Q&A with Stephanie Nunes: A Look at Gluten-free Diets for Runners
Stephanie Nunes of Rock Solid Nutrition is a San Luis Obispo native and Running Warehouse friend. She is a registered dietitian (RD) with over 15 years of experience and is certified as a Specialist in Sports Dietetics (CSSD) that has helped countless athletes, elite and beginner alike, achieve their goals.
Today she will be answering some nutrition questions that have become popular of late. Particularly, we will be discussing food allergies. Given the ever-expanding gluten-free section at many grocery stores and a strong push by many across the world to see more ingredients listed on restaurant menus, this surely a popular topic at the moment.
Running Warehouse: Stephanie, Thank you so much for your time.
You have undoubtedly seen a rise questions from patients regarding various food allergies, particularly gluten. As with nut and other allergies, Celiac Disease (or gluten allergy) and wheat allergies are very real issues for a small portion of the world’s population. However, there is a rapidly growing number of people identifying as gluten intolerant. Could you expand the distinction between these different issues?
Stephanie Nunes: Celiac disease, gluten intolerance, and wheat allergies are very real and can cause a multitude of unwanted symptoms. Celiac disease is a serious condition in which the protein “gluten” (found in wheat, rye, barley, contaminated oats, or any products made with these items), provoke an autoimmune response. This response damages the villi in the small intestine, which decreases nutrient absorption. The Gluten-free diet was first designed for medical purposes to those diagnosed with celiac disease. Once a “gluten-free” meal plan is started, the symptoms of celiac disease generally go away and nutrient absorption returns.
Gluten intolerance or sensitivity is a bit different in that the protein “gluten” can cause inflammation but does not damage the intestine. However, some of the symptoms are similar to celiac disease such as: stomach distress, diarrhea, bloating, fatigue, heartburn, passing gas, etc.
Wheat allergy is sometimes confused with celiac disease. It is different in that you can develop an allergy to any of the four classes of wheat proteins: Albumin, globulin, gliadin and gluten. Symptoms usually occur pretty fast and can include: coughing, asthma, nausea, vomiting, hives, rashes, etc.
RW: Athletes in particular are often more focused on diet and gluten has been criticized among some circles that accuse the protein for evils beyond stomach distress. With prominent endurance athletes like Ryan Hall and members of the Garmin-Sharp cycling team holding gluten responsible for increased inflammation and dehydration, there are bound to be ripples within the endurance community. Do you put much weight to these notions?
SN: I do believe we can reduce inflammation by limiting highly processed and refined foods. Most of these foods contain gluten, fat, sugar, excess calories, and have low nutrient value. Other concepts for decreasing inflammation include increasing fruits and vegetables (lots of colors), decreasing saturated fat, increasing omega 3 fatty acids, increasing fiber, and including a variety of whole grains. Based on professional experience with client analysis (particularly athletes) and recent diet analysis projects completed in my nutrition courses, majority of people are eating too much processed food, not enough whole grains, too much saturated fat, limited fruit and veggies, and too much protein. Is it the flaws in our eating habits that is causing the inflammation? Or is it the gluten? My advice would be to “clean up” your diet as a whole, before unnecessarily restricting sources of whole unrefined grains, which have been proven to be beneficial for your health.
It is not uncommon for high-level athletes to have diarrhea and stomach distress, and I do understand that it can be frustrating. Sometimes timing of eating, hydration status, composition of food eaten before training, consistency of food, and intensity of training can cause stomach distress. If you still suspect gluten sensitivity or intolerance may be causing these symptoms, schedule an appointment with your MD. Do NOT go on a gluten free diet before you are tested. This will affect the results of the test. The MD may assess your blood work and then possibly proceed with a biopsy. If you are diagnosed with celiac disease, consult with a Registered Dietitian to learn about how to follow a gluten-free diet and meet your nutrient needs. If the test is inconclusive and you want to proceed further, contact a Registered Dietitian that specializes in food allergies or autoimmune conditions. They will perform a monitored elimination diet to help you determine the food culprit. The problem with randomly going on a gluten-free diet without understanding your individualized nutrient needs, is that you may be lacking adequate carbohydrates, fiber, iron, and B-vitamins which can all have a negative effect on your health and sports performance.
RW: What additional advice would you give to runners looking to achieve optimal nutrition to achieve their goals?
SN: If you are an athlete and striving for optimal performance and health, here is my advice: Log 3-4 days worth of eating. Contact a Registered Dietitian to help you analyze and individualize your eating plan based on your sport and performance goals. If you don’t have the time or money to do this, go to http://myplate.gov to input your logged food for an analysis. You will likely find there are many basic food concepts you can improve on!!
Focus on quality foods, including carbohydrates, whole grains, lots of fruits and veggies, beans, nuts, non-fat dairy or alternative, lean protein sources, limit saturated fat, increase omega 3 fatty acids, consider probiotics or yogurt, and decrease processed foods. Eating and drinking properly before, during, and after can also assist with your performance goals and recovery.
RW: Thank you so much for your time and sound advice, Stephanie!
Make sure to check out Stephanie’s website for information regarding sports nutrition and wellness.