Diet Sensitivities

Removing gluten from diet helps some greatly, but not all

 
 
Linda Keister, from Hollywood, listens to an explanation of the digestion of gluten by Dr. Arthur Agatston, medical director of wellness and prevention for Baptist Health South Florida, during a routine visit to his office in Miami Beach, Thursday, Jan. 9, 2014. Keister has followed a gluten-free diet for the last two years and says she has lost weight, sleeps better and feels better. Agaston co-wrote the book, “The Ssouth Beach Diet Gluten Solution.’’
Linda Keister, from Hollywood, listens to an explanation of the digestion of gluten by Dr. Arthur Agatston, medical director of wellness and prevention for Baptist Health South Florida, during a routine visit to his office in Miami Beach, Thursday, Jan. 9, 2014. Keister has followed a gluten-free diet for the last two years and says she has lost weight, sleeps better and feels better. Agaston co-wrote the book, “The Ssouth Beach Diet Gluten Solution.’’
DANIEL BOCK / FOR THE MIAMI HERALD

What to know about gluten

    •  Gluten is a protein found in wheat, barley and rye.

•  Since gluten is used as a thickener, it is also used in products such as supplements, lipstick and toothpaste.

•  Gluten-free grains: rice, cassava, corn, millet, buckwheat, quinoa and sorghum.

•  Naturally gluten-free food: lean meat, fish, poultry, vegetables, fruits and brown rice.

• Gluten sensitivity is related to a more serious condition called celiac disease, diagnosed through a blood test and a biopsy. About 1 percent of U.S. people have celiac disease, a medical condition that requires a gluten-free diet. By contrast, gluten-sensitive patients may be able to tolerate some gluten.


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For decades, Linda Keister struggled with a variety of health problems: skin rashes, migraines, joint stiffness, neuropathy in her feet and difficulty focusing.

Doctors said she could cure some of her ailments if she lost some weight. She did, but it didn’t help.

What did work, she says, was reducing the amount of gluten in her diet.

Gluten is a protein found in wheat, barley and rye. Bread, pasta and cereal are big sources; minor sources include soy sauce, salad dressing and soups thickened with flour.

Keister, of Hollywood, did not think she was gluten-sensitive, a health condition known as as non-celiac gluten sensitivity.

“Nobody was more surprised than myself,” said 66-year-old Keister, speaking of her health improvement after she decreased her gluten intake by about 98 percent. “I really do believe gluten plays a big role because nothing else has changed in my lifestyle.”

Dr. Arthur Agatston, Keister’s cardiologist, said that some people are sensitive to gluten because it’s difficult to digest. The undigested gluten irritates the small intestine, causing cramps or other digestive tract problems. In addition, when part of the small intestine is irritated, it cannot absorb nutrients. If the gut cannot absorb calcium, for example, it may lead to osteoporosis.

In more serious cases, the undigested gluten can lead to bigger problems.

“The partially digested proteins mimic proteins of various organs, so we attack our own organs,” said Agatston, medical director for wellness and prevention for Baptist Health South Florida and co-author of The South Beach Diet Gluten Solution.

The book includes 20 gluten-free recipes and a three-phase regimen that helps patients figure out where they fall on the gluten-sensitivity spectrum.

There is no way to diagnose gluten sensitivity except to initally eliminate gluten from a patient’s diet. If health problems disappear, then patients should “add back gluten gradually to see what they can get away with,” he said.

Supermarkets are awash in gluten-free products. In 2012, the U.S. market for gluten-free food and beverages reached $4.2 billion, and, by 2017, it is expected to exceed $6.6 billion, according to Packaged Facts, a Maryland-based publisher of market research.

In addition, the percentage of U.S. adults buying or consuming gluten-free products increased from 15 percent to 18 percent from 2010 to 2012, Packaged Facts reported.

“The numbers are staggering of how many people now are going gluten-free,” said Sheah Rarback, a Miami Herald columnist and registered dietician at the University of Miami Miller School of Medicine and director of nutrition at the Mailman Center for Child Development at UM.

But, warns Rocio Garcia, a registered dietician at Jackson Memorial Hospital, if people want to either eliminate or decrease their gluten intake, they “should get educated and not turn it into a fad.”

While the protein gluten is not important for people’s health, products that have gluten have important nutritional value, Rarback said. Nutrients found in some gluten-rich foods are Vitamin B, iron, folic acid and fiber.

To balance her diet, Keister has added more vegetables (generally a good fiber source) and meat and fish (generally a good iron, Vitamin B12 and zinc source) to her meals, she said.

A lot of people decrease their gluten intake as a way to lose weight, said Agatston. But, he added, gluten-free products are heavily fortified with other nutrients, which can lead to weight gain.

“Some gluten-free food can be the equivalent of junk food,” he said.

He attributes gluten sensitivity to the lack of bacteria — both in our gut and in our food. Bacteria in the gastrointestinal tract helps people digest food.

“But we have been horribly abusing antibiotics that kill the bacteria in the gut,” he said, adding that the lack of bacteria creates difficulty in digesting gluten.

In the past, fermented bread was common. The bacteria that resulted from fermentation helped the GI tract digest food. Since food is rarely fermented nowadays, Agatston said, people are not ingesting bacteria that help digest food.

“Most wheat scientists say they don’t feel it is the way we grow the wheat. It’s what we do to it after,” said Agatston.

For Keister, eliminating almost all gluten from her diet means that she is able to go dancing, biking and sleep through the night.

“I really just feel so much better. I have not been back to see a doctor for any of my pains,” she said. “I used to enjoy having a hearty piece of bread, so I do miss that. But why would I eat bread? To feel the way I used to? It’s a small price to pay to feel better.”

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