The Truth About Gluten-Free Diets

Would you benefit from following a gluten-free diet?

Are you gluten sensitive? Have you been diagnosed with celiac disease (CD), irritable bowel syndrome (IBS) or, do you suffer from a newly emerging disorder known as non celiac gluten sensitivity (NCGS)? A recent study has shown that many people with NCGS are wrongly diagnosed with CD. NCGS patients tend to develop symptoms at an earlier age although CD patients have more severe symptoms such as diarrhea, weight loss, or nutrient deficiencies.

Inflammatory bowel disease (IBD) has also recently been shown to improve on a gluten free diet. IBD causes destructive inflammation of the intestine and is different from IBS and NCGS. Testing a gluten free diet in IBD patients is also safe and potentially highly effective.

Celiac, IBD, Non-Celiac Gluten Sensitivity & More

Would you benefit from a gluten free diet if you do not have CD, NCGS, IBS or IBD? Consult your physician to be tested in order to receive a correct diagnosis. Up to 6% of the general population may have NCGS although there are many subgroups characterized by a different cause, history and response to the gluten free diet.

In fact, many people initiate a GFD without adequate exclusion of CD.  Alternative health practitioners , dietitians, and general health practitioners also often prescribe a gluten free diet to patients with digestive symptoms, In 1 in 4 patients, response to a GFD is variable and symptoms are poorly controlled despite good compliance. Sixty five  percent identified other food intolerances. Once again, consult your physician for an accurate diagnosis of your digestive disorder.

Obesity and Bacteria: What’s the Connection?

Learn About the Unseen Allies That Keep You Healthy and Happy

We are learning more about  how good bacteria that occurs naturally in the gut can affect our overall health and well-being.

Six out of ten Americans are overweight or obese leading to increased risk for heart disease, diabetes, cancer and other diseases. Research shows that overweight and obesity are also directly associated with low levels of good bacteria in the gut.

Diet directly influences which kind of bacteria are populating our gut. Poor diet leads to  bad bacteria in our gut which impacts health problems such as obesity. Are changes to the gut microbiota a cause rather than a consequence of obesity? We don’t know yet. However, studies demonstrate that carbohydrates found in the Mediterranean diet (particularly the non-digestible carbohydrates such as beans) can improve microbiota in the gut and help treat obesity.

Another complicating factor is that bacterial diversity in the gut tends to decrease with age, meaning a high quality probiotic or prebiotic supplement could be particularly effective in individuals over age 50.

Consult with a Registered Dietitian to better understand your specific requirements for a healthy lifestyle. For more information contact Dr. Algert here.

Four Steps to Learning About Elimination Diets:

Elimination diets, particularly the FODMAP  diet, have become more popular in the last few years as people better understand how food choices impact health.

What is an Elimination Diet?

Elimination diets have you cut out foods that your small intestine cannot absorb such as grains and some fruits and veggies. In other words, you eliminate certain foods for a period of time, usually three or four weeks, then slowly reintroduce specific foods and monitor your symptoms for possible reactions.

Did you know?

Many food based and complementary therapies have gained recognition in the mainstream over the past few years. Currently the FODMAP diet is helping 2/3 of people with IBS find relief from symptoms.

Here are five tips on how to start your own elimination diet to help identify food sensitivities:

1. A FODMAP elimination diet will remove gluten, dairy, soy, eggs, corn, pork, beef, chicken, beans/lentils, coffee, citrus fruits, nuts and nightshade vegetables. Your diet will be comprised mainly of rice, meat (turkey, fish, lamb),  most fruit,  and most types of vegetables.

2.The length of an elimination diet can vary depending on your age and severity of symptoms. Children can usually see benefits in 7-10 days whereas adults need to follow the diet longer, around 3-4 weeks. Keep a food record that includes any symptoms or health issues (both positive and negative) that occur.

3. At the end of the elimination period reintroduce foods one at a time for a single day so you can monitor symptoms for the next two days. Keep a food diary that includes symptoms including mood, digestion, energy level and ability to sleep.  If you have no observable symptoms, you can try reintroducing new  foods on day four of your elimination diet.

4. The whole elimination process will take approximately 5-6 weeks and at the end you will have a much better understanding of your food sensitivities.

 It is also important to make an appointment with a registered dietitian to ensure your elimination diet meet all of your nutritional needs.

An elimination diet followed correctly can produce profound results!

For more information contact Dr. Algert here.

Gluten Free Diet in Autism Spectrum Disorders

The evidence to support GFCF (Gluten-free Casein-free) diets in treatment of children for ASD (Autism Spectrum Disorders) remains weak and inconclusive. However success is possible for a subset of children who have gastrointestinal problems (constipation, diarrhea, bloating) and food sensitivities. Here’s a quick summary from my review of two recent scientific papers:

–Children predisposed to GI problems might particularly benefit from a GFCF dietary intervention.

–Children with allergy symptoms also demonstrated improved ASD symptoms on GFCF diet.

–The better the compliance to the diet, the greater the improvement in symptoms.

–Drawbacks to the diet include: 1) nutritionally inadequate in calcium, phosphorus, vitamin D, magnesium and other minerals; 2) social stigmatization and difficulty in complying with the diet.

–Probiotics containing lactobacilli provide protection against infection in the gut and healthy immune function.

–Work closely with a Registered Dietitian to assess dietary adequacy and choose an appropriate vitamin and probiotic supplement.

References:

Nutrition Research Reviews; 2014; doi:10.1017/S0954422414000110.

Pennesik CM, Klein LC. Effectiveness of the gluten-free, casein-free diet for children diagnosed with autism spectrum disorder: based on parental report. Nutritional Neuroscience. 2012 15:85-91.

Mari-Bauset S, Zazpe I, Mari-Sanchis A, et al. Evidence of the gluten-free, casein-free diet in autism spectrum disorders: a systematic review. Journal of Child Neurology 2014, 1-10; doi: 10.1177/ 0883073814531330.

The Importance of Healthy Bacteria in the Gut

I have a 62 year old friend who was recently referred to a gastroenterologist for upper chest and esophageal pain. The diagnosis was heartburn and she was given an prescription of high dose antacids. Her stress level is very high due to impending move and could be related to the pain—here is what I suggested to her instead of taking a very strong medication:

–Check to make sure that you are getting enough low fat sources of protein in your diet. Most people 60 and over need 1.0 grams of protein per pound of ideal body weight—this could equal 80-100 grams per day. Good sources include fish, chicken, yogurt, milk, eggs and cottage cheese. Higher in fat and calories but still a good choice are nuts and soy products.

—Include a good probiotic containing a variety of beneficial gut bacteria as a daily supplement. A recent study showed that VSL #3, a cocktail of eight different probiotics, leads to an increase of good bacteria (lactobacilli and bifdibacteria) and a reduction in the bad gram negative bacteria in the gut. Overall VSL # 3 improves immunity and decreases risk for heart disease and diabetes. The study added 300 mg per day of fish oil which improved immunity and decreased inflammation further in the 60 patients in the study.

Take home message: As you age we wear down good bacteria in the gut and many people begin to experience non-specific GI symptoms. Be sure that you are getting enough high quality protein in your diet and include a wide spectrum probiotic, such as VSL #3, as a supplement to “spiff up” GI health!

Reference: Rajkumar H, MahmoodN, Kumar M, et al. Effect of Probiotic (VSL#3) and Omega 3on lipid profile, insulin sensitivity, inflammatory markers, and gut colonization in overweight adults: a randomized , controlled trial. Mediators of Inflammation volume 2014 article ID 348959; 8 pages.

IBS and FODMAP Diets

Evidence for the dietary management of IBS is variable. Dietary restriction of fermentable carbohydrates (the FODMAP diet) is gaining in popularity as a treatment for IBS. Approximately 3⁄4 of IBS patients get some benefit from following a low FODMAP diet. However, the diet is very restrictive and evidence now shows that it can alter gut microbiota and nutrient intake unfavorably. More studies are needed to understand the implications of long term reduction of intake of FODMAPs on the gut. Work with a Registered Dietitian who understands FODMAP dietary restrictions and gut health to determine the best diet to follow to maximize management of your IBS.

References: Halmos EP, Christoperson Ct, Bird AR et al Diets that differ in FODMAP content alter the colonic luminal microenvironment. Gut doi:10.1136/gutjnl-2014-307264.

De Roest RH, Dobbs BR, Chapman BA et al. The low FODMAP diet improves gastrointestinal symptoms in patients with irritable bowel syndrome: a prospective study. Int J Clin Prac, September 2013; 67:895-903.

The Best Gluten-Free Casein-Free Recipe for Broiled Fish

Best GFCF Way to Cook Fish

gluten free casein free fish recipe

This is an great tasting and easy way to cook any type of fish under the broiler. The key is not to overcook the fish.

Place on the baking sheet or roasting pan:

1-1/2 -2 pounds fish

Juice of 1-2 lemons over fish

Mrs Dash seasoning blend (it is GF!)

2-4 Tablespoons of GF CF mayonnaise

Squeeze lemon juice generously over fish. Sprinkle with Mrs Dash seasoning blend. Spread mayonnaise over top of fish. Place fish under broiler and cook undisturbed for 4 minutes. If the fillets are 1⁄2 inch thick or less , they are done as soon as the exterior turns opaque. If they are thicker, check after 6 minutes; fish up to 1 inch thick probably will be done at this point. Thicker fillets will need another couple of minutes and should be basted with a little more lemon-mayo liquid.

Serve with brown rice or potatoes and a salad.

A Delicious Gluten-Free BBQ Recipe for Entertaining

Gluten-Free Dinner Recipe - Chicken Kabobs, Corn, Rice & Beans, & Cabbage Salad

My friend’s son has Celiac Disease and I prepared this menu last week when they were visiting from Southern California. Everything is gluten-free, prepared from unprocessed ingredients and from the local grocery store. Enjoy!

Starters

  • Corn chips with fire roasted salsa
  • Roasted and salted almonds

Main

  • Chicken and veggie kabobs
  • Sweet and sour cabbage slaw—the best gluten-free accompaniment to BBQ!
  • Fresh local sweet corn
  • White or Brown Basmanti Rice in chicken broth
  • Black beans

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