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You are here: Home / Archives for Nutrition / Gluten-free

Why going ‘gluten-free’ is not enough

September 22, 2014 by drchrista Leave a Comment

Gluten-free is all the rage now with major restaurant chains offering gluten-free menus and even the smallest grocery stores having aisles dedicated to gluten-free products. With the proliferation of gluten-free offerings, one might be tempted to think we are making healthier choices.

This is not the case.

I remember when I first started working with Hashimoto’s patients. After delivering the news that their thyroid condition was in fact an autoimmune condition, I informed them that they needed to go gluten-free in order to prevent their bodies from making antibodies that attacked and destroyed their thyroid gland. Knowing that this can be quite a drastic change for some people, I tried to encourage them by reminding them that this was an opportunity to eat healthier by filling out their diets with vegetables instead of processed wheat products. What quickly became apparent though, is that people simply started swapping their processed wheat products for processed gluten-free products.

Let me be plain: Gluten-free foods are NOT health foods.

  1. Gluten-free products are highly processed. It takes the marvels of modern machinery to make something made of rice flour to not taste gritty and chalky.
  2. Gluten-free foods are high in sugar. What’s the best way to cover-up that chalky taste? Sugar. Lots of it!
  3. Gluten-free foods are terrible for blood sugar regulation. Another way to improve the taste & texture of a gluten-free food, besides adding a lot of sugar, is to using highly refined starches like cornstarch, potato starch & tapioca starch. These are very fine powders that are often a solution to that ‘gritty’ texture of rice flour. The problem is that they are so refined, there is nothing to digest and their carbohydrate content hits the bloodstream very quickly, provoking an insulin spike. This is very hard on the pancreas and is the same mechanism that leads to the development of Type II diabetes.
  4. Gluten-free foods use refined vegetable oils. Fats are another way to cover up the chalky taste & texture. This wouldn’t be so problematic if we were using heat-stable, traditional fats like coconut oil or butter. However, most refined foods have refined fats in them like canola and soybean oil. These oils are not stable at high temperatures and have gone through a complex treatment process to deodorize and clean them before they are even sold to you. Why would they have to go through this process? Because they are so delicate, they become rancid just going through the extraction process. They have to be cleansed and deodorized or they would be too disgusting to eat. While the smell may be gone, the artery-destroying free radicals and inflammation-promoting omega 6 fats are not. Avoid these.
  5. Gluten-free foods are not a good source of nutrients. This is a problem with any processed food. Processing removes and/or destroys the nutrient content. The more highly processed, the more of the nutrients that have been destroyed. Compared to vegetables, grains aren’t that great a source of nutrients to begin with. Refining them further into flours and even starches, removes what little there was to begin with. If health is really your goal, its best to swap out gluten-free wanna-be foods for real, whole foods that are naturally gluten-free. Like vegetables 🙂

It’s for the above reasons that I started recommending a Paleo-type diet when I need my patients to go gluten-free. Paleo is about whole, real foods. It’s also about healing the gut. Because here’s the other thing I began to notice when my patients just started swapping their processed wheat products for gluten-free processed products: they started developing sensitivities to other grain products- particularly the ones that they started consuming more often in the processed gluten-free foods. In the scientific literature this is known as ‘cross-reactivity.’ This occurred because the underlying problem- often a leaky gut- was not fully healed by simply switching to a ‘gluten-free’ diet.

I also noticed this pattern in my Celiac patients. Their symptoms greatly improved on a gluten-free diet, but they still didn’t feel fully well or healthy until they started eating more whole foods and less processed food. Again, years and years of irritation and inflammation in the gut could not be fixed simply by going gluten-free. All grains needed to be eliminated and more nutrient-dense foods like vegetables and bone broth needed to be added.

If a product has to be labeled ‘gluten-free,’ its probably not healthy for you. If health is truly your goal, you would be better off investing in naturally gluten-free foods like animal products, vegetables, fruits and nuts.

Filed Under: Functional Medicine, Gluten-free, Nutrition, Paleo diet Tagged With: autoimmune, carbohydrates, gluten-free, Hashimoto's, hypothyroidism, inflammation, Paleo diet

7 reasons I recommend a Paleo diet to all my patients

October 28, 2013 by drchrista Leave a Comment

Diets fads certainly come and go and it would be easy to consider the Paleo diet another one such ‘fad’ diet. I often hear people argue that ‘everything is healthy in moderation’ and ‘eliminating whole groups of foods is never a good idea.’

Whereas the name ‘Paleo’ may be new, the diet is anything but a fad. I like to think of it as ‘optimum human nutrition;’ it’s the diet our bodies adapted to eating a million years ago. We like to think that cavemen lived ‘short, brutish lives,’ but if the lifestyles of modern hunter-gatherer cultures are any indication, our ancestors enjoyed vibrate health; had lean, strong bodies (this is true according to anthropological data); and enjoyed plenty of leisure time, spending the equivalent of 15-20 hours a week hunting or gathering for their basic needs.

Rhetoric aside, I started recommending a Paleo diet to my patients after seeing the research- indications of how modern foods were eroding way our health and leading to chronic disease. At first, I didn’t know it even had a name, let alone a following. It was just the best foods to eat to facilitate health. When I first read about the Paleo diet, it all ‘clicked’ together and now I had a direction to send my patients in for recipes, meal sharing ideas, and community. More specifically though, here’s my list of the top 7 reasons I recommend a Paleo diet for my patients.

  1. It’s gluten-free, without all the junk. Before discovering Paleo, I prescribed a gluten-free diet for many of my patients. The problem was, they would eat the same foods, just gluten-free versions of them. Instead of swapping breads & pastas for more nutrient dense veggies and animal foods, they would simply fill up on gluten-free breads and pastas. Worse still, several thought that being ‘gluten-free’ made certain junk foods somehow healthier. Not only are these foods often even more heavily processed then their wheat-containing counterparts, it was missing the whole point of the gluten-free diet AND it was much more expensive for them. Paleo has been useful in teaching my patients to eat a more whole-foods diet.
  2. It eliminates cross-reactive foods. I’ve had several patients with Celiac disease who definitely felt better after going gluten-free, but still weren’t 100%, even after years on a strict gluten-free diet. Since other grains can cause gluten cross-reactivity, these folks found that they did much better not just eliminating gluten, but all grain products.
  3. It’s the ultimate elimination diet. When it comes to food allergies, the gold standard for testing is still an elimination diet. I hope one day we have easier & more convenient testing, but at the moment, this is not the case. One thing the food allergy testing via blood doesn’t take into account is that if your immune system is not functioning properly, you may or may not make the antibodies that will show up on the blood test. Some people are over-reactive. When I see an allergy test that has someone reacting to a lot of ‘normal’ foods like green beans or blueberries, I often suspect a leaky gut situation where the immune system is reacting to everything because the gut is not working properly as a barrier system. The Paleo diet eliminates all the common foods that would lead to a leaky gut, thereby facilitating gut healing. Since the gut lining will replace itself in 21 days (in a fairly healthy person), after a month of Paleo, we can reintroduce certain foods and usually get a pretty clear indication of which ones a person has an allergy, intolerance or sensitivity too.
  4. It can help balance blood sugar. Some people think Paleo is the same as low carb or Atkin’s. It’s not. You can do carbs on Paleo, the key is to find the right amount for you based on your health history and activity level. That being said, because carbs on the Paleo diet come from minimally processed, whole foods sources, its much harder to eat the same amount of carb contained in the S.A.D (Standard American Diet). A S.A.D., following the USDA food pyramid guidelines of 8-11 servings of ‘whole-grains’ a day, will have upwards of 300g of carb a day. Unless you are a marathon runner, this is probably way too much carbohydrate for you, especially if you have a job that has you seated most of the day. Conversely, a typical Paleo eater will take in an average of 75-100g of carb a day without paying too much attention to it. By lowering carbohydrate levels, the need for insulin and the dramatic swings in blood sugar are reduced. This helps most people have even energy throughout the day, without the typical after lunch food coma or the need for excessive amounts of coffee and caffeine to keep you going. Lowering carbohydrate intake and getting carbohydrate from whole food, vegetable sources can also reverse insulin resistance and even Type 2 diabetes, especially when coupled with appropriate exercise.
  5. It’s nutrient dense. We’ve all heard of people who have done crazy diets like an all Twinkie diet or all McDonald’s food diet and lost weight, but at what cost? These foods contain very little in the way of micronutrients and even if the body isn’t starving for calories, it will be starving for these missing nutrients. Since a Paleo diet focuses on eating the most nutrient dense of whole foods, many people easily meet their body’s need for micronutrients in far fewer calories then with a diet based on processed foods.
  6. It doesn’t require a bunch of fancy or hard to find super foods. ‘Superfoods’ have become quite the fad lately and many of us seem to think that adding some acai or goji berry to our daily smoothie will forgive a multitude of nutritional ‘sins.’ Variety is key however, especially when it comes to plant foods. It is also helpful to remember that antioxidants, especially those in so called ‘super foods,’ follow a dose-response curve- too little isn’t good for you, but neither is too much. Overloading on super foods not only hurts you by luring you into a false sense of security about the quality of your diet, but also potentially hurts your wallet as you pay more for the marketing and fancy package then actual nutrition. It’s best to stick with nature’s original ‘super foods,’ grass fed butter or ghee and organ meats from grass fed animals.
  7. It’s easier to stick to then a starvation diet. I encourage my patients to eat!!! If it’s a whole food, eat as much as you want. You have to feed your metabolism, both for healing and for fat loss. The main reason typical ‘diets’ (such as calorie-restricted, starvation type diets) fail is that the body’s response to calorie-restriction is to slow metabolism down, ensuring that while you may lose weight temporarily, this effect won’t last. Aside from yo-yoing numbers on the scale, this is not the way to build true health. By feeding the body nutrient dense, whole foods, not only does it keep metabolism humming along, but it gives you freedom- freedom from counting calories, obsessing over food grams and the like.

In the end, I have yet to have a patient who gave it an honest go tell me, “Doc, this Paleo diet thing sucks. I’m quitting.” More often then not, my patients tell me “I feel fantastic! I wish I would have listened to you before and started this Paleo gig sooner!” Which I guess could be reason #8 why I recommend a Paleo diet to my patients- it works!

If you’re local to the Hudson Valley and already a Paleo enthusiast, I’ve started a Paleo Meet-up group just for you! Come join us over here!

Filed Under: Gluten-free, Nutrition, Paleo diet Tagged With: blood sugar regulation, gluten cross-reactivity, gluten-free, Paleo diet

5 things you should know if you’ve been diagnosed with Hypothyroidism

July 19, 2013 by drchrista 1 Comment

  1. thyroid glandIn the U.S., the most common cause of hypothyroidism is Hashimoto’s autoimmune thyroid. It is estimated that this autoimmune disorder is the cause of 80-90% of hypothyroid cases. This means that in most cases of hypothyroidism, the health of the immune systems must be addressed in addition to the function of the thyroid gland itself!! If you are only taking thyroid medication, you’re missing the actual problem.
  2. You can have all the symptoms of hypothyroidism and still have blood work that comes back as ‘normal.’  The lab ranges for ‘normal’ TSH are based on a statistical average and do not represent what is an optimal range for health and feeling good. It is quite common for people to have all the signs and symptoms of hypothyroidism and yet, be told it can’t be that because their lab work is ‘normal.’ If this is your case, you should seek out a functional medicine doctor who can help you understand what is really going on with your thyroid gland.
  3. You can have all the symptoms of hypothyroidism without anything being wrong with your thyroid gland itself. The thyroid gland doesn’t function in isolation. To begin with, it is controlled by the brain. The gland itself only makes thyroid hormone, which then has to travel to every cell in the body, enter that cell, and then travel into the nucleus of the cell where it has its effect. Just like a chain is only as strong as its weakest link, if there is a problem anywhere along the line, the whole process breaks down and results in the same symptoms. If you have hypothyroidism, you need to have a full thyroid panel done periodically, including TSH, T4, T3, T3 uptake and TPO antibodies at the very least.
  4. Diet can be an important part of managing your symptoms. Especially if you do have Hashimoto’s autoimmune thyroid, adoption of a gluten-free diet can have a big impact. Eating gluten actually causes more antibodies to be made to the thyroid tissue, causing more destruction of the gland over time. This can be a common reason why you have to keep upping the dosage of your thyroid medication. Eliminating gluten and adopting an anti-inflammatory diet can go a long way toward helping you keep your thyroid gland intact as well as managing your hypothyroid symptoms.
  5. You can do more to take charge of your hypothyroidism other than just take another pill. While ditching the medication altogether may not be in the cards for you, by managing your immune system through proper diet and lifestyle changes, you can control your symptoms and slow the development of the disease. Using a more holistic strategy may also help prevent the future development of other autoimmune diseases.

Filed Under: Functional Medicine, Gluten-free Tagged With: gluten-free, Hashimoto's, hypothyroidsim

Is Gluten-free right for me? (Part 1)

May 14, 2012 by drchrista Leave a Comment

Gluten-free diets are becoming quite popular these days, causing a debate to rage on about who should be on one and why. On one end of the spectrum are those  who argue that eating grains is evolutionarily novel in human history and that for the most part our intestines have had insufficient time to adapt to eating them. Therefore, to be healthy, grains and more specifically, gluten, should be removed from the diet. On the other end of the spectrum are those who have suggested that by leading to nutrient deficiencies, they are downright dangerous unless you are a diagnosed with Celiac disease. So in the interest of cutting though conflicting opinions and getting down to answers that can be supported by scientific literature, here as some conditions when a gluten-free diet may be appropriate and why.

  1. Diagnosed cases of Celiac disease and gluten sensitivity. These are a somewhat of a no-brainer. If you’ve had testing done that confirms your body makes antibodies to gluten, DO NOT eat gluten. In these cases, your body is reacting to gluten at an immunological level. You may or may not have symptoms right away and depending on what tissues these antibodies react with, your symptoms may or not be tolerable. If you get any negative side-effects from eating gluten, you are in all likelihood destroying tissue through this immunologic reaction. The only way to stop that reaction and preserve the tissue is to not eat gluten, in any amount.
  2. Diagnosed cases of Hashimoto’s autoimmune thyroiditis. A little known fact, but in the U.S., nearly 90% of hypothyroidism cases are caused by Hashimoto’s. In this case, the body makes antibodies to its own thyroid gland, causing the destruction of thyroid tissue and decreased function of this important gland. Prescription thyroid hormone replaces what is lost in terms of thyroid hormone itself, which is necessary to stimulate metabolism in cells, but it doesn’t prevent or stop the immunologic attack on the thyroid tissue from the body’s own immune system. Enough evidence links gluten ingestion to these attacks that patients with Hashimoto’s should go gluten-free in addition to continuing their prescription. If you are currently taking replacement thyroid hormone, but don’t know if you have Hashimoto’s or not, talk to your doctor about a simple blood test that can determine if you do.
  3. Diagnosed cases of autoimmune disease. New research coming out of the University of Maryland’s Center for Celiac Disease Research indicates that three things may be necessary for an autoimmune disease to develop- a gene for the disease, a genetic trigger and a leaky gut. The number one cause of a leaky gut is gluten. Gluten up-regulates the production of a protein called zonulin. Zonulin dissolves the tight junctions between the cells of the intestine, allowing intestinal contents to ‘leak’ through the intestine into the body. The problem with this is that many of these things, like toxins made by bacteria in the gut, don’t belong in our systems or they need to be digested first, like chunks of proteins the need broken down into amino acids first. Since they don’t belong, the immune system in our gut attacks them and tries to keep them out. Unfortunately, this chronic, low-grade inflammation leads to a lot of other problems in the body. One thing that can happen is that the immune cells get their wires crossed and start attacking the body’s own tissue instead of the foreign invader. This is the definition of an autoimmune disease. Many people with autoimmune diseases from MS to RA to Type I diabetes, find they have a lot better control over their symptoms when they adopt a gluten and grain free diet.

Proper testing is of course, key. Stay tuned for the next installment, where I’ll discuss proper testing to determine if a gluten-free diet is right for you.

 

 

Filed Under: Gluten-free, Nutrition

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