One of the acknowledged issues of coeliac disease is malabsorption caused by villi damage. And this is why most people think coeliacs should look weedy and thin. As I said in myprevious post, though, we know that coeliacs and gluten sensitives can be thin, normal or obese. But you can bet your bottom dollar they are all malnourished.
How can this be? How can you be malnourished when you are overweight?
I was reminded of this issue today when reading Nutrivital’s newsletter. They were actually discussing the ridiculous proposed trial to give obese pregnant women the insulin drug Metformin to see if it will prevent them having babies who go on to be obese in later life. Quite rightly, they used this as a pointer to just how mad our healthcare world has become. I can’t help feeling it’s another incidence of profit-hungry Big Pharma finding another unnecessary use for a drug, but maybe I’m just cynical. Anyway, I digress. To their point about malabsorption and food cravings:
“In our experience, people who are obese tend to also be malnourished. Simple calorie restriction isn’t the answer here. There is so much confusing and daunting information about what constitutes a good diet that it can be difficult to know what to eat. Food marketers misinform consumers and persuade toward convenient food alternatives, usually laden with cheap, low quality ingredients and additives. By eating these foods, we end up wrecking our digestion (developing absorption problems and food sensitivities) and our insulin sensitivity. As the body becomes less capable of dealing with the nutrients that the diet does not provide anyway, it craves more food. The kinds of foods craved are processed, sugary, starchy foods – instant energy – which cause more health troubles. Many people who find themselves in this position end up on medication, which can further impede the body’s natural ability to function (given the right conditions).” Nutrivital.
Absolutely right. Very often I see patients who are quite literally starving in the midst of plenty. Either they are eating a poor, low-nutrient diet, their absorption is altered in some way (eg. lack of stomach acid), they have a parasite that needs feeding (eg. candida) or they have a malabsorption state such as the villi damage caused by coeliac disease.
The one symptom you can see in all of those cases is a constant hunger or need for food. Very often, quite uncontrollable food cravings are the result of a need for certain nutrients (chocolate for iron and magnesium is a common one, and think of coal in pregnancy), or of a simple need for glucose as the blood sugar drops. The quick fix, if you like.
The answer to food cravings then is often to make sure the person’s nutrient status is high enough and to solve the malabsorption problem. Having said that, I do know from personal and clinical experience that one of the symptoms of a food intolerance or gluten reaction is a noticeable fast drop in blood sugar. I experience this myself. Sometimes there is nothing for it but to eat, and eat quickly. A hypo of sorts. I haven’t yet looked at mechanisms why this happens – a drop in chromium, a sudden inflammatory response putting pressure on an already-compromised nutrient status, an adrenal issue? – I don’t know. But I do know it happens. The answer: get rid of the food causing the problem – gluten in the case of coeliacs.
So, if you recognise yourself here and suffer food cravings, think about some of these possible causes and get them checked out. If you are coeliac and on a traditional gluten free diet but still getting cravings, certainly check out whether the villi damage is healing. If it isn’t, it may be your clue that you are truly gluten sensitive and need a grain-free diet.