FeaturesApr/May 2014 Issue

Nutrient Know-How: Supplementing a Gluten-Free Diet

People should be getting proper nutrition from their dietóbut that doesnít always happen.

Why Supplement the Gluten-Free Diet?

Although there are no prescription drugs for celiac disease, people on a gluten-free diet may still need to pop some pills. Vitamin and mineral supplements can be crucial to ensuring good health. After years of undetected gut damage, it can take a long time for the body to heal. Supplements aid healing, providing missing nutrients that haven’t been properly absorbed and that aren’t present in many processed gluten-free foods.

Supplements tend to be far-reaching in their effects and benefits, says Christine Doherty, ND, a naturopathic doctor who specializes in celiac disease and the gluten-free diet. Diagnosed with celiac disease in 2003, Doherty is the medical director of Balance Point Natural Medicine in Milford, New Hampshire, and the founder of GlutenFreeVitamins.com, where she formulates C-Liac Vitality supplements geared for those on a gluten-free diet.

“It’s just common sense that supplements would be a good idea for a population that’s on a restricted diet,” Doherty says. “You want to make sure you’re getting a decent amount of vitamin D, magnesium and B complex, because those are really key deficiencies in the gluten-free population. Addressing those deficiencies is such an important part of recovery if you want to be well.”

“In many cases, supplements have side benefits. So if you’re taking a vitamin D supplement for your mood, it can also help to heal your gut, decrease your risk for diabetes, ease your heartburn and strengthen your bones,” Doherty says.

People should be getting proper nutrition from their diet—but that doesn’t always happen. We need supplements to help fill in the gap, says Melinda Dennis, MS, RD, LDN, the nutrition coordinator for the Celiac Center at Beth Israel Deaconess Medical Center and lead nutrition author for CeliacNow.org. Dennis also runs a yearly gluten-free wellness retreat in which she reviews diet and the supplements necessary to restore and maximize health.

“A good multivitamin/mineral supplement can help you with the nutrients you might not even think are related to celiac,” Dennis says. “It’s part of healing from the inside out and maximizing your health on the gluten-free diet.”

“If you’re taking a multi that’s working for you, you should actually feel the benefits. It’s not like you’re going to turn into superwoman or superman but you should feel better,” she says.

Dealing with Gluten-Free Diet Deficiencies

Some people are skittish about taking supplements. The industry is loosely regulated by the FDA and recent headlines have questioned their efficacy and even their safety. The Annals of Internal Medicine reported a study that found that multivitamin and mineral supplements provide little or no protection against heart disease, cognitive decline and cancer.

But studies like these don’t necessarily apply to the gluten-free population, Doherty says. Supplements are vitally important for people who have compromised systems from celiac disease and those who are eating an unfortified gluten-free diet.

DIETARY SUPPLEMENTS

Supplements can help restore and maintain health, agrees Leigh Reynolds, president of Gluten Free Therapeutics, makers of CeliVites, a line of supplements that launched in November 2013. “Celiacs and those on a gluten-free diet have got a double-whammy. In general, gluten-free foods are not fortified like mainstream foods are. Then there’s the issue of absorption. Untreated or newly diagnosed celiacs have problems absorbing what nutrients and vitamins are in their food. This issue can last for many years post-diagnosis while the gut heals,” Reynolds says.

A 2013 study in the journal†Nutrients†found that 87 percent of newly diagnosed celiacs had more than one nutritional deficiency. And 50 percent of celiacs still had multiple nutritional deficiencies ten years after going gluten-free, according to a 2002 Swedish study.

Reynolds retired from a career in the pharmaceutical industry to create CeliVites with her daughter, Taylor, a veterinary pathologist/scientist who was diagnosed with celiac disease in 2008.

“Taylor had severe nutritional deficiencies before she was diagnosed. She was losing weight rapidly and her hair was falling out. She had osteopenia and severe anemia—to the point where she had to have transfusions. We were looking for answers to her problems,” says Reynolds about the story behind CeliVites.

“Even if you eliminate gluten from your diet, the long-term and hidden effects of celiac disease are serious,” says Taylor Reynolds, DVM, PhD. “For me, the key to my good health has been vigilant adherence to the gluten-free diet and the right supplementation. There has been a profound difference.”

Addressing Dietary Pitfalls

The typical gluten-free diet may be high in unhealthy fat, low in carbohydrates and fiber, and low in iron, folate, niacin, vitamin B12, calcium, phosphorus and zinc, says Tricia Thompson, MS, RD, founder of GlutenFreeWatchdog.org. The first step to improving nutritional adequacy, she says, is to improve the quality of a patient’s dietary intake by eating gluten-free whole grains like amaranth, buckwheat, quinoa and millet, and then, if necessary, to take a multivitamin and mineral supplement chosen with the help of their dietitian or physician.

Thompson helped develop the Academy of Nutrition and Dietetics’ nutrition practice guidelines for celiac disease. “The recommendation for celiac disease is that if a person’s usual food intake shows that there are nutritional inadequacies that cannot be resolved through improved eating habits, then a dietitian should be advising that individual to take a daily gluten-free multivitamin and mineral supplement and it should be age and gender specific,” she says. “We want to make sure that people are taking the best supplement for them based on their dietary needs. So a dietitian should be going through a food record and looking to see where the issues may be.”

The result is improved health and wellbeing for those with celiac disease and gluten sensitivity, says Leigh Reynolds. “It’s very empowering to not have to depend on prescription drugs to answer the problem. You can take control of your diet and your nutritional health and you’ll be fine. You’re in control. You can fix this.”

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