By Drew Mulvey MS, CDN
July 21, 2020
Just recently I was introduced to the notion that a gluten-free and dairy-free diet may help overall performance in athletes due to their inflammatory nature. Even some elite athletes such as Tom Brady follow a very specific diet that is considered more “anti-inflammatory” in nature to help keep him throwing long tosses down the field. Amongst those foods that Tom Brady does not consume, gluten and dairy are some of them. With the gluten-free craze also on the rise due to sensitivities, I wanted to look a little further into this. If an athlete does perform better, was it purely because these foods were removed, or were there other underlying issues? Let’s dig a little deeper.
First off, let’s look at the gut and the cause of food sensitivities. It starts with the intestines. The intestinal barrier is comprised of tight barrier junctions consisting of epithelium that maintains the integrity of the lining. When this barrier is compromised, proteins from food particles can escape and enter into the body’s circulation. The body recognizes these proteins as foreign and becomes “sensitive” to that particular substance. Some symptoms that can occur when the body reacts to these can include GI distress, headaches, skin conditions such as rashes, and a decrease in one’s sense of well-being! These are prominent in conditions such as Celiac and other IBD (inflammatory bowel syndromes) where the intestinal barrier is compromised. What are some factors that can cause intestinal permeation? Stress, poor diet, and lifestyle factors such as strenuous exercise. The latter can thus directly affect an athlete’s performance.
Any increase in the duration and intensity of exercise may affect the integrity of the intestines from its impact on the rate of gastric motility, the movement of food down the throat from the mouth to anus, and ultimately result in an increase in gastrointestinal symptoms. Any alteration in this process has the potential of damaging the tight junctions, barriers of skin that maintain the integrity of the intestines, and increase permeation. A recent article published in the Journal of International Sports Nutrition studied the effects of high-intensity training on this phenomenon. The researchers theorized this increase in intensity and duration of exercise can affect the integrity at the gut barrier as the flow of blood is shunted away from the intestinal barrier and more to the extremities. This phenomenon can potentially increase one’s risk of “epithelial injury”.1 Any sort of injury to the epithelium in the intestines may thus trigger an immune response, causing localized inflammation, and ultimately result in a lack of nutrient assimilation which can have a direct effect on athletic performance. In this particular study, cyclists were prescribed a short-term gluten-free diet over the course of 7 days. It found no significant improvement in performance in elite athletes when prescribed this diet.1 Though this may have some merit, there are some confounding factors in this study. In general, a typical elimination diet is prescribed for 3 weeks, or 21 days. This study may have some merit, but 7 days is not a sufficient amount of time for determining the beneficial effects. My advice, take it with a grain of salt.
Therefore, how can the athlete tell if these foods can be triggers? Many other symptoms occur when the gut’s integrity has been compromised such as bloating, diarrhea, low stomach acid, etc. which can significantly impact how well nutrients are digested and assimilated, and athletic performance. When stomach acid is decreased, another problem arises. The ratio of beneficial bacteria to harmful bacteria is offset and can lead to an overgrowth of these offending bacterial strains, better known as SIBO, or small intestinal bacterial overgrowth. SIBO has the potential not only to cause gastric inflammation further contributing to a lack of digestion and GI symptomology listed above but can also have a profound effect on the functionality of the immune system. This is a common phenomenon in those who are endurance athletes and severely impacts the quality of their training.
Therefore, another approach that has been taken to address GI symptoms and reset the balance of bacteria in athletes is prescribing a Low FODMAP diet, or low fructooligosaccharide, oligosaccharide, disaccharide, monosaccharide, and polyol diet. High FODMAP foods are readily fermentable by gut bacteria and can lead to some of the GI symptoms listed above, possibly decreasing athletic performance. Elimination of these high FODMAP foods, including beans, dairy, and gluten-containing grains, are used to combat improvement and decrease the occurrence of these. If the individual is sensitive and experiences the symptoms stated previously, ultimately effecting how nutrients from food are processed, then this style of a diet may be beneficial for the athlete. One population that this may be particularly beneficial to are endurance athletes. In a recent study, 15 healthy subjects were prescribed a short-term low FODMAP diet and measured for improvement in performance and exercise-related GI symptoms. Results demonstrated that those following the diet had significant reductions in GI symptomology, which may ultimately improve performance outcomes.2
Is this for everyone and is conducive to a proper training plan? It may be yes, but there may also be some setbacks. One of the offending factors can be a decrease in specific beneficial gut bacteria while following a gluten-free regimen. An article published in 2010 researched the effects of a gluten-free diet on bacterial diversity in a healthy population. What did the article find? Fecal samples from these subjects displayed a decreased amount of “healthy” microbiota, in particular Bifidobactum and B. longum.3 This bacterial strain is beneficial not only for immunity but balances stomach acid levels and protects the intestinal wall from gliadin, the protein found in wheat.4 By eliminating it, the ratio of good bacteria to bad bacteria may decrease and potentially lower immune function. Does this give you an open invitation to load up on refined bread, pastas, and baked goods? Absolutely not. Quality does matter, as GMO wheat has been linked to exacerbating the problem due to glyphosate content from the weed killer Round-Up.
Can these two approaches benefit an athlete’s performance? For the short term, yes. What can be another way to address this? Putting the athlete or those who are avid fitness goers, on an anti-inflammatory, nutritarian style diet. This includes:
· Supplementing the diet with adaptogenic spices such a turmeric, cinnamon, and ginger and recovery foods such as organic tart cherry, >75% dark chocolate, and beets that help the body to adapt to the stressors of the exercise.
· Removing possible offending foods.
· Adding gut repairing functional foods such as coconut, flax, chia, licorice, marshmallow, and aloe.
· Adding whole-food sources of probiotics such as yogurt, kefir, kimchi, sauerkraut, miso, and kombucha.
· Supplementing with a multi-strain probiotic, particularly those containing L. casei, fermentum, acidophilus and rhamnosus and B. Longum.5
In Moderation (After an elimination diet has been in place)
· Consuming organic, whole, sprouted sources of gluten such as wheat, rye, barley, spelt and farro. Some of these foods include Ezekial Bread, Ezekial English Muffins, Sprouted Whole Wheat or Spelt Flour, and Einkorn (Ancient Wheat)
References:
1. Lis, D., Stellingwerf, T. Kitic, CM, Ahuja KD, Fell, J. No Effects of a Short-Term Gluten-Free Diet on Performance in Nonceliac Athletes. Medical Science Sports and Exercise. 2015. 47(12):2563-70. Abstract retrieved from https://www.ncbi.nlm.nih.gov/pubmed/?term=No+Effects+of+a+Short-Term+Gluten-Free+Diet+on+Performance+in+Nonceliac+Athletes.
2. Wiffin, M. et. al. Effect of a short-term low fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) diet on exercise-related gastrointestinal symptoms. 2019. 16:1. Article retrieved fromhttps://jissn.biomedcentral.com/articles/10.1186/s12970-019-0268-9. Accessed April 23, 2019.
3. Sanz, Yolanda Effects of a gluten-free diet on gut microbiota and immune function in healthy adult humans. Gut Microbes. 2010;1(3):135-137. Abstract retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3023594/.
4. Group, E. The 18 Best Probiotic Strains for Your Gut. Global Health Website. April 22, 2016. https://www.globalhealingcenter.com/natural-health/the-18-best-probiotic-strains-for-your-gut/. Accessed July 17, 2020.
5. Pyne DB, West NP, Cox AJ, Cripps AW. Probiotics supplementation for athletes – clinical and physiological effects. Eur J Sport Sci. 2015;15(1):63-72.
