Going Gluten-Free

by Mimi Winsberg, M.D.

Much attention has been given in the press lately to the gluten-free diet. Thousands of gluten free products have hit the market, and many athletes are asking themselves if going gluten-free could offer a performance edge. A number of professional triathletes have eschewed gluten, and some of the pro cycling teams eat gluten-free when racing.

I have celiac disease. Celiac disease is an auto-immune disease that is triggered by ingesting gluten, a protein found in wheat, barley, spelt, kamut and rye. When people with celiac disease ingest gluten, their immune systems begin to attack the lining of their small intestines, resulting in the inability to absorb key nutrients such as iron, calcium and fat. Celiac disease affects approximately 1 of every 130 individuals, and is diagnosed with a blood test. Those of us with celiac disease need to assiduously avoid gluten in all forms.

What about athletes without celiac disease or gluten-intolerance? Is there any benefit to adopting a gluten-free diet or racing without gluten?

The answer is probably “it depends.” If you replace gluten-containing foods with nutritious alternatives such as fruits, vegetables, nuts and legumes along with nutrient-dense whole grains such as quinoa, buckwheat and amaranth, then you will likely be adopting a healthier diet. But, if you replace the gluten-containing foods with high glycemic alternatives that contain a lot of refined carbohydrates and unhealthy fats, then you may find yourself gaining weight.

Many of the pre-packaged gluten-free products on the market fall into the latter category. In my early days of eating gluten-free, eager to try the gluten-free alternatives to bread, pasta and desserts, I found myself putting on weight rather rapidly. My gut’s new-found ability to absorb fat didn’t help either.

That said, going gluten-free changed my life. I suddenly developed healthy energy, a normal blood count, and an iron-gut that can handle the stresses of ironman racing.

There is certainly anecdotal evidence to support eliminating gluten from the diet in the days leading up to a race, in order to avoid placing unnecessary stress on the gut. This may benefit certain athletes, along with the elimination of dairy products.

If you are considering giving up gluten for health reasons, or because you have experienced gastrointestinal issues when racing:

Get a blood test to determine if you are truly gluten intolerant.
Educate yourself about the various sources of gluten. Gluten hides in many processed foods and products.
In the absence of celiac disease/gluten intolerance, start slowly with dietary changes.
Replace gluten with nutrient dense, lower glycemic index alternatives, rather than packaged products containing a lot of refined carbohydrates.
Be prepared to ask a lot of questions when eating out. The diet is much easier to follow when preparing your own food.

Mimi is a psychiatrist and multiple-time Kona qualifier. She has offices in downtown San Francisco and Menlo Park, California, and can be reached at m.winsberg@gmail.com.