Staying heart healthy and gluten-free

Here are some tips on how to take care of your cardiovascular health at the same time you recover and thrive from your celiac disease. Having celiac disease can make healthy eating a challenge. The dietary restrictions of a gluten-free diet, and the symptoms from recently diagnosed celiac disease, can make it difficult to choose healthy dietary options and maintain physical fitness.

• Exercise regularly – even if you are feeling unwell as your recover from the damage done by eating gluten before your diagnosis. Gentle exercises like walking, cycling, cross-country skiing, snow-shoeing or swimming are excellent choices as you get started. Daily physical activity will make you feel better and help all health conditions, and reduce your risk for cardiovascular disease. Be careful that you do not overdo it, and only exercise at the level to get your breath and heart rate mildly elevated, not out of breath.
• Look for gluten-free whole grains instead of simple starches. This can mean brown rice, buckwheat, quinoa, or millet, as opposed to products made with starches or refined grains.
• Limit snack foods, sweets, alcohol, and salt, or have these in moderation. As you become an expert in reading food labels for “gluten-free”, also check the sodium, sugar, and caloric values in the foods you eat.  Just because something is labelled “gluten-free” it does not mean it is healthy.
  

  Exercise such as light walking is great for your heart.

• Eat whole foods as much as possible, choosing home prepared meals over convenience or fast foods. It is so easy to buy prepared gluten free foods these days, but they are as unhealthy as their gluten counterparts
• Exercise regularly. If exercise was a pill, every doctor would prescribe it to every patient.
• Do not smoke cigarettes or marijuana, and drink alcohol in moderation. There is no known safe level of smoking, and alcohol should be restricted to 1-2 standard drinks per day for women (maximum nine drinks per week) and 2-3 standard drinks per day for men (maximum fourteen drinks per week). If you have trouble quitting smoking or recreational drug use, or reducing your alcohol consumption, see your doctor or consider addictions counselling.
• Maintain a healthy weight and percent body fat. These can be determined by your family doctor or a dietitian, and can be achieved with a combination of healthy diet and exercise (there’s that exercise again!).
• Get enough sleep. If you snore, get tested for sleep apnea. Poor sleep and apnea can cause or worsen high blood pressure, blood sugar abnormalities, and obesity, all risk factors for heart disease and stroke. If you have trouble sleeping, talk to your doctor. And start exercising.
• Practice relaxation and stress-reduction techniques, such as meditation, tai chi, yoga, or gentle exercise (there it is again!). Elevated levels of stress may worsen blood pressure, diabetes, and risk for heart disease and stroke. Consider mental health counselling if you are having difficulty with your mood or anxiety levels and discuss it with your doctor.
• See your doctor every year for celiac checkups, and see if you need to have your cholesterol, blood pressure, and blood sugars monitored.
• If you have high blood pressure, take your medications as directed, and check your blood pressure occasionally in between doctor appointments to make sure your blood pressure readings are not too high or too low.
• If you have diabetes, you are at increased risk of cardiovascular disease. Work with your doctor and dietitian to maintain your blood sugars, blood pressure, cholesterol, and urine protein in a healthy range. It is an extra challenge to maintain a diabetic diet with a gluten free diet, but most of the principles are the same.
• Did I mention exercise? Yes, go exercise.
• Check all of your medications with your pharmacist to ensure they are gluten free.
• Always take your medications as directed by your doctor and pharmacist, and discuss any side effects or concerns with them before changing the medication, stopping the medication, or altering the dose.
• Exercise. Why not right now? If you are able, go for a 10-minute walk and think about this article.

Contributor: Dr Jennifer Zelin is a family doctor practicing in Charlottetown, Prince Edward Island. She has a special interest in celiac disease and is a former recipient of the JA Campbell Young Investigators Award and currently participates on CCA’s Professional Advisory Committee.