Journey Forth #6 : The Accidental Relationship between Gluten and Casein

When I was first diagnosed with celiac disease and started to research the disorder but also the foods that were available, I ran across many people who started pushing me towards a gluten free-casein free diet not only for myself but for Bug as well- we both have the disease and I think he can thank my genes for that ;) I was skeptical and I am still a bit questioning about some theories behind the diet. This particular diet is recommended for many people with celiac disease and other food allergies and it has become one of the diets of choice for individuals with autism and other developmental disorders and is sometimes recommended for people with mental health disorders such as schizophrenia. So I'll cover the basics of both. (Can I stress that I am wading into territory that is not firmly entrenched in science or statistics yet.)

The basics of this diet are that the individual not only avoids gluten but also all foods that contain the dairy protein. Some need to do this due to a true allergy and some people report that they have reactions that are similar to gluten intolerance when consuming the dairy protein. This protein can be found in butter, cheese, cream and milk, as well as yogurt and countless other products including chocolate, lunch meat or other prepared meat products and other non-dairy products. Symptoms of a true milk allergy are very similar to gluten intolerance as well as wheat allergy and celiac disease so trying to separate out the allergies and sensitivities can be pretty rough and time consuming. The most common symptoms may include; multiple skin reactions, anaphylaxis, multiple digestive complaints (including diarrhea, vomiting, and pain), multiple reactions in the lungs (coughing, sneezing, shortness of breath or wheezing), migraines, irritability, hyperactivity and other personality changes, insomnia, fatigue, depression and anxiety... to start the list. ;) If the challenge of eliminating gluten from the diet seems to be formidable, adding the need for casein removal can make the challenge seem like a herculean task.

There are a few reasons put forward for the similarities in symptoms and the immune reactions in the body between ingestion of gluten and casein. All three have been and are currently under study by researchers.

Casein is one of the most common food allergies and some studies suggest that as much as thirty percent of the general population have elevated amounts of the antibodies in their blood.

Casein has a similar molecular structure to gluten and they both create similar metabolic byproducts from their breakdown and digestion.

The enzyme that is needed to digest dairy is found in the brush borders and the tips of the villi in the small intestine... which is the first area that is damaged in gluten consumption for those individuals who are susceptible. With the necessary enzymes being in low numbers or decimated, the digestive process fails until healing and enzyme re-population has commenced... in some cases, a year after a gluten exposure.

For many parents of children with mental health disorders or developmental delays such as autism, this diet is not seen as a “diet” per se, but as a necessity and way of life. The changes in both behavior as well as mentation have been pretty well documented in self reporting and other unofficial forums. From personal experience, I feel a lot more in 'control' of my mind when I haven't had gluten- celiac aside. These experiences as well as watching and learning from friends and parents who have navigated these particular waters, I have found a great deal of confirmation in my mind that there is a great deal of positive evidence for recommendation of this particular diet for people with specific diagnoses or conditions. So even as I stress that the scientific evidence isn't there yet, I feel like I would be remiss if I hadn’t taken the time to discuss it. Whether the problems are due to the body's confusion of the proteins, lack or appropriate digestive enzymes or even another allergy... the problems are very real and need to be dealt with by individual sufferers on a daily basis.

What are your thoughts? Do you personally have experiences with this diet and individuals who use it? Please share if you are willing to...! :)

Journey Forth #4 : Some Common Myths about Gluten and Celiac Disease

When I was first starting the process that led to my diagnosis of celiac disease, I heard many things that I found out later either were not true... or the fact that they happened to be true in my case was unusual. So I thought I would write a short post on the most common myths (at least the ones that I have heard) and mention the true facts behind them.

1. Celiac disease is a simple gastrointestinal disease – For people who have celiac, they soon learn that the disease is anything but simple and doesn't only effect the digestive system. As discussed in past posts, this disorder affects every part of the body and some doctors believe that this disease is primarily a neurological one with some symptoms being digestive... and not the other way around. Even if that viewpoint isn't entirely true, the evidence of how this auto immune disorder effects and damages all organs and body systems seems pretty conclusive.

2. Celiac disease is a children's disease – While children are more likely to be diagnosed and diagnosed early, adults have the disorder as well in pretty high numbers. Estimates on undiagnosed adult celiacs range from 1 in 20 to potentially 1 in 6 for simply gluten intolerance. The symptoms tend to be more noticeable and obvious in children and adults tend to have less obvious or more ignorable symptoms... as well as the unfortunate fact that they are also more likely to be wrongly diagnosed. It is estimated that only 5% of celiacs have been diagnosed which makes up about one percent of the American population. Also, this disorder cannot be 'outgrown' and once truly diagnosed... you will have the disease for your entire life. In essence, there is no cure.

3. Celiac disease is the same as a wheat allergy – this really isn't true. While some people with celiac disease also have a wheat allergy (I might be one of those), most do not. Celiac disease is an auto immune disorder and as such the body responds differently than it does to an allergy. While both are dangerous and not problems to take lightly, they are not the same. Those with a wheat allergy can still eat barley and rye, while those with the celiac disease cannot.

4. Eating Gluten makes you fat – This isn't a true statement at all. Many people have started eating gluten free as a diet choice- some celebrities have made it more popular and 'trendy'. When it comes to gaining weight the answer is usually very straight forward... it you take in more calories than you burn, you will gain weight. While there are exceptions, the vast majority of people who start a gluten free diet will actually gain weight for a few reasons. One is that the person's lifestyle hasn't changed at all. Their eating habits, social customs and physical activity levels are what really cause an individual to develop weight gain. Another reason is that gluten free foods are thought by some to have fewer calories in them then their regular counterparts- with few exceptions, that is an erroneous assumption. Gluten free foods tend to have more fat and sugar to balance the lack of gluten protein. In order to make texture, color, and taste more 'normal', these are the ingredients that tend to be tweaked... and are also the main things that cause weight gain. Also, the average person's diet is heavy on grains with fewer legumes, fresh fruits, vegetables, and other foods that are naturally gluten free. Processed food is another factor in weight gain and so simply changing an unhealthy way of eating for an unhealthy diet without gluten doesn't really change much. Last, exercise is important for anyone and most people will gain weight if they tend to be sedentary creatures (anyone seen a thin sloth? :D Just kidding) All in all, most people do not lose weight on the gluten free diet and most individuals will put on some pounds when beginning the diet.

5. People who suffer from Celiac disease are skinny - Hmm, mostly not true. Yes there are a small percentage of people who are too slender due to the symptoms of eating gluten and the damage that it causes to the patient. However, around 40% of people who are diagnosed with celiac are overweight at initial diagnosis. Less than five percent of patients are underweight. So, not only is a person's weight not necessarily a good indicator for diagnosis, it may actually help convince people that they do not have celiac disease simply because of their extra weight... not a credible diagnostic tool.

So... do you have any thoughts on these myths? Know of one that I missed? What are your thoughts?

Brief Thoughts on Protein and Amino Acids

There are 22 amino acids that are available for human consumption and nutritional needs (that are known). Eight specific amino acids are essential- that is the body cannot produce them itself from other materials . As these cannot be synthesized, we must for optimum heath consume these amino acids in food. (These essential acids are called: histidine, isoleucine, leucine, lysine, methionine, phenylalanine, serine, threonine, tryptophan, and valine.) The non-essential amino acids are still needed and are very necessary in the diet- the name is a little bit of a 'fib' in my opinion. The different between 'non essential' and 'essential' amino acids is simple- the body finds them all essential and needs them for optimal health, but the non-essential amino acids can be made by the body if it gets enough raw ingredients from food. Over the last few years there has been a new category tentatively added called 'conditionally essential'- amino acids that can be synthesized and are not normally required to be eaten, but must be supplied for certain populations whose bodies so not synthesize enough for the body's needs; conditionally essential amino acids are arginine, cysteine, glycine, glutamine, histidine, proline, serine, and tyrosine. All of these amino acids can be found in protein... which is why we need to have some protein in our diets. Protein also is the only food that provides nitrogen which we need as well.

When you don't consume enough of the essential amino acids over an adequate period of time and/or do not consume enough of the rough materials to make the 'non-essential' ones... then illness can result. Some very common symptoms of these deficiencies can include fatigue, allergies, loss of memory, and even heart disease. Some diseases, such as phenylketonuria, require the sufferer to avoid one particular amino acid which makes other amino acids more essential for consumption (As it removes some of the extra building blocks that the body would use to synthesize the necessary amino acid.) And, like any good thing, too much of certain amino acids can cause toxicity and illness: methionine, cysteine, and histadine. Also, imbalances can be caused when too much of certain amino acids are consumed and then complete for the same transporters as other amino acids. This can help make too much of one amino acid available... while not allowing enough of one particular one to be available. It seems that the best way to make sure that you are getting the amino acids are to eat whole proteins in vegetables, beans, meat and fish- other products such as protein shakes may not provide the amino acids needed even if they do provide adequate protein.

There are several vegetables that are high in protein and as I do not really like meat, I think I should fill my diet with more of them. I do eat a lot of beans and legumes and it appears that some of my favorite vegetables are protein rich as well. I also use hemp seed protein in drinks which has omegas and other stuff in it. I think that a great way to have a lot of protein is to eat a lot of green leafy vegetables and beets and add some meat every few days- preferably fish. (At least that is my preference!) And if the vegetables are raw or steamed they would have less fat as well.

So, do you get enough amino acids? And if you are getting enough protein... are you getting too much fat? Are you getting enough variety? Let's discuss! :)

Where I should be... and where I am at- Nutritionally Speaking

So this semester I am taking a nutrition class. One assignment was to write down where nutrient, vitamin and mineral wise I should be... and then after recording an average days worth of food and breaking it down to see how I fit. I did this without adding in the multivitamin that I am fairly bad at remembering to take. Am I eating what I need on an average day or not? (I am sticking with the basics and not adding phytochemicals, etc...)

I am a 36 yo female, therefore I need for good health.....

700u Vitamin A
75mg Vitamin C
5u Vitamin D
15mg Vitamin E
90u Vitamin K
1.1mg Thiamin
1.1mg Riboflavin
14mg niacin
1.3mg Vitamin B6
400u Foliate
2.4u Vitamin B-12
5mg Pantothenic Acid
30u biotin
425mg Choline
1000mg calcium
25u chromium
900u copper
3mg fluoride
150u iodine
18mg iron
320mg magnesium
1.8mg manganese
45u molybdenum
700mg phosphorus
55u selenium
8mg zinc

That seemed fairly easy to come up with. So I recorded my food for the day... and this is what I came up with....

Total calories - 1776
Total carbs - 233 grams
Total fat - 50 grams
Total protein - 53 grams
Total sugar - 49 grams
Sodium - 1449 mg
Potassium - 2163 mg
Fiber - 29.5 grams
Vitamin C - 110.2mg
Vitamin A - 956u
Vitamin E - 5.6u
Iron - 10.84 mg
Calcium - 140 mg
Thiamin - 0.19 mg
Riboflavin - 0.428 mg
Niacin - 9 mg
Foliate - 74.2u
Phosphorus - 486 mg
Magnesium - 133.8 mg
Zinc - 10.05 mg
Vitamin B6 - 1.16mg
Vitamin B12 - 2.5u

Not a good report, really. Yes a few things were high or close to target, but egad.... everything else was low or absent entirely (twelve were completely absent). One thing I can do- I think I will get better about taking my vitamins. I did a fairly good job at following the pyramid too, but vegetables were lacking. Fruit was great as I got five servings of that and beans 'count' as veggies, but I am clearly missing a few things that I am supposed to have... which shouldn’t be a surprise with my food allergies. This list also doesn't take into account essential fatty acids and other very necessary nutrients. It look like if I try and pick up a green veggie everyday and my multi-vitamin I will be closer to where I need to be. For those of you foodies out there, what else can I do?

And to pick on my readers... how are you doing in this regard? Can I challenge you to write down your food for the day and try and figure out where you are- I am willing to help! :)