When you were first diagnosed with celiac disease (CD), you probably began to follow a diet of elimination and replacement.
You eliminated all foods from your diet that contained gluten and replaced them with similar gluten free (GF) ones. You eliminated all medicines and supplements that contained gluten and replaced those. You eliminated all cosmetics and personal items that contained gluten and replaced those.
If you lived with others who were not GF, you had to make sure you were not using their utensils and cooking areas, and you had to be aware of anything that could possibly contaminate your food. You eliminated restaurants that were not GF friendly and replaced them with those that are. The list goes on and on.
However, perhaps we should not look on the gluten free life as one of elimination and replacement but as one of addition and improvement. Maybe, instead of bemoaning the fact that we can’t eat the foods we once did, we should seek out healthier foods to enjoy, knowing that they are restoring to us the healthy bodies we all long for.
Here at the Gluten Free Homestead, we offer recipes that go beyond gluten free in that they are not just substitutes. We strive to present recipes that are not only GF but also taste good and will heal and strengthen your body as well. That’s what we feel GF eating is all about.
In this post, I will discuss a potent super food called probiotic yogurt. If you are still experiencing celiac related health issues, it is something that you should definitely consider adding to your diet. This yogurt is truly a super food. It’s packed with vitamins, minerals and billions of colonies of probiotics. And it is also super delicious and really easy to make.
I have found that probiotic yogurt has given my health a significant boost. It may be a food that can take your health to the next level as well. *Here’s a spoiler alert! If you are lactose intolerant, you may still be able to eat this yogurt.
Let’s first look at a condition many celiacs have that make this yogurt so necessary.
Here’s Something We’re Not Often Told About Celiac Disease
When I went GF about 12 years ago, I thought my medical problems were over and I would heal right away. No such luck. I’m still only about 80% better. Why? Wasn’t a strict GF diet (GFD) supposed to heal me?
Here’s something that celiacs are not often told by their M.D. “Even though you have CD and are going on a GF diet, you may still suffer celiac related symptoms for quite some time.” My M.D. never told me that, did yours?
But it’s true and this is why. If you suffer from CD, there is a high probability that you will continue to suffer inflammatory processes in your gut even after going on a GFD. See here & here. This inflammation is not directly caused by gluten. If this is the case, then solely removing gluten from your diet will not completely heal you.
Recently, researchers have discovered that a significant percentage of celiacs also suffer from a highly inflammatory condition known as gut or intestinal dysbiosis. These two conditions are so closely linked that research is now underway to discover if intestinal dysbiosis is a cause or a consequence of CD. See here, here & here.
Though research into the connection between CD and dysbiosis is still in its infancy, if researchers are correct, then intestinal dysbiosis must be treated along with the CD or you are still going to experience symptoms.
Let’s take a deeper look at intestinal dysbiosis.
Celiac Disease And Intestinal Dysbiosis
Normally about 100 trillion microorganisms inhabit your intestinal tract. Most of these organisms, also known as intestinal flora or intestinal microbiota, reside in the large intestine (colon) with smaller amounts in the small intestine.
Ideally, they exist strategically at the interface of the lumen and epithelium and play an extremely crucial role in maintaining human health. As such they are considered commensal or good bacteria.
Under certain circumstances, the normal gut flora can become grossly imbalanced. For example, beneficial bacteria may be decreased, pathogenic bacteria may increase, or bacteria may be located in areas they shouldn’t be. This imbalance is known as gut or intestinal dysbiosis.
Intestinal dysbiosis has a number of causes.
Dysbiosis can create an extremely inflammatory environment in the gut and throughout other parts of the body. Researchers have now associated dysbiosis to a number of serious illnesses.
As I mentioned before, researchers have found that there is a high correlation between CD and intestinal dysbiosis. However, they are not sure of their exact relationship. In other words, does CD cause dysbiosis or must dysbiosis be present for CD to develop?
Currently, there is a growing body of researchers who believe that dysbiosis must be present for the disease to develop. Here’s the reason why. In order for CD to manifest, a person must have one or both of the HLA DQ2 and DQ8 genes. However, not everyone with the genes gets CD. Therefore, there must be another factor involved in the pathogenesis of CD. Since the correlation between CD and dysbiosis is so high, researchers believe dysbiosis might be involved in the cause of the disease.
Nonetheless, if you have CD, the chances of you having dysbiosis are high. Now consider this. Antibiotics are known to cause dysbiosis. If you’ve had several courses of antibiotics throughout your life, you’ve probably damaged your microbiota.
Do you consume alcohol? Alcohol is known to cause gut dysbiosis (red wine, however, because of its high polyphenol content may actually increase beneficial bacteria and decrease pathogens).
Do you have a lot of stress? Sorry, that’s a stupid question. Who doesn’t have a lot of stress these days? Chronic stress is also known to cause dysbiosis.
After putting all these risk factors together, it’s not hard to understand why a celiac may continue to have gut inflammation even when on a GFD.
There’s no way around it. CD and gut dysbiosis seem to go hand in hand, especially for those who continue to experience symptoms on a GFD. Also, a GFD alone will not resolve a dysbiotic gut. In fact, because many typical GFD’s are high in sugar and low in polysaccharides, they may feed pathogenic organisms making the condition even worse. See here and here.
Dealing With Dysbiosis
Though much is being learned about gut dysbiosis, research into the exact connection between the microbiota and diseases is still in its infancy.
Thus, intestinal dysbiosis can be a difficult condition to diagnosis and treat.
Dysbiosis in the colon can be detected through analysis of stool samples. Small intestinal dysbiosis can be discovered through breath tests. Both tests, however, are significantly less than 100% accurate. More accurate testing can be done through biopsy. However, due to its invasiveness, it’s considered a last resort.
Treatment for dysbiosis lies in restoring a healthy gut flora balance. However, depending upon where the dysbiosis occurs, treatment will vary. Dysbiosis in the small intestine (SIBO) has a very specific treatment protocol. Dr. Allison Siebecker’s site has excellent information on this.
No matter where gut dysbiosis occurs, a primary course of action is to consume a diet that starves bad bacteria and feeds good bacteria, reduces inflammation, and improves the immune system. See here, here and here. A common ingredient in all diets attempting to treat dysbiosis is the consumption of probiotics and fermented foods that are high in beneficial bacteria. Let’s take a look at probiotics first because they are what makes probiotic yogurt so good for you.
Probiotic Therapy And Gut Dysbiosis
Since gut dysbiosis is a disturbance in the normal gut flora, therapies are being designed to restore gut health with the addition of beneficial bacteria. One of the ways this is done is through the use of probiotics.
Probiotics are defined as live micro-organisms which, when administered in adequate amounts, confer a health beneﬁt on the host. They usually consist of bacteria or yeast.
The most common bacterial species used to treat dysbiosis are Lactobacillus and Bifidobacterium. These are commonly found to be lower in people who have CD and intestinal dysbiosis in general. Saccharomyces boulardii, a yeast species, is also a commonly used probiotic.
What Do Probiotics Do?
Three main ways researchers have theorized that probiotics restore balance to the gut microbiota are through:
- The reduction of intestinal inflammation
- The support of the mucosal barrier function (reduction of leaky gut)
- Blocking the effects of pathogenic bacteria
For a more comprehensive list on how probiotics help in restoring balance to the intestinal microbiota, see here.
While it’s possible for probiotics to colonize the gut, researchers believe that it’s more probable that they work by providing an environment where beneficial bacteria can flourish and restore a normal balance. Because of this, researchers believe probiotics therapy must be continued for an indefinite period of time in order for their impact to be maintained. See also here.
How To Get Probiotics
Probably the easiest and most convenient way to get probiotics is in pill form. These pills contain live cultures of microorganisms. As I mentioned before these will usually contain various strains of either Lactobacillus, Bifidobacterium, and Saccharomyces boulardii.
Manufacturers will generally signify how many live cultures are in each pill. This is usually done by a designation of CFU (colony forming unit). Most probiotics will contain between 2 billion – 50 billion CFU’s. While CFU’s are important, what may be more important in a probiotic supplement is the diversity of species.
There has recently been some controversy concerning gluten in probiotics. A study presented by the Celiac Disease Center at Columbia University in 2015 reportedly found that some popular brands labeled as GF actually contain some gluten. Unfortunately, the researchers did not release the names of the culprits. This means that some caution should be exercised. If this report dissuades you from taking commercially produced probiotics, then you should, even more, consider probiotic yogurt.
Do Probiotics Work
While more studies are needed, research has shown that probiotics have been partially successful in treating dysbiosis in a number of conditions.
Because everyone’s intestinal microbiota and dysbiosis are unique, some people will have better success with some probiotics than others. Choosing the right probiotic should be tailored to your individual needs. It’s always best to consult with your M.D. or functional health practitioner. One of the best ways to get probiotics is through healthy food. This is where yogurt enters the scene.
One of the best ways to get probiotics into your gut is by consuming yogurt. Yogurt is usually defined as a food produced by bacterial fermentation of milk. Though yogurt can also be made from almonds and coconut, for our purposes, I will focus on yogurt from fermented milk.
Yogurt is made by adding beneficial bacteria cultures (usually Lactobacillus bulgaricus and Streptococcus thermophilus) to milk and allowing the milk to be heated for a certain amount of time. The bacteria convert the lactose (milk sugar) to lactic acid, which thickens the milk and gives it the tangy taste characteristic of yogurt.
As the milk is fermented, the number of bacterial cultures increase and produce a super powerful probiotic food. Yogurt is also highly concentrated with proteins, vitamins and minerals, such as vitamin B2 and B12, calcium, magnesium, potassium, zinc, and others
Of course, you can buy yogurt in your grocery store. However many commercial brands have included fillers, sugar, artificial coloring, flavors, etc. and are usually made with inferior quality milk. It is also difficult to know how many bacterial CFU’s are actually in commercial yogurt or if there are any at all.
There are some boutique dairies that make high-quality yogurt, though they tend to be rather pricey. Again, it’s difficult to know the actual colony count, though some dairies do guarantee that their yogurt contains live cultures. Here is an insightful guide to purchasing store bought yogurt. When we run out of homemade yogurt, we buy Trimona Bulgarian yogurt. It’s #5 on Cornucopia’s ratings list. I particularly love the taste. Our local stores don’t carry the top 4 brands so I can’t comment on them.
The best way I’ve found, though, to get a yogurt with the highest numbers of probiotics is to make your own homemade probiotic yogurt.
Homemade Probiotic Yogurt
The difference between regular yogurt and probiotic yogurt is the fermenting time. Most yogurt is fermented for about 8 hours. Probiotic yogurt, on the other hand, is fermented for a full 24 hours.
Sometimes you may see this yogurt called SCD yogurt. SCD stands for Specific Carbohydrate Diet. Elaine Gottschall popularized this yogurt in her book, Breaking The Vicious Cycle.
Fermenting the yogurt for a full 24 hours results in some unique qualities. First, more live bacteria cultures are created. Gottschall has claimed that this 24-hour yogurt has a “concentration of 3 billion CFU’s/ml which means that in just a cup of Yoghurt (236ml) you’ll get 708 Billion beneficial bacteria and that’s about 50 times more than that claimed for a typical 15 billion capsule.”
Compare this to the probiotic VSL#3 which has been used in several scientific studies. With 112.5 billion CFU’s per capsule, it has one of the highest concentrations of beneficial bacteria. The manufacturer’s minimum recommended dosage for gas and bloating secondary to IBS is 2 capsules per day. That would render 225 billion CFU’s. However, if Gottschall’s estimates are right then a cup of probiotic yogurt would still be at least 3 times as potent as two capsules of VSL#3. Remember most probiotics max out at around 50 billion CFU’s per day.
I am not saying you should replace probiotics with probiotic yogurt. That’s between you and your doctor. I am saying that probiotic yogurt is an inexpensive and tasty way to introduce a high amount of beneficial bacteria into your system.
As I mentioned before, some diversity of strains in a probiotic may be more important than numbers. If so, then you can supplement your yogurt with a probiotic that contains more species. The species in your yogurt will depend on your yogurt starter. We use GI Pro Start by GI ProHealth (it is listed as GF). We are very happy with this starter. It makes an incredibly creamy, tasty yogurt.
A second important benefit about this yogurt is that because it’s fermented for 24 hours, bacteria convert most of the lactose to lactic acid. Therefore, many people who are lactose intolerant are able to tolerate this yogurt.
Third, the bacteria in yogurt are fresh and in the environment they grew in, contrast this to the bacteria in a capsule which will be dormant.
Use Grass-Fed Milk
Using milk from 100% grass fed cows is an excellent way to increase the nutrient content of your yogurt. Grass-fed yogurt is richer in omega-3 fats and the beneficial fatty acid conjugated linoleic acid (CLA).
CLA has been linked to the following health benefits: superior heart health, the suppression of tumors, reduced body fat and greater fat loss in the obese and overweight. Milk from pastured cows may contain up to 5 times the amount of CLA found in the milk of grain-fed cows.
Introducing Yogurt Into Your Diet
I was able to start eating 3/4 of a cup right away and saw an immediate boost in health. However, if you believe you are very dysbiotic or you have some serious gut issues, you may want to start slowly.
Introducing tons of probiotics into your gut right away may upset your system because of a reaction secondary to the die-off of pathogenic bacteria.
Therefore concerning the consumption of probiotic yogurt, Gottschall states,
“… others can have problems at first. After the starter diet has been completed the yogurt can be tried by introducing it very slowly. Try a teaspoon the first day and watch for any reaction, if all is well, try two the second day, gradually increase it each day. If you have a reaction to it then there may not have been enough healing yet and it may be best to leave it for now and try again later.”
Next week Barbara will show you exactly how we make probiotic yogurt, and she’ll share a recipe for a fun dessert you can make with yogurt.
Have you tried probiotic yogurt? It may be an important food that could take your health to the next level. Let us know how it worked for you.
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