Gluten Free Fitness

Celiac disease

Weighty Matters: How to Lose Weight on a Gluten Free Diet

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Weight issues. You see it everywhere. Commercials on TV “Eat pizza and still lose weight!”, in magazines “take this pill and lose fat effortlessly!”, and in life-someone telling you about the “detox and I lost 20 pounds!” The upshot is that any weight lost with a “get thin quick” scheme will be rapidly regained. Sometimes even more fat/weight is gained then was originally lost.

In Part 1 of this series, I revealed how I was a cheater at the gluten free diet. In Part 2, we covered some physical and psychological reasons why you may experience weight loss or gain with celiac disease/gluten intolerance. Some of those factors are out of your control-others are within your control. In this part, we’re focusing on actionable steps you can take. In other words-what can you do about it?

In the celiac world, I’ve seen many posts on forums about people who have gained weight-either before going gluten free or after. It’s not unique to the celiac/gluten intolerant population by any stretch-a review in the Journal of the American Medical Association in 2010 reported that 68% of the United States population is overweight or obese. That’s completely staggering. The health consequences can not be overstated. I touched on them briefly in my post on Gratitude, Awareness and Prevention.

Losing fat isn’t complicated, but it’s also not easy.

Regarding celiac disease/gluten intolerance and weight, although there are some specific areas that deserve special consideration, there is one overriding principle that always is the primary issue. Calories. Doesn’t matter how you count it, track it, or measure it, calories are the most important factor when it comes to weight management. Of course the quality of calories matters, but the number one factor is amount. Amount of energy you are taking in, versus amount of energy you output through activity. Every single successful weight loss program has people tracking calories in some way, even if it’s a very subtle way of doing it.

  • Counting points? Yup, that’s a way of tracking calories.
  • Counting portions? Si, senor.
  • Counting macros? (Grams of protein/carb/fat) Oui!
  • Using a portion “plate“? Yes ma’am! (By the way-these things are way cool and I wish I had come up with them. Elegance in simplicity.)
  • Measuring/weighing your food and keeping a daily log? Of course-and my personal favorite because it’s the most precise. (I like precise. As precise as possible.)
  • Eating your protein and veggies first, and then if you have room adding something else? Indirectly that will reduce your caloric intake.
  • (Ok-there’s one method that doesn’t really count, and that’s intuitive eating, and will be the subject of another article.)

The major principle to notice is that these methods all have you tracking your intake, in some way. Some just “trick” you into doing it and may be more appealing to your individual personality.

Caveat

One caveat-all these are estimates at best. Without blowing up our food in a calorimeter before we eat it we don’t know exactly, and there’s always some error. But it’s a great starting point. With everything, you start somewhere, track it so you know what you’ve done, and then you can adjust based on your personal real world results.

Doing some kind of tracking of calories is especially important when you have a disruption of the normal function of the gut, as is the case with celiac. As I touched on in Part 2, there are important hormones involved in appetite, hunger and satiety (the sense of being full) which can be affected by the gut not functioning normally. With this, our signals of hunger and fullness may not correlate to what we need to maintain our weight.

It’s like this-for someone with a normally functioning intestinal system and normal weight, the senses of hunger and fullness can fairly accurately help someone maintain their weight. (If they listen to these cues, which again goes beyond the scope of this particular article.) If these signals are off, the sense of hunger may be higher. I have seen people commenting very frequently how hungry they feel all the time, especially when first diagnosed as the gut is still healing.

Math vs. feeling

If we can’t depend on our hunger/fullness, we need to do the math. And truly, relying on hunger cues to maintain your weight is very reasonable, but much less so when you are losing weight. Losing fat means eating less than you need to maintain your current status, which logically means you will feel hungry sometimes. And that’s OK, and should be expected, and not freaked out over. If you want to lose fat, and expect to never feel hungry, you’re wrong. Despite what any magic pill may want you to believe.

Keeping track of what you eat doesn’t have to be complicated. After a little while, measuring and tracking becomes second nature, and not hard at all.

Here 5 steps you can take NOW to make it easier to control your weight.

1) Don’t drink any calories.

This sounds so simplistic, but it’s completely true. A 500 calorie coffee drink will do very little to nothing to make you feel full, and give you a whole bunch of nutritionally empty sugar calories. Same goes for juice. Yes, juices have some redeeming qualities, but you are much better served by eating a piece of fruit. More fiber, more satiety, chewing, and the vitamins. Just chew. (Hmmm…”Just Chew” T-shirts?)

2) Add a vegetable to each meal.

Many of us don’t come close to getting in 7-9 servings of vegetables a day. The good news is that a serving of vegetables isn’t very much-half a cup in most instances. You can put that away easily, and it will help you feel full. I do quite like the idea of adding food in the form of veggies when you are dieting because it minimizes the sense of deprivation-you’re ADDING food!

Yes, it’s nutritionally dense, low calorie food, but it makes your plate look full. That’s a win/win. Perception is reality, peeps. If you think you don’t like veggies, try some new ones. Eat the ones you like. Don’t cook them into a mushy mess. Eat them first to “get them out of the way so I can enjoy the rest of my meal” like my fiance. I don’t care. Just eat them. Fruits too-but focus on veggies first.

3) If you feel hungry, drink a big glass of water and then reassess.

Many times we mistake hunger for thirst. Give it a try next time. I’m also a big fan of brewed teas-they give a lot of flavor, polyphenols and antioxidents, and no calories. (Don’t add a bunch of sweetner-defeats the purpose.)

4) If you have a snack, include a protein source and a veggie.

Examples:

  • Deli turkey (Boar’s Head is gluten free) wrapped around baby carrots-makes you eat slowly also.
  • Broccoli or sliced peppers dipped into cottage cheese or greek yogurt (you can add seasoning as well to your dip)
  • String cheese and snap peas. Combines the crunchy and creamy cravings.
  • Here’s a list of my Top 10 portable gluten free snacks

5) Move more.

All the little things really do add up. Take the stairs, park farther away, take a lunchtime walk at work, walk the dog, window shop, just move. Organized exercise is great-but it doesn’t make up for 12-15 hours sitting on your duff. Move.

If you are saying “But I don’t want to keep track of what I eat” I have this to say to you.

How much do you want to lose fat and be healthier?

When you make that decision, you make time, and make the effort to do what is important to you.

What are your thoughts? What have you done to make weight control easier? What challenges have you faced? Share them below and let’s help each other out!

Weighty Matters: Physical and Psychological Impact: Celiac Disease and Gluten Intolerance

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In Part 1, I told you how I was a cheater when it came to implementing the gluten free diet. Today, we’ll go over some mechanisms behind why we see weight gain and weight loss with celiac disease.

Physical and psychological causes

There are 2 categories to take a look at-the physical, and the psychological. Both have impact on weight management-the psychological is just as powerful as the physiological. We’ll look at issues in both categories. In parts 3 and 4 we’ll cover steps you can take to positively impact your weight and health.

First, the physical.

Physical reasons behind weight loss and celiac disease/gluten intolerance:

  • With celiac disease (gluten sensitive enteropathy), there is damage done to the villi in the small intestine. The damage limits the ability of the intestine to absorb nutrients. With limited absorption, less overall calories and also less vitamins, minerals, etc. Many times a person may feel so sick that they just can’t eat enough to make up for the poor absorption. Worse, they may be eating more of the foods that are actually making them sick without realizing it.
  • People can feel so unwell when they eat they just eat less. Less often, and less in amount. Decreased calories.

Physical reasons behind weight gain and celiac disease/gluten intolerance:

  • Decreased absorption of nutrients can contribute to people never feeling “full.”
    They eat more, in frequency and/or amount. Eventually the calories get absorbed, and it catches up. After diagnosis, there may also be a small overcompensation effect of the gut to absorb nutrition.
  • When your gut begins to heal and absorb nutrients, you may find that you gain weight.
    The nutrition and calories that was just going thru you before in now being assimilated into your body. This is a good thing from a health standpoint. If you listened to part 3 of the podcast with Shelly Stuart she mentioned how she gained a bunch of weight after her gut began to heal. She had been accustomed to eating large amounts of food because it wasn’t being absorbed. When absorption increased, so did her weight. So she recognized that and scaled back on portions, focusing on quality and nutritionally dense foods. The upshot here-you may have been eating more food than you actually needed before, but some of it was going straight into the toilet. How’s that for a visual?
  • The damage and affects of celiac disease may impact the hormones in our gut that control appetite and satiety (the sense of being full.)
2 main hormones are leptin and ghrelin.

Quick definitions per Medical Dictionary.com:

Leptin:
hormone indicating degree of hunger: a hormone produced by fat cells that indicates the degree of hunger to the hypothalamus of the brain. (Tells you when you feel full and stop eating. Problems with leptin can lead to eating too much because “I’m full” doesn’t kick on.) Leptin resistance also appears to be a problem, as many obese indivduals have high levels of leptin, but are not recognizing the full sensation.

Ghrelin:
a gastrointestinal hormone produced by epithelial cells lining the fundus of the stomach; appears to be a stimulant for appetite and feeding.

A study done in 2005 in Italy using classic symptom female celiac patients (the underweight/malnourished classic) showed decreased ghrelin levels after 2 years of being on a gluten free diet, even though their body mass and fat mass had increased.

Another study completed on children with celiac disease showed leptin levels lower than non-celiac children, which then increased after one year on a gluten free diet.

A study in 2003 showed high levels of circulating ghrelin levels in adults with active untreated celiac disease, and normal levels of ghrelin in those who had been treated with a gluten free diet.

So why does this all matter?

We still don’t know, to be honest. This is an example of how our gut affects our hormones, and especially that as someone who has been newly diagnosed with celiac disease or gluten intolerance, you may feel especially hungry. There’s much more research to be done, and I’ve only begun to scratch the surface of what has already been done. But the take home is that our hormones dealing with hunger and the sense of fullness may be affected, and so may not be too accurate when it comes to saying we’ve had enough to eat.

The psychological

Which brings me to the psychological impact of celiac disease/gluten intolerance on weight:

  • After diagnosis there is an immediate reaction of “What can I eat?”
    The gluten free diet can feel overwhelming, with the huge lists of ingredients to avoid. First instinct may be to gravitate toward comfort foods labeled “gluten free,” and the attempt to replicate a “normal” carb based diet with their gluten free substitutes. Unfortunately, this can lead to weight gain. Many gluten free substitutes of ordinarily gluten foods have a higher number of calories. Many times this is due to the need to add additional fats to get a decent “mouth feel” in the product. With the proliferation of gluten free foods in the marketplace (a great thing for choice) also comes an increased need to be aware of the nutritional content and value of what we eat-to look “beyond the gluten free label.” Just because it’s gluten free doesn’t mean it’s good to eat in large quantities.
  • There is also a sense of Thank Goodness I can eat without feeling sick!
    This can lead to eating an increased volume of food as well-just being so happy that you don’t feel sick any more, and taking advantage of that.

Couple that with the fact that our innate mechanism of knowing when to stop eating because we feel full may be affected (we don’t know this for sure yet) because of some hormonal wackiness, and we’ve got some challenges.

In Parts 3 and 4 we’re going to look at steps you can take to impact your weight in a positive way, whether it’s a need to gain, or a need to lose.

If you have questions/comments/experiences, please leave them below. I like to hear from you-don’t be shy!

Probiotics and Gut Health: Say Hello to My Little Friend

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Probiotics. A popular word for sure right now. Looking around in the grocery store it seems like the healthy bacteria are being added to everything from yogurt to cottage cheese to coffee. (Kidding about that last one. Although given how much I love coffee, I’m not opposed to the idea.)

Probiotics by definition

Probiotic: A microbe that protects its host and prevents disease.

Probiotics are found naturally in the gut (stomach/intestines.) With antibiotic use, and sometimes with dysfunction of the gut (such as celiac disease) the balance of this “good bacteria” can be disrupted, and cause intestinal distress such as diarrhea. These little suckers can be a bit fragile, and not all of them can be ingested orally (eaten/swallowed) and survive into the digestive tract.

Different strains

There are many different strains of probiotics. If you think about antibiotics, there are lots of different prescriptions that we have seen or heard of over the years, right? Similarly, there are a number of different probiotics. Thousands, in fact.

However, there are only a handful of these thousand that have been researched upon and shown to be effective. Within the handful of effective ones, they may only be effective for certain conditions. So just ingesting a product with “probiotics” doesn’t necessarily give you any benefit. It depends on why you are taking them, and the strain of bacteria that is in the product. Unfortunately, the labeling for these products is often unclear.

Lactobacillus acidophilus

Lactobacillus acidophilus is a common probiotic. According to MayoClinic.com:

Lactobacillus acidophilus is generally considered to be beneficial because it produces vitamin K, lactase, and anti-microbial substances such as acidolin, acidolphilin, lactocidin, and bacteriocin. Multiple human trials report benefits of L. acidophilus for bacterial vaginosis. Other medicinal uses of L. acidophilus are not sufficiently studied to form clear conclusions.

It’s normally found in yogurt, and in lactose reduced milk. (Lactaid brand ’round these parts.)

Bifidobacteria

Another probiotic group known as Bifidobacteria (one of these strains is the one in the Activia yogurt-long live Jamie Curtis and her healthy bowels.) One of the methods of action is to slow the transit time of material through the intestines-again, reducing diarrhea.

The strain in Activia was produced specifically by Dannon and is known as Bifidus Regularis. As an aside, Dannon settled a class action lawsuit late in 2009 and has since altered the label claims.

Another strain of Bifidobacterium is bifidus infantis. This is the probiotic found in the product Align. Align is gluten free.

The Bifidobacterium probiotic strain appears to have real promise for those with intestinal disorders, including celiac disease and IBS.

Bifidobacterium appears to reduce the permeability of the intestinal walls in response to gliadin. This is especially of interest to those of us with celiac disease as the probiotic can help reduce gliadin’s (protein in gluten) damage to the intestines.

Recommendations were made at the Yale University Workshop in 2008 by a panel of 12 regarding the use of probiotics. Unfortunately, this paper is not available for free access (like so many I want to see,) but a summary from the NY Times stated:

A panel of 12 experts concluded that there was strong evidence that several probiotic strains could reduce diarrhea, including that associated with antibiotic use. Several studies have also suggested that certain probiotics may be useful for irritable bowel syndrome, with the strongest recommendation for Bifidobacterium infantis 35624, the probiotic in the Procter & Gamble supplement Align. (Two members of the panel had ties to Procter & Gamble; three others had ties to other companies that sell probiotics.)

Important to note that there is financial benefit there. That doesn’t mean their opinion should be discounted, it’s just something to be aware of.

Of course, if you have any questions, please contact your physician before starting probiotic use. They are GRAS (generally recognized as safe) by the FDA, but individuals with immunodeficiency or active bowel infection are not recommended to use probiotics.

Align was kind enough to send me samples to try, and a month’s supply for one lucky reader! I used Align for a month, and can say I did not notice a difference. However, I am not a fair subject as I was already taking another brand of probiotic. Align also offers a money back guarantee if you are dissatisfied after trying it. That’s pretty impressive.

Align can be found pretty much anywhere-I saw it at Target and Publix.

If you’d like to win a free month supply of Align, leave a comment below and tell me what your biggest obstacle is to eating healthfully (if you have one), and/or your experience with probiotics. Winner will be randomly selected.

You can get another chance in the virtual hat if you re-tweet this post for my Twitter buddies.


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