Wednesday, September 4, 2013

Interesting articles I've read over the summer

Cat and Kitten, 2008  Photo by A. Stahl

I wanted to share a few interesting news articles that I've been reading over the summer. You see, I never really stop reading. I have friends who ask questions about "gluten free" or celiac disease, or whether or not a certain cross-reactive food is passed on in animal milk and that sort of thing... and I get the bug to go researching.

The only problem with this bug, is that I haven't been trained as a dietician or nutritionist, so I can only access whatever medical paperwork is publicly available or readily found via search engines. So, while these things are interesting, it's best to discuss these papers with knowledgeable gastroenterologist, dieticians and nutritionists who are well versed in Celiac Disease.

I read an eleven page document from The New York Times on "The Extraordinary Science of Addictive Junk Food" by Michael Moss. My take-away from the article was that we need to be very proactive and aware of the psychology of marketing and that if we are to partake of junk food, that we keep it to a very limited amount. Not because it is too sugary or too salty - but because it is so addictive and it can affect us for a long time to come.

The more interesting articles I was reading happened to do with the evolving spectrum of celiac disease. I've long believed that "gluten sensitivity" or "intolerance" happens to be part of celiac disease, even if it is as of yet, not recognized as such. Voilá, attitudes are changing in the medical community.
"Gluten Sensitivity (GS) is a state of heightened immunological responsiveness to ingested gluten in genetically susceptible people. It represents a spectrum of diverse manifestations, of which, the gluten sensitive enteropathy known as [Celiac Disease] is one of many."
Celiac Disease and Non-Celiac Gluten Sensitivity: The Evolving Spectrum
"It is now becoming apparent that reactions to gluten are not limited to [Celiac Disease], rather we now appreciate the existence of a spectrum of gluten-related disorders. The high frequency and wide range of adverse reactions to gluten raise the question as to why this dietary progein is toxic for so many individuals in the world."
Spectrum of gluten-related disorders: consensus on new nomenclature and classification

"Sub-clinical, or hidden, gluten intolerance is a health problem at epidemic proportions in certain populations in the United States and remains largely unrecognized by conventional medicine."
Dr. Daniel Kalish

Some acquaintances of mine were discussing some myths that were driving them crazy about Celiac Disease and I mentioned that wheat grass being gluten free was one of my major concerns, after seeing it featured in "Bedtime Stories" and another film ("Working Mom"?) as a safe option for Celiacs who wish to keep a healthy diet.

The problem is not that wheat grass is gluten free, but that the processing involved often causes the actual product to not be gluten free, and really that Celiacs need not be eating any of the grains (sprouted or not) provided from gluten containing grains because it is just too risky for accidents to happen. It took a lot of looking on my end to find an article that discussed these issues with wheat grass, and I found it at's Celiac section.

"...while wheat grass and barley grass in their pure forms are considered gluten-free, it matters how they're harvested and how products containing them are produced.
...if a farmer allows some of the grasses to begin producing seeds prior to harvest, then that particular crop will contain gluten.
...if a manufacturer of supplements produces gluten-containing products alongside or on the same equipment as it's using for gluten-free labeled products, then those products can be cross-contaminated unless special precautions are taken, and they may contain gluten."
Are wheat grass and barley grass gluten-free?

What the article doesn't discuss is that there is a propensity of people with celiac disease to also be allergic to wheat, barley, rye or oats. If one doesn't know that they are additionally allergic, as well as intolerant -- this can cause some massive issues that are just not worth it.  If you do wish to go there, it is best to be sure you only acquire gluten free certified wheat or barley grass, and that you are certain you are not additionally allergic like I am.   It is very unpleasant if you are, and react as I have been.

Another article that I found was related to gluten traces in gluten free foods. This study was referenced in a recent DZG magazine and I went to find the actual article to read on my own. Basically, the DZG translated the article for a German audience, so I had the benefit of the study in both languages. Double plus! The study is entitled "Might gluten traces in wheat substitutes pose a risk in patients with celiac disease? A population-based probabilistic approach to risk estimation." and was put out by The American Journal of Clinical Nutrition.  The "short" of the article is that there has not been enough study and that some Celiacs are more sensitive than others and will react to trace amounts while others do not. We need to adopt the 20mg/kg gluten threshold for the United States.

I have been hearing some things out there in cyber space about fermentation of grains making it gluten free or suitable for individuals with celiac disease. This is patently untrue, and mostly has been skewed from a few, very small sample-size studies.

Here are the basics:
"Because enzymatic breakdown of gluten proteins often leads to small, difficult to degrade, toxic peptides, the partial breakdown of wheat, rye, or barley proteins during seed germination or in the malting process probably will not usually eliminate toxicity even when there is no trace of the large original proteins remaining. Thus, malt extracts and other hydrolysates of wheat, rye, or barley proteins (including beers) might retain some toxicity. Nevertheless, when such extracts are used in a product in very small proportions, as a flavoring, for example, the amount of toxic peptides present in the final product might be so small as to be negligible. Again, however, good scientific studies are lacking."

"The sourdough fermentation may enhance the recovery from intestinal inflammation of coeliac patients at the early stage of the gluten-free diet.
This study aimed at investigating the effect of corn, rice and amaranth gluten-free (GF) sourdoughs on the release of nitric oxide (NO) and synthesis of pro-inflammatory cytokines by duodenal mucosa biopsies of eight coeliac disease (CD) patients."

There was a study done in Italy with 13 patients:

"The Italian study was designed to assess how 13 Celiacs responded to eating baked goods made with wheat flour treated with lactobacilli and fungal protease. The study, Safety for Patients with Celiac Disease of Baked Goods Made of Wheat Flour Hydrolyzed During Food Processing was published in the January 2011 issue of the journal Clinical Gastroenterology and Hepatology."
"...methods used to assess gluten damage in the participants -- blood tests for anti–tissue transglutaminase antibodies and small bowel biopsy have potential for false negative results. "
Is fermented sourdough wheat bread safe for Celiacs?

"These results showed that a bread biotechnology that uses selected lactobacilli, nontoxic flours, and a long fermentation time is a novel tool for decreasing the level of gluten intolerance in humans."
Sourdough Bread Made from Wheat and Nontoxic Flours and Started with Selected Lactobacilli Is Tolerated in Celiac Sprue Patients

The only issue with the studies is that it is such a small sample size, it was not done with a double-blind and they did not test individuals with the rather broad spectrum of celiac disease. There is no long term study, and you could not sign me up for this test with the reactions I have. Heck, I'm reacting to gluten grains in the fields now!

The other interesting bit of research I went into was the myth of there being traces of gluten in dairy products from animals. Based on testing, no significant amounts of gluten peptides have been detected in cow’s milk.

However, Lactose Intolerance Can Be A Symptom Of Gluten Intolerance. That actually was one of the many symptoms I had as a teenager before we figured out that my entire health issues could be pinned on Celiac Disease.

Here's the research I was able to find:

Here's hoping that you had a wonderful Summer and are easing gracefully back into school.


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