Gluten Free Fitness

Fitness

Common nutrient absorption issues with celiac and what to do about it

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As we all are far too familiar with, celiac disease can present some challenges with absorbing nutrients from our foods.

Villi

Prior to being diagnosed, the inflammation and damage in the small intestine can cause food to “run right through us” so to speak, and even when that doesn’t happen those little villi aren’t up to par. (Which makes me think-those of use with intestinal issues are certainly a but more familiar with anatomy than the average person, aren’t we?

Villi to anyone else may sound like a shape of pasta-but I digress.) And just in case you are not familiar with the word “villi”, it’s not a pasta or a grape varietal, they are the little finger-like projections that stick out from the walls of the small intestine, sucking up the good stuff-nutrients, vitamins, minerals, etc.

When the lovely little villi get mad at us if we eat what they consider to be the wrong thing, they don’t work so well.

They get riled up and inflamed, and then they don’t do a good job absorbing the good stuff anymore. Over time they can also get smaller (“villous atrophy”, anyone-prior to that are “flattened villi”) and then there’s even less surface area to absorb the good stuff. This continues on as long as the irritant is ingested-in this case, gluten.

The good news

The good news is that the gut can heal to a large extent as long as gluten is not ingested-the irritant is removed and healing can begin. Some of us as are very fortunate and are diagnosed quickly, before too much permanent damage has been done. Others who have suffered through a lengthy diagnosing/mis diagnosing process have a bit more of an intestinal structural challenge when it comes to absorbing properly.

This impaired ability to absorb nutrients can create several issues, of which I’m going to touch on just a few, and lump some together as well. A good idea is to get tested for baseline levels of these items by your doctor (the ones that can be tested for,) generally a simple blood test will do the trick and give you a starting point.

1) Overall lack of nutrient absorption can cause weight loss while undiagnosed.

This is not a good thing. Conversely, after being diagnosed people may find they gain weight. Up to a normal weight this is a good thing, and necessary if an individual has been malnourished due to lack of nutrients. Weight gain after diagnosis is not uncommon, and something I will be touching on in greater depth in another article.

2) Essential fatty acids-Omega 3 and 6’s.

They are all over the media lately, so you’ve probably heard of them. In general, we get enough Omega 6’s from everyday stuff. However, unless you eat a lot of fish, you may want to actively get more Omega 3’s in your diet. Fatty fish like wild salmon are great sources. You can also get some vegetarian sources from walnuts, pumpkin seeds and flax. I also supplement with a fish oil. A TBSP a day of Carlson Fish Oil covers me, and really isn’t bad at all, I promise. Pour into a measuring spoon and just slam it.

3) Vitamin D, Calcium and Magnesium.

I lumped these together because they are all important for bone health. At age 30 I was diagnosed with osteopenia, and here I am an athlete who lifts weights! Bone health is a huge issue for celiacs in general, especially the females amongst us. Calcium is obviously in dairy, but that doesn’t help the casein intolerant, does it?

Food sources of calcium: spinach, greens, (turnip, mustard, collard, kale) broccoli, molasses, squash, cabbage

Food sources of magnesium: pumpkin seeds, brazil nuts, halibut, spinach (see a pattern…) beans, artichokes

Food sources of Vitamin D: cod liver oil, salmon, milk. Other dairy products are generally NOT fortified with D.

Even with all this, in regards to Vitamin D that’s more than likely not going to get you enough. And I’m sure you’ve heard about how Vitamin D is the “sunshine vitamin” which we don’t produce enough due to our largely indoor-dwelling and sunscreen-wearing lives. I supplement with all 3-calcium, magnesium and Vitamin D in pill form.

The The Food and Nutrition Board of the Institute of Medicine has established 2000 IU as generally safe for adults. There’s also a lot of talk about the RDA for Vitamin D being raised significantly. There are also many anecdotal reports of much larger doses being used without adverse affect.

I say, do your research and read, then make an informed personal decision. My personal decision involves 2000 IU of Vitamin D, plus the amounts in my multivitamin, Cal/Mag supplement, and limited sunshine from walking the dog.

4) Iron.

There are 2 types of iron: heme and non heme. According to the McKinley Illinois website:

HEME iron is found only in meat, fish and poultry and is absorbed much more easily than NON-HEME iron, which is found primarily in fruits, vegetables, dried beans, and nuts.

The absorption of non heme foods can be enhanced by eating it with a Vitmain C source (such as citrus fruit, strawberries, red bell pepper) or by being cooked in a cast iron skillet.

Heme iron sources: liver (you knew that was coming, didn’t you?), beef, chicken, pork, salmon, tuna, turkey

Non-heme sources: almonds, apricots, beans, molasses, rice, broccoli

This just begins to scratch the surface. I always take a multivitamin/mineral to cover my nutritional bases. I think a digestive enzyme supplement and pro/prebiotics could also be helpful to assist in maximizing nutrient uptake.

Did you notice any patterns in the lists of recommended foods? Green leafy veggies, lean protein sources, healthy fats in the form of nuts and fatty fish, high fiber food like beans and the veggies again….sounds pretty good, doesn’t it?

Go forth and absorb!!


References:
www.mayoclinic.com
www.health.gov
www.mckinley.illinois.edu

The “Smart Choice” label-help or hype?

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You may have heard about this new labeling initiative. It is supposed to, in theory, make healthier foods easier to identify. I first heard about the label a month ago, and it’s potential drawbacks. It made me think twice then, and now apparently these labels have begun rolling out.

The kicker is that Froot Loops have been labeled a “smart choice.” Really? I’m not sure why there wouldn’t be a smart choice label on a banana, or a chicken, or some broccoli….but I digress.

My point is to read all labels and nutrition facts of a product, and then make an independent, informed decision. Don’t trust that if something is called “healthy” or “lowfat” or “sugar free” or “gluten free” or a “smart choice” that is makes it a good choice. It doesn’t. Neither does green packaging. Read, learn, and make your own decision.

One viewpoint from the NY Times:

For Your Health, Froot Loops

By WILLIAM NEUMAN
Published: September 4, 2009

A new food-labeling campaign called Smart Choices, backed by most of the nation’s largest food manufacturers, is “designed to help shoppers easily identify smarter food and beverage choices.”
G. Paul Burnett/The New York Times

Foods with the Smart Choices checkmark include sugar-laden cereals like Froot Loops, mayonnaise and Fudgsicle bars.

The green checkmark label is showing up on store shelves

The green checkmark label that is starting to show up on store shelves will appear on hundreds of packages, including — to the surprise of many nutritionists — sugar-laden cereals like Cocoa Krispies and Froot Loops.

“These are horrible choices,” said Walter C. Willett, chairman of the nutrition department of the Harvard School of Public Health.

He said the criteria used by the Smart Choices Program were seriously flawed, allowing less healthy products, like sweet cereals and heavily salted packaged meals, to win its seal of approval. “It’s a blatant failure of this system and it makes it, I’m afraid, not credible,” Mr. Willett said.

The Food and Drug Administration and the Department of Agriculture have also weighed in, sending the program’s managers a letter on Aug. 19 saying they intended to monitor its effect on the food choices of consumers.

The letter said the agencies would be concerned if the Smart Choices label “had the effect of encouraging consumers to choose highly processed foods and refined grains instead of fruits, vegetables and whole grains.”

The government is interested in improving nutrition labeling on packages in part because of the nation’s obesity epidemic, which experts say is tied to a diet heavy in processed foods loaded with calories, fats and sugar.

The prominently displayed label debuts as many in the food industry and government are debating how to provide information on the front of packages that includes important elements from the familiar nutrition facts box that usually appears on the back of products.

Eileen T. Kennedy, president of the Smart Choices board and the dean of the Friedman School of Nutrition Science and Policy at Tufts University, said the program’s criteria were based on government dietary guidelines and widely accepted nutritional standards.

She said the program was also influenced by research into consumer behavior. That research showed that, while shoppers wanted more information, they did not want to hear negative messages or feel their choices were being dictated to them.

“The checkmark means the food item is a ‘better for you’ product, as opposed to having an x on it saying ‘Don’t eat this,’ ” Dr. Kennedy said. “Consumers are smart enough to deduce that if it doesn’t have the checkmark, by implication it’s not a ‘better for you’ product. They want to have a choice. They don’t want to be told ‘You must do this.’ ”

Dr. Kennedy, who is not paid for her work on the program, defended the products endorsed by the program, including sweet cereals. She said Froot Loops was better than other things parents could choose for their children.

“You’re rushing around, you’re trying to think about healthy eating for your kids and you have a choice between a doughnut and a cereal,” Dr. Kennedy said, evoking a hypothetical parent in the supermarket. “So Froot Loops is a better choice.”

Froot Loops qualifies for the label because it meets standards set by the Smart Choices Program for fiber and Vitamins A and C, and because it does not exceed limits on fat, sodium and sugar. It contains the maximum amount of sugar allowed under the program for cereals, 12 grams per serving, which in the case of Froot Loops is 41 percent of the product, measured by weight. That is more sugar than in many popular brands of cookies.

“Froot Loops is an excellent source of many essential vitamins and minerals and it is also a good source of fiber with only 12 grams of sugar,” said Celeste A. Clark, senior vice president of global nutrition for Kellogg’s, which makes Froot Loops. “You cannot judge the nutritional merits of a food product based on one ingredient.”

Dr. Clark, who is a member of the Smart Choices board, said that the program’s standard for sugar in cereals was consistent with federal dietary guidelines that say that “small amounts of sugar” added to nutrient-dense foods like breakfast cereals can make them taste better. That, in theory, will encourage people to eat more of them, which would increase the nutrients in their diet.

Ten companies have signed up for the Smart Choices program so far, including Kellogg’s, Kraft Foods, ConAgra Foods, Unilever, General Mills, PepsiCo and Tyson Foods. Companies that participate pay up to $100,000 a year to the program, with the fee based on total sales of its products that bear the seal.

The Smart Choices checkmark is meant to take the place of similar nutritional labels that individual manufacturers began plastering on their packages several years ago, like PepsiCo’s Smart Choices Made Easy and Sensible Solution from Kraft.

In joining Smart Choices, the companies agreed to discontinue their own labeling systems, Ms. Kennedy said.

Michael R. Taylor, a senior F.D.A. adviser, said the agency was concerned that sugar-laden cereals and high-fat foods would bear a label that tells consumers they were nutritionally superior.

“What we don’t want to do is have front-of-package information that in any way is based on cherry-picking the good and not disclosing adequately the components of a product that may be less good,” Mr. Taylor said.

He said the agency would consider the possibility of creating a standardized nutrition label for the front of packages.

“We’re taking a hard look at these programs and we want to independently look at what would be the sound criteria and the best way to present this information,” Mr. Taylor said.

Michael Jacobson, executive director of the Center for Science in the Public Interest, an advocacy group, was part of a panel that helped devise the Smart Choices nutritional criteria, until he quit last September. He said the panel was dominated by members of the food industry, which skewed its decisions.

“It was paid for by industry and when industry put down its foot and said this is what we’re doing, that was it, end of story,” he said. Dr. Kennedy and Dr. Clark, who were both on the panel, said industry members had not controlled the results.

Mr. Jacobson objected to some of the panel’s nutritional decisions. The criteria allow foods to carry the Smart Choices seal if they contain added nutrients, which he said could mask shortcomings in the food.

Despite federal guidelines favoring whole grains, the criteria allow breads made with no whole grains to get the seal if they have added nutrients.

“You could start out with some sawdust, add calcium or Vitamin A and meet the criteria,” Mr. Jacobson said.

Nutritionists questioned other foods given the Smart Choices label. The program gives the seal to both regular and light mayonnaise, which could lead consumers to think they are both equally healthy. It also allows frozen meals and packaged sandwiches to have up to 600 milligrams of sodium, a quarter of the recommended daily maximum intake.

“The object of this is to make highly processed foods appear as healthful as unprocessed foods, which they are not,” said Marion Nestle, a nutrition professor at New York University.

Is celiac disease a “blessing in disguise?”

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Is celiac a “blessing in disguise?”

Yes, I know, some of you are going to get a little upset about that. But really, think about it.

Having celiac disease makes us EXTREMELY aware of what we put into out bodies. Now the trick becomes making sure that it is high quality nutrition, not processed but “gluten free.” Now, I am not going to say all processed food is bad all the time. Heck no, I indulged in some Honey Nut gluten free Chex cereal after my weight training workout this morning. However, in my opinion that should be an exception.

I am a firm believer that if you eat well 90% of the time, (and that could easily be extended to 80%, keep in mind I am a physique athlete and so personally choose to be a bit stricter) that you can eat pretty well whatever you please the remaining 10-20% of the time. Including ice cream, my personal favorite splurge.
But I digress.

My point is, celiacs can’t chew mindlessly on the breadbasket while waiting for dinner. We can’t grab a pretzel at the movies. We have to THINK before we put food in our mouths. So really-if you’re already thinking about it anyway, why not take a little extra time.

Is what you are putting into your mouth not just gluten free, but free of empty calories? Free of artificial ingredients? Is it full of nutrition?

I was once told by a very wise person:

Everything you put in your mouth takes you one step closer to, or one step further away from your goals.

Which direction are you stepping?