Background: Prevalence rates for infertility have increased globally. Untreated coeliac disease (... more Background: Prevalence rates for infertility have increased globally. Untreated coeliac disease (CD) and gluten sensitivity can affect fertility. Guidelines encourage testing of women with unexplained infertility for CD and case studies demonstrate pregnancies after introducing a glutenfree diet (GFD). Aims: To understand the experiences of women diagnosed with infertility, investigating the potential role of gluten, including testing and implementation of a GFD. Methods: Participants completed an online survey that included open and closed questions which were coded inductively and analysed using thematic and content analysis. Findings: 29 UK based women completed the survey. The majority identified as White, with one Asian/Asian British, one Mixed, and one Arab participant. Only four had not undergone fertility treatment. Twelve had unexplained infertility, while seven had no diagnosis. Five had primary infertility and five had a secondary infertility diagnosis. TA identified six themes: (1) Experience with gluten in infertility, (2) Experiences with testing for CD, (3) Health beliefs/concerns regarding gluten, (4) Other interventions to help with infertility, (5) Nutritional support for women with infertility, (6) Infertility experience. A GFD alleviated symptoms for those with both intestinal and extra-intestinal symptoms. Participants felt unprepared for CD testing and that healthcare personnel did not treat symptoms seriously. Conclusion: Awareness of extraintestinal manifestations of CD, including unexplained infertility, should be increased amongst healthcare professionals. Women with unexplained infertility should be screened for CD, even without the presence of intestinal symptoms. Women with infertility choosing to implement a GFD need to be better supported.
Male fertility is declining and affects approximately one in seven couples. Reasons for this are ... more Male fertility is declining and affects approximately one in seven couples. Reasons for this are multi-factorial and the subject of on-going research, though environmental contaminants (such xenoestrogens) are believed to be contributory factors. Semen parameters can be improved through a healthy diet and nutritional supplementation has also been shown to improve semen parameters, clinical pregnancy and live birth rates significantly. Despite this, in medical care dietary modification beyond alcohol reduction is rarely recommended. The aim of this review was to consider the psychosocial impacts of infertility in males whilst assessing other nutritional and lifestyle interventions that can be used in personalized nutrition care. More tailored nutrition care needs to consider this and the taboo surrounding the male infertility experience. A systematic approach was used. Three electronic databases (CINAHL, Medline and Academic Search Complete) were searched using predetermined Boolean ...
Celiac disease is known to affect fertility in women, however less is known regarding the relatio... more Celiac disease is known to affect fertility in women, however less is known regarding the relationship between gluten sensitivity and fertility issues. Even in the case of negative serology, there is evidence to suggest a possible role for the gluten free diet as an adjunct therapy in some patients.
A comprehensive integrative handbook on fertility treatment, and Assisted Reproduction Techniques... more A comprehensive integrative handbook on fertility treatment, and Assisted Reproduction Techniques (ART), the book is written by specialist contributors for health professionals and Complementary and Alternative Medicine (CAM) practitioners, and for those seriously considering ART themselves. Integrated approaches to infertility offer both a greater awareness and understanding of the combination of factors that can influence the chances of success when undergoing different types of ART. Leading experts review the evidence and discuss the benefits of different approaches to support the physiological and emotional aspects of fertility and fertility treatment. The book covers everything from identifying and treating conditions that may reduce fertility, including immunological abnormalities and specific male and female factors, to how nutrition, acupuncture, reflexology and yoga can support couples going through assisted reproduction, including helping to improve some immunological aspects. There is also a chapter that looks specifically at support for the over 40's
An Introduction to Mental Health is essential reading for anyone learning the fundamentals of men... more An Introduction to Mental Health is essential reading for anyone learning the fundamentals of mental health. Written for an interdisciplinary audience with a patient-centred focus, it covers historical context through to contemporary issues, including mental health as it relates to the law and to policy. Key learning features include concept summaries, reflective points, case studies and reflective exercises to help situate content in the context of practice
Foodborne infection is a major health issue and its impact on global social and economic developm... more Foodborne infection is a major health issue and its impact on global social and economic development remains unknown (1). A paper published in the journal Nature estimates 30 % of all infections over the last 60 years were Foodborne (2). The Centre for Disease Control in the United States estimates that 76 million people per year are affected by Foodborne illness, with 300,000 requiring hospital treatment and 5000 fatalities (3). Specific foods are associated with specific Foodborne infections and food poisoning (3). Examples include unpasteurised milk (Campylobacter); shellfish (noroviruses); unpasteurized apple cider (Escherichia coli O157:H7), raw and undercooked eggs (Salmonella); fish (ciguatera poisoning); raspberries (Cyclospora); strawberries (hepatitis A virus); and ready-to-eat meats (Listeria). In clinical practice, healthcare professionals, including physicians, have to interpret clinical symptoms; enabling correct diagnosis and the differentiation of Foodborne illness f...
Gastroenterology and Hepatology From Bed to Bench, 2011
Foodborne infection is a major health issue and its impact on global social and economic developm... more Foodborne infection is a major health issue and its impact on global social and economic development remains unknown (1). A paper published in the journal Nature estimates 30% of all infections over the last 60 years were Foodborne (2). The Centre for Disease Control in the United States estimates that 76 million people per year are affected by Foodborne illness, with 300,000 requiring hospital treatment and 5000 fatalities (3). Specific foods are associated with specific Foodborne infections and food poisoning (3). Examples include unpasteurised milk (Campylobacter); shellfish (noroviruses); unpasteurized apple cider (Escherichia coli O157:H7), raw and undercooked eggs (Salmonella); fish (ciguatera poisoning); raspberries (Cyclospora); strawberries (hepatitis A virus); and ready-to-eat meats (Listeria). In clinical practice, healthcare professionals, including physicians, have to interpret clinical symptoms; enabling correct diagnosis and the differentiation of Foodborne illness fr...
Gastroenterology and Hepatology From Bed to Bench, 2012
Aim To assess the clinical characteristic of CD as well as correlation of symptoms and the degree... more Aim To assess the clinical characteristic of CD as well as correlation of symptoms and the degrees of intestinal mucosal lesions in Iranian children. Background Microscopic Enteritis (Marsh 0-II) is associated with malabsorption. Patients and methods From August 2005 to September 2009, 111 cases with malabsorption and classical gastrointestinal symptoms were evaluated. Results The mean (±SD) age of children with CD was 4.9±3.5 years (range, 6 month - 16 years) and the mean duration of symptoms was 8 ± 20.5 months. 50 cases (45%) were female and 61 cases (55%) were male. The most common clinical presentation was failure to thrive in 72%, chronic diarrhea in 65.8% and Iron deficiency anemia in 59.5%. Sensitivity of EMA was 100% in patients with Marsh IIIb and Marsh IIIc. EMA was also positive in 77% of cases with Marsh 0, 18% in Marsh I, 44% in Marsh II and 81.8% in patients with Marsh IIIa. Conclusion Histopathology did not reflect the severity of gluten sensitivity. This would sugge...
This research project examined the assessment feedback method used for summative coursework on a ... more This research project examined the assessment feedback method used for summative coursework on a postgraduate, blended learning programme within the Institute of Health and Society. The aim was to determine if and how the introduction of electronic feedback changes the way students interact and learn from feedback. This study was undertaken with the participants from four student c ohorts from the same Master’s degree programme. An electronic survey questionnaire with primarily open -ended questions was utilised to collect qualitative data about their learning exper ience and the proposed changes. Data was analysed for thematic content using the principles of grounded theory. Responses were analysed manually for key words or sentences, phrases and themes. Codes were applied and then sorted into category schemes. Responses were received from 28 students. Data analysis of the questionnaire responses identified 22 codes. The codes were further analysed to identify simple category schem...
Gastroenterology and Hepatology From Bed to Bench, 2018
Aim: To explore the motivation for gluten avoidance in the absence of coeliac disease (CD) and as... more Aim: To explore the motivation for gluten avoidance in the absence of coeliac disease (CD) and ascertain what symptoms are triggered by gluten and what beliefs/reasons influence this decision. Background: Links between physical/psychological symptoms and gluten in CD are well known but less is known about those who self-select a gluten-free diet (GFD) in the absence of CD. Methods: An empirical study using responses to an anonymous on-line questionnaire. Closed questions were used as a screening tool to exclude participants who had CD, wheat allergy or were following a low FODMAP diet. Data from participants using a GFD in the absence of a medical diagnosis was then analysed using thematic analysis. Results: 120 initial responses, 87 were completed in full. 23 respondents fulfilled the inclusion criteria for thematic analysis. 7 different themes emerged, including one for signs/symptoms. Other themes identified included difficulties of a GFD, health beliefs, feelings and influence o...
Gastroenterology and Hepatology From Bed to Bench, 2020
The current review aimed to synthesize the literature on the complex relationship between food co... more The current review aimed to synthesize the literature on the complex relationship between food consumption and nutritional status as well as the digestive system in order to examine the relationship between immunity and potential responses to COVID-19 infection. The goal is to help inform the many healthcare professionals working with COVID-19 patients. A literature search was performed on PubMed, Scopus, and EMBASE databases. Hand searches were also undertaken using Google and reference lists to identify recent evidence. Studies were critically appraised, and the findings were analyzed by narrative synthesis. Nutritional status can impact immunity in several ways, including affecting susceptibility to infection, severity of disease, and recovery time, and is therefore a significant consideration in the management of COVID-19. COVID-19 can also impact digestive function, which can further impact nutritional status. The role of Vitamin D deficiency in vulnerability to severe respirat...
Aim The purpose of this study is to explore whether the types and quality of breakfast could infl... more Aim The purpose of this study is to explore whether the types and quality of breakfast could influence energy levels (blood glucose levels) and propose ideal breakfast models. Background It is widely considered that a regular breakfast provides a number of health benefits; however, there is no general scientific agreement regarding what kind of food should be consumed. Evidence supports the importance of balancing blood glucose levels by low glycaemic index/load (L-GI/L) and increased protein diets, in particular in metabolic disorders, which non-alcoholic fatty liver disease (NAFLD) has a close relation to. Patients and methods This study was conducted by using a valid and standard questionnaire at the University of Worcester to evaluate the breakfast and dietary habits and energy levels. The Kruskal-Wallis test was used for statistical analysis. Results No significant differences were found either between breakfast consumption, energy levels, types of snack and amount of caffeine ...
An association between coeliac disease and fertility disorders is well recognised in the current ... more An association between coeliac disease and fertility disorders is well recognised in the current literature, but the information related to non-coeliac gluten sensitivity (NCGS) and infertility is lacking. This case highlights a possible role of treating NCGS in the reversal of infertility.
Background: Prevalence rates for infertility have increased globally. Untreated coeliac disease (... more Background: Prevalence rates for infertility have increased globally. Untreated coeliac disease (CD) and gluten sensitivity can affect fertility. Guidelines encourage testing of women with unexplained infertility for CD and case studies demonstrate pregnancies after introducing a glutenfree diet (GFD). Aims: To understand the experiences of women diagnosed with infertility, investigating the potential role of gluten, including testing and implementation of a GFD. Methods: Participants completed an online survey that included open and closed questions which were coded inductively and analysed using thematic and content analysis. Findings: 29 UK based women completed the survey. The majority identified as White, with one Asian/Asian British, one Mixed, and one Arab participant. Only four had not undergone fertility treatment. Twelve had unexplained infertility, while seven had no diagnosis. Five had primary infertility and five had a secondary infertility diagnosis. TA identified six themes: (1) Experience with gluten in infertility, (2) Experiences with testing for CD, (3) Health beliefs/concerns regarding gluten, (4) Other interventions to help with infertility, (5) Nutritional support for women with infertility, (6) Infertility experience. A GFD alleviated symptoms for those with both intestinal and extra-intestinal symptoms. Participants felt unprepared for CD testing and that healthcare personnel did not treat symptoms seriously. Conclusion: Awareness of extraintestinal manifestations of CD, including unexplained infertility, should be increased amongst healthcare professionals. Women with unexplained infertility should be screened for CD, even without the presence of intestinal symptoms. Women with infertility choosing to implement a GFD need to be better supported.
Male fertility is declining and affects approximately one in seven couples. Reasons for this are ... more Male fertility is declining and affects approximately one in seven couples. Reasons for this are multi-factorial and the subject of on-going research, though environmental contaminants (such xenoestrogens) are believed to be contributory factors. Semen parameters can be improved through a healthy diet and nutritional supplementation has also been shown to improve semen parameters, clinical pregnancy and live birth rates significantly. Despite this, in medical care dietary modification beyond alcohol reduction is rarely recommended. The aim of this review was to consider the psychosocial impacts of infertility in males whilst assessing other nutritional and lifestyle interventions that can be used in personalized nutrition care. More tailored nutrition care needs to consider this and the taboo surrounding the male infertility experience. A systematic approach was used. Three electronic databases (CINAHL, Medline and Academic Search Complete) were searched using predetermined Boolean ...
Celiac disease is known to affect fertility in women, however less is known regarding the relatio... more Celiac disease is known to affect fertility in women, however less is known regarding the relationship between gluten sensitivity and fertility issues. Even in the case of negative serology, there is evidence to suggest a possible role for the gluten free diet as an adjunct therapy in some patients.
A comprehensive integrative handbook on fertility treatment, and Assisted Reproduction Techniques... more A comprehensive integrative handbook on fertility treatment, and Assisted Reproduction Techniques (ART), the book is written by specialist contributors for health professionals and Complementary and Alternative Medicine (CAM) practitioners, and for those seriously considering ART themselves. Integrated approaches to infertility offer both a greater awareness and understanding of the combination of factors that can influence the chances of success when undergoing different types of ART. Leading experts review the evidence and discuss the benefits of different approaches to support the physiological and emotional aspects of fertility and fertility treatment. The book covers everything from identifying and treating conditions that may reduce fertility, including immunological abnormalities and specific male and female factors, to how nutrition, acupuncture, reflexology and yoga can support couples going through assisted reproduction, including helping to improve some immunological aspects. There is also a chapter that looks specifically at support for the over 40's
An Introduction to Mental Health is essential reading for anyone learning the fundamentals of men... more An Introduction to Mental Health is essential reading for anyone learning the fundamentals of mental health. Written for an interdisciplinary audience with a patient-centred focus, it covers historical context through to contemporary issues, including mental health as it relates to the law and to policy. Key learning features include concept summaries, reflective points, case studies and reflective exercises to help situate content in the context of practice
Foodborne infection is a major health issue and its impact on global social and economic developm... more Foodborne infection is a major health issue and its impact on global social and economic development remains unknown (1). A paper published in the journal Nature estimates 30 % of all infections over the last 60 years were Foodborne (2). The Centre for Disease Control in the United States estimates that 76 million people per year are affected by Foodborne illness, with 300,000 requiring hospital treatment and 5000 fatalities (3). Specific foods are associated with specific Foodborne infections and food poisoning (3). Examples include unpasteurised milk (Campylobacter); shellfish (noroviruses); unpasteurized apple cider (Escherichia coli O157:H7), raw and undercooked eggs (Salmonella); fish (ciguatera poisoning); raspberries (Cyclospora); strawberries (hepatitis A virus); and ready-to-eat meats (Listeria). In clinical practice, healthcare professionals, including physicians, have to interpret clinical symptoms; enabling correct diagnosis and the differentiation of Foodborne illness f...
Gastroenterology and Hepatology From Bed to Bench, 2011
Foodborne infection is a major health issue and its impact on global social and economic developm... more Foodborne infection is a major health issue and its impact on global social and economic development remains unknown (1). A paper published in the journal Nature estimates 30% of all infections over the last 60 years were Foodborne (2). The Centre for Disease Control in the United States estimates that 76 million people per year are affected by Foodborne illness, with 300,000 requiring hospital treatment and 5000 fatalities (3). Specific foods are associated with specific Foodborne infections and food poisoning (3). Examples include unpasteurised milk (Campylobacter); shellfish (noroviruses); unpasteurized apple cider (Escherichia coli O157:H7), raw and undercooked eggs (Salmonella); fish (ciguatera poisoning); raspberries (Cyclospora); strawberries (hepatitis A virus); and ready-to-eat meats (Listeria). In clinical practice, healthcare professionals, including physicians, have to interpret clinical symptoms; enabling correct diagnosis and the differentiation of Foodborne illness fr...
Gastroenterology and Hepatology From Bed to Bench, 2012
Aim To assess the clinical characteristic of CD as well as correlation of symptoms and the degree... more Aim To assess the clinical characteristic of CD as well as correlation of symptoms and the degrees of intestinal mucosal lesions in Iranian children. Background Microscopic Enteritis (Marsh 0-II) is associated with malabsorption. Patients and methods From August 2005 to September 2009, 111 cases with malabsorption and classical gastrointestinal symptoms were evaluated. Results The mean (±SD) age of children with CD was 4.9±3.5 years (range, 6 month - 16 years) and the mean duration of symptoms was 8 ± 20.5 months. 50 cases (45%) were female and 61 cases (55%) were male. The most common clinical presentation was failure to thrive in 72%, chronic diarrhea in 65.8% and Iron deficiency anemia in 59.5%. Sensitivity of EMA was 100% in patients with Marsh IIIb and Marsh IIIc. EMA was also positive in 77% of cases with Marsh 0, 18% in Marsh I, 44% in Marsh II and 81.8% in patients with Marsh IIIa. Conclusion Histopathology did not reflect the severity of gluten sensitivity. This would sugge...
This research project examined the assessment feedback method used for summative coursework on a ... more This research project examined the assessment feedback method used for summative coursework on a postgraduate, blended learning programme within the Institute of Health and Society. The aim was to determine if and how the introduction of electronic feedback changes the way students interact and learn from feedback. This study was undertaken with the participants from four student c ohorts from the same Master’s degree programme. An electronic survey questionnaire with primarily open -ended questions was utilised to collect qualitative data about their learning exper ience and the proposed changes. Data was analysed for thematic content using the principles of grounded theory. Responses were analysed manually for key words or sentences, phrases and themes. Codes were applied and then sorted into category schemes. Responses were received from 28 students. Data analysis of the questionnaire responses identified 22 codes. The codes were further analysed to identify simple category schem...
Gastroenterology and Hepatology From Bed to Bench, 2018
Aim: To explore the motivation for gluten avoidance in the absence of coeliac disease (CD) and as... more Aim: To explore the motivation for gluten avoidance in the absence of coeliac disease (CD) and ascertain what symptoms are triggered by gluten and what beliefs/reasons influence this decision. Background: Links between physical/psychological symptoms and gluten in CD are well known but less is known about those who self-select a gluten-free diet (GFD) in the absence of CD. Methods: An empirical study using responses to an anonymous on-line questionnaire. Closed questions were used as a screening tool to exclude participants who had CD, wheat allergy or were following a low FODMAP diet. Data from participants using a GFD in the absence of a medical diagnosis was then analysed using thematic analysis. Results: 120 initial responses, 87 were completed in full. 23 respondents fulfilled the inclusion criteria for thematic analysis. 7 different themes emerged, including one for signs/symptoms. Other themes identified included difficulties of a GFD, health beliefs, feelings and influence o...
Gastroenterology and Hepatology From Bed to Bench, 2020
The current review aimed to synthesize the literature on the complex relationship between food co... more The current review aimed to synthesize the literature on the complex relationship between food consumption and nutritional status as well as the digestive system in order to examine the relationship between immunity and potential responses to COVID-19 infection. The goal is to help inform the many healthcare professionals working with COVID-19 patients. A literature search was performed on PubMed, Scopus, and EMBASE databases. Hand searches were also undertaken using Google and reference lists to identify recent evidence. Studies were critically appraised, and the findings were analyzed by narrative synthesis. Nutritional status can impact immunity in several ways, including affecting susceptibility to infection, severity of disease, and recovery time, and is therefore a significant consideration in the management of COVID-19. COVID-19 can also impact digestive function, which can further impact nutritional status. The role of Vitamin D deficiency in vulnerability to severe respirat...
Aim The purpose of this study is to explore whether the types and quality of breakfast could infl... more Aim The purpose of this study is to explore whether the types and quality of breakfast could influence energy levels (blood glucose levels) and propose ideal breakfast models. Background It is widely considered that a regular breakfast provides a number of health benefits; however, there is no general scientific agreement regarding what kind of food should be consumed. Evidence supports the importance of balancing blood glucose levels by low glycaemic index/load (L-GI/L) and increased protein diets, in particular in metabolic disorders, which non-alcoholic fatty liver disease (NAFLD) has a close relation to. Patients and methods This study was conducted by using a valid and standard questionnaire at the University of Worcester to evaluate the breakfast and dietary habits and energy levels. The Kruskal-Wallis test was used for statistical analysis. Results No significant differences were found either between breakfast consumption, energy levels, types of snack and amount of caffeine ...
An association between coeliac disease and fertility disorders is well recognised in the current ... more An association between coeliac disease and fertility disorders is well recognised in the current literature, but the information related to non-coeliac gluten sensitivity (NCGS) and infertility is lacking. This case highlights a possible role of treating NCGS in the reversal of infertility.
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