Are you Sensitive to Gluten?

Why did you give up Gluten?

Is it really necessary to remove gluten entirely from your diet? Gluten is a protein complex largely found in wheat, barley and rye and is composed of strands of gliadin and glutenin. 

It is particularly useful in baked goods as it is structurally amenable to water absorption and enables entrapment of air to create a moist, airy food product.  It also provides flavor.  As such, bakers are inclined to adjust the gluten content of baked goods to improve taste and texture.  This has led to the adulteration of breads that are traditionally dry and dense with added wheat gluten.  This modification has now produced rye breads and black breads that have the texture of an airy, moist white bread.   In and of itself, gluten is a perfectly healthy source of protein.  However, it is not the only nutritious component of whole grains.  Whole grains also contain a bran layer and a germ layer.  The bran layer contains fiber, B vitamins and other trace minerals while the germ layer is a nutrient-rich core containing vitamin E, B vitamins and polyunsaturated fatty acids. Unfortunately, these nutrient dense layers are removed from whole grains to get to the structurally useful endosperm where gluten is located.

 

Makers of processed foods have no practical use for the much healthier bran and germ layers of whole grains so they practically have been eliminated from the Standard American Diet (SAD).  The gluten-containing endosperm, on the other hand, is such a large component of the SAD diet that it is consumed in quantities that have exceeded its health benefit.  It is known that food sensitivities may be created by over-consumption of the same products, resulting in lack of adequacy, balance and variety.  Over the past few decades we have over-indulged on gluten-containing products to the point that we no longer have the capacity to completely digest what was once a perfectly healthy protein.  Gluten intolerance is not to be confused with Celiac disease, an adverse immunological response to gliadin that leads to autoimmune destruction of the small intestine.

As a result of a bona fide sensitivity to gluten or Celiac disease many consumers have removed whole grains from their diets and so are missing out on their many health benefits.  Let’s start with the bran layer.  The fiber in bran directly improves colon health, is beneficial to healthy gut bacteria and lowers plasma cholesterol levels using a mechanism that is free of the side-effects common to pharmaceutical agents.  B vitamins, in both the bran and germ layers, function as co-factors that are critical for cellular activity.  Additional benefits of the germ layer exceed that of any other food category.  The germ layer contains a plethora of antioxidants including vitamin E which is so deficient in the SAD diet, along with heart-healthy fats.

I commend David Perlmutter, author of Grain Brain, for bringing to our attention the many ways that gluten adversely effects our health and leads to cognitive decline.  However, it is somewhat concerning that we have over-interpreted his message and removed whole grains from our diets entirely.  I did a little deep dive to see what Dr. Perlmutter is eating himself.  Although he subscribes to a ketogenic diet (high protein, low carb) he does allow himself 50-100 g of carbohydrates per day.  This includes consumption of amaranth, buckwheat, rice (brown, white, wild), millet, quinoa, sorghum, teff and certified gluten-free oats.  These grains are just as healthy, if not more so, than whole wheat and provide a perfectly sound alternative for those with gluten sensitivity.  More information about the benefits of these gluten-free whole grains may be found on the Whole Grains Council website, http://wholegrainscouncil.org.

Nutrition and Dementia

The Role of Nutrition in Dementia Prevention and Management

Sponsored by the Sackler Institute for Nutrition Science

Hosted by the New York Academy of Sciences
26-27-March-2015
& World Trade Center, New York, NY
#NutrDementia

Day 1 of the New York Academy of Sciences Symposium on Nutrition and Dementia left me bursting at the seams with a newfound understanding of how nutrient status dictates cognitive health. First, I’d like to begin this summary by expressing my appreciation to the Sackler Institute and Nestlé Health Science center for their commitment to identifying Nutrient gaps that affect early childhood development and aging. 

Dr. Irwin Rosenberg, from Tufts University, was the first speaker to point out the inverse relationship between homocysteine levels, which are regulated by B vitamins, and cerebrovascular disease.  This introductory presentation laid the groundwork for the presentations by David Smith and Helga Refsum who showed that B vitamin supplementation (folate, B6 and B12) reduce the rate of brain atrophy by lowering total homocysteine levels.  Although B12 and folate rely on one another for metabolism this effect is largely driven by B12 levels.  The reason why media outlets reported that a large-scale clinical trial showed that B vitamins do not prevent dementia was due to a gross misinterpretation of the data.  In order for the data to be significant baseline levels of B vitamins need to be measured because those who have normal levels will not show any brain changes if treated with B vitamins.  Also, the study was conducted with an inappropriate patient population that did not meet suitable inclusion criteria. Finally, Dementia was not an assessment outcome for the study, only cognitive function.

I must admit that I was unmoved by Gary Gibson’s discussion of how reduction of the mitochondrial alpha-ketoglutarate- dehydrogenase complex (KGDHC) correlates with diminished mental performance, but was very intrigued by the correlation between thiamine (vitamin B1) levels and Alzheimer’s disease (AD).  Thiamine deficiency, which leads to impaired glucose metabolism, can be treated with Benfotiamine, a synthetic S-acyl derivative of thiamine (vitamin B1).  This theme was further elaborated by Dr. Stephen Cunnane who reported that glucose hypometabolism may be abrogated by following a ketogenic diet where ketone bodies may be used as a source of energy for the brain.

Given my own personal interest in the Microbiome I was quite intrigued by Kirsten Tillisch’s assertion that decreased Microbiota diversity correlates with aging.  As such, it may be possible to reverse cognitive decline by increasing Microbiota diversity.  The observation that anxiety and depression decrease when given probiotics supports this hypothesis.

Richard Wurtman was not a speaker at the symposium but certainly piqued my interest by calling the audience’s attention to a product called Souvenaid®, an elemental product, largely consisting of uridine, choline and Omega-3 fatty acids, that has been shown to promote synaptogenesis, thus reversing the synapse loss seen in AD.  This product is currently available in Europe but not in the US.

The data presented by Cédric Annweiler to support the role of vitamin D in cognitive function were rather weak but were supported by Katherine Tucker who shared a list of published studies to show vitamin D levels correlate with reduced incidence of dementia, AD and stroke.  Dr. Tucker cited the outcome of a Boston-Puerto Rican Health Study that provided support for the roles of vitamin B6, Omega-3 fatty acids and vitamin D in improving cognitive abilities.  High sugar consumption and reduced fruit and vegetable consumption correlate with cognitive impairment.

The final presentation of the day, presented by Dr. Martha Clare Morris, was reviewed in the Health Section of the a number of media outlets.  Based on the unique nutritional needs of those at risk for cognitive decline, Dr. Morris compared the benefits of a “Mind” diet, designed to improve cognitive function, with a Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet.  While all three diets improved cognitive function, the Mind diet was significantly better than the other two.  The Mind diet consists of the following foods:

·         Three servings of whole grains every day

·         A salad and one other vegetable every day

·         A single glass of wine every day

·         Mostly nuts as snacks

·         Beans every other day

·         Poultry twice a week

·         Berries twice a week

·         Fish once a week

·         Olive oil as the primary oil used in meal preparation

The following foods should be avoided:

·         Red meats

·         No more than one tablespoon of butter or margarine per day

·         Less than a serving a week of cheese, fried or fast food

·         No fruits beyond blueberries and perhaps strawberries

·         No pastries or sweets, may be replaced with a teaspoon of jam per week

A subsequent blog will be posted shortly to review Day 2 of the Symposium.

Nutrigenomics-How Your Diet Impacts Your Genes

YOUR GENES DO NOT DEFINE YOUR HEALTH

Your risk factors for adverse health conditions are largely dictated by the health of your mother during pregnancy.  Your Mother’s diet and lifestyle, along with everything that she was exposed to shortly before and during pregnancy, have a significant impact on your long-term health.  Under or over-consumption of macro- and micro-nutrients, and anything else with the potential to modify DNA, have genetic consequences that will likely last a number of generations.  While this exposure increases your risk for disease you have the power to control that risk. 

Knowing your health history puts you in the driver’s seat.  If you have an increased risk for any metabolic disease including obesity, hypertension, atherosclerosis and diabetes then it would be prudent to carefully manage your diet by consuming fewer processed foods and less sugar, and by eating more fruits and vegetables.  Increased consumption of fiber is correlated with a reduced risk for atherosclerosis since it lowers cholesterol levels.  You may also ask your physician or nutritionist for a nutrient blood test to see if you are lacking any critical micronutrients such as Vitamin D and iron.  If cancer runs in your family then it may be prudent to refrain from smoking and drinking alcohol.  There are many other cancer protective factors that can also be incorporated in to your lifestyle:  Physical activity has been shown to protect you from cancers of the breast, colon, rectum and endometrium.  Consumption of fruits and vegetables reduces risk for esophageal, lung, mouth, pharynx and stomach cancers.  Foods containing dietary fiber reduce the risk of colon and rectal cancer.

A well-informed expectant mother is encouraged to take prenatal vitamins to ensure adequate iron levels for healthy blood, and folate to ensure proper neural tube development of the baby.  An under developed spinal cord is an extreme outcome of folate deficiency.  Folate is a B vitamin that helps to regulate embryonic and fetal nerve cell formation.  Deficiency of both folate and Vitamin B12 are known to prevent special chemical modifications of your DNA that drive the expression of health regulating proteins.  Although this deficiency may not always manifest as a neural tube defect it may impact health in other, less obvious ways.  These deficiency outcomes may be reversed in future generations through proper diet.

Knowledge is the key to your health.  Research institutes committed to furthering our understanding of how our diet impacts gene expression include the Center of Excellence for Nutritional Genomics (CENG) at the University of California, Davis and North Carolina Research Campus (NCRC).  Both institutions are spearheading research efforts to understand how nutrients, plant phytochemicals, the environment and lifestyle choices impact brain and fetal development, cancer, diabetes, obesity, heart disease, fatty liver and other metabolic disorders.

 

*The content of this blog was derived, in part, from Nutrition Concepts and Controversies 13th Edition.  Editors:  Sizer and Whitney

 

Dog Food Considerations

WHAT ARE YOU FEEDING YOUR DOG?

I recently hosted a Healthy Gut workshop this past weekend.  While I was explaining to the audience the importance of a low pH (~2.0) in the human stomach it brought to mind something I learned from my former pharmacology brethren regarding pharmacokinetics.  The acidic conditions in our stomach serve a number of critical purposes.  First and foremost, it aids in digestion of the food that we eat.  Second, it provides an antiseptic environment to prevent the growth of unwanted microbes. 

I then reminded my audience that unlike humans, the pH in the stomach of a dog is much higher, anywhere between pH 4 to 6.  As a result, dogs have a much harder time digesting any food that they are not accustomed to.  A reputable dog food is specially formulated to be compatible with the unique environment of the dog gut.  When you bring Spot home for the first time you may have to try a few food formulas before you find one that agrees with your pet, but once you find the right brand, stick with it.

Feeding your dog human food may titillate his taste buds but you are sure to wreak havoc on his stomach and immune system.  He simply does not have the digestive conditions compatible for metabolizing food that was not specifically made for a dog.  So what happens when your pet eats something that is not on the doggie menu?  Regurgitation and runny poop may be acute symptoms but you are setting your pet up for a lifetime of chronic disease.  Humans who subscribe to the Standard American Diet (SAD) of processed and sugar-laden foods put themselves at risk for a host of metabolic and inflammatory diseases including Diabetes and even Rheumatoid Arthritis.  Dogs who are constantly fed people food or poor quality dog food are at risk for the same conditions.  A poorly formulated diet will ultimately lead to destruction of the immune system which is a major contributing factor to allergic disease.   Not only is the rate of allergic disease exploding in children and adults, it is also showing up in dogs at an alarming rate.  …and the cause is exactly the same.