Elimination Diet & Gluten Free Diet

Spurred on by my thirty-something patient Keelan and listening to my patients, I decided to research elimination and gluten free diets. Keelan suffered from weight gain and mild irritable bowel starting in her twenties despite efforts at healthier eating and exercise. She did an elimination diet and found she had sensitivity to gluten (protein found in wheat, barley, and rye). After eating a gluten free diet this past year she feels so much better and has lost 30 pounds (and now at a good weight for her size/build). If she eats even a little guten (or pasta), she says she can just feel the quick weight increase.

I feel many people are similar to Keelan. Some estimates say about 95% of our population have at least some sensitivity to gluten. I recommend any of you not feeling well or at your best weight to try an elimination diet and then see what you find out to continue a better healthier diet for you. Along with a good diet, it is essential to drink plenty of water (at least ½ – 1 gallon/day – I drink at least a 13oz bottle of water at 3 meals and on my way home from work), and take a few appropriate daily supplements for your best health (for most people extra vitamin D, fish oil, multivitamin, probiotic, and calcium for women – see us for your yearly physicals to go over the best for you), along with exercise and proper rest/sleep. I have found many people are unsuspectingly vitamin deficient (like vitamin D/zinc/iodine/and more, causing fatigue, hair loss/skin problems, decreased libido, and much more), so please see us for your yearly physical to check what you need and consider some vitamin tests (several at no charge in our office and some blood).

BASIC ELIMINATION PLAN
Elimination or allergy diets are used to isolate food allergies or sensitivities. There are a number of medical symptoms that can be related to food, including recurrent yeast infections, rashes and eczema, irritable bowel syndrome, diverticulitis, asthma, migraines, lactose intolerance (deficiency in the enzyme needed to digest milk or milk products) and more.

You can eat: preferably organic meats-chicken-turkey-fish (Moody Meats or even Target are good places), vegetables & fruits (best organic or well washed, good to get at Fresh Market or http://www.farmfreshdelivery.com/), beans, and rice for at least 14-21 days, then gradually add groups as instructed below every 4-7 days and monitor how you feel/symptoms.

Water – most everyone is dehydrated and this can cause many chronic symptoms such as fatigue, headaches, problems sleeping, joint aches – you need to drink at least 1/2 your body weight in ounces/day (#150 lb person needs at least 75 ounces) – filtered or distilled water (no other fluids count and really only other healthy fluids are herbal or green teas)

Eliminate the following foods from the diet for a period of 14-21days to a month:

1. Dairy products, including cheese (instead use soy milk and soy cheese; rice milk, rice-based ice cream)

2. Egg and egg-containing products

3. Food containing gluten, such as wheat and wheat-based products (including pasta), and barley, oat, or rye grains (alternative grains could be brown rice, buckwheat, spelt, millet, potatoes or sweet potatoes)

4. Citrus fruits

5. Corn and corn-containing products

6. All processed foods including caffeine

Note that suddenly stopping some foods (such as caffeine) can result in withdrawal symptoms (typically headaches) – however this usually lasts only a few days.

Next, reintroduce one food group to your diet about every 5 days.

The reintroduction period allows enough time to determine any intolerances.

Celiac Disease (or also called celiac sprue) is allergic reactions to the protein gluten found in wheat, rye, and barley, and can be very mild or severe leading to malnutrition. Gluten sensitivity is often misdiagnosed because the symptoms can be related to other causes. Some of the many possible symptoms are weight gain, abdominal pain and bloating, fatigue or weakness, cold sores, lactose intolerance, headaches or migraines, gas, diarrhea or constipation, irregular stools, depression, respiratory problems, more frequent infections, swelling and rashes, hair loss, acne, infertility, miscarriage, lupus, autoimmune disease, acid reflux, vitamin D deficiency, joint pain, muscle cramping, and allergies. With gluten allergy one’s immune system attacks its own intestinal lining cells which damages them and allows toxins to enter the blood stream, malnutrition, and inflammation.

Below are recommendations from the Celiac Sprue Association. Their website has a tremendous amount of information at www.csaceliacs.org.

Gluten-free Diet: Basics

Generally allowed foods – meats, poultry, most dairy products (except if lactose intolerant which is common in people with celiac disease), fruits, vegetables, rice, and potatoes.

Alcholic Beverages – gluten-free beer, wine and brandy without preservatives and additives, potatoe vodka, rum, tequila

Breads – commercial gluten-free breads and mixes made from ingredients such as white or brown rice flours and starches such as arrowroot, potatoe, or tapioca.

Cereals – gluten-free cereal grains and sources without malt, hot cereals made from corn meal, cream of rice, hominy, and rice

Cheeses – all aged hard cheeses as cheddar, Swiss, Edam, and Parmesan, and check ingredients on cottage cheese, cream cheese, and pasteurized processed cheese (avoid cheeses with vegetable gum, food starch and preservatives not defined by a gluten-free source)

Crackers and Snack Foods – rice wafers, potatoes or cornstarch based, pure cornmeal chips and tortillas, popcorn, vegetable and gluten-free nut based chips

Desserts – gelatin desserts, certain pudding mixes and ice cream and sherbet or yogurt (without suspect additives, wheat flour, or gluten stabilizers), custard, junket, homemade or commercial desserts from gluten-free ingredients

Drinks and Juices – fresh brewed coffee, tea, chocolate made with cocoa, fruit juices, carbonated drinks and some nut and rice drinks, and a few root beers (and instant or processed drinks without malt, additives, stabilizers, or emulsifiers)

Fats and Oils – olive oils, soy, safflower, grape seed, sunflower, corn oils, canola, margarines, butter, lard, cream, cottonseed, pure mayonnaise, peanut butters, and hydrogenated soy oils (and evaluate low fat combinations)

Flours – use gluten-free flours and starches from food already common in one’s diet (many commercial blends are available)

Fruits – fresh, frozen, dried, or canned fruit (evaluate thickeners, additives, or preservatives)

Grains and Grain Substitutes – any gluten-free grains such as rice, brown rice, corn and popcorn, tapioca, sorghum, flax and wild rice, yams, potatoes, sweet potatoes, soy

Meats or Meat Substitutes and Eggs – meats, meat substitutes, fish, minimally processed poultry and eggs prepared with the allowed grains (evaluate all marinades and coatings, hot dogs and sausages)

Miscellaneous – herbs, spices, nuts, coconut, chocolate, pure cocoa

Potatoes-Pasta-Starches – potatoes and sweet potatoes, yams, hominy, rice and wild rice and gluten-free pastas (in the U.S. the word “starch” is made from cornstarch)

Soups-Soy Sauce-Teriyaki Sauces – read all the label of ingredients

Sweets – sugar, honey, maple syrup, molasses, most jellies and jams, plain hard candy, marshmallows, gumdrops, and homemade or commercial candies made with allowed ingredients

Vegetables – fresh, frozen, dried, or canned unless they contain thickening agents to evaluate (canned vegetables may contain emulsifiers, preservatives, stabilizers, and food starch not defined by source)

Vinegars – balsalmic, apple cider and wine vinegars