Is a gluten-free diet right for you?

By John Hoeber, MS, RD, Owner of Body Kinetics

From celebrities who swear by it to the menu at the hot new restaurant in town, gluten-free is all the rage. Your grocery store may even have a whole aisle dedicated to gluten-free fare. But what exactly is gluten? Is it really that bad for your body? And who needs to worry about it?

Foods to eat — and avoid — on a gluten-free diet

Let’s start with the basics. Gluten is a protein found in certain grains, specifically in wheat, rye, barley, spelt and kamut. Going “g-free,” as some call it, means eliminating these grains and any foods made with them from your diet. Most types of bread, bagels, pasta, muffins, flour tortillas, pizza crust, hot dog and hamburger buns, couscous, tabbouleh, bulgar, cookies, brownies and cereals that contain wheat shreds or flakes are off-limits to those avoiding gluten.

But there are other, unexpected, gluten-containing foods that you need to avoid, too. These include: beer (it’s made with malt, which comes from barley), malt vinegar and other items made with malt or malt flavoring, soy sauce, teriyaki sauce, many gravies (gravy is typically thickened with flour), many fried foods (which are typically coated in flour before frying), brewer’s yeast and imitation crab meat, among others. It is also recommended to avoid oats that don’t specifically say “gluten-free,” as they are often contaminated with wheat during processing.

Gluten is also used in lipstick and some medications, according to the National Institute of Diabetes and Digestive and Kidney Diseases. If you are truly allergic to gluten or have been diagnosed with celiac disease, speak with your pharmacist to see if your prescription medications contain wheat and read all product labels carefully.

What is safe to eat on a gluten-free diet? Any product made with potato, rice, soy, amaranth, quinoa, buckwheat or bean flour (instead of wheat flour).

Gluten allergy, gluten intolerance or celiac disease?

Gluten sensitivity can range from simple gluten intolerance, which can cause mild but fleeting discomfort, to serious gluten intolerance, also known as celiac disease. These are both different than having a wheat or gluten food allergy.

Unlike celiac disease, where gluten is the source of symptoms, a wheat allergy can be caused by any number of proteins, including albumin, globulin, gliadin and gluten. Wheat allergies are commonly found in children and are typically outgrown before adulthood, whereas celiac disease can develop and be diagnosed at any age. While celiac disease can be successfully managed through dietary changes, it is a chronic condition that a person will have to deal with for the rest of his or her life (in other words, there is no cure yet for celiac disease).

Some have suggested that the increase in gluten intolerance in our society is a result of genetically-modified varieties of wheat and other grains being introduced in increasing quantities into our diet. But I suspect that the increase in gluten sensitivity is due to improved diagnosis and wider acceptance of this problem.

Symptoms associated with gluten intolerance

Gluten intolerance has been blamed for more than 250 symptoms. Most of those are digestive and includegas, bloating, nausea, abdominal pain, diarrhea, constipation and vomiting. Other common, non-digestive symptoms include weight gain, dermatitis (a broad term for several types of skin rashes), joint pain,tendonitis, headaches, migraines, depression, anxiety and irritability.

Celiac disease presents with different symptoms in children than in adults. In children, most symptoms are digestive, such as abdominal pain and bloating, chronic diarrhea, constipation, foul-smelling or fatty stool, or vomiting.

In adults, celiac disease symptoms vary widely and can include fatigue, bone or joint pain, bone loss, depression, anxiety, missed periods, canker sores or an itchy rash.

How to tell if you’re sensitive to gluten

Clinical diagnosis is often tricky, but checking to see if you’re sensitive to gluten is relatively easy by way of an elimination-challenge diet. As its name suggests, you start by completely eliminating gluten from your diet for at least three weeks. This means not eating one crumb of wheat bread or drinking one sip of beer.

First do a detailed symptom check by rating, on a scale of 1 to 10, any symptoms that are bothering you. Track these symptoms for at least a week before beginning the diet, and continue to track and note how you’re feeling every day for the three weeks you’re on the gluten-free diet.

At the end of the three weeks, introduce gluten products back into your diet. Have a moderate amount of gluten right away rather than add it gradually. Start with steel cut, whole wheat hot cereal for breakfast, Tabouli salad made with bulgar wheat (cracked wheat) for lunch and wheat berries (cooked like rice) for dinner. Try that for a week before adding in breads and pasta.

Continue to check your symptoms for one more week. If gluten is indeed the source of your symptoms, you will notice an easing or elimination of those symptoms during the three gluten-free weeks, and then a recurrence when you begin to eat gluten again. If you do notice a reaction to gluten, talk to your doctor and describe what you did and how you felt.

The paper mache paste diet

If you feel better without wheat and gluten, it still doesn’t necessarily mean you have gluten intolerance or celiac disease. Rather, you simply may have been eating way too much bread, bagels, pasta, cereal, muffins, tortillas, pizza crust, cookies and brownies. They are all made from flour. Despite forming the basis of most Western diets, flour, whether it’s white or whole grain, is still a processed food and is relatively devoid of nutrients.

When you think about it, the basic recipes for all of those foods are not that much different from making paste for your paper mache art projects: mix together flour and water (or some type of liquid). Put another way, we eat a lot of paste at each meal and then wonder why we have so many digestive complaints.

Going gluten-free for weight loss

Many people have jumped on the gluten-free bandwagon to lose weight — and have seen success from it. That’s expected when you eliminate bread, bagels, pasta, cereal, muffins, tortillas, pizza crust, cookies, brownies and beer from your diet. Especially if you replace them with good starchy veggies like squash, peas, carrots, beets, sweet potatoes, turnips, legumes and even potatoes.

Just don’t replace eating wheat-based pasta, bread and brownies with rice pasta, gluten-free bread, gluten-free cupcakes, gluten-free pancakes, and gluten-free brownies. If you do, well, you’re still eating paste.

The bottom line

If you’re trying to lose weight or just eat healthfully, it’s a good idea to reduce the amount of refined carbs and processed foods from your diet. You’ll probably notice you feel better and have more energy once you do.

However, if you think you might have a true wheat allergy or celiac disease, go see your doctor for a full evaluation.

 

John is a registered dietitian, certified specialist sports dietitian, wellness coach and personal fitness trainer. He is the owner of Body Kinetics Health Club and Spa in Mill Valley/Novato, CA.

Top Foods to Look for at the Farmers Market by John Hoeber

We are lucky in Marin to have an abundance of fresh fruits and vegetables available all year around. There’s a farmers market virtually everyday within a short drive, some supermarkets and restaurants carry locally produced goods, and you can even get a box of fresh fruits and vegetables delivered right to your door. Eating locally produced fruits and veggies supports local farms and pumps dollars into the local economy. It’s good for the environment because our food doesn’t have to be shipped from other states or other countries, and even better for the environment when we support organic farms.

The benefit to our bodies is even greater. When a food is shipped long distances it has to be picked sooner rather than allowed to ripen fully, so it starts out with a lower nutrient content. Then it sits in transit and on the store shelves for much longer losing more and more nutrition every day. Not only is local food more nutritious, it taste much better. It is also thought that local foods eaten in season help us adapt to the local climate.

Here are 7 of the most nutritious foods you’ll find at the farmers markets this month, but talking about them in terms of their vitamin content is limiting since there are hundreds of phytochemicals (vitamin like chemicals) in every food and more being discovered daily. Current science, as advanced as it is, does not yet understand the complexities of the interactions that nature has given us, and if we only look for the few known vitamins we will miss eating some of the best foods out there. Fruits and Veggies are natures vitamin supplements, and the tomorrow’s superfood may turn out to be today’s overlooked side dish.

Apples
Apples are a good example. Many people are concerned about the sugar content in fruits, but don’t know that they contain chemicals that help us regulate blood sugar. Apples are the perfect snack – portable, satisfying and delicious. They’re said to provide a morning pick me up similar to coffee. For weight loss try a small apple 20 minutes before a meal to curb your appetite.

Squash
A great alternative to pasta, bread and rice, squash gives you a host of phytonutrients and increases fullness. There are many varieties and endless recipe ideas for squash. We often saute them with onions, root vegetables, such as purple potatoes and carrots, and greens such as chard and spinach.

Beets
When thinking about phytonutrients think color, and the darker the better. So far we know that beets are great for reducing oxidation and inflammation, and assisting with detoxification of carcinogens. More benefits are found every year.  Cooking destroys some of the nutrients so steam for no more than 15 minutes, or use a micowave. Cooking time is greatly reduced in microwave cooking preserving more nutrients.

Potatoes
Yes, potatoes. Recent studies find the purple variety (remember, the darker the better) to be great for lowering blood pressure, and have phytonutrient quantities similar to spinach and broccoli. Potatoes have gotten a bad reputation because of the glycemic index theory – plain potatoes eaten alone tend to raise blood sugar quickly, but who eats them that way? In fact that’s the more important problem with potatoes, we usually don’t eat them plain we usually fry them or eat them with lots of butter, sour cream and salt. And we don’t eat them alone, eating them with a meal changes the glycemic index. Put them in stews for a satisfying fall/winter meal.

Mandarin Oranges
My orange tree is going crazy right now with these tiny gems. Most of us think of all the vitamin C we are getting from oranges, and yes it’s a lot and Vitamin C is very important, but there are over 400 other bio-active substances found in an orange. Some of them boost the antioxidant activity of Vitamin C, others increase detoxification of carcinogens, some are anti-tumor, others inhibit blood clotting. Oranges are another packable snack. Keep a bowl on the coffee table for when you are tempted for a late night snack, only 45 calories.

Walnuts
Walnuts are one of the most unrecognised superfoods. They have very unique phytochemicals, omega 3 fats, and an important form of vitamin E. They are thought to be good for lowering risk of breast and prostate cancer, diabetes, metabolic syndrome. Mix them in your hot or cold cereal, put them in salads, eat them plain with your apples. Nuts are better for you raw and be sure to eat the skin as well (not the shell), it is where the most phytochemicals are.

Rainbow Chard
Rainbow Chard is one of the best vegetables in the world. It has the same unique class of phytochemicals as beets as well as 13 different antioxidant chemicals. It is thought to help regulate blood sugar, supports detoxification, and much more. Chard should be boiled to reduce the oxalic acid content – which can decrease absorption of minerals like calcium and iron.

These are but a few of natures powerhouse foods, you can’t go wrong by picking a different fruit or vegetable. You’ll be giving your body great vitamins, minerals and amazing phytochemicals. Pick your favorites at the next farmers market and make you and yours a nourishing and nurturing meal.

Why diets don’t work and a 3 step plan that just might

I just read a blog where the author said the reasons diets don’t work is because people are not motivated enough to lose weight, poppycock! One of the main reasons folks fail to lose weight when on a diet is lack of good tasting food! Diet food just doesn’t taste good.  Almost everyone I talk to loves IN and Out Burger.  Why?  It tastes good, no great!  Is it good for you?  Well of course not, it is full of empty fatty calories that your body has a hard time digesting and eliminating, AND is really bad for your arteries. That doesn’t seem to matter to most people.  What matters is that it tastes good.  We want food that is cheap and tastes good. Healthy food can be to expensive and it takes a long time to prepare. To make it taste good you need to add a lot of different flavors like curries, peppers, flowers like lavender and yes some fats like olive and sesame oil.  It is so easy to buy take out that is loaded with fat and salt.  After your done eating it you kind of puff up like a dough boy or girl from the hydrogenated oils and MSG. It is not easy to stop, shop, and cook every night.  You have to have a plan!

 

So what do you do?  You have to have a plan.  A plan, a plan what type of plan?  Here is your 3 step approach:

1. Sit down with you spouse, partner or just yourself on Saturday or Sunday morning and plan what meals you like to eat.  Most people have 7-10 recipes they make at home on a regular basis.  If you don’t, find some that are fairly easy to make, are healthy and taste good. Ask friends if you are stuck.   Write down your dinners for the week – plan one dinner out so you don’t go crazy!  We usually plan sushi out because we can’t make it at home and it really tastes good and is good for you.  Cheap not so much, but how much sushi can you eat of anyway?  Keep your lists each week so you can refer to them for ideas for the future.

2. Go the you local farmer’s market and buy the food for the week.  You can find just about everything you need at the one in San Rafaelon Thursday and Sunday mornings.  Bring your list so you don’t go crazy buying things you are not going eat soon. The vendor’s samples always seem to taste better at the market then when you bring the item home.  Don’t forget to bring your shopping bags.  My son is 5 now and I still bring his stroller and fill it up with food so I don’t have to carry it.  The walking is good for him.

3. Here is the good part.  How to cook this stuff.  It is easier than you think.  Make lots of slow cooked stews.  Cut the veggies, add the meat, liquid like broth, and many different spices depending on you taste. Stick it in the slow cooker before work and it will be done when you get home.

I cook an Papua New Guinea version moo-moo, my sister-in-law Lucy taught me which is curry and light coconut milk base with ginger, sweet potatoes, onions, carrots, mushrooms, and lots and lots of kale or just about any dark leafy green. Serve it over some brown rice and voila! Low-fat, gluten free, leave out the meat and vegan.  You can eat it that night and the next day for lunch. You can also make a healthy hungarian beef stew with lots of paprika, or a brazilian fish stew with red, yellow and jalapeno peppers and light coconut milk. You can mix up the slow food with the quick food.  Quick stir fries, veggies, shrimp in sesame oil with cashews and a little Thai curry.  How about a Mexican style dish with veggies, black beans, ground turkey, with cumin, cayenne pepper and lime. All flavorful, colorful, healthy, low-fat and TASTE GOOD!

Does Wine Reduce Cancer Risk?

If you’ve read the sensationalist headlines that red wine can stop breast cancer please don’t pop open a bottle and celebrate.  Yes, there was a study recently that found that a chemical in grapes, resveratrol, can block the growth of some breast cancers cells. But the negative effects of alcohol on breast cancer are numerous and well documented. According to the American Cancer Society even one drink per day increases the risk of breast cancer, and the risk gets even greater with more. An editorial in the Journal of the National Cancer Institute said “from a standpoint of cancer risk, the message could not be clearer. There is no level of alcohol consumption that can be considered safe.”

It is irresponsible to report on a study about resveratrol and jump right to red wine.  The researchers did not study the effects of red wine, but rather the effects of one chemical in a test tube. Why not say that a glass of grape juice per day is the ticket? The resveratrol content is the same.

I remember seeing an SF Chronicle report many years ago that hearlded the great news that “Pizza Found to Reduce Prostate Cancer in Men”. It wasn’t until the last paragraph that it mentioned that it was the antioxidant Lycopene in the tomatoes used to make the pizza sauce that had a protective effect. But how many guys celebrated with a couple of slices of cheese and pepperoni?

It is important to be a critical consumer of information, especially around health. There are too many people out to sell you anything, even if it’s just a newspaper. There’s a new superfood, or supplement every day, and don’t think that some powerful agricultural boards aren’t thinking how they can market their crop as the next big thing. There’s a lot of PR going in to those bottles, so beware.

As for breast cancer, it is Breast Cancer Awareness Month after all, the American Cancer Society says to limit alcohol use, exercise regularly, and stay at a healthy weight. They continue by saying “it’s not clear at this time whether chemicals that have estrogen-like properties (like those found in some plastic bottles or certain cosmetics and personal care products) increase breast cancer risk. If there is an increased risk, it is likely to be very small. Women who choose to breast-feed for at least several months may also reduce their breast cancer risk. Not using hormone therapy after menopause can also help you avoid raising your risk.” They also encourage women to be tested so as to find cancers at an earlier and more treatable stage.

All very good advice. As for the wine, although there is enough science to say it’s good for our hearts, it also raises our cancer risk. Pour yourself a glass of grape juice, it’s a superfood.

Eight Beauty Boosting Foods

1. Guacamole face mask

Avocadoes are one of the most vitamin-rich foods in your kitchen. They contain Vitamin A, which helps with skin development; Vitamin E, which has anti-inflammatory properties; and Vitamin B, which delivers nutrients to your skin cells.

And the benefits don’t only come from eating them. They serve as an excellent moisturizer for your hair and skin, too! Here’s a quick recipe. Take a ripe avocado. Mash it with a fork. Add 2 tablespoons of honey and apply it to your face and hair for 10 minutes. Of course, you’ll want to rinse it off before you leave the house.

2. Boost your health with berries

Berries always lighten my spirit. When I was growing up, my mom always mixed blueberries, raspberries, and blackberries into a colorful and sweet berry salad when company came over for tea. I’ve carried on the tradition to this day. And the best part? Berries are loaded with antioxidants, which help prevent cell damage that causes wrinkles and promotes aging.

3. Watermelon, the skin mechanic

Did you know that watermelon is an ideal food to eat if you get a cut or scrape? That’s because the seeds contains zinc. I like to think of zinc as a little skin mechanic because it helps repair damaged tissue and heal wounds. Zinc also acts as a mild astringent and may help in the treatment of acne.

4. Protect your skin with tomatoes

Thankfully, sunscreen is not the only thing out there that shields us from the sun’s harmful rays. Believe it or not, a strong antioxidant called lycopene found in tomatoes helps protect your skin from ultraviolet rays.¹ And if you use tomato paste in your recipes, you’ll get four times the concentration of lycopene you get from fresh tomatoes. Of course, you’ll still need to wear sunscreen, but it’s nice to have a little extra boost.

5. Fight off lines with chocolate

Ever heard of polyphenols? I hadn’t, until recently. But you’re probably quite familiar with red wine and chocolate, which contain polyphenols. They’re antioxidants that help block free radicals from damaging the cells in your body. Researchers found there was a 25% reduction in reddening from sun and 42% reduction in scaliness in a group of women who consumed a half a cup of cocoa per day for 12 weeks.² So feel free to indulge a little. After all, you’re fighting wrinkles.

6. Brighten your skin with grapes

Grapes contain resveratrol, an ingredient being used in skin care products more and more often. It’s an antioxidant, an anti-inflammatory, a skin lightener and brightener, and even a sun protector.

I found out that resveratrol develops in the grape skin in response to a bacterial infection that affects the plant. So it acts as a natural antibiotic. I also read that if you’re out of exfoliator, you can actually crush some grapes and spread them over your skin to help shed the dead cells.

7. Produce more collagen with papaya

I’d never consider a collagen injection. But thankfully, we can help our bodies make their own natural collagen by eating papayas. They contain vitamin C, which is required for the body to produce collagen and restore elasticity. Papayas also contain papain, an enzyme that can help repair wrinkles.

8. Hydrate your skin and hair with oysters

They’re not just an aphrodisiac. They’re good for your hair, skin, and nails. Oysters contain omega-3 fatty acids that help prevent dry, lackluster hair and dry, patchy skin. They also contain zinc, which helps prevent acne and promotes wound healing. I guess if your hair and skin become sufficiently lustrous, your partner may not even need an aphrodisiac.

 

Breakfast may be the most important meal of the day

Check out this video and why eating a protein rich breakfast can reduce food cravings throughout the day!

http://vimeo.com/23929986

Long term weight gain

As many of our members know, weight loss is not easy. The strategy “Eat Less, Exercise More” May be Overly Simplistic. Here is a good article from Harvard School of Public Health: http://www.hsph.harvard.edu/news/press-releases/2011-releases/diet-lifestyle-weight-gain.html

MyPlate not your plate?

As a nutrition education tool the USDA’s new My Plate has at least one serious flaw, but viewed as a political document it is right on target. If you haven’t seen it yet, the USDA has done away with the Food Guide Pyramid and has introduced a graphical depiction of a dinner plate divided into portions to represent how much of your diet should come from the different food groups.

Kudos to USDA for recommending that nearly half of our diet should consist of fruits and vegetables. The problem I have, however, is with the grain group. Where do we put peas and carrots? squash and sweet potatoes? Beets, parsnips, turnips, potatoes, lentils, yucca and yams? These starchy foods are more like grains and should be in the same group. I’m of the belief that these starchy foods should form the staple of our diets. They are generally higher in fiber than most grains eaten (most grains eaten being refined) which would help us feel full and satisfied. Ounce for ounce they are much lower in calories than grains (32 in an ounce of yams and 75 in an ounce of bread), which would help us lose weight. They are also packed with phytonutrients. These nutritional gems are starchy like grains are and serve the same macro purpose – to provide energy, yet MyPlate puts them in the vegetable group competing for space with spinach, kale and broccoli. We should eat starchy vegetables instead of grains not along side them as is suggested by MyPlate. Moreover we should not replace green leafy or other great veggies with squash and sweet potatoes, we should eat them together. We would lose weight, be more full and satisfied, and get better nutrient value.

So why does the USDA push grains on us? As a public health policy we need grains because they can be stored a long time and will feed us if there are catastrophic crop failures. To that end the USDA is in the business of supporting grain producers. Farm subsidies for fruits and vegetables are virtually non-existent compared to payments for grains. According to the Environmental Working Group farm subsidy totals for the 15 years 1995-2010 were: Corn $77 Trillion, Wheat $32 Trillion, Rice $13 Trillion, Sorghum $6 Trillion, Barley $2.5 Trillion and Oats $267 Million. Apples are the first fruit and vegetable on the list hitting $261 Million. By the way, Dairy farmers were paid about 6 Trillion.

Grains are very nutritious, don’t get me wrong, I certainly eat them often enough. When you eat them, choose the whole grain variety and you’ll get phytonutrients and fiber. Eat them after a workout and the excess carbs will not be turned into fat. But you’re better off, in my opinion, getting your starchy food fix on peas and carrots rather than pasta and rice.

Athletic Development in Children

Emerging research in exercise physiology in children helps us answer the question of how to help our kids develop into great athletes. The research shows that there are different stages when children are more apt to improve different aspects of athleticism such as speed, agility or strength. For instance the first window of opportunity for improving speed happens at 6-8 years of age in girls and 7-9 in boys, whereas motor skill development is optimal from 9-12, and strength development is accelerated when the adolescent growth spurt begins to slow. The Long Term Athlete Develop Model (LTAD) instructs us on these windows of opportunity and encourages us to develop overall physical literacy in our younger athletes and not specialize into particular sports until High School.

Unfortunately, youth sports are a poor vehicle for overall athletic development. As coaches in youth sports we have one to two hours per week to teach complex position specific skills, rules and strategies to grade school kids so that we can field a respectable team. Not only is there limited time to develop well rounded physical literacy, there is not the expectation. We are expected to teach them how to hit a home run and make the all star team.

Developing more versatile athletes would take doing a few conditioning exercises and some drills from other sports on a regular basis and across all sports. For instance, for a few minutes during softball practice the team might play kickball, run an agility obstacle course and learn how to do a forward lunge. Later in the year at soccer practice they might learn a jump shot, do bear crawls and learn the downward dog. In the short term, taking time out of their practices to cross train might delay position specific skills needed immediately, but specific skills can be picked up much easier later if there is a good base of neuromuscular control, balance and coordination. The LTAD is, as it says, a long term model. It states that if we give our athletes a well rounded youth experience they will flourish at the varsity and college levels, often at sports they are trying for the first time.

The LTAD model is not only designed for optimal performance, but also for injury prevention and long term health. As a personal trainer I see some of these athletes in the gym as middle schoolers and high schoolers. For most of them I need to start with the basics of how to activate core muscles to keep the spine in neutral position, how to activate leg muscles properly to stabilize the knee, or how to stand up straight. We find that the more athletes practice balance and stabilization exercises the less they experience knee or other injuries on the field. What’s a bigger concern are the kids I don’t see because they have been turned off by rigorous youth sports programs.

Canadian Sport for Life and other programs have adopted the LTAD model as a blueprint for national sports programs and we could do the same in our community. With buy in from the major local sports leagues our youth coaches could be trained in exercises that teach the core competencies we need our kids to learn. A cross training program of 15 minutes could successfully be incorporated into every practice in every sport in Mill Valley. Let me know if you think this is a good idea.

How important is the order of exercise when lifting weights?

In a recent study reported by American Fitness, 48 young men were divided into three groups:  One group trained their muscles from largest to smallest, doing the bench press, lat pull-down, shoulder press, biceps curl and triceps extension; another group trained their muscles from smallest to largest, doing the same five exercises but in reverse order;  and the third group acted as a control.  The two experimental groups did three sets of each exercise three times per week for eight weeks.

The order in which the exercises were completed was critical in the improvements that were produced.  For example, gains in the bench press were 39.8% when the exercise was done first and 18.6% when it was done last;  gains in the triceps extension were 74.3% when the exercise was done first and 50.0% when it was done last.  In other words, doing an exercise earlier in the workout generally led to the greatest improvements.

As a rule of thumb, the idea is to train the most important muscles as early as possible in the workout.  That’s when individuals are fresh, both mentally as well as physically.  Exercises that involve larger muscles are usually more important than exercises that involve smaller muscles.  For best overall results, then, muscles should be trained from largest to smallest.