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Gluten-free running

"Gluten-free" seems to be the latest sports nutrition buzzword. Gluten is a protein in wheat, rye and barley that must be avoided by people with celiac disease, an inherited autoimmune disorder. Symptoms of celiac vary greatly and can range from digestive problems (diarrhea, constipation, bloating, gas) to health problems suh as anemia, stress fractures, infertility in both men and women, migraine headaches, canker sores, easy bruising of the skin, swelling of the hands and feet, and bone/joint pain. The person feels lousy. Yet, some athletes don't even realize they have celiac disease. They feel fine - until they experience iron-deficiency anemia or stress fractures due to poor absorbtion of iron, calcium, and vitamin D.

How common is celiac disease? More than we once thought! About 1% of the population (athletes included) has celiac and needs to avoid even traces of gluten. Up to 6% have non-celiac gluten sensitivity. The symptoms are similar but without the autoimmune reactions that result in cancer and osteoporosis. No one is certain why celia disease and gluten sensitivity is on the rise. One theory relates to changes in the composition of our gut bacteria.

How to tell if you are gluten sensitive

If you and others in your genetic family are plagued with niggling health issues (including those mentioned above), you should learn more about celiac disease and gluten sensitivity. Untreated celiac disease can lead to severe complications including cancer of the gut and osteoporosis. If you suspect you are gluten sensitive, don't self-impose a gluten-free diet without first talking with a doctor who specializes in celiac. You need to get your blood tested for specific antibodies and then, to confim the diagnosis, an intestinal biopsy. Do not eliminate gluten before you get the blood tests, because absence of gluten in your diet can interfere with making the correct diagnosis. If you don't get properly tested, you might miss a correct diagnosis or other health problems, like Crohn's, an ulcer, or colon cancer. Plus, if undiagnosed, you might be less motivated to strictly follow a gluten-free diet for life.

If you are "simply" gluten-sensitive, your blood tests will report none of the elevated levels of antibodies that signal celiac disease, but you will feel unwell. Hence, if you have intestinal issues, you might want to try a gluten-free diet for a month or so regardless of the blood test results. One athlete plagued with muscle pain stopped eating wheat and her pains disappeared. She reported she simply "felt better". Others report they recover better and have less stiffness and joint pain with a gluten-free diet. This might be due to eliminating gluten, a placebo effect, or eating better overall (no cookies, pastries, junk food). Adhering to a gluten-free diet is challenging and expensive, so there is no need to self-inflict the limitations if you notice no benefits after a month of gluten-free eating.

Going gluten-free

So what's a hungry athlete to eat if their favorite pasta, bagels, breads, and baked goods are off limits? While a sports diet without pasta may seem like a day with no sunshine, rest assured, a plethora of gluten-free carbs can fuel your muscles. You can enjoy carb-rich rice in all forms (brown, white, basmati), corn in all forms (on the cob, cornmeal, grits), potato, sweet potato, lentils, kidney beans, hummus, quinoa, millet, and tapioca. Oats, if processed in a wheat-free plant, can also be safe.

Many fresh foods are naturally gluten-free. They include all plain fruits, vegetables, milk, yogurt, hard cheese, eggs, meats, fish, poultry, nuts, sunflower seeds, edamame, juice, and wine (but not beer). Just be aware that sauces, gravies, and seasoning mixes might contain gluten, as do marinades and soy sauce. Some gluten-free baked goods, pastas, and frozen meals are quite good; others might leave you wishing for something tastier.

Restaurant and travel tips

At home, you can easily control your diet. When on the road, you need to have a plan. When traveling, carry "emergency food" that doesn't spoil, such as dried fruit, gluten-free bars, and nuts. When eating in a restaurant, you will have to quiz the staff and carefully order your food. Omelets tend to be safe, while salads with croutons are not. Make sure the steak tips are not marinated in a sauce containing gluten, the turkey was not injected with flavor enhancers, the gluten-free toast is not made in the same toaster used for standard breads, the sandwich is prepared on a paper towel or surface not used for other breads (to prevent cross contamination), the rice in not cooked in broth with unknown gluten-containing seasonings, the French fries are not cooked in the same oil as the breaded chicken, the hamburger is 100% beef (with no fillers) and not cooked on the same surface as the toasted buns. Some athletes travel with their own gluten-free pasta and request it be cooked in fresh water, in a clean pot, and drained into a clean colander. This all requires a patient waiter and an understanding chef.

Everyday gluten-free sports food suggestions

Even the hungriest Ironman triathletes need not go hungry on a gluten-free diet! The trick is to eat less processed foods and be a good label reader. Here are just a few suggestions of foods you could find in standard grocery stores.

Breakfast ideas - Fruit smoothie with Greek yogurt; rice cakes with banana and peanut butter; scrambled eggs, hashbrowns, and fruit salad; Rice or Corn Chex, milk and berries.

Lunch - Tuna salad with baked corn chips; 100% corn tortilla with melted cheese and pinto beans, Crunchmaster Multigrain crackers and hummus.

Dinner - Baked chicken, potato and beets; salmon, sweet potato and peas; omelet, corn and tomatoes; baked potato stuffed with cottage cheese and salsa; Mexican beans and rice; shish kabob, rice, salad with oil and vinegar; frittata (potato, onion and egg "pancake"); meals with rice, corn, and quinoa.

Snacks - Apple and cheese; fruit and yogurt; baked potato chips; corn chips; rice crackers: trail mix (nuts & dried fruit); peanut butter and banana; baby carrots and hummus; popcorn; corn nuts; raisins; grape juice and all fruit juices, smoothies.

Commercial sports foods - Ensure, Gatorade, Powerade, Bakery On Main Granola Bar, Bonk Breaker Bar, Bumble Bar, Enjoy Life Snack Bar, Elev8Me Bar, Extend Bar, Go Raw Bar, Hammer Products (Heed, Perpetuem, Bar, Solids), Kind Bar, Lara Bar, Nonuttin' Granola Bar, Omega Smart Bar, PB&Whey Bar, Perfect 10 Bar, Pure Bar, PureFit Bar, thinkThin Bar, Quest Bar, Gu, Jelly Belly Sports Beans, Sharkies. Wheat-free but may not be gluten-free: Odwalla Bar, Clif Builder's Bar, Clif Shot Bloks.

Credits - WorldwideRunning.com would like to thank Nancy Clark for the permission to reprint the article "Gluten-Free Sports Diets: Winning Without Wheat" by Nancy Clark. Text © by Nancy Clark. Sports Nutritionist Nancy Clark, MS, RD counsels both casual and competitive athletes in the Boston-area (Newton; phone: 617-795-1875). Her best-selling Sports Nutrition Guidebook can help you eat for health and high energy. For more information about her books and online workshop, visit NancyClarkRD.com.