulemba kalata zomwe mwatseka.
- Nthawi iliyonse mukatumizira chirichonse pamalata ku kampani yanu ya inshuwalansi, ayitaneni sabata kuti atsimikizire kuti zolembazo zalowa mu "dongosolo" lawo.
- Ngati kampani yanu ya inshuwalansi ikukana kuvomerezedwa kapena kukana pempho lanu, funsani zomwe mukuyenera kuchita kuti mupemphe chigamulo. Mukapempha pempho lanu, tumizani makalata anu onse kalatayo mpaka pomwepo komanso zolemba zanu, ngakhale mutatumiza kale.
- Ngati inshuwalansi yanu ikuperekedwa ndi abwana anu, funsani antchito anu ogwira ntchito kuti athandizane nawo. Wothandizira ubwino amanyamula katundu wolemera kwambiri ndi kampani ya inshuwalansi kuposa momwe mumachitira payekha.
Zomwe mungagwirizane nazo (kapena kutchula) mu makalata anu a inshuwalansi:
- Leffler DA et al. Phunziro loyang'ana limodzi la magawo asanu a zakudya zopanda zakudya za gluten kwa akuluakulu omwe ali ndi matenda a celiac. Pharmacology & Therapeutics 2007; 26: 1227-1235
- "Ngakhale kuti mayesero a serologic omwe alipo tsopano ali ndi zidziwitso zapamwamba kwambiri komanso zenizeni zowononga matenda a celiac, sangathe kuwongolera njira zogwiritsira ntchito zakudya zopatsa thanzi zomwe zimawathandiza kuti asamadye zakudya zamagetsi."
- Niewinski MM. Kupititsa patsogolo mu matenda a celiac ndi zakudya zopanda thanzi. Journal ya American Dietetic Association 2008 Apr; 108 (4): 661-72
- "Ndemangayi ikufotokoza mwatsatanetsatane za zakudya zopanda thanzi komanso kufunika kokhala ndi uphungu wochuluka kwa odwala onse omwe ali ndi matenda a leliac ... Zakudya zopanda thanzi zimakhala zovuta ndipo odwala amafunikira maphunziro okhudzana ndi zakudya kuchokera kwa katswiri wodziŵa bwino zakudya zamankhwala."
- Green PHR ndi Cellier C. Celiac matenda. New England Journal of Medicine 2007; 357: 1731-43.
- Gulu lachipatala liyenera kuphatikizapo munthu wodzitetezera wodziwa bwino yemwe amayang'anitsitsa zakudya za wodwala komanso zakudya zamankhwala nthawi zonse ... .Achikulire chodziŵika bwino amafunika kudziwa kuchuluka kwake kwa kudya [zakudya zopanda thanzi] komanso zifukwa zomveka zosaganizira. .. "
- Pietzak MM. Kuwatsata odwala omwe ali ndi matendawa: kukwaniritsa kutsata mankhwala. Gastroenterology 2005; 128: S135-41
- "... kugwirizana ndi zakudya zopanda thanzi, makamaka ku United States, ndizovuta kwambiri ... .Zomwe zilipo, njira yothandizira odwala omwe angoyamba kumene kutero ayenera kuphatikizapo ... uphungu wothandizira odwala odwala ..."
- Mariani P et al. Zakudya Zakudya za Gluten: Kodi Pali Vuto Lowopsa kwa Achinyamata Amene Ali ndi Matenda a Celiac? Journal of Pediatric Gastroenterology & Nutrition 1998; 27: 519-523
- "Ngakhale kuti zaka zapitazo pakhala kusintha kwakukulu kwa zipangizo zozindikira za CD, timakhulupirira kuti nthawi yayamba kuonetsetsa kuti pali mavuto okhudzana ndi kutsatiridwa kwa CD, osati kungogwirizana ndi zakudya komanso kudya zakudya za zakudya zokha. "
- Hallert C et al. Umboni wa mavitamini osauka kwa odwala omwe ali ndi zakudya zopanda thanzi kwa zaka 10. Pharmacology & Medical Therapeutics 2002; 16: 1333-1339.
- "Tinapeza zizindikiro zosonyeza kuti ali ndi mavitamini osauka omwe amalembedwa ndi 56% mwa odwala akuluakulu omwe ali ndi vutoli, kuphatikizapo asanu ndi limodzi pa folate supplementation. Izi zikuwonjezeranso kuti odwala akudya zakudya zopanda thanzi kwa zaka zambiri amatha kukhala ndi vitamini osiyanasiyana kusowa kwake kumatanthauza, makamaka kuperewera kwa anthu. "
> Zotsatira:
> American Celiac Task Force, Matenda Ogwidwa Ndi Amuna Ambiri ku United States Gulu la United States. Zotsatira za zakudya ndi kukhazikitsidwa kwa matenda a celiac. Gastroenterology 2005; 128: S121-S127
> US Dept of Labor Bureau of Labor Statistics
> American Dietetic Association
> Yunivesite ya ku Illinois Yophunzitsa Yachilengedwe ku Dietrotics
> Leffler DA ndi al. Phunziro loyang'ana limodzi la magawo asanu a zakudya zopanda zakudya za gluten kwa akuluakulu omwe ali ndi matenda a celiac. Pharmacology & Therapeutics 2007; 26: 1227-1235
> Niewinski MM. Kupititsa patsogolo mu matenda a celiac ndi zakudya zopanda thanzi. Journal ya American Dietetic Association 2008 Apr; 108 (4): 661-72
> Green PHR ndi Cellier C. Celiac matenda. New England Journal of Medicine 2007; 357: 1731-43.
> Pietzak MM. Kuwatsata odwala omwe ali ndi matendawa: kukwaniritsa kutsata mankhwala. Gastroenterology 2005; 128: S135-41
> Mariani P et al. Zakudya Zakudya za Gluten: Kodi Pali Vuto Lowopsa kwa Achinyamata Amene Ali ndi Matenda a Celiac? Journal of Pediatric Gastroenterology & Nutrition 1998; 27: 519-523
> Hallert C et al. Umboni wa mavitamini osauka kwa odwala omwe ali ndi zakudya zopanda thanzi kwa zaka 10. Pharmacology & Medical Therapeutics 2002; 16: 1333-1339.