• Although weight gain indicates that the intestinal lining is healing, if it exceeds an acceptable level, other health concerns can arise. Excessive weight gain increases the risk of coronary artery disease, hypertension, type 2 diabetes, osteoporosis, and certain types of cancer. 1
  • In general, gluten-free processed foods contain more fat, sugar, carbohydrates and less fiber than gluten-containing processed foods, and consequently are higher in calories as well. Food manufacturers add the extra fats and sugar to improve texture and mouth-feel in the absence of gluten.
  • Many processed GF foods are made from white rice, corn, potato starch, and tapioca, all of which are high in carbohydrates, low in fiber, and tend to have poor nutritional value. Foods that are high in carbohydrates and low in fiber break down quickly into sugar (glucose) in the body. This may leave you feeling unsatisfied and prone to compensate by eating more calories. 2
  • Eating more meat, cheese, or desserts/'junk foods' and other high fat and high sugar foods in an attempt to avoid gluten exposure or to compensate for feeling deprived of other foods can lead to weight gain and has been seen in those following a GFD. 3 It is a common feeling among those with celiac disease to miss or crave certain foods that are no longer allowed. In general, this feeling passes or is greatly reduced as you get used to the gluten-free diet and find your way to a healthy, balanced way of eating. 

    However, if you continue to feel a sense of deprivation and reach for gluten-free equivalents (which may be higher in calories, fat and sugar) or simply continue to eat more food than is healthy for you, consider the following: 
    • Talk to your dietitian or doctor for some help in coping with the dietary changes and finding healthy alternatives;
    • Connect with a local support group to speak with others who can relate to your concern and offer suggestions: Click here for Resources ;
    • Get a referral to see a clinician specializing in eating behaviors if this is a significant problem for you.

WHAT DOES HEALTHY WEIGHT LOSS INVOLVE?

  • Calories in versus Calories out:" 
    You may not realize how many calories you are actually eating. Keep track of what you eat for a few days (including beverages) and estimate your average calories per day.
  • Here are a few online calorie counting programs: 
    www.myfitnesspal.com 
    www.nutritiondata.com 

    Compare this to the amount of calories estimated to maintain your weight based on your activity level, age and gender (see links below). To lose weight you must take in fewer calories than your maintenance calorie needs. To achieve this negative calorie balance, you can eat fewer calories, burn more calories through exercise or, ideally, a combination of both. 

    Visit: 
    http://health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf 
    for Estimated Calorie Needs Per Day by Age, Gender, and Physical Activity Level - Appendix 6 (page 78) 

    http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/healthy-weight-basics/balance.htm
  • Balanced Diet: 
    Aim for a variety of foods each day, including vegetables, fruits, whole gluten-free grains, lean proteins, and healthy fats. Fiber, found in fruits, vegetables, gluten-free grains, plain nuts and seeds, and dried beans and legumes, is a well-known weight loss friend. Since fiber is not readily digested by the body, a person will feel fuller for a longer period of time on a high fiber diet and can eat fewer calories.
  • Portion Control: 
    Many dietitians teach how to control portion size using the USDA's ChooseMyPlate.gov plate model. This is a quick and easy way to visualize a balanced diet that limits high calorie, high fat foods and ensures adequate intake of fruits and vegetables. Picture a dinner plate that is divided into four sections: 4
    • 25% of the plate is for lean protein which includes meat, poultry, seafood, beans and peas (black beans, lentils, split peas), eggs, processed soy products, nuts, and seeds. Beans and peas can be considered part of the Vegetable and/or Protein group.
    • 25% of the plate is for grains (refined and whole grains). Half of the grains chosen should be whole grains, such as gluten-free whole-grain brown rice, wild rice, millet, quinoa, amaranth, buckwheat, and whole-grain corn.
    • ~30% of the plate is for vegetables that are divided into 5 categories (dark green vegetables, starchy vegetables, red and orange vegetables, beans and peas (also in the protein section), and other vegetables).
    • ~20% of the plate is for fruit.

choosemyplate

  • Finish off with the dairy group on the side of the plate. All fluid milk products and many foods made from milk that retain their calcium content, such as yogurt and cheese, are considered part of this food group. Calcium-fortified, gluten-free non-dairy beverages are also included. Note that some of these beverages (such as rice and almond milk) are lower in protein than cow and soy milk. Most Dairy Group choices should be fat-free or low-fat.
  • Visit www.choosemyplate.gov for specifics on creating a healthy diet and important details about each food group.

fats2

  • "Consider Amounts and Types of Fat: 
    All fats are high in calories and, therefore, need to be limited for weight control. However, some types of fat are healthier than others. You can see how much total fat, saturated fat, trans fat, and unsaturated fat is in any given food item by checking the Nutrition Facts on the food label.
    • Saturated fats are solid at room temperature, such as butter, lard, and some vegetable oils like coconut oil and palm oil. These can raise cholesterol levels and the risk of heart disease. Limit your saturated fat intake to 8-10% of your daily calories.
    • Unsaturated fats, such as nuts, or vegetable oils (such as olive or grapeseed oil), which are liquid at room temperature, are a much healthier choice.
    • Trans fats, in which a vegetable oil has been hardened by hydrogenation, occur naturally in small amounts in beef, pork, lamb, butter, and milk. But their most negative impact can be seen in commercially prepared foods, such as cookies, cakes, pretzels, and other snacks. Avoid trans fats as much as possible.
    • Exercise. Exercise is an essential element of weight loss and a healthy life. Better nutrition and increased physical activity reduce the risk of the most common and costly health problems in the United States, such as heart disease and diabetes. 5 It takes only 30 minutes per day, five days per week to see long-term health benefits of regular physical activity. If weight loss is your goal, you'll see results if you are physically active (moderate-to-vigorous intensity) for about 60 minutes on most days. 6
    • The following websites offer practical tools to help you determine the number of calories you need per day to lose, gain or maintain your weight, how to make wise food choices, and how to track your own progress. Try them out! 

      www.foodpyramid.com 
      www.eatright.org 
      www.fitday.com

TAKE HOME MESSAGES:

log

  1. Keep a daily food record for a few weeks to see what you are actually eating. It's a great way to notice patterns and unnecessary calories you may be eating. Share this information with your dietitian or doctor. Click here for a downloadable formand click here for instructions.
  2. Weight gain does not happen overnight. Similarly, losing weight, and keeping it off, takes time. Consult with a dietitian to help you with your goals. Stay positive and stay focused!

References:

  1. What is the evidence to support the nutritional adequacy of a gluten-free dietary pattern? American Dietetic Association Evidence Analysis Library. 
    www.adaevidencelibrary.com/evidence.cfm?evidence_summary_id=25060. Accessed July 1, 2011.
  2. Dennis M. Weight Gain: A Common and Sometimes Unwelcome, Measure of Healing. In Real Life with Celiac Disease: Troubleshooting and Thriving Gluten-Free . Eds. Dennis M, Leffler D. AGA Press. Bethesda, MD, 2010.
  3. See J, Murray JA. Gluten-free diet; the medical and nutritional management of celiac disease. Nutrition in Clinical Practice, 2006;21:1-15.
  4. United States Department of Agriculture. www.ChooseMyPlate.gov. Accessed September 7, 2011.
  5. U.S. Department of Health and Human Services. Dietary Guidelines for Americans 2010.http://health.gov/dietaryguidelines/2010.asp. Accessed September 7, 2011.
  6. U.S. Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans. www.health.gov/paguidelines/guidelines/summary.aspx. Accessed July 1, 2009.

Revision Date: 11-6-12 
Author: Melinda Dennis, MS, RD, LDN 
Editors: Suzanne Simpson, RD; Nixie Raymond, MS, RD, LDN, CSP and Rupa Mukherjee, MD

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