From the regions

GLUTEN FREE BOUNTY

T TAKES a bold move to go from a farmer’s market stallholder to a NZI Rural Women NZ Business Award winner – but this is exactly what Sue Loder the owner of ‘Well & Truly Artisan Pantry’ did. Sue had applied for the awards in July last year and won the ‘Bountiful Table’ category which put her in contention alongside six other rural businesses for the supreme award.

“What I loved about the process more so than winning the award was having to stop and look at the business and reflect on it. Quite often, particularly in the recent period dominated by COVID, you are often spending time fighting fires. To take the time to be reflective has been a great reminder of where we have come from and where we are going,” Sue says.

Located in Kaipaki, Well & Truly Artisan Pantry owners Sue and husband Matt bought the small market business three years ago and converted a double garage on their six-acre section into a commercial kitchen. The focus behind this Crossed Grain Logo accredited range is to create products with wellness in mind, using whole all-natural nutritious food – just how nature intended, simply made, special and 100% gluten free.

Sue prides herself on the business being totally artisan. The entire range is handcrafted, from blending of the ingredients to cooking and packaging. Each part of the process from the measuring of ingredients to the bag filling is all done by hand.

Part of living a balanced life for Sue and her family is living in their rural community, “It’s funny most people we meet don’t know where Kaipaki is, but it’s the best kept secret around. We have such a wonderful community, and we love being a part of it. It’s about getting back to basics, connecting with the people and the land around you”. CL

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“We love how the Crossed Grain Logo provides such assurance for our coeliac customers; it aligns with one of our core values of people before profits.” wellandtruly.nz

HOW IT SHOULD BE.

WE BELIEVE IN MAKING BEAUTIFUL SOY SAUCE THAT ALSO TASTES AMAZING. OUR SOY SAUCE IS NATURALLY BREWED THEN SIMPLY BOTTLED. THERe's NO ROOM FOR ADDED PRESERVATIVES, COLOURS OR FLAVOURINGS. Now that's one thing you don't have to worry about.

BONE HEALTH

Dr David Kim talks to Coeliac Link about coeliac disease, BONE HEALTH and OSTEOPOROSIS.

STEOPOROSIS

is a condition where your bones become thinner and lose strength such that you become more predisposed to broken bones (fractures), in some instances without significant trauma. Our bone density declines with ageing, particularly in the post-menopausal period in women. Roughly one in three women and one in five men over the age of fifty will suffer a broken bone due to osteoporosis in their life time. These fractures not only cause pain and suffering but also often lead to disability, temporarily or permanently, with loss of independence in many instances.

What is the relevance of osteoporosis in coeliac disease? While osteoporosis often occurs ‘naturally’ with ageing, a significant proportion of osteoporosis and fragility fractures occur, at least in part, due to other factors that weaken the bones. These ‘risk factors’ are usually modifiable and treatable, and coeliac disease is one such example. Bone density can be objectively assessed with bone mineral density (DEXA) scan, and mild-moderate reduction called osteopenia, and moderate-severe reduction called osteoporosis, can be readily detected. Studies revealed that osteopenia or osteoporosis was present in at least a quarter of coeliac disease patients at the time of diagnosis. Additionally, it has been shown that those with coeliac disease have about 30% increased risk of bone fractures compared to others without coeliac disease.

What are the mechanisms of poor bone health in coeliac disease? There are a number of ways in which coeliac disease reduces bone density and bone quality. Most well-understood mechanism is through malabsorption of calcium and vitamin D – both play important roles in maintaining healthy bones. Another mechanism is through malnutrition related low body weight; weight is an important factor in maintaining bone mass. Other possible links between coeliac disease and bone health include immunological and inflammatory processes directly impacting on bone health. Abnormalities in sex hormone metabolism, such as delayed puberty, hypogonadism and early menopause that are common in coeliac disease, can also negatively impact the bone.

What to do to improve and maintain good bone health if you have coeliac disease? Good coeliac disease care through strict gluten free diet is the first and foremost way to improve and preserve bone health. Vitamin D and/ or calcium supplementation may be needed in some situations. DEXA scan should ideally be performed at the time of diagnosis of coeliac disease particularly if the condition may have been present for a number of years prior to the diagnosis or there are concurrent risk factors for accelerated bone loss. These risk factors include family history of osteoporosis, low body weight (BMI under 20), inflammatory conditions such as rheumatoid arthritis and inflammatory bowel disease, other hormone conditions such as overactive thyroid or parathyroid, and having been on certain medications that are known to reduce bone density. These medicines include corticosteroids (e.g. prednisone) and hormone suppressing cancer treatments such as those used in breast and prostate cancers.

There are a number of online fracture risk calculators that could also be used. While these cannot replace a DEXA scan, they provide a reasonably reliable osteoporotic fracture risk. One such tool freely available for New Zealanders is called Know Your BonesTM: knowyourbones.org.nz.

Upon completing this questionnairebased analysis, a short report is generated stating whether you are at low, medium or high risk of fractures. This report can be printed or downloaded so that the information can be discussed with healthcare professional.

If you are deemed to have osteopenia or osteoporosis on DEXA scan, your healthcare professional will discuss the necessity and options for bone-protection treatment. There are now several different treatment agents available, most of them funded, in New Zealand. These medications are generally safe and well-tolerated, and can significantly reduce risk of future fragility fractures, by about 50%. CL

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Dr David D.W. Kim (MBChB & FRACP), Endocrinologist, Auckland

RESOURCES

More useful information about osteoporosis can be found from following online resources: • bones.org.nz • osteoporosis.foundation

Bakels PROUDLY SUPPORT COELIAC AWARENESS WEEK

JUNE 6-12 | 2022

Bakels Gluten Free Flour is a quality flour suitable as a direct replacement for standard flour in many types of baking. Visit bakels.co.nz for recipes