Tag Archives: Low Carb

Celiac Disease, Food Additives and the Benefits of a Gluten-Free Diet

November 13th, 2017
0
Matt Poteet, Pharm.D.

Celiac Disease Food Additives and Benefits of Gluten-Free Diet - Dietary Rehab

Celiac disease is an autoimmune disorder in which the body’s immune system mistakenly reacts to gluten. Glutens are proteins found in wheat, rye, barley and triticale.

Put simply, celiac sufferers cannot properly digest gluten. Instead, the body starts to destroy part of the small intestine, making it difficult to absorb vital nutrients. If you or a loved one has celiac disease, or you simply want to be your healthiest self, consider a gluten-free diet.

About Celiac Disease and Gluten

Celiac disease affects everyone differently, and can be difficult to diagnose. There are more than 200 known symptoms of this disease, including:

  • Nausea
  • Fatigue
  • Joint pain
  • Malnutrition
  • Depression
  • Vomiting
  • Chronic diarrhea
  • Abdominal bloating and pain

Symptoms can affect the entire body, and can appear in children and adults. Celiac disease is hereditary, and affects as many as 3 million Americans. About 97 percent of celiac disease cases go undiagnosed.

The only treatment for celiac disease is to follow a gluten-free diet. Gluten acts as “glue” that holds foods together, and exists in many products. It’s what gives bread a chewy and elastic texture, and is an important ingredient in making baked goods.

Beer, cereal, bread, pasta and many other foods contain gluten. Gluten is a completely indigestible protein that can slip through the lining of the intestines and cause inflammation in people with celiac disease.

Normally, the small intestine has villi that line the inside to help the body absorb nutrients. If one has celiac disease, ingesting gluten irritates this lining and causes the immune system to attack the villi.

Over time, this can lead to damage or destruction of the villi, and the inability to absorb important nutrients. This can cause malnutrition and a variety of related health problems. Adhering to a gluten-free diet can stop the symptoms of celiac disease, and allow the body to function normally.

Food Additives as Hidden Sources of Gluten

The number of hidden sources of gluten that exist in everyday products may surprise you. Identifying the more latent sources of glutinous material found in processed foods can be challenging, especially early on during your diet change.

Many people overlook one very significant source of gluten: food additives. Food additives for protein, texture, flavor or color may very well contain a source of gluten that causes a flare-up.

Companies may add ingredients to products to improve some element of it, such as the look or taste. Unfortunately, these additives can render the product inedible to people with celiac disease or gluten intolerances.

Always check labels for additives before consuming a product. Take a smartphone with you while you shop, and look up additives you aren’t familiar with. When in doubt, call the company to see if the product is gluten-free.

Percentage of Americans on Gluten-Free Diet Without Celiac Disease Chart - Dietary Rehab

Celiac Disease Foods to Avoid

If you’re new to a gluten allergy or celiac disease, you’re probably wondering what foods you can and cannot eat on your new gluten-free diet. Luckily, scientists have increased their understanding of gluten intolerances in the past few years, leading to a trend of gluten-free food production. Nowadays, it’s relatively easy to find gluten-free alternatives to your favorite dishes.

The list of foods to avoid is long, but common foods that contain gluten include:

  • Barley
  • Beer
  • Bleached bread, cake, graham or granary flour
  • Couscous
  • Malt
  • Pasta
  • Rye
  • Soy and teriyaki sauce
  • Wheat
  • Edible starch
  • Filler

Gluten-containing additives include:

  • Wheat protein
  • Textured vegetable protein
  • Flour
  • Food starch
  • Dextrin
  • Caramel color
  • Anything with the word “wheat”

Avoid vague descriptions such as “artificial flavoring,” “spices” or “natural flavor.” It’s unclear where these ingredients came from, and they could have a source that contains gluten.

The list of foods and additives that may contain gluten is even longer: Dried fruit, flavored coffee, ice cream, candy and many other food items can potentially contain gluten. Get in the habit of reading ingredients labels carefully if you’re adhering to a strict no-gluten diet.

What You Can Eat

Going gluten-free isn’t just about what you can’t eat. People with celiac disease can still eat some grains that are naturally gluten-free, including brown rice, wild rice, and quinoa.

Other naturally gluten-free foods include:

  • Unprocessed beans and nuts
  • Fresh eggs
  • Fresh meat and poultry
  • Fresh fish
  • Fruits and vegetables
  • Most dairy products

Safe grains and starches include (as long as they aren’t processed with additives that contain gluten):

  • Buckwheat
  • Flax
  • Corn
  • Cornmeal
  • Sorghum

The Benefits of a Gluten-Free Diet

Receiving a celiac disease diagnosis isn’t the only reason to consider going gluten-free. There are many other medical conditions that eating gluten can exacerbate. For example, eating gluten-free can ease the symptoms of irritable bowel syndrome (IBS).

Removing gluten from your diet can solve many mysterious issues you have with digestion, energy levels and other issues. You may have a non-celiac gluten intolerance, or gluten sensitivity if you can’t seem to figure out what’s wrong.

Going gluten-free can result in benefits such as:

  • Better digestive health
  • Increased energy
  • Improved cholesterol
  • Weight loss from cutting out processed and unhealthy foods
  • Improved cardiovascular health
  • Less bloating and gas
  • Reduced risk of diabetes
  • Improved conditions such as IBS and arthritis

Note that if you don’t need a gluten-free diet for medical reasons, eliminating gluten completely may actually do more harm than good. You could miss out on a healthy, well-balanced diet and beneficial whole grains if you go gluten-free by choice.

Work with a dietician for a meal plan that’s suited to your individual needs, whether or not you have celiac disease. Visit your doctor for more information about celiac disease and gluten-free diets.

See More Nutrition Resources

TAGS:

Cholesterol Made Easy- Part 1

May 5th, 2012
2 responses
Matt Poteet, Pharm.D.
Cholesterol Made Easy Part 1
By John Meadows CSCS, CISN and Matt Poteet, Pharm.D.

It seems kind of funny to say “made easy” and cholesterol in the same sentence. The truth is that many facets of cholesterol are actually extremely complicated and beyond the scope of our knowledge by a long shot. Cholesterol synthesis is one such facet. There are at least 12 steps to get 2 acety Co-A to its end form of cholesterol, and there are a ton of big words through these steps like, geranyl pyrophosphatase, squalene, and other words that give me a headache. Knowing the terms and complex biochemical reactions are completely unnecessary for the average guy or gal who simply wants to be be healthy, have a great life, and someday bounce their grandchildren on their knee. Seeing the need for both clarity and simplicity in the subject of cholesterol, we decided to write an article where 95% of the technical and medical  jargon is thrown out. Only the bare necessities are here in easily digestible, but physiologically sound form. By the time we finish we hope to have presented  cholesterol in the clearest and simplest manner possible in a way everyone can both understand and utilize.

We will attempt demystify the things that you usually hear associated with cholesterol though like “good” and “bad” cholesterol. We will talk about the basics, and also talk about what tests are out there in regards to cholesterol and what they really mean. I think you’ll enjoy this part, as it’s fairly easy to understand, and you’ll very quickly realize how the information that is out there, is mostly incorrect. So hang on tight, and get ready for some cholesterol truth!

How many kinds of cholesterol are there?

There are at least 2 right? Good and bad? WRONG. There is only one kind of cholesterol. It is inheritantly good, and it looks like this.

Riveting pic, I know. Exactly what does cholesterol do in the body? Why is it so important?

  1. It is the beginning structural building block for sex hormones like testosterone
  2. It is very important for cell membrane integrity and fluidity. No cholesterol would mean your cells would be like mini blobs with no rigidity
  3. It is a crucial component of Vitamin D synthesis, with a little help from the sun of course.
  4. It is a primary structural component of your brain and CNS, comprising up to 60% of its overall dry weight. In fact, the highest concentrations of cholesterol in your entire body are in your brain and nervous system.
  5. It is used to make bile acids which are crucial in digestion and absorption of fatty acids and fat soluble vitamins.

So it goes without saying, we need cholesterol. So far so good, we have established that there is only kind of cholesterol, and it’s very important.

Lipoproteins

When someone is speaking of their “cholesterol” levels, what they are actually talking about is a group of molecules called lipoproteins. These lipoproteins act as the carriers of cholesterol. They make it possible for very oily components such as triglycerides and cholesterol to travel through the water-based body. Oil and water don’t mix except with the help of lipoproteins! There are many numerous types of lipoproteins known to us today. Medical science are constantly subdividing them based upon various factors such as size, density, and constituency.But there are five main types which we will discuss today.  The first three you may not know much about, but hang tight for the cool stuff.

  1. Chylomicrons – In size, chylomicrons are the largestof the  lipoproteins. They are created in the small intestine in response to eating a meal, and their main “job” is to be filled with the dietary fat (triglyceride) and cholesterol after you eat a meal (mostly triglyceride),  and then transport these substances to the liver, muscle, and other body components which need them. Once the chylomicron has finished delivering its triglyceride packages to the various body addresses, it is much smaller than when it started. It then travels back to the liver where it is broken down, and possibly reassembled into other lipoproteins like VLDL…
  2. VLDL (Very Low Density Lipoprotein) – VLDL is the second largest in size of the five lipoprotein classes. It is manufactured in the liver and has a similar role in transporting  oily substances through the body. But while the chylomicron’s job is to transport the oily substances that you eat, VLDL’s job is to transport the oily substances which are already in your body from place to place. In comparison to chylomicrons, the triglyceride content is usually a little lower, while the cholesterol content is usually a little higher. As VLDL moves about in the body delivering its packages to the various organ systems, an enzyme called LPL (lipoprotein lipase) removes triglyceride for use by the body. As VLDL gradually loses the triglyceride, it becomes smaller and changes in to….
  3. IDL (Intermediate Density Lipoprotein) – By the time VLDL changed into IDL it is usually carrying about half cholesterol and half triglyceride.  IDLs are further acted upon by enzymes (hepatic lipase), lose more triglyceride and turn into LDL. Ah finally. We made it to something familiar…LDL..the bad stuff!

I know what you are thing, so Matt and John, that’s cool and all, but what does this have to do with anything???

Well remember we said there is only one kind of cholesterol, and you probably thought if there is only one kind, then what exactly are HDL (good), and LDL (bad) cholesterol?

As we said previously, cholesterol does not dissolve in water (thus not blood either).  To get from point A to point B it must move through these lipoprotein carriers. I feel that this situation calls for an analogy. Imagine a road with delivery trucks traveling to and fro with passengers. The trucks are the lipoproteins, the people cholesterol, and the packages in the back are triglycerides. The “HDL” trucks are carrying “cholesterol” people on the road to the Liver Station (your liver). Going the opposite direction are “LDL” cars carrying “cholesterol” people from Liver Station to other places such as Heart City. Keep this fresh in your mind because we are going to return to this analogy often in this discussion.

  1. LDL (Low Density Lipoprotein) – By the time we get to LDL, we only have a few packages left. They are sliding back and forth on the floor. I hope they aren’t fragile! We now have a molecule carrying about 90% cholesterol and 10% triglyceride. When a cell needs some cholesterol, it hangs out a vacancy sign ( in the form of an LDL receptor) The delivery driver is tired of hearing these cranky passengers by now. They have been saying “are we there yet?” for the past 3 hours! So the LDL whips into the LDL recpetor and is transported into the cell. His job is done.  Aha, you say. Now it will wreak havok! Well not so fast. More on this later.
  2. HDL (High Density lipoprotein) – Of course we have to mention these carriers too. They are the taxis of the body, stopping along the way to pick up straggling cholesterols who may have had too long of a night out on the town. They  head back to the liver hopefully not running too many red lights. There the excess  will be removed by the body as bile or broken down and re-allocated to other places in the body for other tasks.

lipoproteins

Now that we have laid some groundwork for what is truly going on with cholesterol in your body, lets address a few of the more common myths in our society about cholesterol.

MYTH  #1 – Eating fat will raise LDL levels. BUSTED- As was described above, dietary fat (yes even the saturated kind) is shuttled via chylomicrons from your intestines to the rest of the body. This does nothing to the LDL level in your blood. The amount of dietary fat  that reaches the liver also has little to do with the level of total cholesterol production. We know that in general if you eat less fat, your liver makes more cholesterol, you eat more fat, and your liver makes less due to the fact that there are more chylomicrons circulating. Your body is extremely efficient at regulating itself.

maple bacon donut

Probably a Bad Idea

So take a step back, where does the LDL come from? It originally comes from the VLDL once it has some fat removed from it. Now remember that VLDL’s job was to transport oily substances which were already in the body, not the dietary fat we have eaten (chylomicrons job). So what raises VLDL? Not dietary fat. Think excess carbohydrates. Excess carbohydrate turns into triglyceride very efficiently in the liver, and since it is already IN the body it is the responsibility of VLDL and ultimately LDL to transport it through the body. It is actually proven that generally a lower carb and higher fat diet LOWERS VLDL level. So eating fat will lower VLDL, and in turn the harmful types of LDL. Oh, there are different types of LDL? Absolutely. We will get to the different  types of LDL in just a minute.

We didn’t think of this on our own I am sad to say, the American Journal of Medicine did (Seshadri et all, A randomized study comparing the effects of a low carbohydrate diet and a convention diet on on lipoprotein subfractions and C-reactive protein levels in patients with severe obesity. Amercian Journal Of medicine 117 (5) 2004 pages 398-405), as they were trying to prove the Atkins diet was bad for you. Oops.

Also, in November 2002 studies were published espousing lower carbohydrates for improvement in cholesterol levels. In one study Duke researchers found that “after six months, participants on the Atkins diet had lost 31 pounds, had an 11 percent increase in HDL (good cholesterol) and a 49 percent drop in their tryglyceride levels. Atkins dieters had a 49% reduction in VLDL levels, versus 17% for those on the low-fat group”.

Ok back to your regularly scheduled programming.

How Big is Your Truck?

Slowly but surely the word is getting out that LDL comes in various sizes. Larger particles are more buoyant and fluffy, and don’t lodge into endothelium as easy as smaller particles do. So if this is true, then the semi trucks, and Escalades on the road carrying it’s passengers (cholesterol) are less likely to crash and do damage. They just sort of bounce off the guardrails and keep moving.

The smaller delivery cars, the freaking Miatas, and especially those dang Dodge Darts have the potential to wreak some havoc. They can get stuck under the guardrails (endothelial cells) when they crash. When they get stuck, tons of emergency vehicles have to come to try and get them out of the mess. (Circulation 2002; 106: 3143-3421). And that is when things get messy and very dangerous through plaque formation and ultimately cardiovascular disease.

How Many Cars Can Be On the Road?

traffic jam

So we know that having smaller cars on the road is bad, but what about having so many cars you have a traffic jam regardless of whether they are big or small? Yes that is also an important factor in this discussion. This is called particle concentration. High LDL particle concentration is also considered a player in increased cardiovascular events. El Harchaoui K et al. Value of Low Density particle Number and Size as Predictors of Coronoary Artery Disease in Apparently Healthy Men and Women. J Am Coll Cardiol 2007;49:547-53.

This area is a little grey, but at some point if you just get overloaded with particles bad things are going to happen.

MYTH BUSTER #2 – The myth is that if you have an in range LDL reading (< 100) you are good to go. This is not always certain. LDL readings in standard blood tests  only measure the amount of LDL cholesterol (the number of delivery vehicles)! There is no biological rule that all cars have to be full of people/cholesterol. In some of us, we might have trucks that are only partially full of people, but have a lot more trucks. So think of it this way if this still doesn’t make sense. You can have 10 containers each containing 1 lb of mag 10, or you could have 20 contains that each contain .5 lbs of mag 10. It’s still 10 lbs total, but you have more containers in the second example.

If this sounds far-fetched let me explain. When you eat a lot of sugary food, such as HFCS , your LDL carriers/trucks will fill up with excess triglyceride leaving less room for cholesterol, which requires more delivery trucks to be made and put on the road. The lesson is sugary crap in your diet will give you a higher particle number or concentration that could lead to heart disease and diabetes.

Summary

 

Key points from part 1:

high cholesterol diet

  • There is only one kind of cholesterol, and it is inherently good for us
  • In order to transport oily substances like cholesterol and triglycerides, there must be carrier molecules called lipoproteins. There are five major types of lipoproteins, with HDL and LDL the most well-known.
  • Common LDL lab tests only show the percentage of  total cholesterol that is LDL. It does not show how big the LDL is, or how many particles there are.
  • Larger, more “fluffy” LDL particles seem less likely to cause CV issues down the road.
  • Smaller LDL particles are much more dense and lodge more easily into endothelial tissue, becoming stuck and oxidized, causing an inflammatory response, and leading ultimately to cardiovascular disease.

Stay tuned for Part 2 where we will discuss:

  • LDL pattern B. How its really the villain in the story and why we produce it
  • How modern commercial food preparation, not dietary fat, is to blame for heart disease
  • Dietary strategies to correct a bad cholesterol test like low HDL, high LDL, and high triglyceride.
TAGS: