Anything “chronic skin”, give thought to gluten

The highly knowledgable and extremely experienced Dr. Rodney Ford, New Zealand’s “Doctor Gluten” has tweeted the following:

“If ANYONE has chronic skin disease look at this. I put heaps of people GF for their skin – they get better”

He has included a link to the following full text medical paper, full of explanation and with excellent pictures.  LINK

Remember, the tests used to diagnose celiac disease ARE NOT trustworthy when considering gluten-related tissue damage any place else than in the intestines.  The blood tests used are only testing for a type of tissue damage that happens to the intestines.  Much of the damage that happens to other types of tissue, such as the skin, can be caused by anti-bodies that are different and DO NOT show on the tests for celiac disease.  The term “celiac disease” refers only to the damage done to the intestines by the auto-immune attack triggered by the gliadin that is part of gluten.

English: HLA-DQ2.5 with a deamidated gliadin p...

English: HLA-DQ2.5 with a deamidated gliadin peptide in the binding pocket(yellow). Alpha-5 (orange) and Beta-2(Blue). Image rendered from 1S9V using MBT Protein Workshop. 3D-structure as part of: Kim, C.-Y., Quarsten, H., Bergseng, E., Khosla, C., Sollid, L.M. (2004) Structural basis for HLA-DQ2-mediated presentation of gluten epitopes in celiac disease Proc.Natl.Acad.Sci.USA 101: 4175-4179. (Photo credit: Wikipedia)

Note: we still often use the term “gluten” because so many people are used to using that word.  In reality, it has long been known that one specific part of gluten, a protein molecule called “gliadin”, is the part responsible for the auto-immune triggering.

If you think you don’t have to understand about gluten-related auto-immune disease because you follow a low-carb or grain-free lifestyle, think again.  With the immune system, an exposure of even 20 PPM can trigger damage and you cannot go by whether you feel symptoms of not. See “Why talk gluten when low-carb or grain-free?” and “Gluten awareness even for low carbers”.

See sidebar for link to Dr. Rodney Ford. Yes, he has unusually strenuous opinions, but consider his degree of frustration from the thousands of people he has treated in his long career who have had their health turned around by a gluten free diet – even in the absence of diagnosed celiac disease. Current lab tests and medical investigations very unfortunately cannot rule out gluten as a cause of ill health in any particular person.

Celiac disease limiting fuel for endurance – keto-adaptation would solve that!

Nutritional Ketosis as an Effective Strategy for Fueling Endurance

From New Zealand comes this report of an ultra-endurance athlete who had difficulty meeting fuel needs.
One solution for this would be the strategic use of nutritional ketosis.  To use this strategy, the athlete needs to be metabolically adapted to burning ketones for fuel.  This means being in nutritional ketosis for at least some weeks before the race day. The term that is used is “being in a state of keto-adaptation“. The advantage is that during the endurance exercise, the body can draw on the vast calories stored as fat (even in very slim people), while using less of the glycogen stores.

Case Study: Nutritional Strategies of a Cyclist with Celiac Disease During an Ultra-endurance Cycle Race.

Department of Human Nutrition, University of Otago, Dunedin, New Zealand.

Abstract

Food intolerance is becoming increasingly prevalent and increasing numbers of athletes participating in sporting events have celiac disease. This poses challenges as dietary recommendations for exercise are largely based on gluten containing carbohydrate-rich foods. The K4 cycle race covers 384 km around the Coromandel Peninsula, New Zealand. Lack of sleep, darkness and temperature variations pose a number of nutritional challenges. Limited food choices present those with celiac disease with even greater challenges. This case study describes the intakes of one such athlete during training and competing in the K4. Nutritional intakes were obtained during training using weighed food records and during the race via dietary recall and the weighing of foods pre- and post- race. As simple substitution of gluten containing foods for gluten-free foods leads to increased energy intake, alternatives need to be considered. During the race, insufficient energy was consumed to meet the nutritional guidelines for endurance performance. This was probably due to the nature of the course, racing conditions, the consistency of gluten-free food, and towards the end of the race, sensory specific satiety.  PMID: 22645170

To go to the font of the scientific knowledge on this, the book to read about the use of nutritional ketosis as a strategy for athletic performance is The Art and Science of Low Carbohydrate Performance by Jeff S. Volek, PhD, RD and Stephen D. Phinney, MD, PhD.  The price is more than reasonable ($8.95 on amazon and no I have absolutely no commercial ties or links).

A gluten-free low-carb bar in a pinch

Aside

On my recent trip to Denver for the obesity conference, I was so very glad to have found a gluten-free low-carb snack bar that I can use in a pinch.

I keep pretty much to real foods and eat quite simply.  Personally, I don’t fill my life with low-carb baking or with a lot of artificial sweeteners or sugar alcohols as sweeteners.  (For some people, though, this can be an important part of their long-term strategy that works for them.)

When travelling while eating gluten-free and low-carb, things can get difficult even when all goes according to plan.  I was glad that I planned ahead for this and had ordered from the US a box of snack bars and packed some for the trip.

I have absolutely no ties to any companies, so I’ll go ahead and mention the name Quest Bars, which I learned of through listening to Jimmy Moore’s LLVLC podcasts.  Having some of these with me really came in handy and saved me from having to go hungry on more than one occasion.

These bars are not sold in Canada.  You can, however, order them from the US for personal use (not to bring them in and sell them) as long as you stick to an amount that a Custom’s Agent would consider reasonable for personal use for a couple of months.  I ordered them from a major on-line supplement retailer that I have ordered from many times in the past 5 years or more.

To me, this is something I would only turn to for uncommon situations, such as a long flight.  If I started to think that I “needed” to have one every week or every few days, I would start to wonder about myself and to understand that I was just making up excuses.  Having the option of a gluten-free low-carb snack bar is great to know about, but if they start to call your name from the cupboard, perhaps they aren’t for you.

Gluten awareness even for low-carbers

There has been a fair amount of interest in my article on the need for gluten awareness even in the world of low-carb nutrition or grain-free eating, such as a Paleo lifestyle.

The topic is much larger than can be contained in any one blog post.  I tried to explain my thoughts a bit more in the comments section under the article, including:

With the immune system, the dose causing impact is orders of magnitude less than for the blood-sugar control system.

With the immune-system, the price to pay for small intakes is out of all proportion.

The Canadian Celiac Association is one place to look for info, such as this article on the new food labelling laws coming into effect in Canada in August.

Canada is in a transition period between the old labelling regulations and new regulations that take effect on August 4, 2012. By that date, labels for all food products sold in Canada will have to carry clear identification of the priority allergens, gluten, and added sulphites at a level greater than 10 ppm.

In Canada, gluten means “any gluten protein or modified protein, including any protein fraction derived from the grains of the following cereals: barley, oats, rye, triticale, wheat, kamut or spelt”. The definition also applies to the grains of hybridized strains of the cereals listed above.

And this article on cross-contamination:

People who need to eat gluten free need to check both the ingredients in food and any cross-contamination with gluten-containing ingredients that might happen when the food is manufactured, packaged and prepared for eating.

When you think about avoiding cross-contamination, you need to realize that crumbs matter. Look around your kitchen to see where there are crumbs – on the counter top, in the microwave, on the cutting board or in the corners of your metal baking dishes? Anywhere you see crumbs is a potential place for cross-contamination.

The Celiac Disease Foundation at celiac.org has an article on gluten in medications, along with extensive other info.

Celiac.com offers a mind-boggling list to keep in mind when reading food labels Unsafe Gluten-Free Food List (Unsafe Ingredients), along with extensive other info.

You might enjoy a “Wheat is Murder, Go Paleo” t-shirt from Tom Naughton’s site Fat Head.

I know, I know. Just eat non-processed real foods and you don’t have to worry about labels.  Yeah, that’s what I do.  But life ain’t perfect and neither are people and the penalty for small “sins” should not be so large.

When the 8 percent of us who need to avoid even tiny intakes of gluten (this is a rough estimate, true incidence not known and likely rising) are aware, knowledgable and active, life will get easier as the world adapts to our presence.