Monthly Archives: October 2013

Is Gluten Free Right for Me?

I hear the question every day – “Is gluten free right for me? Should I be gluten free?” Spoiler alert – there is no easy answer.  There are so many reasons why gluten free diets might benefit everyone, but there is also a right way and a wrong way to do it, and from what I’ve seen lots of people are doing it the wrong way.  Gluten free diets have helped lots of people, but the real question is it healthy for YOU? Let’s explore this idea:

Why Should I Be Gluten Free?

Anyone who knows me knows that I am serious about food sensitivities.  Many people are sensitive to foods that are common in the modern diet – not allergic, just sensitive.  This means that by eating that food you are creating a low-level inflammation in your body that is always there because the food is always there.  While you’re in good health and things are going well that may not show up as anything, but if you get sick or if your body has a weak spot somewhere (like allergies or eczema or behavioral disorders or arthritis) then that low-level of inflammation is going to make your thing, whatever that happens to be, worse.

As it happens, gluten is one of the most common food sensitivities, along with dairy, corn and soy.   Does this mean everyone should eliminate it?  No – not at all.  It does mean that if you happen to be sensitive to gluten then eliminating it is going to make a world of difference to your health, both now and long-term. If you’re sensitive to it, then the answer to the question “is gluten free right for me” is a resounding YES. If you’re not sure how to figure out what your food sensitivities are, the please check out the full post on it here.

Outside of the food sensitivity angle, eliminating gluten from your diet often means that you’re cutting out a lot of the starchy, carb-rich roods that we seem to adore so much (as long as you’re doing it right). This helps you prevent diabetes and heart disease and also keep that waist-line trim – all in all that’s not too shabby for a simple diet change.

What Are the Risks of Being Gluten-Free?

 

Is gluten free right for me? Gluten-free cookies (yep. Still cookies.) Although they look like they *should* be healthy, these gluten-free cookies are really still cookies. Really.
© Raymond Kasprzak | Dreamstime Stock Photos

 

Risk is maybe too strong a word, but there can be pitfalls. The most common of which is that people switch to gluten-free, but still eat just as many cookies and crackers and breads and pastas as they did before. This is still a good idea if you’re gluten-sensitive (or obviously if you have Celiac disease) but doesn’t give you any of the benefits of a lower carb diet. There seems to be a common misconception, that looks like this:

Gluten-Free = Healthy

Sadly, that is not the case.  Gluten-free just equals gluten-free.  The cookie is still a cookie, with all the carbs and calories and sugars that go with it.  Here’s the thing though, that still doesn’t mean:

Gluten-Free ≠ Healthy

Gluten-free can be an awesome way to eat, it’s just a matter of doing it right. So let’s talk about that.




The Right Way to Eat Gluten-Free

The basic rule to eating well gluten-free is eating well.  That means the normal rules still apply – just because it’s gluten-free doesn’t mean you get a free pass to the cookies, cakes and baked yummies. So here are some good guidelines:

  • Make the bulk of your meal fresh veggies and fruits – I try to go for 2/3 of meals, but breakfast sometimes isn’t as easy to proportion that way.
  • Include a good protein-source like grass-fed grass-finished beef, natural poultry, organic eggs, organic dairy or wild-caught fish (in moderation because populations are dwindling). If you’re vegetarian than focus on complete proteins like beans and rice, nuts, or seeds.
  • Include plenty of good fats – avocados, olives, olive oil, grass-fed butter, nut and seed oils
  • The smallest portion of the meal should be your sugars and starches – even if those starches are gluten-free starches.

The biggest problem is that lots of people are going “gluten-free” which means they still eat a Standard American Diet (SAD for a reason) except that the vast quantities of bread, pasta, cookies, crackers and sweets all have GF on the label.  I’d love to say the gluten-fairy took away all the sugars and carbs and calories when she took away the gluten, but sadly that isn’t the case. Just remember to think about the big picture when you’re going gluten-free.

Is gluten free healthy? The Answer is yes, as long as you do it the right way. Is gluten free right for me? Well… that depends on you.



Finding Your Food Sensitivity

I am a huge believer in the food sensitivity problem, largely because finding and eliminating a food sensitivity has literally changed my life. That sounds really cliché, but it’s actually true. Just keep reading and I’ll explain.

What is a Food Sensitivity?

Food sensitivities are a little bit mysterious, but one thing we know for sure is that it isn’t an allergy in the conventional sense.  If you eat a peanut and swell up and have to go to the hospital, that isn’t a food sensitivity. That’s a food allergy and it’s pretty easy to spot (just look for the ambulance and the disgruntled school nurse wielding an epi-pen.) Food sensitivity is allergy’s sneakier, tricksier second-cousin.  Your immune system is reacting to a food, but it’s not reacting in a huge dramatic way that gives you a clue to what’s happening.  It’s also not reacting immediately so you can put it all together in a nice simple way, like peanut + me = badness.  Instead, it’s a vague, ambiguous process that can’t be identified through normal means – you have to actually be your own science experiment, and god knows that’s fun.  Actually, I’m a bit of a geek, so I do *love* any kind of science experiment.

Eating a food that you’re sensitive to create a slow-moving background level of inflammation that just keeps your body irritated enough to make whatever else might be going on worse.  Everybody’s body has a weak spot – some place where they’re most likely to break down – and that’s where the low-level inflammation from a food sensitivity hits.  It just creates inflammation that people say is just “normal” for them, or just “aging” or something that’s “in their family.” Uh-huh.  So – here’s my story:




I grew up being a bit of a (read: ENORMOUS) tomboy.  The things I liked doing were all a little rough-and-tumble like hiking and camping and building things and riding horses and skiing into trees and dancing for hours on end. When I started having joint pain pretty young I just assumed it was because I road-tested my body and that it was “normal” (did you spot the dead-giveaway?) Yep. It’s also “in my family” to have joint pain, so there’s that.  Here’s the thing: when joint pain starts at around 6 years of age, it’s only going to go downhill.  By the time I got out of med-school I was having pain that made me feel like an 80-year-old woman and to shuffle when I first got out of bed.  It may occur to you that this isn’t, perhaps, “normal.”

Me, being a tomboy. Before discovering my food sensitivity Me, busy being a tomboy. This was before discovering my food sensitivity.

I had a great patient at that time and I was happily telling her all about how to discover her own food sensitivities at home, which involves the being-your-own-guinea-pig thing.  We’ll talk about it in a minute,  but it is a little involved.  Anyway, I’m explaining all of this to her and she looks me dead in the eye and says “this is the hardest thing anyone has ever asked me to do. Have you done it?” After which there was a pause, then a somewhat reluctant “no” from me.  The bottom line is that she agreed to test her food sensitivities if I would test mine.  Sigh.

So, I did.  As it turns out when I eat wheat I feel like I’ve been hit by a truck – but not until the next day.  So the day I eat wheat I feel great and have no troubles at all, then the next day I wake up and can hardly move. I’m achy (like 6/10 pain), stuffy, puffy and swollen and pretty darn irritable. If I stay away from wheat I actually don’t have that.  Huh.  Huge thanks to that patient, by the way, to whom I owe a lot of health.

Could I have a Food Sensitivity?

Yep, you could.  Pretty much everyone could. That’s the strange thing about food sensitivities. It can be a food you were raised with, that you’ve always eaten, that has always been a favorite and it could still be causing you a tremendous amount of trouble. Here are some general symptoms and conditions that I’ve seen associated with food sensitivities (not a complete list by any stretch of the imagination):

  • Pain of any kind including arthritis, neuralgia, fibromyalgia, gout.
  • Mood disorders including depression, anxiety, mood swings, and OCD.
  • Behavioral disorders like ADD, ADHD, oppositional-defiance, outbursts and anger issues.
  • Digestive problems like diarrhea, constipation, bloating, gas, indigestion, gallbladder sludge and stomach pain.
  • Hormone issues like hypothyroid, PCOS, irregular cycles, low sperm count, diabetes.
  • Autoimmune disorders like lupus, hashimotos thyroiditis, Behcet’s, psoriasis.
  • Skin problems like eczema, hives, itching and acne
  • General issues including allergies, fatigue, weight gain, and swelling.

Finding Your Food Sensitivities (or, Being Your Own Guinea pig)

Guinea Pig (pretend), just like you.

This is actually a pretend Guinea pig, but since you will only be a pretend Guinea pig too, it seemed appropriate. If you really want one of these, you can buy it here.

Testing your food sensitivities is a simple process, but it does take some work – mostly in reading labels. Here’s what you do:

  1. Eliminate: Eliminate the food you’re testing COMPLETELY for 14 days – this means read your labels because wheat, corn, dairy and soy are in all kinds of things that you wouldn’t suspect.
  2. Challenge: Enjoy the heck out of the food you’re testing for a day.  If you’re testing wheat then have wheat day. Eat some waffles and pasta and a great french bread with a ton of butter.
  3. Observe: Like any other good experiment you have to be a careful observer. After your challenge day, take the food you’re testing back out of your diet for three or four days and watch to see what happens in your body.  For most people, the fireworks start the day after challenge day, but sometimes it’s even more delayed than that. Your body will tell you clearly if you’re sensitive to something.
  4. Retest: This isn’t actually necessary, but if you’re like me you’ll go through exhaustive mental gymnastics to convince yourself that you aren’t actually reacting to that food (my big rationalization was that I actually got a flu, which coincidentally started the day after wheat day.) So if you don’t believe the reaction the first time, then after your observation period, have another challenge day.  This time, believe your body when it tells you it’s sensitive (I could rationalize one well-timed flu but two is too much).

What Should I Test First?

The big four food sensitivity foods are:

Wheat (but it’s good to test Gluten too), Dairy, Corn and Soy

And those are in everything so read your labels!! Look in weird places like soy sauce (which has wheat), and salad dressings (which have everything).

The next most popular foods to react to are:

Nightshades (tomato, potato, peppers, eggplants), Citrus (lemons, limes, grapefruit), Beef and Chocolate

The great thing is that you can eliminate and challenge one food at a time or if you want to do it all at once you can just eliminate everything and go down to a really simple diet and then re-introduce foods one at a time.  This is a choose-your-own-adventure type of experiment.

I would highly encourage anyone who is having health problems to start testing themselves for food sensitivities – it truly does make all the difference in the world. For me, I went from a roughly 6/10 daily pain level to a 1-2/10. That is pretty freaking awesome – especially since I don’t have to take any drugs or supplements to do it.  As a side bonus, my allergies dropped down to almost nothing – I don’t take allergy medications except for the occasional mold-mix on days when Austin is literally covered in mold.



MTHFR mutation, or How to Know if You’re a Mutant.

So, everyone kind of freaks out when I use a word like mutant because it sounds so sci-fi and X-men-ish but the MTHFR mutation doesn’t give us anything nearly so exotic as superpowers, more like just more of the usual problems. The thing is, we’re all mutants in one form or another. We all have a tremendous degree of genetic variability that gives us the amazing and awesome diversity of looks, personalities, traits and oddities that make us human. These mutations, or genetic variances, can make our enzyme processes work differently; meaning more slowly, more quickly or not at all. This is why some people are still doing great after five cocktails and others are bleary-eyed and drooling.

MTHFR gene mutations. Here portrayed, wildly inaccurately, as mutant carrots.

Behold the mutant carrots. Muah hah ha… Don’t worry, MTHFR mutations aren’t quite this funky.  Thanks to simply-sharon.com for the great photo.

For the most part, genetic variance creates relatively small changes because there are so many overlapping systems in the body. It’s all part of the great mystery – our bodies are designed with a plan A, plan B, plan C and probably the back-up super-secret plan X just to make sure everything goes right.  There are, of course, a few places where no matter how many overlapping systems we have, our bodies can’t compensate for how many little things have gone wrong.

One of the places this can happen is in the various genes for a process called “Methylation.”  Methylation, as you might have deduced, is the process where your body adds a -methyl group to some other molecule to help it become more active.  One of the most important places this happens is in the gene that methylates folate (the B vitamin) into it’s active form.  This group of genes are called “methylenetetrahydrofolate reductase,” or MTHFR for short. If you have too many genetic variances in these genes then you may not be able to activate your folic acid or other B vitamins.

MTHFR Mutation Problems Include:

  • High homocysteine levels in your blood and urine – this increases your risk for heart disease including high blood pressure, heart attack and stroke.
  • Increased risk of neural tube defects and preeclampsia if you become pregnant.  Neural tube is your baby’s brain and spinal cord so it isn’t generally an area you want to be defective.
  • Improper neurotransmitter production – this can lead to depression, anxiety, mood disorders and complex psychiatric illness.
  • Increased risk for the eye disorder glaucoma.




So – none of these complications are good things.  Generally they’re not issues you want to be dealing with in your life and certainly not a combination of them (bad enough to be depressed, but to be depressed with heart disease sounds worse). This leads to two questions, which naturally I will endeavor to answer for you.

Who Should Test for MTHFR?

MTHFR has a lot of variability and different people notice it in different ways. Usually I suggest testing for people who have had anxiety or depression since childhood, for people who have parents, siblings, children or themselves with spinal cord defects that might be related, or for people who have anxiety, depression or mood disorders “in the family.” This being a genetic mutation we usually see it show up in parents, aunts and uncles, siblings and children so if many people in the family are struggling then it’s time to look at your genes. Also if your homocysteine tests high at your doctors office even if you’re taking B vitamins then there’s a good chance there’s a problem.

How Do I know If I’m a MTHFR Mutant?

Great question! The best way to know, is to test. Your doctor can run a complete genetic analysis which will give you all of this information and is by far the best option if you have insurance.  This would also mean you could get a prescription methylfolate to help your body compensate.  If you don’t have insurance then there’s a great not-too-expensive way to do it at home, which comes with the added bonus of learning just how much neanderthal you have in you (I’m 3%!!!).  It’s called 23 and Me, and it’s an at-home saliva DNA test kit that gives you all kinds of great information about yourself like your neanderthal percentage, your ancestry, and also more serious things like your disease risk, certain gene markers for serious disease and also genetic differences that may cause you to react differently to certain drugs or chemicals.  All in all it’s pretty nifty.

Once you get your DNA info from 23 and Me, then you can plug it into the neatest service ever, which is donation based, called Genetic Genie.  Genetic Genie can run a full methylation analysis (for a suggested donation of $10).  I can tell you from looking at mine that this gives you an overwhelming amount of info and lots and lots of great ways to compensate for any genetic oddities you might find.

What Do I Do if I Have A MTHFR Mutation?

The short version is don’t worry, and take a methylated B vitamin.  This means the folic acid should be methyl-folate or some variation thereof, including L-5-Methyltetradydrofolate, L-5-Methyltetrahydrofolinic Acid, or 6(S)-5-methyltetrahydrofolic acid (the longer the word, the better apparently).  The B12 should be Methylcobalamin, and you may see something extra in there to just add extra methyl groups like trimethylglycine or betaine anhydrous.  Also, you should NOT take regular folic acid or anything that isn’t a methylated folate, simply because all of those will compete with the methylated folates and just continue the problem.  It isn’t always this simple because there are additional mutations that can interfere as well so some people have side effects when they take methylfolate, which you can read about here. If you find out you have an MTHFR mutation it’s not the end of the world, there is plenty we can do. It’s a good idea to check your kiddos too, or just switch them over to the methyl forms of B vitamins, and also if you have other genetic relatives who are struggling to pass on the good word about methylated B vitamins and your own new super-mutant status.