Gluten Free Fitness

celiac disease

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

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Whew! Part 4 is here.

As a quick recap-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. In Part 3, we reviewed some action you can take to lose weight/fat if you choose, on a gluten free diet. Finally now in Part 4, we’ll tackle the issue of gaining weight.

For many, celiac disease or gluten intolerance can cause an unplanned and unwelcome loss of weight. The difficulties in absorbing nutrients from the small intestine can lead to malnutrition, even with the best of diets. After a gluten free diet has been initiated, the healing process can begin. However, this may take some time, and will be dependent on many factors, including the severity of the intestinal damage.

Eliminating gluten, and being very careful and aware of cross contact and hidden gluten is the first step. If gluten is not eliminated the damage will continue and no healing, and therefore absorption, can occur.

Keep in mind that other food intolerances may be found in conjunction with celiac disease. Lactose intolerance is very common. Personally I am intolerant to soy. Shelly Stuart mentioned her corn intolerance in Part 3 of our podcast series. (She also touched on other issues that may cause continued intestinal distress after eliminating gluten such as parasites-obviously we recommend you follow up with your doctor for a comprehensive review of what may be causing continued symptoms.) Definitely check in with your doctor to make sure there are no other problems that may be causing you to have continued impaired absorption.

You can also ask your doctor about supplements that may speed along the healing process. L-glutamine and probiotics are worth looking into. I think a good gluten free multivitamin is never a bad idea, and talk to your doctor about fish oil. Of course-the most important thing is making sure you are getting optimal nutrition from your food.

In gaining weight, we are looking to add calories that will give great nutritional value as well. After all, you wouldn’t run a high-end Ferrari with low test gas, would you? So don’t expect your body to be able to give you healing oomph! and performance on crappy food. We’re talking about lots of good food.

Here’s 5 steps to help bring your weight back up where you want it:

1) Start your day with a good breakfast.

No, I’m not your mother, but I sound like it don’t I? Seriously though, breakfast is the most abused meal. People forget about it all the time, or have a coffee and call it good. That won’t work. Prepare ideas ahead of time so you can get going with minimal time and effort. Here’s my egg bake that I cook up on Sunday and have for the week. And here’s a portable “pancake”. Heck, some chicken if that’s how you roll. Greek yogurt, string cheese, fruit, smoothies (Amy at Simply Sugar and Gluten Free has an awesome Green Smoothie recipe-I’d add some protein like hard boiled eggs, yogurt, cottage cheese or protein powder and you’re good.) Shelly Case just wrote an article on breakfast foods on the Be Free For Me blog. My recommendation is that you try to have a decent protein, carbohydrate and fat source in the meal, which brings me to….

2) Have a decent protein, carbohydrate and fat source in each meal.

Now don’t throw up your hands, I saw that!
This is not rocket surgery.
Once you get the hang of it, it’s very easy to do, and doesn’t take extra time at all. Here’s an example:

For breakfast, I have some of my egg bake casserole (protein from egg whites, veggies from spinach and tomato), some gluten free oatmeal (carbohydrate) with berries (fruit carbohydrate) and slivered almonds or flaxseed (healthy fat.) If you’d like listings of more ideas in each of those categories, here’s a list of my top 10 gluten free carbohydrate sources.

3) Eat every few hours.

There’s no magic to this, but if you are trying to get in extra calories it’s often easier to split them up over the day, rather than stuffing yourself like Thanksgiving turkey. And instead of stuffing yourself you can…

4) Sneak in extra calories.

Eat calorically dense food that doesn’t make you full. Examples of this would be olive/coconut/your favorite oil, nut butters, and nuts or seeds. Basically healthy fats-they pack more calories per gram than your carbs and protein. If you can’t do nuts, check into sunflower or pumpkin seeds. I haven’t tried it yet, but Shirley over at Gluten Free Easily has used Sunbutter in some of her recipes. It’s a sunflower seed butter.

Along with that, drink some calories. The exact OPPOSITE of what I wrote in the article about losing weight. Protein shakes with some added fats (chocolate protein and peanut/almond butter shake, anyone?), milk, almond milk, hemp milk, etc and so on. If you need to, a couple shakes or smoothies a day would be a fine way to get in extra nutrition. In no way did I look at all of these to see if they were gluten free, but Smoothierecipes.net has an extensive database of drinkable calories.

5) Like a good Scout, always be prepared.

Never let yourself get hungry. Never let yourself be without something gluten free and good to eat. Here’s my top 10 portable snack foods. Also consider premade or homemade protein bars/brownies. Larabars are low on protein, but tasty as heck. Zing Bars are a staple in my house for traveling.

Regardless though, my go-to-fail-safe-can-even-take-it-on-a-plane-without-getting-patted-down is a empty shaker bottle with a scoop or two of protein powder, and a bag of nuts. My friend Kim also just reviewed some gluten free jerky I’m going to have to try, although it’s more stinky than protein powder and nuts.

Keep something with you-in your car, your purse, your pocket. (Hey-is that a Zing bar in your pocket or are you just happy to see me?)

So there are some ideas to get you started! Keep in mind-as your gut heals, you will begin absorbing more nutrients. When you heal, you may find yourself gaining weight much faster than you intended, so keep reassessing where you are and where you want to be.

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

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!

Gluten Free Protein Powder Reviews

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Gluten Free Protein Powder Reviews and Recommendations (or not!)

Protein powder. It can be so useful, so tasty, so convenient! It can also be completely vile tasting, or worse, make us sick due to cross-contact or hidden gluten. This page is for us all to share our experiences with protein powders, so we can learn from each other and hopefully spare ourselves from wasting money on a product that is nasty.

Please, please be aware that reformulations do occur, so always check labels prior to ingesting any product. If in doubt, contact the company directly.

Here’s what to do
  • Leave a comment below indicating the brand of protein, flavor, and quick summary of the nutrition facts if you have the label handy. Please also indicate the gluten status-if you’ve contacted the company please include that information, if there’s a gluten free label, no gluten containing ingredients, etc. Whatever is applicable.
  • Add your review: How was the flavor, the consistency, the mixability? Would you purchase it again? Feel free to use a 1-10 scale if you would like.

Of course, taste is individual, and what one person finds delicious another may find revolting-but I’m hoping that this will give us a good starting point.

Here are a couple I’ve done

Bring the reviews! I will be adding more as well. 🙂

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.


Additional references:

Guest Post: Kim Bouldin from Gluten Free is Life

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Hi guys!  My name is Kim and I write a blog on gluten-free living called Gluten-free is Life.  Erin asked if I would do a guest post and I was thrilled and honored to write one.  I have been gluten-free for a little over 4 years now.

Kim and her daughter, Hannah

Training

I am currently training for my first full marathon.  I ran my first half marathon last October and learned a lot about nutrition and fueling and some of the unique obstacles that come along with following the gluten-free diet.  I believe that every obstacle is only as big as you make it out to be.

Where there is a will to get over an obstacle, there is a way to get over it.  There are just as many protein-filled foods out there to fuel a gluten-free athlete as there are to fuel any other athlete – it is all about creativity.

Training foods

Now that I am really ramping up my training, I have to pay close attention to the foods that I am putting into my body.  I have to make every calorie count.  For those that know me, I do have a sweet tooth.  I have to limit some of those treats now so that I have room for those nutrient dense foods that will carry me through my runs, especially the long ones.

Some of the protein-rich foods that I include in my diet are:

  • Egg whites
  • Lean chicken
  • Lean turkey
  • Salmon
  • Lean red meat (filet mignon)
  • Beans (garbanzo &black beans are my favorites)
  • Nut butters (almond butter has a special place in my heart)
  • Greek yogurt
  • Quinoa (Erin’s note-this is a combo of carbs and protein, but is unique in that for a carb source it is unusually high in protein)
  • Buckwheat
  • Millet
  • Cheese
  • Nuts
  • Tuna

All of the above foods are naturally gluten-free.

For carbohydrates, I include:

  • Oatmeal (Bob’s Red Mill or Lara’s by Cream Hill Estates)
  • Brown rice
  • Breads made from whole grain gluten-free flours
  • Brown rice cakes
  • Gluten-free cereals
  • Blueberries
  • Strawberries
  • Apples
  • Pears
  • Grapes
  • Dried Fruit (raisins, cranberries, cherries, figs, apricots)
  • Bananas
  • Corn Tortillas
  • Squash (acorn, butternut, kabocha, spaghetti)
  • Peas
  • Potatoes (baked sweet or regular)

I make up most of my diet from the foods listed above & fill in where necessary.  I have been playing around with different foods for my pre-run fuel.  Some of my favorites have been:

  • Zing Bars (love the protein in these)
  • Rice Cakes w/ Almond Butter
  • Banana w/ Almond Butter
  • Blueberry Muffins from Purely Elizabeth

I don’t like to run with a lot of food in my stomach, so this has been something I have really been experimenting with.  While I like bananas, they make my stomach feel the fullest of all the options I listed above, so I have only been using that if I have no other options.

Refueling

For refueling, I try to grab a re-hydration drink of some sort.  I have been experimenting with coconut water & it seems to work well & doesn’t make me feel queasy like Gatorade does.  I will be reviewing some coconut water later this month on my blog.

Once I get the drink in, I reach for protein and some carbs, but mainly protein.  I usually go with a 1 egg/3 egg white frittata made with spinach & tomatoes.  I add in some Frank’s Red Hot to spice it up.

(Erin’s note-LOVE Franks’! Favorite hot sauce by a long run!)

I will also have rice cakes with almond butter & fruit spread on the side.  I have been toying with some protein shakes, but haven’t found one that I love yet. The You Bar Shakes were good, but they are dairy based.   I don’t do well with a lot of dairy or soy, so that makes it tough.  I have yet to try the rice protein shakes.  They are next on my list.

Challenges

One of the biggest challenges I have had to overcome is eating after my long runs to get enough calories in.  I know this sounds silly to some, but I have no appetite after my long runs.  I have to break all the “rules” with listening to my body’s hunger cues, because they are just not there on days when I run 8+ miles.  I literally watch the clock to make sure I am getting some kind of food in every 3 hours or so.  I try to eat smaller meals on these days so I don’t feel “stuffed” and then in turn, sick.

These are the days that I really need to make every calorie count by getting the best nutritional bang for my buck.  I snack on dried fruit a lot on long run days – calorie dense &can be an excellent source of fiber, nutrients, antioxidants and complex carbohydrates.  I love adding dried fruit &walnuts or almonds to my salads.  I have found that eating “by-the-clock” on long run days works well for me.  It helps me keep my energy up through the day and not feel like I was run over by a bus the following day.

I am entering week 9 of marathon training now.  I have a half marathon race coming up on March 21, 2010 that I am using as a training run.  I am running this race to help raise money for the March of Dimes and a couple of NICUs in the Atlanta area.  Only 10 more weeks until my first marathon!  Wish me luck!

Erin’s note: GO KIM!

Kim was previously profiled here as a Gluten Free Athlete. She gives many great reviews and advice for families with children living gluten free at Gluten Free is Life.

Non Celiac Athletes Going Gluten Free: Is there a Performance Benefit? Part 2

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In Part 1, we reviewed some mainstream and popular athletes who had gone the gluten-free route. The experiences that they shared showed a perceived improvement in performance on a gluten free diet. These athletes were not diagnosed with celiac disease. So, what gives?

There are several potential reasons why the athletes may have in fact shown improved performance. These are essentially educated guesses, as we don’t really KNOW.

The sciency reasons:

1) The athletes were undiagnosed, but had celiac disease.

The statistics for celiac disease, and the numbers of undiagnosed, stagger me every time. Approximately 1% of the population (in the US, Canada and Europe) is estimated to have celiac disease. Here’s the kicker-95% of those are undiagnosed.
It’s very feasible that some of these athletes have been walking around with celiac disease and didn’t know it. Put them on a gluten free diet and all kinds of magic happens. We’ll talk about the magic in a bit.

2) The athletes were gluten sensitive.

This is a bit of a can of worms. “Gluten sensitivity” is a big umbrella term that covers a bunch of stuff. Celiac disease falls under this umbrella. However, as we are learning, celiac disease as it is currently diagnosed only refers to damage to the small intestine, which is also referred to as gluten sensitive enteropathy. Gluten can cause damage to many other areas of the body, not just the gastrointestinal system (your guts, for easy reference:) Gluten sensitive neuropathy
(nervous system-brain and peripheral nerves) is recognized as being the most common. However, gluten can affect many other systems of the body, and for more information on the various conditions I recommend you check out Shelly Stuart’s incredibly thorough 12 part series at her Celiac Nurse blog, for which a link will be at the end of this post.

A study performed in Iceland back in 1992 showed that 25% of the randomly selected 200 participants (48) showed high levels of gliadin antibodies. Antibodies are produced when the body mounts an attack against the offending invader-in this case, gliadin, the a portion of the gluten protein. 14 of these 48 people also had gluten sensitive enteropathy, or what is commonly referred to as celiac disease-gluten sensitivity of the gut. 25% is a lot of people to show a form of gluten intolerance. I’ve heard varying numbers and statistics thrown around for gluten sensitivity, even as high as 70%. This is difficult to pin down though. Interestingly, a study published in the journal Gut in 2007 (frustratingly, I could not
access the free full text, but the summary only-luckily there was an article that covered it on celiac.com) showed all NON-CELIAC participants in the study showed an antibody response when challenged with gliadin. All of ’em. Not some, all.
And that brings us to…

3) liminating gluten can have positive effects for all.

I’m going to preface this by saying that more research needs to be done, before the wheat growers association (I made that up, I don’t know that an organization by that name exists, but I’m sure there is one to that effect) comes and sues me. It is possible (how’s that for covering my butt) that wheat gliadin can cause intestinal permeability and immune system response in the intestines. Also, this permeability can cause additional damage to other areas of the body, including the nervous system. And given the research mentioned above, this may extend to everyone, not just those with diagnosed/undiagnosed celiac disease or gluten intolerance. It appears that there is a huge spectrum of tolerance to these wheat proteins-ranging from absolutely no apparent ill effects, on to celiac disease and related autoimmune disorders.

4) Improved absorption of nutrients all around!

If these athletes did have an undiagnosed gluten sensitive enteropathy, then it stands to reason that with eliminating gluten they were able to absorb more nutrition. More nutrition=feeling better=performing better. If it was a gluten sensitive neuropathy, they were able to think better. Thinking better=improved performance.

OK, enough science. You asleep yet?

Here’s the less technical reasons these athletes may have improved their performance.

1) Eliminating gluten meant eliminating a large number of processed foods.

Let’s be honest. Aside from hidden gluten, eating a gluten free diet does not have to be hard. Although I am grateful to the manufacturers for giving us gluten free options of processed food-there is just as much junk that’s gluten free as there is gluten full. Gluten free junk is still junk. Naturally gluten free foods are easy, can be inexpensive and highly nutritious. Stick to the perimeter of the grocery store, keep your diet primarily fruits, veggies, meats/fish, beans, nuts, eggs, potato and rice. Easy peasy. It also is inherently more nutrient dense than eating processed food-gluten free or not. More nutrients=more fuel to muscles and brain=higher performance.

2) Eating gluten free made them more aware of overall food quality.

Sometimes as athletes we just look at food as fuel. And that’s not necessarily a bad thing. But, we perform better with
higher quality fuel. Like a high performance car. Put in crap fuel, get crappy acceleration and knocks. With the added attention to eating gluten free, additional attention can be given to high quality food. This is exactly why I feel so strongly that celiac disease is a blessing in disguise. Built it reminder to eat well, should we choose to perceive it in that light. The athletes on the Garmin team (and now Radio Shack) are certainly receiving a very high nutrient density diet. These guys make their living performing, and their livelihood depends on them performing well.

So I have to say that yes, there can absolutely be a benefit to non celiac diagnosed athletes eating gluten free. Just like
in everything though, it depends on what you eat and how much-not just that it’s gluten free.

It will be interesting to see the press on the Radio Shack cycling team and the gluten free diet as the Tour de France gets closer. Lance’s return to the biggest race in cycling to sure to get a ton of coverage.

Please leave a comment below with your thoughts or experiences!


Resources:

Non Celiac Athletes Going Gluten Free: Is there a Performance Benefit? Part 1

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My Dad handed me a Men’s Journal magazine, saying “they talk about gluten free in here.” I looked at the front cover and sure enough, there it was at the top of the cover. “No More Wheat-the Surprising New Diet for Athletes.” My very sophisticated first response was “huhmph” or something along those lines. I am rarely at a loss for words, but I was caught without anything pithy to say.

Several months ago, a friend of mine had mentioned that the Garmin professional cycling team was going gluten free. (Prior to my last knee surgery I was a fairly avid cyclist-now I just can’t take the chance of crashing onto one of these very expensive knees.) The driving force behind this decision is Dr. Allen Lim. He now is working with Team Radio Shack (Lance Armstrong’s current team.) We’ll get back to the reasoning behind going gluten free in a bit. Let’s take a look at some athletes who have taken the gluten free route and their experiences.

Winning without wheat

The Men’s Journal article titled Winning Without Wheat discussed the Garmin’s team experience and results with going gluten free. It was noted that the athletes were gluten free during the racing season-not necessarily the off-season. During the season, the riders reported performance improvement along with reduced digestive issues. (I found it interesting that the article did not mention if the athletes had been tested for celiac disease, or if any of them chose to continue eating gluten free off season.) It was not reported if the performance improvements were perceived, or if there had been specific testing parameters on a “regular” versus gluten free diet.

The word on wheat

An article in Bicycling magazine titled The Word on Wheat discussed the idea of voluntarily going gluten free, and the potential pitfalls of a gluten free diet. (which I addressed in the nutrient deficiencies in the gluten free diet post and refers you to Peter Bronksi’s well written review) They also mention celiac disease versus non celiac gluten intolerance.

A pro triathlete named Desiree Flicker is quoted as saying:

It does end up being a lot healthier because it forces you to stay away from overly processed foods.

Flicker was diagnosed with celiac disease at age 29 after dealing with gastrointestinal issues for almost 10 years. She noted a performance improvement after going gluten free. (To me this is a “well, duh” moment-of course a celiac will have improved performance on a gluten free diet-but we’ll get to that.)

Gluten free to ease digestion

The rationale presented behind originally moving the Garmin team to gluten free is basically to ease digestion. There are multiple fragments of gluten that can cause adverse reactions, even without specific wheat allergy or celiac disease.

The spectrum of non celiac gluten intolerance is an area that seems to be expanding rapidly. Improved digestion leads to improved absorption of nutrients, which can then translate into improved performance.

Correlation doesn’t necessarily mean causation

Keep in mind that while this can be a correlation, it’s not necessarily a causation without proof. In other words, it looks like a gluten free diet may be associated with improved performance, but without specific controlled variables we cannot say that a gluten free diet caused the improvement in performance.

I was unable to find any research studies that examined the effects of a gluten free diet and performance. It does appear that there is quite a bit of anecdotal evidence where people have experienced improved performance.

Based on these anecdotes, it appears that there is potential for improved performance in athletes to eat a gluten free diet even if they are not diagnosed with wheat allergy or celiac disease.

In Part 2 of this article we will take a look at why a gluten free diet may correlate with an improvement in performance.

Stay tuned! If you have experienced improved performance with eating gluten free speak up! Leave a comment below!

Supplements for the Gluten Free Athlete: Glutamine

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Here’s a shocker-I have a fitness background. In the fitness world, there is something that is affectionately referred to as “bro-science.”

Interestingly enough, there is actually a definition for “bro-science” at urbandictionary.com:

Broscience is the predominant brand of reasoning in bodybuilding circles where the anecdotal reports of jacked dudes are considered more credible than scientific research.

There has been much debate surrounding glutamine in the weight training world. It was touted as a recovery booster/fat mobilizer/muscle sparing/ all that and a bag o’ chips for many moons, and turns out that the research doesn’t support that position. (Gleeson, M. Dosing and efficacy of glutamine supplementation in human exercise and sport training J Nutr. 2008 Oct;138(10):2045S-2049S among others.)

Fight bro science

There are many good bros and female bros (bras?) out there fighting the good fight and protecting the world against the proliferation of bro-science. A few are Alan Aragon, Lyle McDonald, Leigh Peele, and Cassandra Forsythe, as well as my buddy JC Deen. There are many others of course-but these are a few I reference regularly and have in my Google Reader.

Ok, so what does this have to do with celiac disease, living gluten free, or glutamine supplementation?

Glutamine and gut health

Although glutamine may have limited benefit from a sports performance/physique enhancement perspective, it may be much more useful for gut health.

First of all, what is glutamine? Glutamine is an amino acid. It is considered conditionally essential (meaning there may be times when the body cannot produce enough, and it must be ingested through the diet.) The gut tissue has been found to absorb up to 65-76% of ingested glutamine.

Also, glutamine is used for fuel by the cells in your body that fight disease and infection. When plasma glutamine levels are lowered, this can contribute to suppresion of the immune system. In short, glutamine helps reduce inflammation, improve immunity, promote repair, and assist in production of other important factors in the gut.

I have to note that in looking through the scientific research, I have found studies that support these statements, and other studies where no significant difference has been shown. As always, this is a case of buyer beware-educate yourself, discuss it with your doctor or health care practitioner, and make an informed decision. It will not hurt you, but it may not help either. There has been quite a bit of supporting evidence that it is beneficial for gut health.

Some of you may be thinking:

But glutamine is an amino acid found in gliadin-and a reaction to gliadin is what is examined when gluten intolerance is being tested.

Dr. Stephen Wangen in his book Healthier Without Wheat: A New Understanding of Wheat Allergies, Celiac Disease, and Non-Celiac Gluten Intolerance clarifies

Do not be confused by the fact that gliadins contain glutamine. This does not mean that glutamine is a problem for people who are gluten intolerant, nor does it mean that glutamine should be avoided. In fact the opposite is true…

Two forms of glutamine

Note: Glutamine can be found in two forms, and this is particulary important to note if you have celiac disease or gluten intolerance. There is L-glutamine, which is the free form amino acid, and glutamine peptides. Glutamine peptides are often sourced from wheat, and can cause a reaction in those with sensitivity. Avoid glutamine peptides, and if you choose to supplement look for L-glutamine.

Dr. Wangen states that due to the fact that the small intestine uses glutamine as a primary energy source, providing extra L-glutamine can assist in speeding the healing of the digestive tract. He recommends a dose of 3 grams (3,000 mg) split into 3 doses throughout the day.

Shari Lieberman also discussed L-glutamine supplementation in her book The Gluten Connection: How Gluten Sensitivity May Be Sabotaging Your Health–And What You Can Do to Take Control Now. She recommended 500 mg-3 grams of L-glutamine.

There also have been studies of non-celiac endurance athletes which have shown protective immune system qualities when the training load is high. (L. Castell, The effects of oral glutamine supplementation on athletes after prolonged, exhaustive exercise. Nutrition Volume 13, Issues 7-8, July-August 1997, Pages 738-742 )

So what does this mean to the celiac or gluten intolerant athlete?

It means that supplementing with L-glutamine may be a worthwhile expense. If you are training hard, your immune system and gut can use all the help it can get with recovery. It can help with antioxidant control of free radicals produced in exercise. By maximizing your gut health, you are maximizing absorption and therefore fuel.

What’s your opinion? Have you taken L-glutamine? Leave your feedback in the comments!


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Gluten Free “Diet” vs. Gluten free Lifestyle

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Living gluten free has received quite a bit of mainstream press lately. The Dr. Oz feature of course comes to mind, and there was a 12 page special report in USA today in November, and numerous other articles in publications including the NY Times.

With the rising awareness of a gluten free “diet” comes increased numbers of people trying the “diet.” Here’s the reason I am adding quotations every time I use the word diet here. There’s a method to the madness, I promise.

“Diet” as per Dictionary.com has several different meanings and uses. It can be used as a noun, a verb, or an adjective:

  1. Food and drink considered in terms of its qualities, composition, and its effects on health
  2. A particular selection of food, esp. as designed or prescribed to improve a person’s physical condition or to prevent or treat a disease
  3. Such a selection or a limitation on the amount a person eats for reducing weight
  4. To select or limit the food one eats to improve one’s physical condition or to lose weight

This is only a small selection of the 10 potential meanings.

Gluten free and weight loss?

You can see how this one little word has multiple conotations associated with it. Most people associate the word “diet” with the 3rd definition, from my experience. A lifestyle approach to diet would be definition #1. With the media exposure of the gluten free diet, there are some who are associating the gluten free diet with a weight loss diet.

Not so fast, buttercup. This is not necessarily the case. Any method of eating can be a weight/fat loss diet. It depends on activity level, what you eat, but most importantly how much you eat. Can you gain weight on a gluten free diet? Hells yeah. You can lose it too. You can gain/lose weight eating anything. The laws of thermodynamics do not change.

Popular diets

Let’s take a very quick and admittedly non-complete look at some popular “diets.”

  • Atkins: Taken in it’s purest form, the idea of eating meats and vegetables, and fats only. Excludes a complete food group.
  • South Beach: A balanced diet including all food groups eventually, but in their whole forms.

At their inception, people by and large did quite well using these methods of eating, provided their daily caloric intake was less than their daily expenditure. Then, there was the advent of the Atkins bars, and pancakes, and the South Beach cereal, and more bars, etc and so on. These foods made it easier for people to consume more calories. It’s much easier and quicker to eat several to many hundred calories worth of a nutrition bar than of chicken and broccoli. The satiety (fullness) factor is less, so more is eaten. And guess what? No more fat/weight loss.

The gluten free “diet” in it’s purest form is a very healthful diet, and can certainly aid in controlling calorie intake.

Peter Bronski just did a blog post (here is his Gluten Free Athlete profile) on a brochure he found at his local market.

Check this out:

  • Eat more non-processed foods.
  • Eat an abundance of fresh vegetables and fruit.
  • Eat a serving of beans or legumes and nuts daily.
  • Eat fish twice a week, especially wild salmon.
  • Pay attention to your calcium and vitamin D intake to maintain healthy bones.
  • Choose lean poultry and meats as well as low-fat dairy products.
  • Balance the food that you eat with daily physical activity.

Sounds like an awfully nutritious way to live to me.

Getting into trouble

Where we can get into trouble is just like in any other “diet.” The gluten free cookies, candies, cereals-these are items where it is very easy to overeat calorie wise.

So when people ask me if they can lose weight on a gluten free diet, the answer is yes. It’s not rocket surgery. You can lose weight eating Burger King if you keep your calories where they need to be. (I DO NOT recommend that-it’s just an illustration.)

Does this mean that everyone should go on a gluten free diet?

Heck no. For those with celiac disease and gluten intolerance, living gluten free is not an option, it’s a necessity. And you can choose to eat gluten free in whatever manner you wish. For those with celiac disease and gluten intolerance, this is not just a “diet.”

It’s a lifestyle, and a medical necessity. It’s a way of life and a way of living. It’s extremely important that manufacturers and restaurants understand the medical implications of the gluten free distinction and follow good practices, not just jump on the gluten free bandwagon.

There are those have not been diagnosed with gluten intolerance or celiac disease who choose to live gluten free. They may be part of the many who are undiagnosed. It may be a personal decision. Honestly, the description provided by the brochure above would be a beneficial way for most people to eat.

Bottom line-there is no “magic” in a gluten free diet. If by going gluten free you cut out processed carbs, then by default your calorie intake may drop, which will cause weight loss if your activity stays the same. It’s not magic. It’s math.

What are your thoughts? Have you experienced people asking you about a gluten free diet? Speak your mind in the comments below!