Gluten & Psoriasis: Part 2

 

Q&A: How to Ensure a Healthy and Nutrient Dense Diet while Gluten-Free

Are you considering a gluten-free diet? If so, you may feel concerned about the recent articles suggesting that a gluten-free diet may put your health at risk. While a gluten-free diet can be helpful to many with psoriasis it is also important that it is done right! The trick is to educate yourself on the pitfalls and to understand how to construct a well-balanced and healthy diet.  Hopefully this gluten-free diet Q&A helps get to the bottom of some of these important considerations and puts you on the right track for health!

Is a gluten-free diet healthy

Done right— Yes.  

A gluten-free diet that is whole foods-based and that substitutes gluten-containing grains for gluten-free grains, while excluding or limiting processed foods, is a healthy and nutritionally balanced diet.  

The scientific community agrees that gluten itself is not an essential dietary component. The concern with eliminating gluten is that the elimination of gluten-containing foods made from whole grains in general could result in nutrient deficiencies. However, with the right dietary approach, you can ensure that you are achieving a nutrient dense diet.

For more information on how best to construct a balanced diet, I recommend reviewing the anti-inflammatory diet pyramid and substituting whole and cracked grains and pasta for gluten-free grains & seeds.

Are gluten-free products healthy?

There is the perception that gluten-free products are healthy, simply because they are gluten-free. Clever packaging and marketing slogans can trick consumers into thinking they are making a smart choice.

The truth is that most gluten-free products are actually less healthy than their wheat-based counterparts. They are often higher in sugars, bad fats, calories, and lower in micronutrients. Gluten adds to the texture of a food, as well as to the pleasing nature of the product.  Gluten-free food manufacturers have to make up for not having gluten and they do so by adding extra sugars, saturated fats, and fillers such as starches and refined flours.

Gluten-free diets that consist of a significant percentage of these products do put you at risk for low fiber intake and result in gastrointestinal complications, low nutrient intake, inflammation and possible weight gain due to high sugars and saturated fats.  In general processed foods, with gluten-free products being no exception, should be avoided.

However, there are some wonderful products on the market as well! I personally rely on a few of these products to supplement my own diet. The key is to learn to read your labels and get to know and understand your ingredients. This way you can make healthy choices.

Look for:

  • Low or no sugar: including cane sugar, agave, coconut sugar, maple syrup, honey, brown rice syrup…
  • Whole gluten-free grains/seeds or whole grain flours such as buckwheat, quinoa, millet, teff, and oat. Avoid too much rice, tapioca, potato, or corn starch
  • Avoid added vegetable oils

 

What am I missing with a gluten-free diet?

Studies have shown that a gluten-free diet can lead to nutritional deficiencies. Gluten-free diets can be low in fiber and essential micronutrients including iron, calcium, zinc, phosphorus, and B vitamins. However, done right, a gluten-free diet can be just as balanced and replete with fiber and micronutrients.  

Take fiber for example – it’s not that a balanced gluten-free diet lacks fiber-rich foods.  Vegetables, fruits, beans and legumes, gluten-free grains and seeds including chia and flax seeds, are all wonderful sources of fiber. However, gluten-free products are often made with a significant percentage of starches and refined flours that lack necessary fiber. Therefore, it’s not the gluten-free diet that puts you at risk, but rather relying on processed foods as a significant contributor to your diet that poses the problem.

With regard to nutrients, wheat-based breads and other foods are often fortified with essential vitamins and minerals while gluten-free products are rarely fortified. It’s not that wheat is a better grain than, say, quinoa or teff. (In fact, quinoa and teff are often called “supergrains” because of their high nutrient density!) It’s simply that we add vitamins and minerals to wheat-based flours. Your body can receive the same vitamins and minerals you would typically get from wheat-based flours by taking a multivitamin. Therefore, it is a good idea to ‘fortify’ your diet with a good daily multivitamin to ensure that you are covered for any micronutrient gaps.

Is a gluten-free diet a risk for high levels of arsenic and other heavy metals?

A recent study showed that people on a gluten-free diet have higher levels of arsenic, mercury, lead, and cadmium. The assumption in this study is that people on a gluten-free diet are consuming more rice and fish, and higher rice and fish consumption is considered the cause, as both of these foods have increased amounts of heavy metals.  

Fish can be a wonderfully healthy part of your diet, however, pay close attention to the type and source of your fish. The EWGs Good Seafood Guide is an awesome tool to help you make healthy and responsible choices. I also recommend limiting your intake of fish to 2-3 times per week. Sardines are a particularly healthy choice – they are loaded with omega-3 fatty acids and low in heavy metals, not to mention delicious!

Rice absorbs more arsenic than other crops and is often a substitute for wheat in many gluten-free products. Therefore, that’s why those who consume gluten-free products regularly can develop higher levels of this heavy metal. Again—read your labels!

In your own baking, rather than using rice flours, consider using other flavorful and healthful gluten-free grains and seeds such as oats, quinoa, buckwheat, millet, and teff.  I have gotten in the habit of buying bulk grains and seeds and grinding* them when needed for baking. I find my breads and muffins to be lighter, fluffier, and yummier that way!

* Grinding grains/seed:  I use a simple coffee bean grinder and grind about a cup at a time.  I grind to the consistency that I like for my specific recipe. It’s super quick and easy!

Will I gain weight on a gluten-free diet?

The right gluten-free diet will not lead to weight gain.  

However, if you consume processed foods regularly, research shows that you may be at risk. Again, many gluten-free, processed products have higher levels of sugars, saturated fats, and calories than those made from wheat flour. Therefore, it is best to avoid processed foods as much as you can. An occasional treat is fine, but it’s your overall balance and understanding of what makes a diet healthy that matters.

The exception here is if you have celiac disease. The classic presentation of celiac disease includes weight loss (although some can present with weight gain). In this case, once a person adopts a gluten-free diet and their gut heals, they begin to absorb nutrients better and may, as a result, gain weight.

What about additives in gluten-free products?

Additives are food constituents or synthetic substances that are used to enhance food texture or color, or to preserve it.  Below are a few that are often added to gluten-free products and that you should be familiar with.

Additives that are OK in moderate amounts

Xanthan gum is used as a substitute for gluten due to its gum-like quality. As an additive to breads, it helps to create the often desired chewiness and overall texture. Xanthan gum is a product of sugar fermentation by the bacterial species, Xanthomonas campestris. Human and animal studies have demonstrated a good safety profile for this substance. At very high doses it can have a laxative effect. However, you would need to eat 2 loaves of bread baked with xanthan gum in order to achieve the levels used in the study. This would be impossible for most people! I personally use xanthan gum in my baking but I limit my weekly dose to be cautious.

Inulin (chicory root fiber) is often used in gluten-free foods for it’s ability to add moisture and to create a more creamy texture. It is actually considered a functional food, meaning that it offers specific health benefits. Inulin is a prebiotic – a non-digestible food that serves as fuel for beneficial bacteria in our gut. It, therefore, has the ability to improve bowel regularity as well as help to establish and maintain a healthy gut microbiome. The Journal of the American Dietetic Association found most people can tolerate up to 10 grams of native inulin and five grams of “sweet” inulin (a variation of inulin) daily. Beyond this level (which would be difficult to achieve in a normal diet) it can cause bowel distress.

Additives to avoid

Carrageenan is an extract from the seaweed, Chondrus crispus. It is used to modify and improve the texture in many foods and drinks by acting as a stabilizer, thickener, or emulsifier.  But, this is one to avoid! Carrageenan causes inflammation and has been linked to cancer.

Artificial dyes, sweeteners, and flavors have been linked with several health problems such as behavioral issues in children, neurologic symptoms, fatigue and cancer. There are too many artificial dye, sweetener, and flavor ingredients to list here, but if you can’t pronounce it, it’s probably a good sign to avoid it!

Preservatives such as BHT (Butylated Hydroxytoluene) and BHA (Butylated Hydroxyanisole) have also been shown to likely be carcinogens and hormone disruptors.

Again, sticking to a whole foods diet, free of processed foods, is optimal for health.

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In conclusion, a gluten-free diet can be helpful to many people with psoriasis, But it’s important to educate yourself on the pitfalls and better understand how to construct a well-balanced and healthy diet. If you are interested in giving it a try, here are the key takeaways to get you started:

  • Eat a whole foods, anti-inflammatory diet
  • Enjoy a variety of gluten-free grains & seeds
  • Limit your rice intake
  • Look for fish with low levels of heavy metals
  • Limit or avoid most processed gluten-free products
  • Learn to read labels and avoid rice flours, starches, sugars, saturated fats, artificial dyes/sweeteners/preservatives & carrageenan.
  • Take a daily multivitamin

 

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Gluten and Psoriasis: Part 1

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Monday, September 17th, 2018

Psoriasis & Depression: What’s the Connection?