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 30th 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!
Great post! I'm a celiac myself (and a baker, though this certainly was a delicious looking post), and this is what a lot of people need to hear.
ReplyDeleteMy daughter went through the low-FODMAP diet for severe IBS (under doctor supervision) and gluten is one of her triggers. So not like celiac where we have to worry about cross contamination, but she does have to avoid eating it.
ReplyDeleteFor baked goods we love the Pamela's Products flour mixes - they make delicious rolls and pizza crust. And King Arthur Flour has a cake recipe that is really complicated but makes a truly delicious cake. Our favorite treat is the Glutino chocolate-covered pretzels :-)
You are right that this diet can backfire. I have found that the gluten free label really changes how people look at food. Products marketed as gluten free tend to be fairly unhealthy - cookies, cake mixes, breads and pastas that are not whole grain, fruit snacks, chips, etc. But because that cake mix says "gluten free" family members and friends see it as a "safe" food. At home we try to stick with unprocessed meat, veggies, potatoes, rice, etc but I know she gets way more cake and other sugar when visiting relatives than she would have before she was sick!
I also would think very carefully before trying this with a child. It has made a huge difference for my daughter, and in her case her symptoms are so severe the restrictions are worth it to her. But it is something that differentiates her from her classmates, and it's hard for a kid to have to pass up the birthday cookies and cupcakes that all her friends are eating (we send her own treats on those days but it's still not the same). It's not something we take lightly.