This past October, as I was sitting on a plane flying from Phoenix to Kailua-Kona for the Ironman World Championships, I looked around and saw a sea of triathletes. The fit, hardened bodies and the transition-bags-as-luggage gave them away. And if not for those, the compression socks certainly told the tale.
Sure enough, both the men sitting on either side of me were competing in the race. We chatted about where we were from, how many Ironmans we had completed, our families, and what we did for a living (besides spending inordinate amounts of time swimming, biking, and running). When I mentioned that I was a registered dietitian I prepared myself for an onslaught of questions. My seatmates did not disappoint.
“What do you think about gluten-free diets for athletes?”
I knew it was coming.
Over the past several years I’ve been amazed at the growing popularity of gluten-free diets and the huge increase in the availability of gluten-free foods. I’ve watched in awe as client after client filled in “gluten intolerance” on their history forms or “gluten free” as their diet of choice. And I’ve at times been astonished about the number of inquiries I’ve received requesting information about eating gluten free, especially from endurance athletes. I watched as the entire Garmin Transitions Pro Cycling Team—not to mention Chelsea Clinton and her nine-tiered, 500 pound, four-foot tall wedding cake—followed suit.
After all, unless you have been diagnosed with celiac disease, a genetically inherited chronic condition in which eating gluten causes an immune response that results in damage to the small intestine, is there really any benefit to going gluten free?
To answer this question, I did some research and learned that there are three main factors at hand:
1. Gluten sensitivity versus celiac disease: Going gluten-free isn’t for just those with celiac disease any more. According to the Gluten Intolerance Group (GIG), some people who experience distress when eating products that contain gluten (and show improvement when following a gluten-free diet) may have gluten intolerance, not celiac disease. However, with gluten intolerance, there is no indication that gluten consumption causes damage to the small intestine, as is the case with celiac disease.
Mark Dinga MD, RD, LDN and himself a celiac disease sufferer, says that eliminating gluten is not where he would start: “When patients come to me with gastrointestinal symptomatology (ie: nausea, bloating, gas, diarrhea), lactose is the first place we begin. I would also consider things such as fiber (too much or too little), fat intake, and even fructose intolerance all before going to gluten. But you better believe I have gluten in the back of my mind as a possible issue.”
2. Under-diagnosis. Although awareness has certainly increased over the past decade, celiac and gluten sensitivity has been largely under-diagnosed in the past, often being brushed aside by physicians as a case of irritable bowels. The Center for Celiac Research at the University of Maryland puts the incidence of gluten sensitivity at seven percent of the U.S. population, or 20 million Americans. It therefore appears that the condition is far more common that celiac disease, which affects about one percent of Americans. Dinga reports that “for every one person diagnosed with celiac or gluten insensitivity, there are 10 lying in the weeds, undiagnosed, not feeling well and not understanding why.”
3. Gluten-free diets. Many claims have been made about the power of the gluten-free diet, none of which have any supporting evidence. The gluten-free diet has not proved itself a cure for autism, nor is it a sure-fire method to lose weight. Indeed, one of my concerns as a dietitian is that endurance athletes use the diet as a mask for disordered eating. The gluten-free diet can be a healthy alternative if it helps athletes reduce the amount of processed foods in their diet (many of which contain gluten) and instead include more fruits, vegetables, healthy fats, whole grains (besides wheat, rye, and barley) and lean proteins. One potential pitfall of long-term gluten-free diets is the development of vitamin B deficiencies—wheat is fortified with the vitamin B complex, whereas other grains often aren’t.
If you are an endurance athlete hoping to work on your diet for the upcoming race season, should you consider going gluten free? If you have any gastrointestinal issues or are unusually tired or plagued with “brain fog”, trying a gluten-free diet to see if there are any improvements is an option. It’s important to remember though, that gluten itself is not a bad thing, and there’s no benefit in going gluten free if you don’t have celiac disease or sensitivity.
Beth Shutt, RD, LDN, CNSC is founder of The Athlete’s Eutrophia, a sports nutrition consulting business based in Pittsburgh, PA. She is a Registered Dietitian (RD) and an amateur triathlete, who combines these two backgrounds to provide customized nutrition planning specifically for athletes. Beth races for the MarkAllenOnline Triathlon Team and competed in Kona for the first time in 2010.