Gluten-Free Diets

By Nancy Clark, MS, RD, CSSD

Gluten-free seems to be the latest nutrition buzzword. Gluten is a protein in wheat, rye and barley that must be avoided by people with celiac disease, an inherited autoimmune disorder. Symptoms of celiac vary greatly and can range from digestive problems (diarrhea, constipation, bloating, gas) to serious health problems such as anemia, stress fractures, infertility in both men and women, migraine headaches, canker sores, easy bruising of the skin, swelling of the hands and feet, and bone/joint pain.

Celiac Disease and Gluten Sensitivity Are on the Rise

Some people don’t even realize they have celiac disease. They feel fine – until they experience iron-deficiency anemia or stress fractures due to poor absorption of iron, calcium, and vitamin D.

How common is celiac disease? More than we once thought! About one percent of the population has celiac and needs to avoid even traces of gluten. Up to six percent have non-celiac gluten-sensitivity. The symptoms are similar but without the autoimmune reactions that result in cancer and osteoporosis. No one is certain why celiac disease and gluten-sensitivity are on the rise. One theory relates to changes in the composition of our gut bacteria.

How to tell whether you are gluten-sensitive
If you and others in your genetic family are plagued with niggling health issues (including those mentioned above), you should learn more about celiac disease and gluten-sensitivity. Untreated celiac disease can lead to severe complications including cancer of the gut and osteoporosis. Two websites that offer abundant information include www.celiac.org and www.glutenfreediet.ca.

If you suspect you are gluten-sensitive, don’t self-impose a gluten-free diet without first talking with a doctor who specializes in celiac. You need to get your blood tested for specific antibodies and then, to confim the diagnosis, an intestinal biopsy. Do not eliminate gluten before you get the blood tests, because absence of gluten in your diet can interfere with making the correct diagnosis. If you don’t get properly tested, you might miss an accurate diagnosis or other health problems, like Crohn’s disease, an ulcer, or colon cancer. Plus, if undiagnosed, you might be less motivated to strictly follow a gluten-free diet for life.

If you are “simply” gluten-sensitive, your blood tests will report none of the elevated levels of antibodies that signal celiac disease, but you will feel unwell. Hence, if you have intestinal issues, you might want to try a gluten-free diet for a month or so regardless of the blood test results. One athlete plagued with muscle pain stopped eating wheat and her pains disappeared. She reported that she simply “felt better.” Others say they recover better and have less stiffness and joint pain with a gluten-free diet. This might be due to eliminating gluten, a placebo effect, or eating better overall (no cookies, pastries, junk food). Adhering to a gluten-free diet is challenging and expensive, so there’s no need to self-impose the limitations if you notice no benefits after a month of gluten-free eating.

Going gluten-free
So what’s a hungry person to eat if his or her favorite pasta, bagels, breads, and baked goods are all off-limits? While a diet without pasta may seem like a day without sunshine, rest assured that a plethora of gluten-free carbs can fuel your muscles just as well. You can enjoy carb-rich rice in all forms (brown, white, basmati), corn in all forms (on the cob, cornmeal, grits), potato, sweet potato, lentils, kidney beans, hummus, quinoa, millet, and tapioca. Oats, if processed in a wheat-free plant, can also be safe.

Many fresh foods are naturally gluten-free. They include all plain fruits, vegetables, milk, yogurt, hard cheese, eggs, meats, fish, poultry, nuts, sunflower seeds, edamame, juice, and wine (but not beer). Just be aware that sauces, gravies, and seasoning mixes might contain gluten, as do marinades and soy sauce. Some gluten-free baked goods, pastas, and frozen meals are quite good; others might leave you wishing for something tastier. Two popular brands of gluten-free breads (commonly available at Whole Foods or Trader Joe’s) are “Udi’s” and “Rudi’s.” Hint: They taste better when toasted!

Restaurant and travel tips
At home, you can easily control your diet. When you’re on the road, you need to have a plan. When traveling, carry “emergency food” that doesn’t spoil, such as dried fruit, “Lara Bars,” and nuts.

When eating in a restaurant, you’ll have to quiz the staff and carefully order your food. Omelets tend to be safe, while salads with croutons are not. Make sure the steak tips are not marinated in a gluten-containing sauce, the turkey was not injected with flavor enhancers, the gluten-free toast is not made in the same toaster used for standard breads, the sandwich is prepared on a paper towel or surface not used for other breads (to prevent cross-contamination), the rice in not cooked in broth with unknown gluten-containing seasonings, the French fries are not cooked in the same oil as the breaded chicken, the hamburger is 100 percent beef (with no fillers) and not cooked on the same surface as the toasted buns. Some people travel with their own gluten-free pasta and request it be cooked in fresh water, in a clean pot, and drained into a clean colander. This all requires a patient waiter and an understanding chef.

Everyday gluten-free food suggestions
Even the hungriest “Ironman” triathlete does not need to go hungry on a gluten-free diet! The trick is to eat less processed foods and be a good label reader. Here are just a few suggestions of foods you’d find in standard grocery stores:

Breakfast: Fruit smoothie with Greek yogurt; rice cakes with banana and peanut butter; scrambled eggs, hash browns, and fruit salad; “Rice” or “Corn Chex,” milk and berries.

Lunch: Tuna salad with baked corn chips; 100 percent corn tortilla with melted cheese and pinto beans; “Crunchmaster Multigrain” crackers and hummus.

Dinner: Baked chicken, potato and beets; salmon, sweet potato and peas; omelet, corn and tomatoes; baked potato stuffed with cottage cheese and salsa; Mexican beans and rice; shish kabob, rice, salad with oil & vinegar; frittata (potato, onion and egg ‘pancake’); meals with rice, corn, and quinoa.

Snacks: Apple and cheese; fruit and yogurt; baked potato chips; corn chips; “Blue Diamond Nut Thins;” rice crackers; trail mix (nuts and dried fruit); peanut butter and banana; baby carrots and hummus; popcorn; corn nuts; raisins; grape juice and all fruit juices; smoothies.

Commercial sports foods: Ensure, Gatorade, Powerade; Bakery On Main Granola Bar, Bonk Breaker Bar, Bumble Bar, Enjoy Life Snack Bar, Elev8Me Bar, Extend Bar, Go Raw Bar, Hammer Products (Heed, Perpetuem, Bar, Solids), KIND Bar, Lara Bar, Nonuttin’ Granola Bar, Omega Smart Bar, PB&Whey Bar, Perfect 10 Bar, Pure Bar, PureFit Bar, thinkThin Bar, Quest Bar, Gu, Jelly Belly Sports Beans, Sharkies.
Wheat-free but may not be gluten-free: Odwalla, Clif Builder’s Bar, Clif Shot Bloks.

Nancy Clark, MS, RD, CSSD (Board Certified Specialist in Sports Dietetics) helps both casual and competitive athletes feel great from the inside out. Her practice is at Healthworks, the premier fitness center in Chestnut Hill MA (617-795-1875). Her Sports Nutrition Guidebook and food guides for runners, cyclists and soccer players are popular resources. They are available at www.nancyclarkrd.com. For upcoming workshops, please visit http://www.sportsnutritionworkshop.com.

The articles written by guest contributors are the sole responsibility of the individual writers in terms of factual accuracy and opinion and do not necessarily reflect the views of the publisher of this blog.

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