Karen Collins, MS, RD, CDN
American Institute for Cancer Research
Weekly column for the week of October 17, 2005
Q: Which type of supplement is better ? a drink or a pill?
A: If you are having trouble getting enough calories and protein, either because your energy needs are very high or you are having trouble eating, a supplemental drink would be the best choice for you. You should choose one of the many drinks available depending on your lactose tolerance, how much fat your body can handle and how many additional calories you need. If you don?t need extra calories and protein, but only extra amounts of one or more vitamins and minerals, then a pill may be better for you. Either of these options is considered a "supplement" to healthy eating. Neither can replace all the nutrients and beneficial substances you get from eating balanced, mostly plant-based meals.
Q: Can someone who must eat gluten-free foods follow a diet that lowers a person?s cancer risk, too?
A: Yes. A gluten-free diet, specifically designed for people with celiac disease, whose digestive tract is damaged by foods containing gluten, can also meet a variety of other health concerns, like lowering cancer risk. If you are unsure how to create a gluten-free diet that does this, you can talk to a registered dietitian or a doctor with experience treating celiac patients. There are also reputable websites and books that offer support, up-to-date information and recipes. In addition to avoiding tobacco, the following diet and lifestyle principles are the main ones that will lower cancer risk for everyone, including celiac patients: focus your meals around vegetables, fruits, whole grains and beans; maintain a healthy weight and stay physically active; limit fat, alcohol and sodium; and choose mostly beans, poultry, or seafood for protein instead of large amounts of red meat. None of these principles are in conflict with a gluten-free diet. However, restrictions on eating gluten make it much more difficult for celiac patients to eat the recommended three servings of whole grains a day. Wheat (and its many derivatives), barley and rye contain gluten. Oats are gluten-free, but often contaminated with gluten during processing, so this grain may be best avoided, too. Rice and corn, including popcorn and 100 percent cornmeal, are gluten-free and safe to eat. Although classified as fruits, quinoa and buckwheat (kasha) are grain-like and gluten-free and can bring variety to a celiac patient?s diet. Amaranth is another safe option, although not technically a grain. The greatest problem for someone who must avoid gluten is the hidden gluten in baked and processed foods and commercially-prepared foods found in restaurants and grocery stores. If you find it too difficult to eat the recommended daily servings of whole grains, at least strive to follow the other principles. Because untreated celiac disease can lead to lymphoma of the small intestine, you shouldn?t risk eating whole grains that may be tainted with gluten.
Q: Since vitamin D is a fat-soluble vitamin, can we absorb it from skim milk?
A: Although it is true that we need some fat to absorb vitamin D from our digestive system, the fat does not have to come from the same food. As long as there is a small amount of fat present in our digestive system, that appears to be enough. Studies that have looked at the absorption of vitamin D from skim milk and juice, which is also fat-free, show that the absorption of this vitamin is undeterred by the lack of fat in these liquids.
Reprinted with permission from the American Institute for Cancer Research
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