It is estimated that 1 in 133 people in the United States
have celiac disease, and 6% of the population is gluten intolerant. Whether due
to a diagnosis of celiac disease or non-celiac gluten sensitivity (NCGS), the
gluten-restricted athlete faces possible threats to their performance.
Gluten consumption in the case of a celiac diagnosis will
damage the small intestinal villi and interfere with the absorption of
nutrients. Failure to comply with a gluten-free diet will result in a lack of
energy and diminished performance capacity. Nutrients of primary concern are
iron, calcium, vitamin D, folate, zinc, and vitamin B12. Those newly diagnosed with
celiac disease may need temporary supplementation as their intestinal lining
heals.
Gluten may further impede performance as it can cause
abdominal pain, diarrhea, indigestion, and chronic fatigue if not eliminated from
the diet when necessary. Long-term complications include anemia, vitamin and
mineral deficiencies, and bone mineral loss (which can lead to osteoporosis and
further bone damage).
The gluten-free athlete must ensure adequate carbohydrate
intake to fuel activity. Non-gluten grains include: amaranth, arrowroot,
buckwheat, chickpea, lentil, corn, millet, potato, quinoa, rice, and sorghum.
A drawback of gluten-free carbohydrate sources is their
lower fiber content. Athletes need ~25-35 g fiber/day, which can be met by
incorporating gluten-free fiber sources from other food groups, such as fruits,
vegetables, legumes and nuts. Fiber should be introduced into the diet slowly,
with adequate water consumption and physical activity to support motility.
It is important to maintain an overall balanced diet,
including protein, fruits, vegetables, and healthy fats. Fresh fruits and
vegetables are naturally gluten-free. Canned products are acceptable if packed
in water, rather than syrup or other substances, as these products may contain
gluten.
Meals and snacks should be planned ahead of training and
competition, especially if on the road. It is advised to always have a snack handy.
Some convenient options include dried fruit/nut trail mix, rice cakes with
peanut butter, a piece of fruit, or gluten-free sports nutrition bars.
Athletes should notify team health care members (dietitian,
athletic trainer, physician, etc.) of their dietary restriction. Gluten may be
present in sports foods, supplements, and catering at group meals. Alerting the
staff can help avoid possible contamination.
It is advisable to check food labels on all sports foods and
gels, and to seek out items marked gluten-free. Safe brands and products
include: Gatorade, PowerBar Protein Plus Powder, PowerBar Gels, Gu Energy Gels,
Ensure, Lara Bar, KIND Bar, PURE Bar, Clif Builder’s Bar, and Odwalla.
With the appropriate planning, support, and education, the
gluten-free athlete can meet all of their nutritional needs and avoid any detriment
to their performance.
Jessica Pearl, MS, RD, CSSD, CSCS, CLT is a Registered
Dietitian and Exercise Physiologist in private practice in New York City. She
has a Bachelor of Science in Kinesiology from the University of Michigan and a
Master of Science in Applied Physiology & Nutrition from Columbia
University. For more on Jessica visit jpearlnutrition.com
or email her at jessica@jpearlnutrition.com.
