Monday, July 27, 2009

Living Gluten-free – But What Should I Eat?

Those of us following a gluten-free diet can get very focused on what we cannot eat. We can’t eat gluten, obviously, and we exert a lot of time and energy identifying those hidden gluten sources that can make us feel ill. Sometimes we spend so much time being “gluten-meters” that we forget to focus on what we should eat.

When I was speaking to one of my children last week we were discussing the mental checklist that I go through each afternoon to make sure that I’m on track for getting all my necessary nutrients each day. If you wait until the evening to review, the day is basically done and it’s too late. So instead, I do it each afternoon while there’s still time to make needed corrections.

To make this easy I came up with six major points (all beginning with the letter “F”).

Follow the 6 Fs

1.Flush your system of toxins. Drink a minimum of 8 glasses of clean, pure water each day. A recent study showed that those who exercised a lot needed 3 to 4 more glasses and those exercising moderately needed 1 to 2 more. Ramp up to it by adding another glass each day until you get to the desired amount. Staying well hydrated will help to keep your weight down and it will flush toxins from your body – a strong key to good health.

2.Fresh – we could add to that: Organic, Unprocessed and Real – everything you eat should fall into this category. Organic unprocessed, fresh food has an incredibly higher amount of health promoting nutrients as compared with pesticide laden processed food. There is absolutely no comparison. Is organic more expensive? Somewhat, but remember to buy seasonal food and take advantage of your local farmer’s market. This will keep costs down. Plus, not buying all the processed foods such as soda, chips, candy, etc should help to save money in the long run.

3.Free – you want to eat food that’s free of hormones, antibiotics, pesticides and heavy metals. Ideally it should be grass-fed, wild or farm-raised with a high quality diet. Our local fish market offers very high quality farm-raised fish that is fed krill, a small fish high in omega-3 fatty acids. Most farm-raised fish is of a lower quality than wild so I encourage you to speak to your fish market and find out the difference and what they specifically offer.

4.Fiber - helps to keep bowel movements regular and stabilize blood sugar. Flax seeds, fruits, veggies when consumed in adequate quantities are usually sufficient to provide adequate fiber. But if not, adding a fiber powder (use mostly soluble fiber) is a good idea. It’s very important to have 1 to 2 easy, large bowel movements every day. If not, toxicity in the body increases, leading to health problems.

5.Fat – It’s important to consume good fat. Omega-3 fatty acids found in cold-water fish, eggs and flax seeds tend to be underconsumed by the average American. Omega-3 fatty acids can protect against stroke, obesity, osteoporosis, depression, they raise good cholesterol, lower triglycerides and are anti-inflammatory. Inflammation is considered the trigger for most of the major diseases killing Americans such as heart disease, cancer and diabetes. Extra virgin olive oil and coconut oil are good oils for cooking.

6.Flush (again, but different) – Otherwise known as that nice “glow” one gets after exercise. It’s important to exercise 30 minutes per day, 5 days per week. Remember to combine stretching, strengthening and aerobics to get the most benefit from your exercise regime.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of The Gluten Effect

Monday, July 20, 2009

Gluten Containing Foods

I was doing an analysis of my website and was surprised that the “gluten containing foods” page was the most commonly read. Having seen some of the other websites and blogs on the internet I realized that there remains a lot of confusion about what does and does not contain gluten.

While from one perspective it could be quite easy (all fruit, vegetables, nuts, seeds, oils, beans and animal protein is gluten-free), our pre-prepared, pre-packaged foods add a great deal of complexity.

My daughter was away for a few days and called me from the airport today informing me that she didn’t feel well and suspects she was exposed to gluten. She went on to explain that she was very careful but in hindsight suspects a salad dressing was the root of the problem.

So let’s address the two most common pitfalls I see patients fall into:

1. They don’t speak up and ask enough questions. My daughter is a perfect example of this. Maybe she didn’t even consider that a salad dressing COULD have gluten in it. But remember that gluten is a great thickener so unless that salad dressing is oil and vinegar that you personally pour from a bottle – ask about the ingredients.

When you’re outside your own kitchen ask questions about ingredients. If it’s not easy to find out, don’t chance it, eat something else. While some people think they’re “being difficult” asking questions at a restaurant, think of it this way instead: you may be very well saving the health of the waitperson or a member of their family by enlightening them about gluten. That exact situation has happened to me on several occasions in restaurants. Similarly, your dining partners may very well learn something about their health.

Americans are not particularly healthy and gluten is playing a role in that a large percentage of the time. So asking questions and being vocal about gluten is not only good for you but likely also for someone who’s within earshot!

2. Patients haven’t committed to memory what the glutinous grains are. I was amazed this past week when a longtime patient was about to start eating barley. She and her entire family are gluten sensitive and they know it. Yet she didn’t know that barley was a no-no.

Please visit my website at: for the most comprehensive list of grains and other foods that contain gluten. I am updating the list constantly to keep it as current as possible.

I hope this helps.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Thursday, July 16, 2009

Gluten Attacks the Health of a Family

Below is an email I received from a reader. I post it here as an example and hopefully an inspiration. It can be difficult to do the right thing for your health and the health of your family when those around you are not supportive or in fact downright insulting. That's why we wrote our book and that's why we have this blog - to support and improve the health of Americans by providing the truth about gluten sensitivity and celiac disease.

There is plenty of scientific research out there to support the effects gluten has on the health of sensitive individuals. We are way beyond "theory".

Please help to spread the word. There are too many families like the one below - suffering with a multitude of symptoms needlessly.

Thank you for your support.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of The Gluten Effect

"Wow! Finally a website/blog and a medical practice that gets it!!! Our entire family of 4 was diagnosed with Celiac/gluten sensitivity in 2005 by Enterolab after our daughter testing positive blood with Prometheus and my husband testing negative blood with Prometheus. We have no health insurance and therefore no primary care doctor. We went about our testing utilizing friends who have health insurance and Celiac and their recommendations. Going Gluten Free initially cured us of pretty much every single symptom. My brother is an MD working at NIH in Maryland. He no longer speaks to my family because we did not do the "gold standard" testing route. He has accused us of feeling better gluten free psychosomatically and does not believe we truly have Celiac. My husband and I are the ONLY family member on both sides of our family who will or have done testing. EVERYONE else thinks we are crazy----doing a "Diet Du Jour" and trying to eat this new 'popular' way. This is absolutely sickening as there is severe osteporosis, aneurysms, arthritis, reflux, obesity, lymphoma, and a whole host of other gluten related illnesses ongoing in pretty much every other family member. Our daughter showed symptoms from the time I started feeding her food: mystery skin rashes, extreme clinginess, crankiness. At about 5 she had headaches, gas, constipation, stomachaches, very low immunity, 'wavy' eyes, joint and bone pain and then started getting horrible bloody noses. Our son started getting bloody noses at about 18 months. My husband and I had horrid reflux, joint pains, mystery joint injuries that took months to heal. anxiety, depression, weight gain, bloating, gas etc. I guess we were all 'asymptomatic'!"

Monday, July 06, 2009

Diagnosing Celiac Disease - Intestinal Biopsy with villous atrophy no longer the “gold standard”

If you’ve been through an intestinal biopsy to determine if you have celiac disease you were likely told one of two things: “your villi are very damaged, you have celiac disease” or “your villi appear normal, you don’t have celiac disease.”

The focus of a biopsy is the health or damage of your villi – the finger-like projections responsible for absorbing nutrients and giving your small intestine its large surface area (the size of a tennis court!).

While diagnosing celiac disease is important, here at the clinic we are also very concerned with correctly diagnosing the larger share of gluten sensitive patients, or those with non-celiac gluten sensitivity. But with that said, it’s not unusual for patients with severe digestive symptoms, secondary to gluten consumption to come to us confused with their negative celiac diagnosis. They have proven to themselves time and time again that gluten is no “friend” and the digestive symptoms gluten causes them to suffer are clearly no coincidence.

If they have such a severe reaction why didn’t their biopsy show it? Here’s a possible answer.

First I’d like to give credit to a dear friend, Dr Thomas O’Bryan, who has dedicated himself to educating doctors about gluten sensitivity. I’ve known Tom for many, many years and it was interesting to discover that our paths had taken such a similar turn after years of not seeing one another. Dr O’Bryan has his finger on the pulse of the research done in this area and he has pulled together several articles supporting the point I’d like to make.

First, villous atrophy should no longer be considered the “gold standard” when diagnosing celiac disease.

Second, if a patient chooses to receive a biopsy they must ensure that it includes an IEL (intraepithelial lymphocytosis – don’t worry I explain below) count so as not to miss the earlier manifestations of celiac disease.

Wow, that’s a mouthful. Don’t worry about pronunciation, let’s just stick with “IEL” and explain what it means.

When you think about it, it makes sense that the first thing that happens in celiac disease is not complete annihilation of the villi. Considering the small intestine is 23 feet long and the surface area is so large, something must happen before the destruction of the villi. Everything happens on a gradient, right? Exactly. So it should be no surprise to learn that before the villi atrophy they inflame or get irritated. That’s what the IEL count measures – the amount of inflammation. So if a biopsy is not taking an IEL count, it could very well be missing the early stages of celiac disease.

Now please understand I’m not a great fan of biopsies. But if you plan to get one you should at least get the most accurate and comprehensive data on the health of your small intestine.

If your doctor is not comfortable with the IEL count or it’s not part of his or her “typical” study, find a new practitioner – that doctor is out of step with current research.

Keep in mind also that those suffering from gluten sensitivity often show no sign of intestinal inflammation because gluten is affecting them predominantly at a system distant from the GI tract. Our book, The Gluten Effect addresses that point and explains how it occurs. So if you already know that gluten has a negative effect on you there is no need for you to reintroduce it into your diet in order to put yourself through a biopsy. Remember, reintroducing gluten can create negative effects the likes of which you may never successfully reverse. It’s a gamble I wouldn’t advise you to take.

Below is a list of journals that presented articles that all basically stated the same thing: villous atrophy should no longer be considered the “gold standard” of celiac diagnosis and IEL count is a specific marker that must be included with every intestinal biopsy to prevent missing early celiac disease. You will note that the earliest articles were written in 2002 – 7 years ago. I always say that the medical profession is about 10 years behind scientific research. So by that estimate this should be more common knowledge within the next few years. But let’s not wait that long – spread the word today!

With a little research, your doctor can find these articles: Modern Pathology (2005), Journal of Clinical Pathology (2004), European Journal of Endocrinology (2002).

Until next time, to your good health!

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of The Gluten Effect

Wednesday, July 01, 2009

4th of July and Summer Barbeques

Ah, summer. Outside barbeques, eating watermelon and getting “glutinized”…
Wait, what was that? I think it’s a term coined by my patients but getting “glutinized” is defined as unknowingly eating gluten and having to deal with the resulting consesquences of having done so – definitely no fun.

I’ll never forget a couple of summers ago when an arthritis patient, who had been pain-free for months as a result of removing gluten, went to a summer barbeque and got “glutinized”. She was in bed for three days with excruciating pain and swelling of her joints.

The point of holidays and eating with friends and family is enjoyment, not feeling ill.

So here are a few tips to enjoy the event with no lingering side effects afterwards.

1. If you know the host or hostess, call ahead and find out what they’re serving. If there’s a lot of pasta salads and desserts offer to bring some items of your own.
2. Ask questions. Don’t be shy about finding out the ingredients of something. This point goes beyond summer parties - to be successful at avoiding gluten you’re going to have to get over any shyness about finding out the ingredients in what you’re eating. Just think, you’re likely going to get into a discussion about celiac and gluten sensitivity that may very well save the life of the person you’re talking to! You asking questions may very well open the door to that person’s improved health.
3. When in doubt, do without! If you’re really worried about what is going to be served, eat before you leave home. If you’re not starving you won’t make unwise decisions.

I hope this helps!

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of The Gluten Effect