Iziguli Ezingazange Zinikezwe I-Gluten, Ukululekwa Kwezondlo Kubalulekile
Abantu abanesifo se-celiac babhekene nezinselele eziyinkimbinkimbi ezinzima, ngisho noma balandela ukudla okungenamsoco we-gluten. Okokuqala, kumele baphuluke (cishe ngangokunokwenzeka) kusuka ku- malabsorption yezakhi ezenzeke ngenkathi besadla i-gluten, okungenzeka ukuthi ibangele i-anemia, i-bone mineral mass mass kanye ne- osteoporosis , ukungabi namagciwane okwevithamini nezinye izinkinga .
Njengokungathi lokho kwakunganele, ngokungafani nemikhiqizo ene-gluten esitolo, imikhiqizo embalwa ye-gluten engenakusiza ihlotshaniswa noma iqiniswa ngamavithamini engeziwe, okwenza kube nzima kubantu abanesifo se-celiac ukuthola amavithamini ananele ekudleni kwabo.
I-gluten-free products ngokuvamile iphansi kumavithamini B, i-calcium, i-vitamin D, i-iron, i-zinc, i-magnesium ne-fibre. Eqinisweni, ucwaningo luye lwabonisa ukuthi abantu abanesifo se-celiac basengozini yemiphumela emibi eminingi yokudla okungenayo i-gluten, kuhlanganise nokukhula okwedlulele kokukhuluphala.
Kungani Isidakamizwa Kubalulekile empilweni yakho
Ngenxa yazo zonke lezi zingozi zokudla okunomsoco, i-American Celiac Disease Alliance, i-Digestive Disease National Coalition, i-Gluten Intolerance Group yaseNyakatho Melika, nodokotela abaningi bancoma ukuthi i-dietitian ebhalisiwe kufanele ibe yingxenye yeqembu lokunakekelwa kwezempilo eliqapha isimo somsoco wesiguli futhi ukuhambisana nokudla.
Ngaphezu kwalokho, ucwaningo lubonisa ukuthi kwabanye abantu abanesifo se-celiac, isizathu esiyinhloko esenza bangakwazi ukuhlala ngaphandle kwe-gluten ukuthi abaqondi ukudla. Ngeke yini kube ukukhulula ukuthola usizo oluvela kuchwepheshe?
Uyini umehluko phakathi koNutrition and Dietitian, futhi Ngikuphi Okufanele Ngikubone?
E-US, abantu abanesifo, kuhlanganise nesifo se-celiac, abadinga ukululekwa okunomsoco kufanele baxoxe nesidlo sezincwadi esibhalisiwe (esabizwa ngokuthi i-RD).
I-RDs iqedile izidingo zezemfundo nezokuhlangenwe nakho ezisungulwe yi-American Dietetic Association's Commission on Registration Dietetic, okufaka okungenani ubuncane be-bachelor degree kusuka ekolishi noma eyunivesithi eqinisekisiwe kanye nohlelo lwama-pre-professional olwamukelekile. Ama-RDs kumele adlulise ukuhlolwa okunamandla futhi ahlanganyele ezinhlelweni eziqhubekayo zemfundo eziqhubekayo zokugcina izimpawu zabo.
Amanye ama-RD aphethe ama-degree aphakeme futhi izitifiketi ezengeziwe ezindaweni ezikhethekile zomkhuba. Ngokuqondene nabantu abanesifo se-celiac, i-National Foundation for Celiac Awareness iqinisekisa ukuthi abantu ababhalisiwe babhalisiwe njengengxenye yohlelo lwayo lwe-Gluten-Free Resources, Education, and Training (GREAT). OKUQALA kubantu abadliwayo yi-Continuing Professional Education (CPE) umhlinzeki ogunyaziwe neKhomishani yokuBhalisa ngeDietetic. (Kukhona nezinhlelo ze-GREAT zokuqinisekisa izisebenzi zokupheka, izisebenzi zokudlela, nezinye izimboni zezimboni zokungenisa izihambi.)
Ngokungafani ne-credential RD, ayikho imigomo kazwelonke kanye nobufakazi obuhambisana neziqu ze "dietitian" (ngaphandle kwegama elithi "kubhalisiwe") noma "umsoco" futhi akukho siqinisekiso sokuthi umuntu osebenzisa lezo ziqu uye waba nemfundo ehlelekile ekudleni nasekunomsoco .
Ngezinye izikhathi isazi seDemetri esiBhalisiwe siphinde sinikezwe isihloko esithi "Nutritionist" (isibonelo, empilweni yomphakathi, izikhungo zempilo kanye nezikhungo zemfundo). Ngezinye izikhathi, noma kunjalo, lezi ziqu zisetshenziswe abantu akukho ukuqeqeshwa okusemthethweni. Ngaphandle kokuba isondlo sokudla okunomsoco sibe ne-"RD" yokuqala ngemuva kwegama lakhe, kufanele uqinisekise ngokucophelela iziqu zomuntu.
Ngokwe-Bureau of Labor Statistics eMnyangweni Wezabasebenzi wase-US, amazwe angu-48 anemithetho elawula izidakamizwa, izifunda ezingama-35 zidinga ukuthi abahlinzeki bavunyelwe futhi abangu-12 badinga ukuthi nabo baqinisekiswe yi-state, abazimele ngesitifiketi nganoma yiziphi izinhlangano zezobuchwepheshe.
Qinisekisa ukuthi uchwepheshe wakho wokudla okunomsoco uhlangabezane nezidingo zombuso (noma izwe) lapho akwenza khona.
Ngifumanaphi I-Dietitian Ebhalisiwe?
E-US, ungavakashela i-American Dietetic Association sika ukuthola isayithi lomsebenzi wezondlo ukuze uthole isidlo sokudla esiseduze nawe. Yiqiniso, ungabuye ubuze udokotela wakho, noma amalungu eqembu lakho lezinsizakalo zesifo se-celiac, uma angancoma umqeqeshi wokudla okunomsoco.
E-Australia, vakashela i-myDR.com.au; eCanada, Izidakamizwa zaseCanada; e Hong Kong, eHong Kong Dietitians Associated Limited; e-Ireland, i-Irish Nutrition and Dietetic Institute; eNew Zealand, i-New Zealand Dietetic Association; e-UK, eNutri-People noma eBritish Nutrition Foundation.
Ingabe Umshwalense Wami Uzokhokhela Ukwelapha Okunakekelwa Kwezokwelapha Ngezifo Ezibucayi?
Ngokwesitatimende esihlangene esivela ku-American Celiac Task Force (manje se-American Celiac Disease Alliance), i-Digestive Disease National Coalition, kanye neGluten Intolerance Group yaseNyakatho Melika, "Ukwelashwa kokudla okunomsoco kuphela ukwelashwa okwenziwe ukwelashwa kwezifo ... izingozi zokudla okunomsoco ezihambisana nesifo se-celiac, i-dietitian ebhalisiwe kufanele ibe yingxenye yeqembu lokunakekelwa kwezempilo eliqapha isimo somsoco nesiguli ngaso sonke isikhathi. "Njengoba kunikezwe le mihlahlandlela, izinkampani zomshuwalense kufanele zikhokhele ukubonisana kweziguli ze-celiac nge-RDs.
Noma kunjalo, kunethuba elihle ukuthi uzodinga ukuqinisekisa inkampani yakho yomshuwalense ukuthi udinga ukunakekelwa kumuntu odlayo. Ukuphela kokuphela kukhona iziguli ezine-celiac nesifo sikashukela. Ngenxa yokuthi i-Medicare inqume ukuthi iziguli ezinesifo sikashukela zidinga ukululekwa okunomsoco wezokwelapha, ezinye izinkampani zomshuwalense zizovuma ukwelulekwa okunomsoco kubantu abanesifo sikashukela .
Uma ubhekene nenselele yokuqinisekisa inkampani yakho yomshuwalense ukuba uvumeleke, udinga ukufakazela ukuthi ukwelashwa okunomsoco wezokwelapha okuvela kubhalisi obhalisiwe (1) kunesidingo ngokwezokwelapha esimweni sakho futhi (2) izinga lokunakekela iziguli ezine- celiac izifo . Ukusikisela okulandelayo kungase kusize:
- Zama ukuba "ingxoxo" okuningi ngokubhala ngokusemandleni. Uma ukhuluma nommeli wenkampani yomshuwalense, ubhale phansi igama lomuntu okhulume naye nosuku, bese uthatha amanothi kulokho okwakushiwo.
- Okungenani, thumela inkampani yomshuwalense umuthi wokwelashwa okunomsoco kusuka kudokotela wakho, noma ukuhanjiswa. Ngcono nakakhulu, cela udokotela wakho - kanye nesidlo sokudla, uma usuvele ubhekene nokubonisana kwakho - ukubhala izincwadi enkampanini yomshuwalense egameni lakho echaza ukuthi kungani ukubonisana kunesidingo sempilo nokuthi lokhu ukwelashwa kuyinkinga yokunakekelwa okwamanje eyamukelwayo . Uma uneminye imibandela engabhekwa njengezinkinga zokudla okunomsoco, njenge-anemia noma i-vitamin deficiencies, khuluma ukuthi kubhalweni lwakho nenkampani yomshuwalense bese ukhumbuza udokotela wakho kanye nomsoco wokudla ukuze akhulume ezincwadini zabo, futhi. Uma bethumela izincwadi, thola amakhophi bese ubafaka ngeposi yakho kumphathi wakho womshuwalense, futhi.
- Ukufakazela ukuthi ukwelulekwa okuvela kumfundi wokudla okunomsoco kuyinto ejwayelekile yokunakekelwa kweziguli ezinezifo ezingavamile, kusiza ukuthumela amakhophi ezihloko ezibalulekile ezincwadini zezokwelapha ezigcizelela leli phuzu. Okungenani, faka izingcaphuno ezivela kumaphepha abalulekile. Abambalwa abavela ngezansi, ekupheleni kwalesi sihloko.
- Noma nini lapho ufaka khona noma yimaphi amadokhumenti encwadini yakho (amakhophi ezincwadi, imiphumela yokuhlolwa kwezokwelapha, ama-athikili, njll), qiniseka ukuthi usho encwadini yakho ukuthi ungubani.
- Njalo uma uthumela noma yini ngeposi kwinkampani yakho yomshuwalense, shayela ngeviki kamuva ukuqinisekisa ukuthi imibhalo ingene "ohlelweni" lwayo.
- Uma inkampani yakho yomshuwalense iphika ngaphambi kokuvunywa noma iphika isimangalo sakho, thola ukuthi yini okudingeka uyenze ukuze ukwedlulise isikhalazo ngesinqumo. Uma wenza isikhalazo sakho, thumela amakhophi azo zonke izincwadi zakho kulowo mbandela kanye nanoma yimaphi amadokhumenti asekelayo, noma ngabe uwuthumele ngaphambili.
- Uma umshwalense wakho unikezwa umqashi wakho, cela umphathi wakho wezinzuzo zezisebenzi ukuthi azibandakanye. Imenenja yezinzuzo ithwala isisindo esiningi nekhampani yomshuwalense kunokuba uyenze njengomuntu ngamunye.
Izihloko zokufaka (noma ukucaphuna) ngokuxhumana nenkampani yakho yomshuwalense:
- Leffler DA et al. Ucwaningo olulindeleke lokuqhathanisa ngezinyathelo ezinhlanu zokulondeka kokudla okungenalutho kubantu abadala abanezifo ezicashile. I-Pharmaceutical Pharmacy & Therapeutics 2007; 26: 1227-1235
- "Nakuba izivivinyo ze-serologic zamanje zinezinzwa eziphakeme kakhulu nezici zokuthola isifo se-celiac, azikwazi ukufaka indawo yokuhlolwa kokudla okunomsoco ekuhloleni kokunamathela kokudla okungenayo i-gluten."
- Niewinski MM. Ukuthuthukiswa kwezifo ze-celiac nokudla okungenamsoco we-gluten. Journal of the American Dietetic Association 2008 Apr; 108 (4): 661-72
- "Lokhu kubuyekezwa kugxile emininingwaneni yokudla okungenayo i-gluten kanye nokubaluleka kokululekwa okunomsoco okwedlulele kuzo zonke iziguli ezinesifo se-celiac ... Ukudla okungenamsoco kunzima futhi iziguli zidinga imfundo ephelele yokudla okunomsoco ovela kuchwepheshe wezokwelapha."
- I-PHR eluhlaza kanye neCellier C. Celiac. I-New England Journal of Medicine 2007; 357: 1731-43.
- Ithimba lezokunakekelwa kwezempilo kumele libandakanye isazi sokudla esinekhono eliqapha isimo somsoco nesiguli sokudla ngaso sonke isikhathi ... .Ukudla okunomsoco okudingekayo kudingeke ukuba ahlole izinga lokunamathela [ekudleni okungenalo gluten] kanye nezizathu ezingenzeka zokunganaki. .. "
- I-Pietzak MM. Ukulandelwa kweziguli ezine-celiac isifo: ukufeza ukuthobela ukwelashwa. I-Gastroenterology 2005; 128: S135-41
- "... ukuhambisana nokudla okungekho gluten, ikakhulukazi e-United States, kuyinselele kakhulu ... .Ngokuqinisekile, indlela yeqembu ekulandeleni isiguli esanda kutholakala kufanele ifake ... ukwelulekwa kokudla okunomsoco nge-dietician obhalisiwe ..."
- UMariani P et al. Ukudla Okungenayo I-Gluten: Isici Sengozi Yokunakekelwa Kwemithi Kubantwana Abakhulelwe Nezifo Zama-Celiac? I-Journal ye-Gastroenterology & Nutrition 1998 yezingane. 27: 519-523
- "Nakuba eminyakeni eyedlule kube nokuthuthukiswa okukhulu ekusebenziseni amathuluzi we-CD, sikholelwa ukuthi isikhathi sesifikile ekuqapheliseni izinkinga mayelana nokulandelwa kwe-CD efanele, hhayi kuphela ukuhambisana nokudla kodwa futhi nokulinganisela kokudla okunomsoco yokudla ngokwayo. "
- Hallert C et al. Ubufakazi besimo sevithamini esimpofu ezigulini ezingama-celiac ekudleni okungenalutho kwe-gluten iminyaka eyishumi. I-Pharmaceutical Pharmacy & Therapeutics ka-2002; 16: 1333-1339.
- "Sithole izibonakaliso ezibonisa isimo samathamini ompofu ku-56% weziguli ezindala eziphethwe yi-celiac, ezihlanganisa nesithupha kwi-folate supplementation. Lokhu kufakazela ubufakazi bokuthi iziguli ezinamathele ekudleni okungenalutho kwe-gluten iminyaka zijwayele ukuthuthukiswa kwevithamini ehlukahlukene Ukuntuleka kwezinto, ikakhulukazi ukungabi namuntu. "
> Imithombo:
> I-American Celiac Task Force, I-Digestive Disease National Coalition kanye neGluten Ukungabekezelelani Iqembu laseNyakatho Melika. Iziqondiso zokudla kanye nokuqaliswa kwesifo se-celiac. I-Gastroenterology 2005; 128: S121-S127
> US Dept of Labour Bureau of Labor Statistics
> I-American Dietetic Association
> Uhlelo lwase-Southern Illinois University Didactic kuDietetics
> Leffler DA et al. Ucwaningo olulindeleke lokuqhathanisa ngezinyathelo ezinhlanu zokulondeka kokudla okungenalutho kubantu abadala abanezifo ezicashile. I-Pharmaceutical Pharmacy & Therapeutics 2007; 26: 1227-1235
> Niewinski MM. Ukuthuthukiswa kwezifo ze-celiac nokudla okungenamsoco we-gluten. Journal of the American Dietetic Association 2008 Apr; 108 (4): 661-72
> I-PHR eluhlaza kanye neCellier C. Celiac. I-New England Journal of Medicine 2007; 357: 1731-43.
> Pietzak MM. Ukulandelwa kweziguli ezine-celiac isifo: ukufeza ukuthobela ukwelashwa. I-Gastroenterology 2005; 128: S135-41
> Mariani P et al. Ukudla Okungenayo I-Gluten: Isici Sengozi Yokunakekelwa Kwemithi Kubantwana Abakhulelwe Nezifo Zama-Celiac? I-Journal ye-Gastroenterology & Nutrition 1998 yezingane. 27: 519-523
> Hallert C et al. Ubufakazi besimo sevithamini esimpofu ezigulini ezingama-celiac ekudleni okungenalutho kwe-gluten iminyaka eyishumi. I-Pharmaceutical Pharmacy & Therapeutics ka-2002; 16: 1333-1339.