Heal Thy CORE with a Gluten-Free Diet
Inflammation is now known to be the precursor to most disease and dysfunction. Inflammation in the gut inhibits muscular function of the CORE and the essential stabilizing muscles as a result of the viscero-somatic reflex, putting the pelvic girdle at risk of dysfunction. Therefore, reducing inflammation and healing the gut is a key component to pelvic rehab and activation of the CORE. As a physical therapist specializing in core dysfunctions, I cannot ignore inflammation in the gut and provide my patients with as many resources as possible, including a referral to a knowledgeable nutrition expert.
Gluten, the protein in wheat and other grains such as barley, spelt, rye, triticale, etc, is often at the heart of inflammation for many reasons. This can be the result of celiac's disease, food allergy and/or gluten sensitivity. Gluten is one of the top food allergens and is often recommended to avoid in persons with auto-immune diseases, joint pain and digestive issues. Experts claim it is the way wheat is harvested, often sprayed with glyphosate (the ingredient in Round Up) to increase crop production. Our immune system increases its response to pesticides and other foreign substances in our diets. This is a good reason to buy and eat organic fruits and vegetables, in addition to avoiding genetically modified organisms (GMOs) . Since gluten contributes to inflammation, many people find their seasonal allergic reaction to environmental allergens such as trees, ragweed, pollen, etc. is improved by avoiding gluten.
Ten years ago, I was diagnosed with a wheat allergy after many years of experiencing headaches, chronic pain and constipation. I recently discovered the secret to my musculoskeletal pain was driven by inflammation in my gut. It took me years to figure this out and research is now confirming this phenomenon. Initially, I focused so much on avoiding gluten, while depriving myself of other foods that I was sensitive to, including most dairy products. I became so obsessed with the avoidance of foods that I didn't supplement my diet with essential vitamins and minerals. Gluten-free packaged products, although convenient, can contain a lot of processed sugar and other ingredients that wreak havoc on the gut. At the time, I had only half the solution to heal my gut. Now, there is overwhelming evidence that healing a leaky gut, one cell thickness in the lining of the intestines causing essential nutrients to leak out of the gut and contributing to inflammation, is responsible for food allergies and many diseases affecting all systems of the body. Many experts believe a leaky gut can be remedied by avoiding gluten and balancing out the good and bad bacteria in the gut, also known as the "microbiome." In addition to avoiding gluten and pesticides, it is recommended to take a probiotic containing multiple strains of bacteria, eat fermented or cultured vegetables and/or yogurt that contains more than one live culture to restore the microbiome and heal the gut*.
Ironically or purposefully (I believe nothing happens by chance), I was drawn to helping other individuals heal and recover from pelvic pain and chronic conditions that affect the core. I opened my private practice physical therapy clinic in 2009 and named it Healthy Core Wellness & Rehab. I have never had what I would call a healthy core, even before having children. After a lifelong history of constipation and irritable bowel syndrome, five pregnancies, three reproductive surgeries and multiple falls and traumas as an active child, I am a work in progress, like many of you. I want to share with you what I have learned thus far so you can avoid making some of the same mistakes, some albeit expensive ones, and simplify gluten-free living.
1. Clean out your pantry and get rid of any temptations. Realize not everyone in your family is going to buy-in to your new way of living, but if you are doing most of the cooking, they will benefit too. When I switched to gluten-free, my husband lost inches on his waist, became less bloated and experienced less joint pain, even though he didn't think he had a problem with gluten. Avoid any flour or products containing: wheat, durum flour, cous cous, graham flour, kamut, semolina, spelt.
2. Substitute baking and cooking with gluten-free flour alternatives (see examples below), including gluten-free flour blends, breadcrumbs and pasta. Generally rice, quinoa, corn and nut flour variations that are non-GMO are safe. I made the mistake early on not using a blend of flours and buying mixes that tasted horrible. Once I learned how to cook and prepare gluten-free food properly, it was an easy sell for my family and now no one knows the difference (except that my toilets are not clogged on a daily basis).
3. Avoid beer and some distilled liquors with the exception of maybe Tito's vodka, hard cider and Omission beer. Celiac.com has a more comprehensive list of alternatives that are safe (Celiac.com). Red wine contains resveratrol, known to help reduce inflammation, and may be a better choice (in moderation).
4. Avoid most candy with the exception of some of my favorites: Gin-gins, Skittles, organic gummy bears and most plain chocolate. You can find a more comprehensive list online that is out of the scope of this blog. I have found most hard candy contains gluten and have suffered from its effects unknowingly.
5. Ask for a gluten-free menu when eating out. Most restaurants now have a separate menu and if not, ask your server to consult with the chef. If I am patronizing a restaurant, I should have my food exactly how I need it to be! Realize there is a risk of cross-contamination any time you eat out or away from your home. Be careful of condiments such as ketchup, soy sauce and salad dressings and opt instead for mustard, horseradish, salsa, oil and vinegar or ask if the dressing was made inhouse and if it contains gluten.
6. Watch for hidden sources of gluten often disguised under the names, malt flavoring or modified food starch. Other sources of gluten you should avoid include: processed cheese (such as blue cheese), soy sauce, some prescription and over the counter medicines and vitamins, licorice, most gravies or anything not certified gluten-free. The FDA requires less than 20 parts per million in order for the label to boast of being gluten-free. Also note that wheat-free does not guarantee a product to be gluten-free.
7. Bring your own gluten-free food to parties, on trips, when traveling by plane. I have suffered from the negative effects of hunger and out of desperation eating something I shouldn't have. Unless I am familiar with the grocery store where I am going or the food that will be where I am going, I pack some my own food. I am fortunate that most members of my family (siblings included) are now gluten-free so get-togethers are now easier for me to enjoy.
8. Rotate grains in your diet. If you have rice one day, avoid it for two days, while incorporating other grains, if necessary, during this time. According to some experts, grains should be avoided altogether, but this is one area I struggle with. Moderation is key and admittedly, sometimes I tip the scales. I find it takes about 72 hours to clear the inflammation from my gut due to colon transit time.
9. Include probiotic foods or supplements in your diet. I recently canned my own fermented cabbage (as seen in the above photo) and make homemade coleslaw and sauerkraut to control the ingredients and reduce additives. Dr. David Perlmutter, author of Grain Brain and Brain Maker, recommends a probiotic containing the following five strains of bacteria:
lactobaccilus brevis - improves immune function and enhances immune activity (pickles and sauerkraut).
lactobaccilus acidophilus - keeps good and bad bacteria balanced, reduces inflammation and yeast formation, aids in healthy cholesterol levels (yogurt, fermented dairy products).
lactobaccilus plantarum - helps fortify the gut lining, reducing risk for leaky gut to help with food allergies and digestion of protein (sauerkraut, cultured vegetables, Kimchi).
bifidobacterium lactis - prevents digestive issues, boosts immunity and reduces salmonella effects (fermented milk products, yogurt).
bifidobacterium longum - improves lactose intolerance, prevents diarrhea and food allergies and has an antioxidant property.
MY FAVORITE BRANDS
UDI's - comes in a variety of breads, pizza crust and muffins; the chocolate muffin version is to die for when I must have chocolate! Pizza Hut now offers Udi's gluten free crust.
Absolutely Gluten-Free crackers. These are my new favorite go-to snack and is a staple in my pantry. There are only a few ingredients, if you get the plain crackers, including tapioca, potato, palm oil, natural vinegar, honey, egg yolks and salt. I like that they are dairy-free and they are not hard like so many rice crackers I have tried.
King Arthur makes a gluten-free flour blend, pancake mix and other flour variations. I also found many recipes on their website, www.kingarthur.com, including one for making your own flour blend. To save money, you can make your own by buying the flours separately and mixing and storing the blend in an airtight seal in your pantry. Here's the recipe I use with Bob's Red Mill flours: I often add 1/4 to 1/2 teaspoon of xantham gum to the recipe as a binding agent.
6 cups rice flour (brown or white)
2 cups potato flour or starch
1 cup tapioca flour or starch
Pamela's makes a gluten-free flour blend that includes guar gum to help the ingredients stick. I recently discovered this flour and love it! It is sold in a larger resealable bag, is cheaper than some of the other blends and creates desserts and foods with a texture similar to regular flour.
Live G free cornbread mix and other products are sold at ALDI's. I am not able to eat some of these due to the contents including sunflower (another one of my allergens), but the cornbread is amazing!
Kinnikinnick and other products, including rice noodles, which has a similar texture to regular pasta. I like the long spaghetti style noodles best.
Bisquick gluten-free mix makes great pancakes and waffles and can be used as a substitute in many other recipes.
Gillian's bread crumbs are free of wheat, soy and dairy, which is a plus for me, and we use it to replace bread crumbs in any recipe, such as baked chicken and meatballs.
Follow other gluten-free blogs. Why reinvent the wheel when someone else has discovered an easier way to cooking and baking gluten-free. I follow these posts on Facebook: Against All Grain, Chocolate Covered Katie, neurologist Dr. David Perlmutter, Amy Myers, M.D. and Gluten-Free on a Shoestring. I have also purchased books to be able to find the recipes I need or I SHARE recipes to my Facebook page to look back at. I am not on Twitter or Pinterest right now, but I know some people really find these sites helpful.
Let me remind you that I am not a nutrition expert or dietician and recommend that you find one to help you in your journey. I am still learning and as I write this, the research is evolving. Ten years ago, being gluten -free was extremely difficult. However, now with popularity gaining, more people understand and have jumped on the gluten-free bandwagon for their health. Do your own research and don't just take my word for it. Best wishes in your new gluten-free life of discovering your true health potential. Here's to a HEALTHY CORE!