Allergy

13 September 2011

Djokovic: wheat and the tennis ace

US Open champion Novak Djokovic's transformation from good player to supremo has set the world of tennis alight. Could his new wheat-free diet really have made such an impact?

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US Open champion Novak Djokovic's transformation from good player to supremo has set the world of tennis alight. Could his new wheat-free diet really have made such an impact? DietDoc has a closer look.

My hubby is an avid tennis and sports fan, so I have also been watching the television coverage of the US Open Tennis Championships for the past two weeks. It has been highly entertaining and surely the most amazing player of them all is Novak Djokovic. This man has set the world of tennis alight with his run of more than 65 wins, nine titles, four Grand Slam titles and his total transformation from a somewhat fragile player to an unstoppable tour de force.

What has changed?

Anyone who has been watching Novak’s metamorphosis, must be wondering what on earth changed in his life to permit him to become unstoppable. The commentators at Flushing Meadows and at many of his earlier matches this year, all mentioned that he has made changes to his diet and that these changes together with an improved training programme, have lifted Djokovic from a good player to the dizzying heights of a supremo.  

Public deductions

According to the same commentators Novak has a wheat allergy and by simply avoiding wheat, he has written himself into the history books. As a nutritionist, I am of course pleased that nutrition is taking centre court, but I must admit that I am still a bit sceptical. I am also rather worried about the nutritional conclusions the public will arrive at. 

It is a well known phenomenon that if sports stars or celebs announce that they are drinking a mixture of chilli and honey to lose weight or like Djokovic that they are avoiding wheat, desperate slimmers and other individuals who may be suffering from a variety of conditions, will follow suit. Wheat and carbohydrates are already the pariahs of the diet world, so the news about Djokovic’s supposed wheat aversion, will probably trigger another anti-carb movement, to the detriment of balanced nutrition.

Coeliac disease?

Intrigued, I did a Google search to see what theories are being put forward to explain Djokovic’s phenomenal performance. As predicted, many members of the public have jumped to the conclusion that Djokovic suffers from coeliac disease.

Now coeliac disease according to a fact sheet on “Food Allergy and Coeliac Disease" published by the Food Standards Agency of the UK Government (2006), is not an allergy, but an "autoimmune disease" (i.e. the body of a patient suffering from coeliac disease produces antibodies that attack its own tissues). The autoimmune reaction is initiated by gluten, a protein that is found in cereals such as wheat, rye, barley, oats, kamut and spelt.

Coeliac disease is diagnosed when a patient had undergone an endoscopy and a biopsy of the intestines has shown clear signs of coeliac disease. According to a most entertaining blog posted by Alex Gazzola (2011), who has published several books on food allergy, intolerance and coeliac disease, there is no evidence that Djokovic has undergone any of these investigations. I am inclined to agree with Alex Gazzola, because patients with coeliac disease have really serious, debilitating symptoms which if untreated for two decades would probably preclude a highly active sports career and have stunted our tennis star’s growth.

It is more likely that the World No 1 tennis player has a more general wheat sensitivity and/or that his general diet has just been fine tuned to exclude foods that contain wheat. This will of course automatically exclude other potential allergens such as colourants, flavourants, preservatives, yeast and other additives, which may, or may not, have been contributing to Djokovic’s previous tendency to run out of steam or go into a dramatic decline at crucial stages of a match. I suspect that he may have a more general allergy to wheat because in the past, he did exhibit symptoms such as breathing difficulties, irritated eyes and low energy levels.

Typical symptoms of coeliac disease

Patients who test positive for coeliac disease usually suffer from the following symptoms: 

  • nausea
  • bloating
  • tiredness
  • constipation
  • reduced or stunted growth
  • skin problems

If you suspect that you, or a member of your family, may be suffering from coeliac disease then it is important to be tested because following a strict gluten-free diet (i.e. free of wheat, rye, barley and oats, as well as the lesser known and used cereals, kamut and spelt) is much more difficult and complicated than avoiding wheat alone. Patients with coeliac disease need to be counselled and guided by a registered dietician so that they do not inadvertently ingest gluten and trigger their debilitating symptoms. In addition, the dietician will have to ensure that young coeliac patients do not develop deficiencies of essential nutrients, which will further retard their growth.

Importance of correct diagnosis

Besides the above mentioned problems, obtaining a correct diagnosis will help to identify those patients you have other digestive problems such as Irritable Bowel Syndrome (IBS), milk and dairy intolerance, or a deficiency of digestive enzymes, which may not require elimination of wheat. Each condition has its specific diet. For example,  patients with milk intolerance need to cut out milk and dairy products, while patients with constipation-linked IBS may need to increase their intake of insoluble dietary fibre which is specifically found in wholewheat products (i.e. these patients generally need to increase their wheat intake!).

In all these cases, patients who cut out food groups at random after self-diagnosis, may expose themselves to deficiencies, which can in turn lead to negative consequences. Anyone who is diagnosed with a milk intolerance or allergy would need to take extra calcium supplements to compensate for the loss of calcium from their diets. Patients who avoid wheat may develop severe constipation because they have eliminated their prime source of insoluble dietary fibre which stimulates peristalsis and ensures regularity.

Consequently it is safer and more sensible if you have the necessary examinations and tests to determine what condition you suffer from and then to consult a registered dietitian to assist you not only to avoid the offending foods, but to compensate for lost nutrients resulting from an avoidance diet.

Coeliac disease and slimming

A Health24 reader recently asked me for a slimming diet that is tailored to the needs of coeliac patients. The basic principles for weight loss in coeliac patients are to reduce total energy intake by eating less or smaller portions of your permitted foods, cutting down on fats and doing regular exercise. Once again I would recommend that coeliac patients should consult their dieticians when they need to lose weight, because many standard slimming aids may contain gluten (e.g. most diet shakes and slimming bars). The dietician will adjust the energy content of your coeliac diet to help you lose weight.

To find a registered dietician in your area, visit the Association for Dietetics in SA (Adsa) website and click on "Find a Dietician". You can also phone the Adsa Head Office at 011 789 6621 or 011 789 1383, to obtain the contact details of your nearest dietician.

Djokovic does it again!

I watched the exhilarating US Open Men’s Finals match between Djokovic and Raffa Nadal, and Novak did it again! Djokovic won the match beating Nadal with a blistering score of 6-4, 6-2, 6-7, 6-1, to garner his third  Grand Slam title this year - a performance to remember.

If this is what a change in diet can do for a champion, then you too can achieve great goals such as losing weight and improving your health by eating the correct diet. Just keep in mind that you must find out which dietary changes will benefit your condition with the aid of trained experts and not blindly follow the lead of the rich and famous when it comes to diets.

- (Dr IV van Heerden, DietDoc, September 2011)                                                            

References

(Gazzola R, 2011. Novak Djokovic: Wimbledon champion, gluten free, probably not a coeliac. Coeliac, Food Allergy and Intolerance Ink. 4 July 2011. http://foodallergyandintolerance.blogspot.com/; Food Standards Agency (2006). Food intolerance and coeliac disease. Food Standards Agency, September 2006 )

 Any questions? Ask DietDoc

 Read more:

Wheat allergy
Allergy, intolerance: which is it?
Coeliac disease

 

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Allergy expert

Dr Morris is the Principal Allergist at the Cape Town and Johannesburg Allergy Clinics with postgraduate diplomas in Allergology, Dermatology, Paediatrics and Family Medicine dealing with both adult and childhood allergies. obesity and diabetes societies and runs a trial centre for new drugs.

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