Gluten Free or Gluten Freedom? You Decide. How a Gluten Free Diet Impacts Weight & Health

Do you really need to give this up?

Go ahead and eat how you’d like. Want to only buy organic produce? It’s your call—just don’t ask me to foot the bill. Into whole grains? Vegetarian or Vegan? Serious meat eater? Really it’s not for me to judge.

But you know I can’t just leave it at that. My concern is that if you choose to eat in a particular manner that it be without unnecessary rules that negatively impact your wellbeing—either physical or mental. And I’m concerned when you and others get caught up in the supposed health hype of the day, only to learn the hard way that it just wasn’t worth it.

Let’s talk gluten free

Yes, I even add gluten to my breads!

I hate pain and suffering. So if you have celiac disease and are suffering the effects of this autoimmune condition—this reaction to gluten that strangely results in self destruction of part of your small intestine, there is no diet I’d rather see you follow. Please follow it 100%. Period. Avoid cross contamination from wheat, rye, barley and its derivatives. Read labels and avoid it like the plague. And contact a Registered Dietitian who knows the ins and outs of following this diet to focus on what you can include, not just what you need to avoid.

And I hate deprivation. I mean, denying yourself great, fresh gluten-rich breads and hearty wheatberries and barley (see recipes from Food to Eat and Drop the Diet) to me is painful. I simply don’t see the why if you don’t have celiac disease. If you don’t have celiac choosing gluten free does nothing to enhance your wellbeing nor help you manage your weight. But you’re not alone for believing it will. At my 30^th college reunion recently, I confessed my profession to a classmate, a very bright MBA, Ivy educated attorney. This smart and sensible guy hopefully queried “Do you think I have to stick with this gluten free diet I’m on? Would I be okay if I just gave it up?” Yes, poor judgment knows no IQ limits! So LA classmate, this one goes out to you!

But aren’t there benefits of a gluten free diet?

What Gluten Free will do to your weight

Or these?

Start following a GF diet and no doubt you’ll be much more mindful of what goes in your mouth—because you have to be. You read labels and you think before you eat. And that’s a good thing from a weight management standpoint. It’s hard to be an impulse eater while following a GF diet. Besides, how many rice cakes or GF cookies can you really eat? But if you don’t cook much and you rely on ready-made GF products, the quality of your diet may suffer—along with your weight. GF breads are more calorie dense, as they are missing the scaffolding that gluten provides to assist leavening. And GF breads and other products are often (although not always) lower in fiber—there’s no whole wheat, or rye or barley. (Of course you can add quinoa and brown rice, but these you need to prepare.)

Or this?

If you are following a GF diet because of celiac disease, then your weight may very well increase; with poorly controlled celiac (think pre-GF diet), there is malabsorption. You eat, but much of what you eat passes through without being incorporated into your body. Resolve the underlying issue by avoiding the culprit—gluten—and you will restore normal absorption and get all that you eat. And yes, that may result in some (perhaps very appropriate) weight gain.

But if you’re like the majority of individuals following a gluten free diet, you haven’t tested positive for celiac (through a blood test or via an endoscopy and biopsy of your small intestine). Rather, you follow this diet for a range of other reasons.

A tale of 2 RDs

My favorite, homemade rugelach. Recipe on this blog! Not GF!

It’s amazing what desperation will do. When the medical community fails you—when they have no answer for your symptoms or no cure for your disease, alternative, non-evidence based practices look very appealing. And what’s to lose? Yes, even rational thinkers can be sucked into the hope that this may solve our problems. As I’ve written about previously, my diagnosis with MS 12 years ago lead me to the gluten free diet. Anecdotal evidence abounds and the theories seemed believable. So yes, I followed a gluten free diet—meticulously. Labels were read and dining out was largely avoided—except for at establishments that took gluten free seriously. I was cautious about cross contamination as well—I had my own jar of preserves and butter—no gluten rich crumbs were to enter my body.

And then I stopped. It wasn’t just that I thought about my favorite breads and baked goods I could no longer eat—that was a challenge— or the time it took to prepare everything from scratch—I do that largely anyway. But when my 3 month MRI showed more new damage to my spinal cord it was a done deal. The GF diet did nothing for my disease. Mind you, I’m not blaming it for the worsening of my condition during that time period; the disease progression coincided with the GF diet, but there was no evidence that it was caused by it! Anecdotes like mine are rarely posted. You generally just hear the success stories, leading you to believe only the positive.  

Which brings me to another RD

Kay struggled with many of the classic symptoms you hear about, attributed to gluten intolerance—GI cramping, low back pain, diarrhea, fatigue, to name a few. And regrettably, her doctors failed to screen her with the simple blood test that picks up the majority of sufferers with celiac, nor suggested an endoscopy to take a look at what was going on. Rather than delay, Kay began a gluten free diet and by her report started to get relief from her symptoms within days—not fully, but significantly.

In Kay’s situation, this was likely celiac—just never diagnosed. I often see patients, though, who believe they have a gluten problem who likely don’t. One recent patient had been avoiding all gluten for many months, yet continues to have diarrhea 3 times/day. If it were a gluten issue, symptoms would certainly be improving. Another patient believes she fails to tolerate gluten and reports following a GF diet and feeling great. But a closer look revealed lots of hidden gluten sources—like on a daily basis. No, avoiding gluten wasn’t what was helping her—because surely she only perceived she was avoiding it. Rather, the placebo effect just might have been working its magic.

Dessert, not bread, from Tartine, San Francisco. Yum.

So why share all this? Because there is so much misinformation out there that it’s easy to get sucked into the craze of the days. And I believe that you should be educated about the impact of your diet choices—both physically and mentally—so you may make informed decisions.

And no, I have no financial interest in gluten-rich products, but I do love my favorites including Tartine (San Francisco), Seven Stars (Providence, RI), Guillaume (Montreal, Canada), and Clear Flour (Boston, MA). And of course Kings Highway Bagel in Brooklyn, NY, where I grew up. What are your favorites?

And for those who follow GF, what are your favorite, certified GF baked goods? Please share!

Food Finds: Fig Jam

It feels like a little secret I need to share. And maybe I’ll discover from your responses that only I was the last to find out.  It’s about jam. Fig jam. Seem strange?

Keep in mind that looks aren’t everything. The fig, dried fig especially, would hardly draw you to it from its appearance. But the jam from this fruit truly enhances many foods, I’ve discovered. I’ve tried a few brands, but so far my favorite two are Bonne Maman (from France) and Organic Adriatic Fig Spread (a product of Croatia, it says). Both are easily found in US supermarkets (at least those in the suburbs in New England).  I even indulged at Williams-Sonoma (I had a gift certificate) and paid about $15 for a jar, but it didn’t compare to the other two brands which price at $4-5.

Why such affection for this product? It's a combination of its sweetness, which serves as a perfect and unexpected complement to a range of foods, and its texture, with its tiny seeds and chewy fruit pieces. And for a minimal addition of calories, it truly enhances the pleasure of eating so many foods!

So far, here are my favorite uses:

Spread on a sandwich with a strong cheese (an aged cheddar, goat cheese, or Manchego, a delicious Spanish cheese), topped with some baby spinach greens. Totally yum! I promise to add a photo of this soon, but today I had soup for lunch instead!

Dropped by teaspoonfuls onto homemade pizza. Yes, even with the tomato sauce, it works surprisingly well. Alternatively, buy some dried figs, slice them up and toss on the pizza instead.

As a topping on fish, especially salmon or other strong flavored fish. Spread it lightly when the fish is just about done cooking. Or, mix up a simple sauce, adding some balsamic vinegar to a few tablespoons of the fig jam to thin it out. A bit of Dijon mustard can be mixed in as well.

Mixed  into a cup of plain yogurt. A tablespoon will do. Delicious!

 Dried figs are quite high in fiber, probably the highest fiber fruit you'll find. From the estimates I've seen, they contain about 2 grams per single piece of dried fruit. About 3-4 pieces (that's 6-8 grams of fiber) would be the equivalent of eating a full size fresh fruit, such as an apple. But the jam, in the quantities you'll be using, won't make a dent in your fiber intake. Oh well. Guess you'll just have to include it in your diet because it tastes good!

Enjoy! And please share your creations with fig jam!

Food Finds: Cereals, Hot and Cold

I'm overwhelmed. As I move down the cereal aisle, hovering around the oatmeals I feel paralyzed. Where do I begin to decode the hidden information on these packages?  How can I guide you to navigate  the absurd abundance of food choices, in this single section of the cereal aisle, as well as in the many sections throughout the market?  There's the lower sugar, the high fiber, the weight control--the choices are endless. And if you read my NuVal blog entry you know I am not a believer in the "oversimplify" method, providing a single score or value to a product.

So here are the facts. If you are lured to oatmeal for its fiber content, motivated to help with constipation, forget it. Wrong type of fiber to help move things along. For that, try All-Bran Bran Buds, high in insoluble fiber, from wheat bran. It contains an unusually high amount per serving, and it tastes good. Only 1/3 cup and you get 13 grams of total fiber, 10 grams insoluble. The other 3 grams come from psyllium and oats, sources of soluble fiber. This is the type that helps lower cholesterol (if you are able to take in 7-13 grams of it per day) and helps slow the rise in blood sugar (really only an issue for those with diabetes, not for the rest of you). No need for a whole bowl of Bran Buds, either. Try mixing cereals or add some Bran Buds as a crunchy topping to yogurt.

Ok, back to the oatmeal. If you have time on your hands, about 30 minutes, my favorite is steel cut oats. For Americans, this cereal will look quite different than the Quaker you are used to. Think whole grain rice or barley cut with a sharp knife, then cooked. It has a chewy texture and is quite satisfying. A quick version could be prepared as follows:

Soak the oats overnight. Before going to bed, boil four cups of water in a pot, add one cup of oatmeal. Simmer 1 minute. Cover pot and store overnight in refrigerator. The next morning cook the oatmeal on low heat for 9 – 12 minutes, stirring occasionally.

But beware of the serving sizes! On McCann's Irish oats, the steel cut type, 1/4 cup dry makes the equivalent of one serving, as compared to most cereal labels. For Quaker oats, AKA rolled oats, the package can be misleading regarding serving size. The heart symbol portion may seem like a wise choice, but for most of us, this portion would be excessively filling. Both varieties are healthy and tasty options, with zero sodium. Add a bit of brown sugar (or not, if you are diabetic and closely counting the carbs) and cinnamon for additional flavor. Dried fruit added during cooking is also a nice treat (dried cherries are my personal favorite). For either type of oats, you can cook multiple portions in advance and refrigerate, then microwave reheat. Or, you can have the convenience of microwaving the rolled oats. Just be sure to place in an extra large bowl and cover with plastic or a volcano will erupt in the microwave! Really! And if you must do the packages, you can mix and match, one plain and one flavored pack. With the exception of young kids, I don't know anyone who only needs one package.



Another hot cereal that ranks is Bob's Red Mill varieties--the 5, 7, and 10 grain versions (I think I've got that right). Grainier texture, it's a very satisfying hot cereal which, like most things, tastes even better with a bit of sweetener (and in this case, a splash of milk).


Given the cool temperatures these mornings, I should stop here. But cold cereals do give us a lot of options and are so convenient. So here are a few word about my favorites:


-Kashi Heart to Heart. Cheerios-like, but tastes sweeter, without them adding more sugar. Hmmm. I suspect they manage it by reducing the sodium, which is at a lower level than Cheerios. And you must try the warm cinnamon variety! Yum.


-Kashi Cinnamon Harvest. Think Shredded Wheat with flavor, but less sugar than frosted varieties. Quite good!

-Barbara's Shredded Spoonfuls. Bad name, I must admit, because it makes us think shredded wheat, which will turn lots of you away. But trust me--it's delicious and nothing like Shredded Wheat.
These three choices are modest in fiber (about 4-6 grams) and overall tasty, yet healthy options.


-Barbara's Puffins. A particularly good choice for kids, and several versions are gluten free.


-Nature's Path Flax Plus Flakes. More fiber (the constipation-curing type) in a simple flake. And stands up to milk better than regular bran flakes.


So start with these. And tell me what you think. Are there others that are your favorites that might be worth mentioning? There are plenty of others I didn't mention, but could have, if I had the time and the space on this page.



As a final note, I must confess. I was raised on Captain Crunch and Fruit Loops, and Tony the Tiger I thought was GRREAT! 
Enjoy!

Food Finds: Roasted Walnut Oil

I decided it was time to share my favorite food products with my blog followers. I will post them bit by bit (bite by bite?) as I can. Only food items I have tasted and really value will be listed. But this isn’t going to be an all-inclusive list. And I will share my thoughts about tips for fitting them into a balanced diet. Of course I will give you a few words about their nutritional value as well, although don’t expect to see a score! (see the last post for more on that subject).

To find all posts, see the label index on the blog home page. I will link them all to the label “food finds”. Let me know your thoughts on these products, as well as any others you’d like me to evaluate.

Walnut oil

Most people haven’t had much experience with walnut oil, unless you happen to live in or travel to southwest France. This brand, La Touranelle, (which sounds French, but is Californian) in particular is incredible—intense, rich, aromatic and nutty. I have tried other brands available locally, only to be disappointed. For the best price you can purchase it at Marshall’s or Homegoods, of all places! But it’s hit or miss. Whole Foods and Williams Sonoma carry it as well for a heftier price. 

Another brand available from a store called Fiore on Bar Harbor, Maine, is also terrific, and could be ordered on line.

Order direct at www.FIOREoliveoils.com

Walnut oil is ideal in salads, although you can also drizzle some on steamed veggies. Because the flavor is so intense, a little goes a long way, so you don’t tend to need as much oil. Toss a couple of tablespoons onto your greens (enough for 2-3 people). Then add a mild vinegar, such as a balsamic or rice vinegar (I use the unseasoned, which does not have the added salt and sugar and tastes just fine).

Another benefit of walnut oil (besides the exceptional flavor) is that it is also quite high in omega 3 fatty acids.