Pam Cureton is a clinical and research dietitian specializing in the treatment of celiac disease. She currently works with Alessio Fasano, M.D., at the Center for Celiac Research at Massachusetts General Hospital and for the University of Maryland celiac clinic. Cureton’s recurring column answers readers’ questions about nutrition and the gluten-free diet. In this article, she answers your questions on carbs, whole grains, weight gain and the most nutritious gluten-free flour.
Q: I am trying to eat healthier while following my gluten-free diet. Should I be avoiding all carbs? Are there good carbs and bad carbs?
“Carbs,” or carbohydrates, are your body’s primary energy source, and they’re a crucial part of any healthy diet plan, gluten free, of course. Carbs should never be avoided, but it is important to understand that not all carbs are created equal.
Carbs can be classified as either simple or complex. Simple carbohydrates considered “bad” are composed of easy-to-digest, basic sugars with little nutritional value for your body. These carbs break down quickly and enter the blood stream, causing a rapid rise in blood sugar, and can lead to a quick crash as the blood sugar level quickly falls. Examples of simple carbs would include cake, cookies, candy, sodas, and other refined and processed sugars.
Complex carbohydrates are considered “good” because they take more time to break down and contain important nutrients such as vitamins and fiber. Complex carbs help keep blood sugars on an even keel, without big spikes and dips. These include foods such as vegetables, beans and lentils, whole-grain flours and cereals, high-fiber breads and pastas.
It is not necessary to avoid “bad” carbs completely. Moderation is the key to following a healthy diet. There are so many great-tasting gluten-free bakery products on the market today, it is difficult to avoid indulging once in a while. Follow the 90/10 rule: eat healthy nutritious foods 90 percent of the time and enjoy the fun stuff 10 percent of the time!
Q: I am reading a lot lately about the importance of whole grains. I worry that I am not getting enough whole grain following a strict gluten-free diet. How do I know if I am getting enough?
It is true that studies have indicated people following a gluten-free diet can be low in whole grains. However, you are not alone as 40 percent of people on gluten-containing diets are also missing the 2010 Dietary Guidelines for Americans. The guidelines recommend three to five servings of whole grains be included daily (or at least 48 grams).
Whole grains provide an excellent source of Vitamin E, B vitamins, fiber and minerals such as zinc, iron and magnesium. Wheat is not the only grain that provides such nutrients as the gluten-free alternative grains can be powerhouses for nutrient rich products. Look for the yellow Whole Grain Stamp on the label to identify if a product is, indeed, a whole grain.
For more detailed information and recipes for incorporating whole grains in the gluten-free diet, visit glutenfreediet.ca.
Q: I was diagnosed with celiac disease and have been following a gluten-free diet for the past year. Contrary to the popular belief that gluten free helps with weight loss, I have gained more than 10 unwanted pounds. Please help!
This is a good news-bad news situation. The good news is that your weight gain is a sign of healing in the intestines and your villi are repairing and doing their job of absorbing nutrients again. Before your diagnosis, the damage to the gut may have prevented the absorption of these important nutrients/calories and therefore you did not gain weight. Now that you have followed the diet, healing has occurred and you have regained your ability to absorb again.
Now that you have adjusted to the gluten-free diet, it is time to take a closer look at what types and amounts of gluten-free foods you are including. It is also time to not only look at the ingredient list for sources of gluten but look at the nutritional label for key nutritional facts.
Start with portion size. Not all packages are a single serving, and their idea of a serving may not be the same as yours. Next, look at calories and fat per serving to see if the gluten-free product is equal to your former wheat product. Recently, many gluten-free products have improved on their calorie and fat content and are closer to the wheat counterpart. But many remaining products still contain more of both.
Also look at the nutritional panel for the amount of fiber in the product as fiber will help to fill you up and stay satisfied longer. Here again, the gluten-free market has made many improvements, so look for breads, crackers and pasta that provide at least 2 grams per serving.
For more information on what to include for a balanced diet, check out choosemyplate.gov to find out how many calories per day you should aim for and what foods you should use to fill up your plate .
Q: Is there one ideal gluten-free flour that I should be including in my diet, the one that has the best nutritional profile?
With the great selection of ancient grains and gluten-free alternative flours, it would be difficult to choose just one. Each grain/flour has distinctive properties it brings to the end product—different taste, texture and nutrients. But you should try new gluten-free alternatives if you are currently using only refined rice flour and starches.
Coconut flour is an interesting one to experiment with. It’s rich in protein, fiber and fat, which makes it filling. Coconut flour is also an exceptionally good source of manganese, which helps you to better utilize many nutrients, including choline and biotin (found in eggs), Vitamin C and thiamin.
Coconut flour needs special consideration when used in recipes as it is extraordinarily absorbent, and very little coconut flour is needed to successfully produce a recipe. Because of this characteristic, it is best to start with established recipes. For more information about baking with coconut flour and recipes, visit bobsredmill.com or nourishedkitchen.com/baking-with-coconut-flour.