Christmas 2016 newsletter

For those of you feeling ‘time-poor’ and still with a pile of cards to write, skip to part 2 for a few festive tips to ease you through this indulgent period.  For those with a few more minutes, read on if either vitamin D, or the hot topic of gluten avoidance interests you, as the latter certainly continues to receive both confusing and inaccurate media attention.


Many of you know to supplement vitamin D at this time of year, due to the obvious lack of sun in the northern hemisphere through the winter months. Vitamin D is actually the precursor to some really important hormones synthesized in the liver and kidneys after skin exposure to the sun’s rays.  But did you know, if your cast shadow on the ground is longer than your height, the sun is too low and weak to synthesis vitamin D?   We need to be closer to the equator or in the southern hemisphere at this time of year, to make this precious, multi-purpose vitamin/hormone.  

How do we use vitamin D?

Most people are aware that we need good levels of vitamin D to work with calcium and protect bone health, but did you know that low vitamin D status has been implicated in the prevalence of autoimmune diseases like multiple sclerosis, rheumatoid arthritis, insulin-dependent type 1 diabetes, and inflammatory bowel disease?1 Evidence is also accumulating for its ability to reduce the risk of developing many age-related diseases that have a genetic component, like macular degeneration.2

Vitamin D receptors have now been found in brain tissue, and research is showing low vitamin D status correlates with cognitive decline.3  A study using Vitamin D supplementation alongside omega-3, showed how it can support the immune system’s innate ability to clear the brain of amyloid plaques that are associated with Alzheimer’s.4

Test before Supplementing

I would advise a simple skin-prick test to determine your vitamin D status before starting any supplement regime, because being a fat soluble vitamin that the body can store for a few months, it is not advisable to supplement unnecessarily. But sun exposure is also no guarantee of good vitamin D levels, our ability to synthesize vitamin D declines with age.  Even tennis pros in Florida over a certain age have been found with low levels. Ideally, you want serum levels to be between 50 and 75 nmol/L

Blood-spot, skin-prick test-kits can be ordered online through Birmingham City Hospital’s pathology department for £28.00   click here:


Being fastidiously gluten free is clearly a must for those with Coeliac Disease, but for those with an ‘intolerance’ to wheat, the media would have us believe it is simply a faddy lifestyle choice.  So is there any scientific basis for intolerance?  Or, are there any actual health benefits achieved by avoiding gluten?

The answer is YES, and it’s all to do with the surface lining of the gut, because eating a lot of wheat and gluten has been shown to increase gut permeability.  I know that sounds a little absurd as the gut is supposed to be permeable, how else would we absorb nutrients. But gluten produces a hyper-permeability that for some can cross a threshold into the level of ‘leakiness’ that produces food intolerances and inflammation and immune reactions.  A healthy gut lining has a good barrier function as well as the ability to absorb fully digested nutrients. Gluten has been shown to disrupt that barrier function leading to inappropriate passage of undigested food particles, leading to immune reactions.

See my blog Gluten confusion’

For those with positive blood tests for gluten antibodies, our NHS also requires a biopsy, or visual proof of ‘villous atrophy’ (flattening or loss of villi on the surface of the small intestine) to confirm a diagnosis of CD.  This is another example of clinical practice unfortunately lagging far behind the evidence base of current research, as research now shows the autoimmune disease process triggered by antibodies to gliadin (a protein in gluten) is not limited to gut villi destruction. Other organ tissue can be affected.  So a negative gut tissue biopsy that gives you the all-clear to eat gluten, could in fact lead to the silent, unseen disease progressing unchecked, somewhere other than the gut.

How do we know this? See the references for the blog article above ‘Gluten Confusion’.

These are the NICE guidelines for symptoms that could indicate when to test for Coeliac disease:   

  • persistent unexplained abdominal or gastrointestinal symptoms
  • faltering growth
  • prolonged fatigue
  • unexpected weight loss
  • severe or persistent mouth ulcers
  • unexplained iron, vitamin B12 or folate deficiency
  • type 1 diabetes, at diagnosis
  • autoimmune thyroid disease, at diagnosis
  • irritable bowel syndrome (in adults)
  • first‑degree relatives of people with coeliac disease.

On the subject of gluten, look out for my feature on Leaky Gut Syndrome which will be published in January’s issue of ‘Eating & Living Gluten-Free’.

Tips for surviving the festive extravagances!

  • It’s easier to be aware and mindful of your tummy indicating it feels full when you eat slowly
  • When snacking with pre-dinner drinks, choose nuts in preference to crisps, because crisps will increase a blood sugar spike caused by any alcohol, whereas the protein and fats in nuts should modify it.
  • Try and fit in some brisk strolls around the block. Muscles that have ‘spent’ their stores of glucose and energy will be much more receptive to taking up blood glucose from the next meal.  Muscles that have remained comatose in front of the TV will be less receptive, meaning the next load of  blood glucose will be converted to fat – and stored in fat cells
  • Remember alcoholic as well as fizzy soft drinks contain high levels of nutritionally empty calories
  • Try to avoid constant grazing between meals. It’s far better to let a complete meal travel through the various stages of digestion before new food arrives.
  • Before going to social events with buffets, have a nutritious snack like a yoghurt with a banana and a few walnuts, or some carrot sticks with hummus. It will stop that first drink being absorbed into the blood stream too quickly and also prevent you feeling famished until the food finally arrives, leading to the temptation to overload your plate.

Thank you for signing up for my newsletter, and if you know of any friends, neighbours, relatives or colleagues that you think may be interested in nutrition news or the real facts behind headline-grabbing pieces in the popular press, do encourage them to sign up at

 Merry Christmas and best wishes for a healthy 2016

References for vitamin D  

1 Cantorna MTMahon BD. (2004) Mounting evidence for vitamin D as an environmental factor affecting autoimmune disease prevalence. Exp Biol Med (Maywood). 229(11):1136-42.

2 Hendrick B (2011) Macular Degeneration, Study Finds. Online:

3 Soni M et al., (2012) Vitamin D and cognitive function. Scand J Clin Lab Invest Suppl. 243:79-82.

4 Gray N (2013) Omega-3 and vitamin D may help clear Alzheimer’s plaques. Online:

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