Should I Eat Gluten Free?

by Heather D’Eliso Gordon, CSSD

Question: A teammate of mine was recently diagnosed with celiac disease. She has been eating a gluten-free diet for about a month and is riding much stronger during her training rides and races. Would you recommend I try eating a gluten-free diet because I occasionally get gastro-intestinal symptoms like stomach cramps, bloating and diarrhea? I’ve been hearing so much about eating a gluten-free or wheat-free diet, is it necessary?

Answer: This is a great question and one that comes up often. Let me briefly explain what celiac disease is. It is an autoimmune disease (like lupus, rheumatoid arthritis, Type 1 Diabetes) where the body identifies gluten (a protein found in wheat, barley and rye) as an invader. When a person with celiac disease eats food that contains gluten, over time (days, months, years) the small intestine’s cells become damaged and lose the ability to absorb nutrients effectively. Symptoms may not even be gastro-intestinal; rather, it may be exhibited by fatigue, unexplained weight loss or gain and bone/joint pain, among others. Approximately, one in 120 people are diagnosed with celiac disease in the United States, and many people go undiagnosed for years. Diagnosis involves blood tests and a biopsy of the small intestine. The only way to reduce symptoms, heal the intestines and prevent long-term complications of celiac disease is by life-long adherence to a gluten-free diet. 

Going on a gluten-free diet involves a complete lifestyle and diet adjustment, therefore before trying to eat a gluten-free diet I would begin by keeping a detailed food and symptom journal. This will help you identify if the cramping, bloating and diarrhea are related to other common reasons: lactose intolerance, eating fatty foods, eating highly processed foods, excess caffeine, stress, etc. As an athlete, food and nutrition can sometimes be put on the back burner, and stress levels can be high due to managing a hectic lifestyle. Due to a busy schedule, athletes often eat convenience foods and fast food, not to mention bars, gels and sports drinks. Even for someone without a gastrointestinal disease, these foods can promote gas, bloating and irregular bowel habits. What can be helpful at this stage is to bring your food and symptom journal to a registered dietitian for a thorough review and dietary recommendations. Oftentimes, irritable bowl syndrome is the culprit and can be remedied by making changes to the diet. BUT, I would also review this website www.celiac.org to review other symptoms and learn more about celiac disease to make an informed decision.

Back to the diet itself: is it wheat-free or gluten-free? If you are diagnosed with celiac disease then your diet will be gluten-free and thus wheat-free. Gluten is the common name for the proteins in specific grains that are harmful to persons with celiac disease. These proteins are found in all forms of wheat (including durum, semolina, spelt, kamut, einkorn and farro) and related grains rye, barley and triticale and they must be eliminated.

Separate from celiac disease, there are also people that have wheat allergies or sensitivities. This does not require eating a gluten-free diet, but some people find it easier to do so.  Definitive tests for wheat allergies are controversial, so be sure you are certain before you make the effort to change your diet. Oftentimes people will begin eliminating foods in their diets unnecessarily resulting in inadequate nutrition (lack of calories, vitamins, minerals) and low energy levels. This can lead to poor performance in training and races, including stress fractures and frequent bouts of upper respiratory infections. On the flip side, saying “no” to convenience foods and desserts that contain wheat can come as a blessing in disguise for those watching their calorie intake and waistline.

If you are following a gluten-free diet, these suggestions can be the foundation of a healthy diet for an active person, and even for those without celiac disease.

• Whole grain and enriched gluten-free carbohydrate sources: rice, corn, flax, quinoa, amaranth, millet, potatoes, buckwheat, soy, tapioca, wild rice, oats (only if certified gluten-free due to strict processing methods)
• Protein sources: meat, poultry, seafood, un-breaded fish, eggs, dairy foods, nuts, seeds
• Healthy fats: olive oil, flaxseed, tuna, salmon, nuts, seeds, avocado
• Fruits (fresh, frozen, dried)
• Vegetables (fresh, frozen, canned, if rinsed), vegetable juices
• Snacks such as corn chips, rice cakes, gluten-free pretzels/crackers
• Gluten-free specialty sports foods such as gluten-free sports bars and gels

Resource: www.scandpg.org

This is your homework in a nutshell:

• 1) Review the website to make an informed decision: www.celiac.org
• 2) Keep a food and symptom journal
• 3) Talk to a registered dietitian for a review of your journal
• 4) Talk with your doctor if you determine that you may have celiac disease.

Try some gluten-free grains – I’ve given you two recipes for quinoa, one of my favorite gluten-free grains. It’s very easy to make, it’s delicious and provides long lasting energy. So, even if you don’t have celiac disease, give gluten-free grains a try.

An alternative breakfast that will give you the energy needed for a long workout:

Quinoa Breakfast Porridge   Makes 4 servings:

2 cups water

1 cup quinoa, rinsed

½ tsp ground cinnamon

½ cup whole dried apricots

¼ cup sliced almonds

Bring the water to a boil, add the quinoa. Reduce heat, cover and simmer 5 minutes. Add the cinnamon and dried apricots, stir, cover and simmer until water is absorbed, another 5-7 minutes. Add the almonds and serve with milk, soy milk or cream. Sweeten with honey or brown sugar if needed.

Recipe adapted from NPR.org 10.30.07

Try this quinoa salad as a wholesome lunch or part of a summer dinner.

Quinoa & Black Bean Salad

Ingredients:                                                               

Salad                                                                             Dressing

1 ½ cups dry quinoa                                                    1/3 cup fresh lime juice (~ 3 limes)

1 ½ cups canned black beans, drained and rinsed*    ½ tsp. salt
1 ½ Tbsp. red wine vinegar                                         1¼ tsp. ground cumin

¼ cup fresh cilantro leaves, chopped fine                   1/3 cup olive oil
1 ½ cups corn* (if canned, drain & rinse)                   Salt & pepper to taste
1 red bell pepper, de-seeded, chopped into 1 inch pieces                             

3-4 scallions (green onions), chopped fine

1 clove garlic, minced fine
¼ tsp. cayenne pepper                        

*Use fresh corn and beans if time permits – best flavor and nutrition

Instructions:

1. Bring a medium pot of water to a boil over high heat. Add quinoa and boil uncovered on medium-high heat about 11-14 minutes. Taste a few pieces, they will have a slight crunch and the germ (white comma-shaped filaments) will release from the seeds and unfurl – a sign that the quinoa is either done or very close. Do not stir while cooking as this may cause stickiness.

2. While quinoa is cooking, in a small bowl toss beans with vinegar & add salt and pepper to taste.

3. Add beans, corn, bell pepper, scallions, garlic, cayenne and cilantro to the quinoa. Toss well.

4. In a small bowl whisk together lime juice, salt, cumin and add oil in a stream while whisking.  Drizzle over salad and toss well with salt and pepper.

Salad may be made a day ahead, covered and refrigerated. Bring to room temperature before serving.

Recipe makes 8 main or 16 side dishes. Wonderful served with grilled chicken, fish or tofu.

Nutrients/main dish serving (~1 cup):

280 calories 12 grams fat, 41 grams carbohydrate, 6 grams fiber, 8 grams protein 

Recipe adapted by Heather D’Eliso Gordon, from www.aicr.org