The Foodie's Guide to Gluten-Free

I WISH these were gluten free…

As a practitioner that sees a lot of gut health issues, and conditions associated with it, it is likely that I will ask you go try going gluten free. I do this, not because I am trying to be the stereotypical Naturopath portrayed in movies, or because you are celiac, but because it can truly have a negative effect on some people’s health if there is a sensitivity. No, it doesn’t effect everyone, or at least everyone the same, but for those with a more chronic condition that they are seeking help with, it is a great place to start. There is research that shows gluten can increase zonulin in the gut, which I’ve spoken about before, which causes a more “leaky gut.” Gluten can cause different reactions, including the obvious bloating and cramping, to swelling, headaches and fatigue.

Gluten-What?

What the heck is gluten though? Gluten is the protein in certain grains, including wheat, spelt, kamut, rye and barley. It is what makes it stick together well. It is not in oats, millet, buckwheat, corn, rice, quinoa, sorghum. In years past, trying to find gluten free bread that didn’t crumble immediately was almost impossible! Luckily now there are so many great options to choose from. I am creating a guide for those patients of mine that need some guidance, but also all those out there wondering whether this is something they should try for their health. (Hint…if you are asking yourself that, you should probably try it!) Halifax has a few less options than bigger cities, so let me know if there are other favourites I may not know about.

My Gluten-free Tips

1. My number 1 tip for going gluten free is to not worry so much about replacing every type of gluten product you have. You can do a lot with a lettuce wrap, sweet potato, cauliflower or bed of rice. Try a burger on a lettuce wrap, or seasoned ground meat in romaine. Or even sloppy joes in a roasted sweet potato. You will end up buying less gluten free products and eating more whole foods :)

2. Bob’s Red Mill is my go-to for gluten free flours for baking. No more complicated recipes needed with a binding agent such as xanthum gum, since their blends are all ready to go and come out tasting great!

3. Eating out when you are gluten free has become easier as well (except for brunch…that’s still hard for me sometimes!). A lot of restaurants have gluten free options or substitutes so all you need to do is ask. A go to for me is just their meat/fish, potato and veggie dish. There is usually always something like that.

Favourite Gluten Free Products

• Baking Flour: Bob’s Red Mill 1:1 Baking Flour - the best baking flour I find. It works so well for mostly anything you are baking. (blue bag better than red bag as you need to add the xanthum gum to the latter)

• Oats: Regular oats - Unless you are celiac, you can use regular oat flakes. These are a go to for me for quick pre-made breakfasts and snacks. I love my oats!

• Pasta: Cantelli or Barilla gluten free pastas are good grocery store brand options. GoGo Quinoa Pastas are sometimes available and a good option. Kids also tend to like the 100% legume pastas you can find now (eg. Chickapea pasta), which provide a good source of fibre. Be careful with this though if you are sensitive to beans or bloat with too much fibre.

• Crackers: Blue Diamond Artisan Nut-Thins/Almond crackers, Mary’s crackers are great options as well as several options at Costco that are great. Breton even has gluten free crackers in the regular cracker section.

• Bagel: O’Doughs Thins - Found at Superstore in the freezer section. They are delicious with a little peanut butter for a quick breakfast if you are craving more carbs (but not with the calories - bonus!). Their sandwich buns are pretty good as well. Little Northern Bakehouse has good bagels as well.

• English Muffins: Glutino brand - I’m not a big english muffin gal but I’ve been told these are a go to for some people.

• Bread: This one is a toss up depending on what you are looking for. Some options are - Little Northern Bakehouse Gluten Free bread is apparently really good, especially their Honey Oat Bread; Promise brand from Sobeys; Costco Gluten free bread (comes in a pack of 2 loafs); fresh bread at the market (look around, you may find a gem). Glutino and Udi’s are best for making stuffings etc, since they are still a bit crumbly.

• Burger buns: O’Dough Hamburger Buns - I discovered these in the summer and I was very impressed! If you aren’t going for the lettuce bun, try these. There are many other options in the freezer sections.

• Wraps: Superstore has its own wrap that is decent; Sobeys carries ones that aren’t frozen in the health food section. Some can get expensive so look around.

• Pizza: Sabatassos Gluten-free Pizzas - Since I can’t eat dairy, these came highly recommended by a great source. Found at Costco and they are apparently amazing! Lots of other options now at your local grocery store.

There you have it, some great options for those of us that are gluten free! I promise it isn’t so bad. I love to cook and I’ve made out alright 😉

Any favourite products of yours I’m missing here? Let me know!

In health & happiness,

Dr. Karen

Leaky Gut - Yes there could be "holes" in your gut!

As a Naturopathic Doctor who sees a lot of gut issues, I get questioned often by people who have heard the term leaky gut, wondering what it is and if it could be the cause of their health issues. This is something I do see often in practice and I find very important to fix in order to treat a number of different issues, such as IBS, eczema, depression and most autoimmune disorders.

What is leaky gut?

Your gut is actually quite fragile as the lining of your intestines is made up of only 1 layer of cells, called enterocytes, lying between your gut lumen and the blood vessels. A border of microvilli on top increases the surface area to aid in absorption of nutrients, water and electrolytes. The intestinal lining also regulates the trafficking of environmental antigens (1) . These enterocytes are held together by tight junctions, like water-way locks, preventing the cells to come apart when inappropriate. Remember the childhood game red-rover? This is the game your gut is always playing. However, damage to the gut lining from inflammation and stress, releases a protein called zonulin which weakens these tight junctions making the lining more permeable (2) and ultimately creating small gaps between the enterocytes that cannot close up. Food particles, or antigens get absorbed between the cells now instead of through the cells, activating an inflammatory and/or immune response in the gut and blood stream.

What health issues can this cause:

• Local inflammation - IBS symptoms such as bloating, cramping, diarrhea, constipation

• Autoimmune conditions (1) - Hashimotos thyroiditis, Rheumatoid arthritis, Lupus and IBD, MS

• Systemic conditions - eczema, psoriasis, acne, joint pain, headaches, seasonal allergies

• Mental/emotional issues - depression and anxiety, chronic fatigue

What causes leaky gut:

• Gluten - this was the first thing found to increase zonulin levels

• Bacteria and infections - or bacterial endotoxins also found to increase zonulin levels

• Stress - this decreases stomach acid and digestive enzymes leaving larger particles of food to descend into the intestines which irritate the gut lining

• Medications such as proton pump inhibitors, antibiotics and NSAIDs

• Simple sugars and food additives

How to fix leaky gut:

If you haven’t read my blog post about the 4Rs in gut health, I’d lead you there to shed a little more light on my whole gut healing protocol. Ultimately we need to reestablish the zonulin-dependent intestinal barrier function to close up those gaps between the cells. There are a few favourites of mine that been shown to be very effective at REPAIRING the gut, but don’t forget to REMOVE, REPLACE and REINOCULATE as well.

• L-glutamine - this is my go-to for any gut issues, from mild to major. Always given in powder form to ensure a high enough dose.

• Collagen - helps to support and strengthen the gut lining like glutamine. I love the brand Sproos that I carry in my practice.

• Zinc carnosine - studied to heal the gut, including the stomach lining after H.pylori or an ulcer or after NSAID use

• Mucilaginous herbs - marshmallow, aloe vera, DGL, slippery elm

If you struggle with any of the conditions listed above do not hesitate to reach out to discuss the best treatment options for you! Heal your gut to heal your body and start feeling yourself again.

In health & happiness,

Dr. Karen

References:

1 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384703/

2 - https://www.ncbi.nlm.nih.gov/pubmed/21248165

Indigestion - To Test or Not To Test

I often see new patients with undiagnosed digestive issues, that they have been struggling with for months, sometimes years. They have seen their GP and given either no solutions, a medication they have to stay on to feel better, or referred to a GI specialist and are waiting for many more months to then be told their scope was clear and you just have IBS! I know this can very frustrating! 

This is where Naturopathic Medicine can come in and be very helpful. We have been trained in the ins and outs of the digestive tract and possible conditions and have had many hours of nutrition training to cater a food plan specific for you. I love treating digestive concerns for a few reasons:

• Time to explain how the digestive tract works 

• Access to GI lab tests that are specific to the patient

• Tools such as nutrition, herbs, and neutraceuticals that can be specific for the patient 

• Most conditions I have found stem from gut health so I can treat skin issues, hormone issues etc by addressing the gut! 

Testing can be an invaluable tool at times and can speed up the treatment process.  I go through the 4Rs in gut health (see post here) with all my patients and usually start with the basics in gut health and/or work with where they are at or how severe their digestive symptoms are, but testing can be very helpful. For example, a recent patient of mine opted to do both the SIBO breath test and the IgG food sensitivity panel during his initial visit so we could gather all necessary information as soon as possible then treat accordingly. On his second visit, we could jump right into the test results, in this case positive for hydrogen SIBO and a sensitivity to a few specific foods, and start antimicrobial herbs specific for his SIBO results. He then saw quick results! I believe we would still have gotten moderate results without testing but with it results happened much sooner and were much better. 

Some GI tests have been criticized in the news as of late but considering the results I see when these tests are included in our clinical diagnoses and ultimately the treatment, I have to disagree with some of their conclusions. A few of the digestive system tests I use are:

• IgG food sensitivity - This is a comprehensive test including 160 foods that you could have an IgG sensitivity to. I always make sure patients are aware that if several foods come back as a sensitivity then we are dealing with a “leaky gut” generally and eliminating the bigger culprits is important as well as a lot of gut healing support. 

• SIBO Breath Test - Many cases of “IBS” are associated with an imbalance in bacteria that cause bloating, gas or bowel movement issues. In the case of SIBO it is an imbalance in the upper GI bacteria and the digestive wave is not functioning correctly. Testing reveals if this is the case, how severe the imbalance is and what type of dysbiotic bacteria is highest. We can then treat more effectively. 

• GI Mapping or Stool Analysis - In more complex cases or if there is a history of parasites and negative scopes, stool analysis is valuable. Among other things his reveals what bacteria, parasite or virus is running rampant in the gut as well as how much inflammation is present. This test is very comprehensive and informative, but it is also more expensive. 

If you have been dealing with digestive issues for awhile with no diagnosis or direction, testing may be of benefit to you. There are many Naturopathic approaches to healing the digestive system and it is one area I love treating. Come visit me! 

In heath & happiness,

Dr. Karen

(Photo credits: 1 - https://www.everydayhealth.com/digestive-health-pictures/lets-hope-its-just-gas.aspx; 3 - www.sibodoctors.com)