My college swim coach was always encouraging our team to go see a sports nutritionist. He knew that nutrition was a critical element in our training. Brief pause right here: HE WAS SO RIGHT. I don’t generally like to play the what if game because I find it gets me into trouble, but the more I learn, the more I can’t help but wonder what if. What if I had realized the importance of nutrition and had made sure that I was properly fueled when I was swimming? How much faster could I have been? Would I have been able to recover in between workouts and after meets faster? Would I have felt better? Been stronger? If you’re reading this and training for anything I STRONGLY urge you to consider the role nutrition could play in your performance.
But to continue my glutard story: In the Fall of 2011 I went to see a dietitian who specialized in sports nutrition. The appointment was similar to going to the doctor–I filled out a form with my medical history and checked boxes next to symptoms I was currently experiencing. But, instead of taking my weight and height (actually she never even measured me, just asked me how tall I was), the registered dietitian determined my body composition with a Bod Pod and measured my metabolic rate with a Medgem indirect calorimeter. She also had me tell her what I typically ate in a day. The big take-away she gave me from my appointment was that I likely had celiac disease or a wheat intolerance and should stop eating gluten for 6 weeks to see if I felt any better. She said that if I was going to see a difference, I would see it in 4 -6 weeks. Not really sure how to avoid gluten because, as she told me, it’s in practically everything I was eating, I pony-uped the extra hundred and something dollars (okay, my parents did) for her personalized meal plan….which, I was very disappointed to find, ended up not being very personalized. After following it for two days, I couldn’t deal. I went online. My mom went online. And we figured out what I needed to avoid and what foods I could have, and how I was realistically going to do this.
The first week was really hard. I was kind of scared to eat and was extremely cautious about what went into my mouth. Even so, I sometimes slipped up and would realize after I had eaten something, that it actually had wheat in it. Did I need to avoid food that didn’t contain gluten itself but was manufactured in a place that also made food that did contain gluten? How big a deal was this cross-contamination thing? Did I need to stop sharing peanut butter with my roommates because the knife they used to scoop out the peanut butter might have also touched a piece of bread? It was SO confusing. I ended up just avoiding most processed and shared food. I began baking gluten-free bread. Which is not the same thing. At all. But can be tasty, as long as you don’t think of it as bread.
My roommates were incredibly supportive and nice as I went through this process. I don’t think I ever thanked them. But, if you’re reading now, thanks guys! You really were so great. One of the most difficult parts about not eating gluten is dealing with social situations and you guys helped alleviate a lot of that stress for me by being so accommodating and supportive. My now brother-and-law, on the other hand, called me a glutard. My sister scolded him. I wanted to be offended, but I was laughing, so that just wouldn’t have come across very genuinely…
After about about 3 or 4 weeks I noticed a significant difference in how I was feeling. I wasn’t bloated all the time, I didn’t have as many bathroom issues, I had more energy, etc. I said okay, guess I have a gluten intolerance or celiac disease….and I completely stopped eating gluten. For three years. I have since learned through my dietetic training that the dietitian I saw did not handle my visit correctly, and here’s why:
Celiac disease is an autoimmune disease. When people with celiac disease eat gluten (a protein found in many grains such as wheat and barley) their body launches an immune response that results in the destruction of the walls of their intestines where nutrients are absorbed. This damage means that people with celiac disease aren’t always able to obtain the nutrients that they need. The treatment for the disease is to never eat gluten. Untreated celiac disease can lead to a lot of other serious health problems because when you have celiac disease and keep eating gluten your intestine continues to be damaged. Some of these problems include anemia, diabetes, miscarriages, neurological issues, stunted growth, multiple sclerosis, intestinal cancer, and osteoporosis. Knowing whether or not you have celiac disease, therefore, is extremely important. It is critical that if you suspect that you have celiac disease that you get tested for it while you are eating gluten, because to be tested for celiac disease you have to have the gluten proteins in your body. The test looks at your intestinal lining for signs of damage from gluten that would be present if you have celiac disease. What the dietitian should have done when she suspected that I may have celiac disease was to tell me to go get tested.
Over the course of my three years not eating gluten, the gluten-free craze took hold and avoiding gluten became easier socially. However, within the dietetic profession, it became much more difficult because avoiding gluten–without knowing if you have celiac disease–was looked down upon, and for good reason. If you don’t have celiac disease, there is no nutritional reason for you to eliminate gluten from your diet. When you avoid gluten, you omit many beneficial whole grains from your diet. Now, you can get the benefits these grains provide (fiber, vitamins, minerals etc) from other sources, but why make your life more difficult by avoiding something if you don’t need to? Gluten-containing grains and cereals, are easily accessible and are often fortified with nutrients commonly lacking in people’s diets. The majority of gluten-free grains are not fortified, which can create an extra nutritional challenge for those who previously received many of their micronutrients from fortified grains. Furthermore, since there are so many health problems associated with celiac disease it is extremely important to know if you do have the disease so that you can be aware of any other health risks you might have. The combination of realizing that I was becoming reluctant to tell people in my soon-to-be profession that I ate gluten-free (but didn’t know if I had celiac disease..aka being a hypocrite for what I would one day advise to patients) and noticing that many of the improvements in symptoms that I had experienced three years ago were gone, I made an appointment with a gastroenterologist.
He agreed that I had a number of the classic celiac symptoms (history of autoimmune disease in my family, fatigue, diarrhea, bloating, abdominal pain, joint pain…) and should be tested. This meant that I needed to eat at least 14g of gluten (about two slices of bread) a day for two months. He also thought it would be a good idea for me to be tested for lactose intolerance. Now when you introduce a type of food into your body that you haven’t had in years, your body isn’t happy. The first few weeks were kind of miserable. My stomach hurt, I spent a lot of time in the bathroom, and I began to get these awful migraines. I took the lactose breath test, which measures how well your body is able to digest lactose (milk sugar), and was found to be extremely lactose intolerant. People with celiac disease often have high numbers on this test because the enzyme that breaks down lactose is released from the intestinal walls. If these walls are damaged from gluten, the enzyme, even if it is being produced by your body, can’t get to the milk sugar to digest it. My doctor said that given how my body reacted when I initially started eating gluten again and how severely lactose intolerant I was, that it was likely I had celiac disease….but after being officially tested (blood work, biopsies, EGD)… I DO NOT HAVE CELIAC DISEASE! This was (is), obviously, great news! Dealing with a lactose intolerance is nothing compared to following a gluten-free diet, especially because if I do want to eat dairy I still can. I just take a lactase supplement to give my body the enzyme, lactase, that my body doesn’t produce enough of to easily digest milk sugars. Lactard>Glutard. (By “>”, I mean, easier to be than. Not greater than.)
It was fantastic, life-altering news! I was overjoyed, but, at the same time, I felt completely foolish for making my life more difficult and expensive by not eating gluten for three years. THREE YEARS. Who does that? Did I just imagine that I had felt better? The thing is I did feel better, especially when I first began to avoid gluten–and those first few months were the hardest as I learned to navigate life without gluten. Looking back, I realized that my paranoia about what I ate meant that I also significantly reduced the processed junk I ate and, the big one, I think, is that when I cut out gluten, I also cut out most of my dairy. I didn’t replace glutenous things–bread, pasta, etc–with the gluten-free substitutes because, even though some tasted okay, I knew what the real thing was supposed to taste like and this wasn’t it. Gluten and dairy go together like peanut butter & jelly or mac & cheese. Oh wait, mac & cheese…lasagna, ravioli, pizza, many sandwiches, pasta, cereal, calzones, grilled cheese…it all has gluten and dairy. With many gastrointestinal symptoms of lactose intolerance overlapping with celiac symptoms, it is likely that some of the improvement I experienced could have actually been from my reduced dairy intake, not my gluten elimination.
About a year into my gluten free lifestyle, I completely rethought my career path and went from thinking about taking a finance job at an orthopedic company to deciding to become a registered dietitian. Becoming gluten-free is not the reason for this change, but I found that really paying attention to what was in the food I was eating–something that I had originally thought I was going to hate to do–was actually something I enjoyed. I shadowed dietitians in the area in various settings and began to really think that dietetics would be a good professional fit for me as it allows me to utilize my passion for food to help others. As I reflect on this whole experience, I’ve decided that my glutard journey is actually going to make me a better dietitian (no matter how I decide to practice) for a number of reasons:
- My experience with the dietitian I saw has given me a lesson on what NOT to do.
- If I ever suspect someone of having a health issue, I will refer them to be tested for it before suggesting any kind of nutritional treatment.
- When I do suggest a nutritional change, I will help my patient through it by providing resources and education on how to make that change. Just searching “online” is not a great option for people. “Online” is big and can end up being confusing and scary when you’re dealing with a health issue.
- If I suggest a major dietary change to a client. I will then follow up with that client to see how it is going.
- I will remember that as a registered dietitian nutritionist, I am a health professional. People will pay to consult me about their nutrition because of the education and training I am going through now. They will trust me, just like I trusted the dietitian I saw, because registered dietitian nutritionists are supposed to be the experts. With this trust comes a lot of responsibility to provide evidence-based, best practices to the public because the advice health professionals provide really does affect someone’s life.
- Diets are complex. If anything, my experience illustrates how confusing it is to reduce a problem to just one attribute of a person’s diet. Eating more or less of one food is probably also going to cause someone to eat less or more of another food. For this reason, reductionist diets aren’t usually very sustainable and there should be a solid health reason for eliminating foods from one’s diet.
- If a future client has to be on a restrictive diet for any reason, I won’t just be able to empathize with the client, but will genuinely understand what they are going through. Consequently, I’ll be able to offer some practical ways to make the experience easier to clients. I think it is also important that I share tips I’ve learned with other dietitians who have not experienced the struggles of a restrictive diet so that they can, in turn, tell their clients.
- I now make delicious gluten-free meals and baked goods, and I am very comfortable experimenting in the kitchen to make something work. (When I say on my flirt bakery page that I am willing to accommodate any dietary need…I really mean it and am genuinely excited to take on the challenge, so please give me one!)
- I have gotten a lot better at handling awkward social situations. One of the most challenging parts of not eating gluten is when you are in a social situation where gluten consumption is expected. Being put on the spot when the hot guy buys you a beer that you can’t drink but you don’t want to seem rude, high maintenance, or uninterested is tricky. Handling it takes confidence, grace, and creativity–three things I believe I have more of now.
- I’ve learned that even though you might feel like you’re a burden to someone–you usually aren’t as much of one as you think. People like feeling helpful and involved. Sharing your needs with people is important, and while it can be difficult with people you don’t know very well, I’d argue that it is with these people that it is the most important to share. People that know you well, like friends and family, often give you the benefit of the doubt. People who don’t know you well need to understand why you need something different. Once you explain, they usually are happy to accommodate you and simply happy to have gotten to know you better. This obviously goes for dietary and health needs, but I’ve found that it works the same way for many values and beliefs as well.
If you are interested in learning more about celiac disease, one of the best resources for information is the Celiac Foundation website. But before you head over there….TRY THIS SOUP!
Not to brag, or anything, but this soup is kinda amazing. Especially when it’s below zero outside and you have a loaf of glutenous, crusty bread to eat it with–although without the bread, the soup is gluten-free. Consequence of the time when I really began cooking for myself coinciding with becoming a glutard: I cook gluten-free by default, and currently many of the recipes on this blog are gluten-free. But, back to the soup: Full of sweet-spicy warmness, this healthy soup is perfect for waiting out winter!
Roasted Sweet Potato & Black Bean Soup Recipe
3 or 4 medium-large sweet potatoes, peeled and chopped
3 medium jalapeños, cut in half with seeds and ribs removed (the “rib” is the white part where the seeds are attached to the pepper. This is often where the extra spicy-ness is)–add as many or as few jalapeños as you like depending on how “hot” you want the soup to be.
1 tablespoon olive oil
1 medium onion, diced
1 teaspoon garlic, minced (~1 clove)
3 medium carrots, peeled and chopped
1 medium pear, peeled and chopped
3 medium stalks celery, chopped
1 can diced tomatoes
1 can black beans, drained and rinsed
32 fl oz box vegetable stock or broth (~4 cups)
salt & pepper to taste
1. Roast the sweet potatoes and jalapeños:
–Preheat oven to 400°F.
–Cover a baking sheet with aluminum foil.
–Place peeled and chopped sweet potatoes and jalapeños on prepared baking sheet. Sprinkle with olive oil, salt, and pepper and mix, so all sides of the sweet potato cubes and jalapeños are coated.
–Roast for 30 minutes or until the potato cubes are soft and slightly browned. (you can the pan in the oven before it is preheated). The jalapeños will be soft and will have some roasting marks on them.
2. While the potatoes are roasting, chop the rest of the ingredients. Add the olive oil to large soup pot and heat on medium-high. Add garlic, onion, carrots, celery, and pear. Cook until the onion is translucent with the cover to the pan on.
3. Add can of diced tomatoes (and all the can’s juices) and the rinsed and drained black beans. Let cook for a few minutes until the liquid starts to disappear. Test a carrot. If it is soft and can easy be pierced by a fork, you’re good to go. If not, add a little chicken stock/broth and cook until a carrot can pass this test.
4. Add the roasted sweet potatoes and jalapeños to the rest of the soup. Use either an immersion blender to blend the soup right there in the pot, or divide the soup into batches and use a blender. Either way, gradually add the rest of the vegetable broth until the soup is smooth. If you used the blender and portions of your soup are cooler than others, I suggest putting all of the soup back on the stove for a few minutes prior to serving.
5. TASTE! Add salt and pepper as you’d like…I ended up adding probably a teaspoon or so of each. Enjoy!