Posts filed under ‘Feel Better’
Yesterday I explained how Celiac is just the beginning of the gluten conversation, hardly the end. I also discussed how our conventional model of testing is barely skimming the surface of those of us with gluten issues as it’s catching only 1 in 8 people reacting to gluten. (More on better testing at www.cyrexlabs.com)
But let’s say you’ve done some gluten testing and you appear, on paper, to be in the clear. Whew!
Should you still avoid it? Maybe.
In this article I’ll explain why we all may want to at least minimize gluten, how tough is it to avoid, why you can’t really be “almost” gluten free and why you may be more reactive to gluten now than you were before.
First, our food supply is a mess. Wheat is one grain that is very “modified genetically” (although it does not meet the criteria to be considered genetically modified, aka GMO) in our country. (With most grains and all of our soy being modified, picture me now fist shaking in the air cursing, “Monsanto!”) While it’s not technically “GMO” our adulterated gluten has been genetically spliced and diced enough that it fires up our tummies and our T cells. Our immune system doesn’t like this new gluten much, so whether it’s GMO or not is sorta 6 of one, half dozen of the other….but at the end of the day, this modified gluten is largely to blame for the rash of gluten reactivity we’re seeing today.
The wheat/gluten we’re eating today is not what our parents ate and certainly not what our grandparents ate – and also not what our counterparts in Europe are eating. Our homegrown American gluten is a completely foreign molecule that our bodies, namely our immune systems, have never dealt with evolutionarily. Just like when we shake hands with our friend who has a cold and our immune system sees that virus and launches the attack, it does the same with our modern gluten.
This GMO issue makes gluten unarguably an inflammatory food in general, for us all, positive gluten testing or not.
And here’s a few more ways gluten is firing up our immune system, causing inflammation and generally being naughty:
In order to make gluten mix well with other ingredients, food manufacturers deaminate it. This chemical process makes the gluten molecules water soluble in order to make processed, packaged foods. However, this also creates a molecule that is much more reactive than plain gluten or gliadin (see my post yesterday for a graphic showing how wheat becomes gluten and gliadin, etc).
We grow and farm massive amounts of wheat and it’s stored in large bins for long periods of time, allowing mold to act on it and create little immune aggravators called enterotoxins.
Many of us have “intestinal permeability”, aka a “leaky gut”. A leaky gut is due to inflammation in the gut that has caused a bit of swelling in the cells of our intestines, damaging the junctions between the cells allowing larger proteins to get through. Normally only small things pass through such as a single amino acid, a vitamin, or a molecule of glucose. When these larger proteins end up in our blood stream, our immune system sees them, gets all wound up and here comes the inflammation baby!
We can get a leaky gut from years of a bad diet, various medications, having hypothyroidism, being under high stress, eating foods that we are sensitive to, taking antibiotics or doing anything that disrupts the delicate balance of bacteria in our gut. Many of us have poor digestion including low stomach acid production (either inherently or we take acid lowering medications such as TUMS or Zantac) or low enzyme output to digest our food (we need different enzymes to breakdown fats, proteins and carbohydrates). Any of these can disrupt the healthy gut bacteria in our intestines or cause inflammation (leading to the leaky gut issue) making us more intolerant to foods (think to back when we were young and could “eat anything” and now there are various foods that give us mild to significant digestive distress).
Ok, back to the question: if gluten is inflammatory and I could have any number of issues listed above, should I stop eating it? Is gluten inherently just bad?
Well inflammation is bad and we know this genetically modified Franken-Gluten is causing inflammation so yeah, it’s bad. Is it terribly bad for everyone? Not necessarily.
If your immune system is healthy and your gut is healthy and you don’t have a lot of other inflammation in your body, you’ll do OK vs. someone who is struggling with any of those things. For those of you lucky ones, I’d say going totally gluten free is probably not necessary but I’d still discourage anyone from eating several servings of gluten per day. Always focus on more vegetables and fruit vs. grain based carbohydrates. Think sweet potato, pumpkin, squash, fruits and legumes vs. breads, pastas, rice, etc.
However, if you have an autoimmune disorder, a thyroid condition, PCOS, digestive trouble, depression, anxiety, mood issues, acne or are struggling to get pregnant, my advice is to avoid it.
Not sold? Give it up for 45 days at least. The skies may not part and the heavens may not open up, but many of your symptoms may clear up. If they don’t add it back in and see if you feel any different.
Is It Hard To Be Gluten Free?
At first, yes. But after you’ve done it for a while, at times, still yes. It can be tough if you don’t plan ahead , you will find yourself in restaurants awkwardly ordering some off the menu concoction, you will have friends and family give you a hard time for eating “so weird”. But it does get easier and if you feel better, look better, have more energy, are less depressed and losing weight, then it’s worth it.
And the question on everyone’s mind: is Dr Brooke gluten free? Yes. I wouldn’t ask any of my patients to do something I was unwilling to do myself or didn’t think was that important. And knowing all of the info I’ve just shared with you in the past two blogs, how could I not be? And how could I feed this food to my family?
Do I like being gluten free? Well I like feeling better – gluten makes me tired, cranky, irritable and depressed – although my gut doesn’t react at all. But no, I don’t like it all of the time. I have been very hungry in an airport when I’ve forgotten to pack snacks for myself, I’ve been sad perusing a menu seeing how limited my options are and I’ve never tasted the delicious looking chocolate croissants at my favorite Park Slope coffee shop. I can live without bread or pasta but I do miss the occasional beer, but hey, that’s life! No sense dwelling on the downsides of it and feeling restricted, that just makes it all so exhausting and depressing. I’d rather focus on all the literally thousands of foods I can eat. Feeling badly and knowing I’m damaging my body just isn’t worth the few minutes of yum I’ll have from that buttery, flaky croissant. What’s more, most of the gluten containing foods are simple carbs that wreak havoc weight loss – one more reason to avoid them.
One of my patients put it best last week when asked if she felt deprived not being able to eat gluten. She brilliantly replied, “No! I felt deprived before when I had lower energy, worse allergies and funky digestion.” It’s all in our perspective.
Can You Make Yourself Sensitive to Gluten?
How about this conundrum: I used to eat gluten with little ill effects, avoided it and now when I eat it I feel like a truck hit me! Did I make myself allergic to it?? No, not really.
If we eat a food that we are even mildly reactive to on a daily basis our immune system just plain gets tired and depleted. When we take it out for a while and the antibodies have time to replenish, they are ready to rock when they see that food again and your reaction is quicker and seems more severe. This will not get better, the longer you avoid something you are sensitive to more often the more significant your reaction will be. (Unless the issue was due solely to a leaky gut, in this case fixing the leaky gut issue should remedy the sensitivity…but there are often multiple factors at play.)
Does this mean, to save yourself a nasty reaction you should dose yourself every day? Definitely not! This just tells you that you’ve done the right thing by cutting this food out of your daily diet. And remember, even if your symptoms seem slight such as a “little tummy ache” or just a bit of bleeding gums when you have gluten, you are reacting and it is a stress on your body and your immune system.
Can’t commit? Can you go “almost gluten free”?
If you are not someone with an autoimmune disorder or the conditions I mentioned above, don’t have significant symptoms when you eat it but still are a bit warry of this ubiquitous protein, can you just eat it on occasion? Sure. But if you do have any autoimmunity, hypothyroidism, PCOS, etc then remember this scary fact: the inflammatory reaction created from a bite as small as a crouton lasts for 3-6 months . Having a bite here and there really doesn’t let your immune system recover. That said, less is better than more so if the best you can do is minimize it, then at least do that. Like I always say: if you can’t do everything, don’t not do anything….at least do something!
So for my final trick, I’ll answer the aggravating question: Why when I ditched the gluten, I didn’t lose any weight!! What gives???? Tune in tomorrow for 7 Reasons Why You Didn’t Lose Weight Going Gluten Free. See you soon!
With many a Hollywood starlet going gluten free as of late, including the stir caused by Miss Miley Cyrus’s gluten free fueled weight loss, this little grain based protein is grabbing everyone’s attention. Seems right now everyone from Paleo to Vegan is talking about gluten.
This “gluten free craze”, as its being called, is not new although it’s been gaining popularity the past few years. Gluten has been on the radar of natural health practitioners and nutritionists for a long time. So, why now all the fuss?
I’ve been meaning to write an article on this subject for awhile but due to my practice growing so quickly and of course my new job as mommy, my blogging has sadly gone by the wayside. But with both the mainstream media and many of my most revered nutrition and fitness peeps lately saying the gluten free lifestyle is nothing but “trendy”, I wanted to lay this out in greater detail so you can see it’s anything but a fad.
The gluten talk often turns to whether or not you have Celiac Disease (an autoimmune condition where you attack the enzyme that digests gluten in your intestines and can have antibodies to the alpha gliadin component of wheat causing destruction of the microvilli – hairlike projections on the intestines where absorption of nutrients takes place).
But let’s look closer at gluten and how it’s broken down and how Celiac disease is actually just one small facet of the gluten problem. Gluten (from the Latin word for “glue”) is the composite of two proteins called gliadin and glutenin. These exist, joined with starch, notably in wheat, rye, and barley – and most of our packaged foods, sauces, and the list goes on. Here’s how we go from wheat to gluten to gliadin and several other nasties that I’ll explain in a bit:
Not so simple as alpha gliadin huh? Here’s where the advice we hear from Dr Oz to the top fitness magazines to many a blog leads us astray. That advice being: if you do not have Celiac then you don’t need to worry about gluten. Oh my word! This is this not even the beginning of the story, let alone the end.
What’s worse, our current screening for Celiac and gluten reactivity misses 1 in 8 people with gluten issues. Surprised? Confused?
Let’s first talk about the many, many flaws with our conventional testing for gluten allergies and sensitivities (among the tests that deem you Celiac or not) and then I’ll get to how those various breakdown products of gluten cause problems for so many people – yes, even those without Celiac. Bear with me here comes some science…
To be screened for Celiac, the first testing your doc will do includes a couple of antibody tests: alpha gliadin (which is just one form of gliadin) and tissue transglutaminase (an enzyme you make in your intestines that digests gluten). Sometimes an antibody called anti-endomysium is included as well. A positive on any one of these will likely yield an “avoid gluten” recommendation from your MD, however this is not in and of itself diagnostic of Celiac. An intestinal biopsy that shows erosion and flattening of your “villi” is the gold standard for diagnosis of Celiac Disease. So literally, your tissue needs to be damage to a certain extent before we label it “Celiac”.
There are a couple major issues with this blood testing we use to say yah or nah to gluten. First, you MUST be eating gluten/wheat in order for these tests to be accurate. If the antigen, the protein (in this case alpha gliadin), is not around, the antibodies we’re looking for in your blood might not be there in high enough numbers to catch on testing. If you’ve been avoiding wheat and gluten for a while you could geat a false negative. Furthermore, you have to have a healthy immune system for these tests to be really accurate and if you have autoimmune disease (most of which have some level of gluten intolerance as a component) such as Hashimoto’s Hypothyroidism, Rheumatoid Arthritis, Lupus, etc, or are under a lot of stress, your immune system may not have the strength to show enough of these antibodies for us to pick it up. And perhaps the biggest issue is that our conventional testing screens for reactions to alpha gliadin only, but here’s the bigger picture one more time:
There are alpha, beta, gamma and omega gliadins…and you could be reactive to any of the four forms.
Or you could be reactive to deaminated gliadin. Deamination is something that’s done to make the protein water soluble so it can be mixed with other components to make packaged foods. The reaction to deaminated gliaden is much stronger than regular gliadin. There are three of types of deaminated gliadin (15, 17 and 33) and you guessed it, you could react to any of them.
Or you could be reactive to gluteomorphins (a byproduct of us digesting the gluten protein). Morphin like morphine, reacts on opioid receptors in your brain and literally gives you a high. The people reacting in this fashion are those that tear up in my office when we discuss going off gluten – they are truly addicted. This group also can feel worse when they come off gluten because their brain is missing that fix, more on this later. (FYI: there are caseomorphins found in dairy as well. Tough for you to lose the milk moustache? This mechanism may be at play.)
Or you could be reacting to glutenin (remember that gluten is made up of gliadin and glutenin) and this isn’t tested for conventionally either.
Or finally you could be reacting to wheat germ agglutinin, which is not a gluten reaction but more of a “wheat sensitivity” to the lectin portion of wheat germ.
So when we focus on “Celiac” and we look at testing for alpha gliadin and tissue transmaminase, can you see just how much we’re missing? And how a negative test from our doc can give us a false sense of security as we continue to eat gluten?
And want to know how we’re missing even more people who are reactive to gluten? Usually what gets you tested is complaining to your doc about some sort of digestive trouble (although some autoimmune patients are screened, as well as those having immediate family relatives with Celiac). However, gluten reactivity in the scientific literature is being categorized, not as a digestive issue but as a neurological one. Huh??
Consider this 2002 article from the Journal of Neurology Neurosurgery and Psychiatry: patients with enteropathy (erosion of the small intestines due to gluten) represent only 1/3 of patients with neurological manifestations of gluten sensitivity.
Yikes! That means 2/3 of us – over half – that have some sort of reactivity to gluten do not have digestive symptoms! We’re getting missed entirely. Reactions can be depression, neuropathies, brain fog, fatigue, insomnia, anxiety, infertility, female hormone imbalances, acne, etc. The gluten issue extends well beyond the gut, so notion that we are in the clear if we don’t have Celiac is simply not accurate.
This isn’t just the ramblings of gluten-phobic Dr Brooke – who by the way, is descendant of a long line of wheat farmers! (I doubt they are reading this blog though. My grandfather’s response to
a computer is “I don’t watch that thing.”) For at least 15 years, medical journals have been talking about how we’re missing the boat by focusing on Celiac, alpha gliadin and digestion symptoms only.
In 1999, the British Medical Journal stated that we are catching only about 12.5% of reactive gluten patients by diagnosing those with overt Celiac – the teeny, tiny, tip of the ice berg, so to speak. The journal Gut in 2006 said that, “For every symptomatic patient with Celiac disease there are 8 patients with no gastrointestinal symptoms”. This means we’re missing 7 of 8 people reacting somehow to gluten with our current model of testing.
If you’ve lost all confidence that you’ll get any sort of reliable gluten testing, rest assured there is now a test that will screen for reactions to all of the gluten reactivity I’ve discussed. Visit http://www.cyrexlabs.com and inquire about Array 3.
Not able to get adequate testing – or don’t want to? You have another option: you can always eliminate gluten and see if you feel better. But note that you have to eliminate it completely and usually for 4-6 weeks or until your symptoms are gone. Then you introduce it back and see how you do. If you feel better off gluten, listen to that! You’re body doesn’t lie. Most of us ignore the signals our body sends us every day, if your body does better off this inflammatory food go with it – testing or not!
But let’s face it, even with a positive test on the Cadillac of panels from Cyrex Labs, many people simply do not want to give up gluten. It’s in most of our favorite comfort foods and nearly all of our packaged, widely available, convenience foods.
I had a patient that I saw off and on for nearly a year and her weight just wouldn’t budge. She had horrible acid reflux that even with Nexxium, was so bad it affected her sleep and her workouts. When in a prone positions (face down), like for a push up, she had so much reflux she couldn’t finish a set. She had eczema, a few bouts of skin cancer, her stomach ached every time she put food in it, and no matter what we did the scale just wouldn’t budge.
Her doc had tested her for alpha gliadin and assured her that gluten wasn’t a problem for her. My suggestion to skip her beloved morning bagel was a very hard sell. Finally she agreed to a 30 day trail elimination. In that month she lost 15 pounds, eczema was gone, had zero heartburn and no reflux. She had no pain with eating and more energy than she’d had in years. At the end of the 30 days she said, “Yeah this has really worked wonders and I’ve never felt better…but it’s just too hard to avoid. I can’t do this forever.” So she’s back on bagels, back to being overweight and back to burning pain every time she eats. She’s also had another bout of skin cancer – and she was only 30 years old. Ay yi yi…..
Is gluten inherently evil? No, but our modern genetically modified gluten has proven to be a trouble maker for a whole lot of folks and there is mounting evidence that it makes a host of conditions worse – such as autoimmune disease like Hashimoto’s Hypothyroidism. And I don’t want to downplay Celiac Disease – it is a very real condition and an obvious reason to avoid gluten containing foods. But hopefully I’ve illustrated that Celiac patients are not the only ones that should consider living the gluten free life.
Who else should give up gluten? Tune in tomorrow for the answer! And up next after that: 7 reasons why, unlike Miley, you didn’t lose weight when you went gluten free.
Questions? Post them here or email me at email@example.com. Looking for tasty, you’ll-never-miss-it, gluten free recipes? Keep up with me on my Facebook page!
Standing in the aisles of your local health food store or shopping on a any number of websites, it’s easy to be daunted by what supplements you should take. Next to fish oil, methylating nutrients make the top of my list for good health on many levels. But what the heck does it mean to be methylating?
Technically, methylation is the subtracting or adding of a “methyl group” (one carbon and three hydrogen atoms) to some other molecule – like a protein or DNA. This process is going on all the time in your body and it’s crucial to you staying in optimal health. It’s often been said in functional medicine circles that “if you don’t methylate well, you aren’t well”.
Serotonin, for example needs to be methylated in order become active – without this process your serotonin will be low and you may feel depressed or have trouble sleeping. A compound called homocystine needs to be methylated in order to regenerate the important amino acid methionine – failure to do so is dangerous for cardiovascular health. Adrenaline must be methylated in order to get out of your system so that you can “wind down” – lacking methylation here could leave you anxious or wide awake come bed time. These are just a few of the scads of methylation reactions happening right now that are keeping inflammation down, detoxification running smoothly, hormone metabolism up to par and your mood on even keel. Know this: if you support methylation your entire body will benefit.
With nearly every system in your body affected by this chemical reaction, your mood, PMS, sleep quality and mood will all be better when it’s clipping along smoothly. Consider supporting this system with: B vitamins (particularly B12, B6, and folic acid), trimethyl-glycine (also known as betaine) and SAMe.
Wondering how your metylation stacks up? You can see homocystine levels on a simple blood test or you can have various alternative testing done to see markers of methylation (see www.metametrix.com for more information or find a functional medicine practitioner).
B vitamin status is seen in a common CBC, aka a complete blood count, and more specifically B12 levels are checked with a test called methylmalonic acid. (Note: blood levels of folic acid or B12 are not accurate for B vitamin status, but rather reflect recent vitamin intake from food and supplements. Methylmalonic acid and homocysteine are not routinely run, so you’ll need to ask your doctor.) There is also a genetic marker for methylation called the MTFR gene that can be tested for as well.
When looking for a supplement, I recommend using a combination product of several B vitamins and in light of recent damming evidence on synthetic folic acid, look for a product containing a particular form of folic acid: L-5-methyl tetrahydrofolate, to ensure efficacy and safety.
Keep your morning cup of coffee – it’s loaded with antioxidants and you’ll lose more weight when hopped up on caffeine. No wait – all that caffeine might cause diabetes and is bad for weight loss. What should you do? Opinions on both sides are strong – strong like a piping hot cup of French Roast, and there is research backing both sides of this argument. And it’s an argument indeed – take away a cup of Starbucks from a java junkie and you might not live to tell the tale.
When it comes to weight loss, popular advice based on interpretation of current research poses several problems. First, like any other plant ‘medicine” coffee seems to behave differently that caffeine alone – meaning that’s its other constituents and antioxidants play a role in how one responds (Translation: studies done on caffeine alone shouldn’t be directly applied to coffee and often times caffeine dosed in these studies is well in excess of what the average coffee drinker consumes). Next, studies pertaining to insulin sensitivity and diabetes are done on so called healthy subjects – ignoring the fact that there may be subtle derangements in their insulin function but they are not overtly diabetic or full blown insulin resistant.
Caffeine’s effect on insulin is where coffee plays into fat loss. Here’s what you need to know:
* Caffeine appears to acutely lower insulin sensitivity, but the effect is not chronic. Meaning that in the healthy, exercising individual, coffee drinking does not lead to diabetes . However, it does lower your insulin sensitivity in the short term so avoid drinking it with starches (optimal or allowable and for sure skip the muffin at your coffee break). If you have insulin resistance, diabetes or are not following a lower carb diet, caffeine can make insulin matters worse.
* Raising epinephrine is one mechanism by which caffeine perks you up, a preworkout coffee or tea will allow you to perform better, exercise harder and burn more fat at the gym. Avoid post workout caffeine to avoid thwarting the effects of your Recovery Shake. And if you have anxiety, insomnia or are at all aggravated from caffeine it’s wise to avoid coffee and caffeinated beverages in general.
* The fat in cream or Half & Half will slow caffeine release into your system making it a better fat burner. But keep it light as to not pile on the calories and saturated fat. 1 tbsp or less is fine.
* Finally, caffeine appears to be less of a diuretic than once thought – meaning it isn’t as significant of a factor in dehydration.
Is there a digital clock on your nightstand? Do you fall asleep to the TV? How about the flashing light on a wireless modem? Or like me, is there the light from the City That Never Sleeps streaming through your window? New research shows that even if you can fall asleep with the lights or TV on, if you’re trying to lose weight – you probably shouldn’t.
Researchers at Ohio State University looked at how light exposure during sleep affected food intake, glucose tolerance (how well insulin clears glucose, getting it into cells for use) and body mass increases in mice – and what they found might have us all reaching for the eye masks.
In the study, the mice were housed in one of three conditions: 24 hours of constant light, a standard light-dark cycle (16 hours of light and eight hours of darkness) or 16 hours of light and eight hours low light. The results showed that, compared with mice in the normal cycle of light-dark, those in the dim light had a significantly greater increase in body mass.
The researchers found that mice exposed to a dim light at night for eight weeks had a weight gain of 12g, which was about 50 percent more than mice that lived in a standard light and dark period. This dim light scenario is most like the seemingly negligible light in our bedrooms which may be thwarting our weight loss efforts.
Interestingly, even with no difference in activity or food consumption, the mice exposed to dim light ate more at night and gained more weight. This illuminates the notion that a big dinner or late night snacks is not ideal for leaning up.
The mice that were in exposed in constant bright light also gained more than the mice under normal light dark cycle, which shows us how metabolism is affected by abnormal sleep schedules like shift work, for example.
The link between sleep and body fat is slowly unraveling as we understand more about the body’s internal clock (known as circadian rhythm) and the actions of hormones like leptin and human growth hormone (both of which rise during sleep) and known light sensitive hormones like melatonin.
While we learn more, note that light leaking into your sleep environment could be causing:
Increased appetite at night
Difficulty regulating meal timing during the day
Difficulty losing weight in general
Excessive cravings or overeating
Block out any light leaks and get leaner by:
Replacing or covering up digital clocks
Turn off electric devices with lights such as computers, stereo systems, cell phones, etc
Consider black out shades, particularly if you have street light coming in your bedroom windows
Use an eye mask
Don’t sleep with the TV on
Try candlelight only during the evening, or at least 1 hour before bed turn off electric lights
And finally, unless your blood sugar dips too low during the night (causing you to wake frequently) then aim to have your last meal 2-3 hours before bedtime to allow leptin and growth hormone to rise. Healthy hormone patterns and a good night sleep are essential to a healthy, fit body – so lights out!