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Gluten and Asthma

It hit me like the investigator at the end of “The Usual Suspects”, about two weeks into my initial experiment with the Paleo diet, in March of 2010. I hadn’t used my inhaler once since I started cutting grains out of my diet, and this was through 4-times-a-week CrossFit workouts that left me exhausted, making sweat angels on the rubber mats. I’ve had asthma for a good 25 years, sometimes going through an inhaler a week, which is pretty awful. If not for my sensitivity in recognizing my symptoms early (something I see rarely in the asthmatic kids I take care of in the hospital), I’d have ended up admitted myself, many times over, and maybe worse.

The mainstay for severe asthma like mine is high doses of inhaled corticosteroids, which are supposed to stay in the lungs but end up getting absorbed in the body in tiny amounts, leading (eventually) to long-term problems like chronically elevated blood sugars, increased fat gain and muscle breakdown, and low bone density. Aside from Advair and its ilk, the only thing that has ever provided a temporary cure for my asthma has been the Paleo diet. I started getting flashbacks to my worst asthma attacks, and how they always seemed to happen around large amounts of unhealthy food, especially processed carbohydrates. Gluten is Keyser Soze. There’s got to be a link, I told myself. I can’t be the only one.

“I’m smarter than you and I’m gonna find out what I want to know and I’m gonna get it from you whether you like it or not.”

A simple PubMed search of “gluten and asthma” leaves one wanting more. About 60 articles, only one of which has a minimally-promising abstract. No trials of gluten-free diets, no HLA links between celiac disease and allergic tendencies, nothing. The blogosphere, of course, has plenty of anecdotal evidence, and I plan to add myself to the throng next month with my return to full-on Paleo eating.

This study (http://www.ncbi.nlm.nih.gov/pubmed/22082016) fromItaly found intestinal damage similar to celiac disease in 30% of patients who had both seasonal allergies and GI complaints (pain, weight loss, poor appetite). A cohort of those patients ate a gluten-free diet for 6 months and had a significant drop in GI symptoms and in medication use.

The problem with all these studies is they are asking the wrong question, or starting at the wrong assumption. Celiac disease is a known entity, a gluten sensitivity or allergy with GI and skin symptoms, which can only be diagnosed/‘confirmed’ by an invasive small intestine biopsy. People have studied the prevalence of asthma and allergies in these ‘confirmed’ patients, and what happens when they are given a gluten-free diet. But nobody has looked at what happens if patients with asthma and allergies are *presumed* to all have ‘silent’ celiac disease and are treated the same way. This one (http://www.ncbi.nlm.nih.gov/pubmed/11215557, also fromItaly) comes close, but focuses on making the diagnosis rather than the clinical course of disease. The investigators studied and tested 400 patients with allergic disease, and found that 1% are positive for anti-endomysial antibodies, which have since been shown to be unreliable in making the diagnosis of celiac to begin with.

How about no biopsies, no endoscopies, and just diet modification? I guess I’ll have to be my n of 1, yet again. One of these days, I want to open up a Paleo clinic for kids with chronic illnesses. But that’s a topic for another day.

Food experiment #1: Gelato Quest at Whole Foods. The girl and I have been talking about raiding the gelato station at Whole Foods for quite a while, and last week we grabbed a double scoop of Caramel Brownie and Cookies & Cream, after bailing on Banana Hazelnut and something with blueberries in it. Final scores:

Display – 4/5. 12 flavors, all pretty-looking in their big metal bins, just like a gelato display should be. And they keep a part of the surface untouched so you can see what the ice cream looks like with some drizzled fudge topping or nuts.
Flavor – 3/5. I liked the caramel one quite a bit. All it was missing was a bit of salt on the top to give it an extra kick in the junk.
Creativity – 4/5. They had a good mix of flavors. Sorbets, chocolate, cake pieces.
Texture – 4/5. A bit on the airy side, but not grainy or gritty.
Affordability – 1/5. $3.50 for a little cup. But the guy behind the counter offered many a free sample, and generous scoops that spilled out the sides of the 4oz cup.
Ambience – 3/5. A bit *too* polished. Whole Foods inBirminghamis not quite the crunchy hippie paradise it is in other places I’ve lived, but maybe gentrification *is* happening everywhere. Employees? Laid back. Customers? Neo-con.
Final – 19/30. The current leader by a nose over Trattoria (17).

Food experiment #2: Spiked Herbal Tea. Not our brightest idea. We started with Twinings blackcurrant tea and added healthy measures of Stoli Citros. Ick. I drank most of it and slept quite nicely, thank you.

Alright, off for some squats! Which makes me ask yet another question. What is the best ‘workout regimen’ for my goals during the Paleo Challenge month (namely, to maintain my strength/muscle, increase my conditioning, and lose some body fat)? Musings for the weekend. Also, we attempt to make bacon truffles. Or chocolate-covered bacon. Or, we just eat bacon and chocolate all evening and call it a success.



One thought on “Gluten and Asthma

  1. How many days a week do you want to work out? I’ve recently switched to this 3 day a week weight routine. It’s a lot less than my usual 5 day split but I’m actually enjoying it. Something different. My goals right now are the same as yours. Take at least one day off between weight workouts.

    For more fat loss and cardio training I’m adding 2 days of HIT cardio training. Whatever cardio you like,- can be done in 30 minutes if you really hit it hard.

    3 Day Weight Routine

    Day 1
    Full Squats
    Flat Bench Press
    Conventional Deadlifts
    Standing Military Press
    Pull Ups or Lat Pulldowns
    *All done for 5×6 w/ 120s rest

    Day 2
    Romanian Deadlifts
    Flat Dumbbell Press
    Seated Cable Rows
    Incline Hammer Curls
    Lying Triceps Extensions
    *All done for 2×15 w/ 30s rest

    Day 3
    Incline Dumbbell Press
    Barbell Rows (underhand)
    Dumbbell Split Squats
    Reverse Lunges
    Standing Dumbbell Press
    Lat Pulldowns (underhand)
    *All done for 3×10 w/ 60s rest

    Love the thought on gluten and asthma. Glad you are still dating “the girl”.

    Posted by Debbie | December 16, 2011, 3:43 am

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