Tuesday, October 08, 2013

And now for something completely different.

What We Eat Affects Everything

This is an excellent interview with Robynne Chutkan, MD, an integrative gastroenterologist, founder of the Digestive Center for Women, and the author of the new book with the really awful name, Gutbliss: A 10-Day Plan to Ban Bloat, Flush Toxins, and Dump Your Digestive Baggage.

Y'all know about my obsession with nutrition and wellness. This interview really explains the why around the increase in gluten-sensitivity, as well as explaining the fascinating differences between men and women's GI tracts. The interview is super informative, but it is fairly long. For those of you not down with the text heavy pages, a couple of highlights for me:

It's really about the 80 percent rule. Most of us are “toxing” 80 percent of the time and detoxing 20 percent of the time. And we should really think about flipping that—we should think about detoxing 80 percent of the time. And I’m not suggesting anything extreme. Today I did some work at home, I made a fruit and veggie smoothie for breakfast, went to spin class, I met some people for lunch, and I had a kale salad with roasted chicken and a big bottle of water. Nothing so profound, but all healthy stuff that made me feel good. And if you're doing that 80 percent of the time, you can tolerate that 20 percent of debauchery in whatever form that might be, whether you’re drinking a bit too much, or not exercising, eating the wrong food, having too much ice cream. And then we don’t have this need to constantly be detoxing and cleansing all the time.

Does your daily food intake look like this...












Or like this?











Oy vey, the band-aid of constant tox/detox/tox/detox. Ugh, just take care of your body most of the time! This is how I rationalize whiskey and the occasional Sherman (and cookie), and why I'm confident I'll look as good as Christy Turlington inside and out in my mid-40s (and hopefully 50s).

You mentioned going gluten-free, and I wanted to get your take on that. It seems like a lot of people going in that direction don’t have a diagnosis of celiac disease. What do you tell people who are interested in trying it? Is there evidence that people who tested negative for celiac disease still benefit?

First of all, I think it’s important to distinguish celiac disease from gluten sensitivity, because celiac disease is an autoimmune disease that is associated with a lot of other problematic things, like osteoporosis, iron deficiency anemia, arthritis, diabetes, even cancer. And if you have celiac disease, whether or not you have symptoms, it’s important to come as close as you can to 100 percent avoidance of gluten, because the ongoing exposure to gluten can damage the small intestine and lead to some of these other associated problems. So that’s the first thing I tell patients, is that we have to figure out what’s going on. And some patients say, Well, can’t I just empirically avoid gluten? And I tell them, no, because if you have celiac disease, you have to be 100 percent regardless of whether you have symptoms. If you have gluten sensitivity (but don't have celiac disease) and you want to eat an almond croissant, go for it. Part of the issue is that the wheat itself is not what it used to be. It’s been hybridized and had different things done to it to increase the crop yield and shorten how long it takes for the wheat to bear. One can make all sorts of scientific and unscientific arguments about what we’re meant to eat, but I don’t think we’re meant to eat animal crackers, for example. I think it's a stretch to call the refined, processed wheat products a food group, but I also don’t think everyone needs to empirically avoid them all the time.

Certainly if you’re having digestive problems, it’s worth trying. I usually tell people to do a six-week elimination trial; if you don’t notice a difference there’s no reason to avoid it. But my biggest caveat is to tell people there’s no point in doing this and then eating gluten-free bread, and gluten-free pancakes, and gluten-free cookies. It’s sort of like sugar-free. If you’re diabetic, I would say to you, you should think about having fruit for dessert. I would never recommend that someone have sugar-free ice cream or a sugar free drink, because that stuff’s worse than the sugar quite frankly. The same thing applies to gluten. If you think you’re gluten sensitive and you feel poorly when you eat gluten, you should avoid wheat. It just makes sense. If you’re lactose intolerant you should avoid dairy. This is your body giving you feedback saying no, I don’t like this thing. But if you decide once a month, I’m going to have a sandwich using regular bread and I may not feel so great, but I don’t have celiac disease, just a sensitivity, I think that’s okay and I think that is preferable to eating gluten-free garbage every day. Gluten-free processed products can be just as bad for you as the regular stuff that contains gluten. They’re not providing you any nutrients, they’re empty calories. So that’s a big challenge that I face with some of my patients. If you’re just gluten sensitive, have a pancake on the weekend if you really want it, but don’t eat gluten-free cookies every day of the week and think that somehow this is being healthy. Just like I would never eat low-fat or sugar free ice cream. If I’m going to have ice cream I’m going to have the real thing—I’m just not going to eat it every day.


Amen. I may not have mentioned before that I have been following a low-gluten diet for the past couple of years. This diet has accomplished something that an army of Western dermatologists, acupuncturists, and Chinese herbalists were unable to do: rid me of my eczema. I still eat the occasional wheat-crusted pizza and white flour tortillas and hand-pulled Chinese noodles and other deliciousness, but in both small quantities AND good quality.

It can be done, people.

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