Celiac Disease

Gluten and the gluten-free craze has been a big topic as of late. Most people have seen the amount of gluten-free items in the grocery store go from a few products on the shelves here and there to entire sections dedicated to these products. Different eating styles from the Paleo diet to straight gluten-free diets have surged in popularity. When asked in polls, many people do not even know why they may want or need to adopt a gluten-free diet, but said they would (or do) just because of the perception that it is “healthier”.  While it certainly can be a benefit for someone trying to lose weight or manage their blood sugars by limiting carbohydrate-rich foods containing gluten such as breads, pasta, tortillas and cereals, other individuals actually NEED to keep gluten out of their bodies to avoid the development or exacerbation of certain health conditions. Most notable of these would be a wheat allergy, Non-Celiac Gluten Sensitivity (NCGS) and Celiac Disease, which to most people are a source of confusion as they all appear to cause similar problems in the body. However, if you do find that you experience some type of intolerance to gluten, it is imperative that you know what condition you have. Since it is the most serious of the three, we’ll start by discussing celiac disease here today.

Celiac disease is an inflammatory autoimmune disorder that can occur in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine.  It is estimated to affect 1 in 100 people worldwide and that two and one-half million Americans are undiagnosed and are at risk for long-term health complications, which is why addressing and properly identifying a gluten sensitivity issue as soon as possible is so important. Because it is an autoimmune disorder, this means that the body’s immune system is overreacting to some type of stimulus and attacking its own cells in a particular organ or system. In the case of celiac disease, the body attacks the epithelial cells in the small intestine, which are essentially the “inner lining” of the intestines. These cells have small finger-like protrusions off them called villi that allow for the absorption of nutrients from the food we eat to pass into the bloodstream to be used for energy, healing and all other necessary functions. If the body attacks these cells, it destroys these villi leaving the cells unable to absorb the critical nutrients. So not only does a patient who has celiac disease have to worry about the gastrointestinal issues, but also about varying degrees of malnutrition that can lead to vitamin deficiencies and anemia.

But before you assume that you automatically have celiac disease based on just the symptoms, remember that there are 3 criteria that would have to be met in order for you to be diagnosed as such. First, you must have had exposure to gluten in some form in order for the body to react to it. Second, you must also have a condition known as “leaky gut” syndrome. Normally those epithelial cells that line the inner intestinal walls are stacked close together forming “tight junctions” that only allow small, properly digested particles of food through to the bloodstream. In gluten, there are certain protein components that are harder to break down for some people and these indigestible fragments cause the cells to release a protein called zonulin that loosens the tight junctions. Now the gluten fragments get through to the bloodstream where they have the potential to begin a damaging cascade. This process can occur in many individuals with the other types of gluten sensitivities, but it is the third component that will identify the condition definitively as celiac disease. A suspected individual must be a carrier of a gene for one or more of two proteins called HLA-DQ2 or HLA-DQ8. It is these two proteins that, when gluten fragments enter the bloodstream, will display the fragments to certain immune system cells which will then initiate a series of biochemical reactions that stimulate the body’s immune system to (incorrectly) start attacking the intestinal cells, destroying their ability to absorb nutrients.

Now remember, all 3 conditions would need to be met to develop celiac disease. Some people may be carriers of the genes, but if they don’t expose themselves to gluten and/or don’t allow themselves to develop a leaky gut, there would be much less chance of ever developing the condition in the first place. Also, in individuals who do have celiac disease, by the same order of logic, they can reduce the symptoms and progression of the disease by eliminating gluten from their diet and healing the gastrointestinal tract so that a leaky gut is no longer a contributing factor. If you or someone you know is suffering from the symptoms associated with celiac disease, it would be wise to have an evaluation done to determine if you actually do have it or one of the other gluten sensitivity conditions. In future posts, we will discuss these other conditions in more depth as well.

In Health, 

Dr. Brad Niewierowski

Why Breakfast Cereals Aren't the Best Way to Start Your Day

Coming from someone who grew up eating cereal on a regular basis, and who still ate it throughout most of his adult life (healthier options by that time of course), breakfast cereals were hard to give it up until I learned about the health consequences of partaking of it on an almost daily basis. Yes, it is a quick and easy source of food, they taste good (almost to the point of being addicting) and the marketing departments make them sound like they are the healthiest foods possible, but there are a few things to consider before grabbing those boxes and digging in or pouring a bowl for the children.

One of the major issues is what they are primarily composed of: the grains. According to a growing number of experts, including Dr. Loren Cordain, a professor at Colorado State University and an expert on Paleolithic lifestyles, humans are NOT designed to eat grains, and doing so may actually be damaging to your gut. The problem isn't only that they are inferior sources of nutrients compared to foods like fruits and vegetable; grains actually contain anti-nutrients that may damage your health. Ironically, we're often told that whole grains are the best for our health, but the high-fiber bran portion of grain – a key part that makes it a whole grain -- actually contains many anti-nutrients that may increase intestinal permeability and lead to leaky gut syndrome.

Gliadin

Gliadin is the primary immunotoxic protein found in wheat gluten and is among the most damaging to your health. Gliadin gives wheat bread its doughy texture and is capable of increasing the production of the intestinal protein zonulin, which in turn opens up gaps in the normally tight junctures between intestinal cells (enterocytes).

In celiac disease the body will make antibodies to gliadin after it is digested by the intestinal enzyme tissue transglutaminase, resulting in severe autoimmune damage to the delicate, absorptive surfaces of the intestines. It does not, however, require full blown celiac disease to suffer from the adverse effects of this protein. In fact, it is likely that our intolerance to gliadin and related wheat proteins is a species-specific intolerance, applicable to all humans, with the difference being a matter of the degree to which it causes harm. This helps to explain why new research clearly shows gliadin increases intestinal permeability in both those with, and those without, celiac disease.

Lectins

Lectins are a key mechanism through which plants protect themselves against being eaten, and are found in highest concentrations in their seed form -- which makes sense, considering that seeds are the plants' "babies" and whose survival ensures the continuation of their species. When animals consume foods containing lectins, they may experience digestive irritation, along with a wide range of other health complaints. The degree to which the adverse effects are expressed depends largely on how long that species has had to co-evolve with that particular form of plant food it is eating. Since humans have only been consuming unsprouted grains and beans in large amounts for approximately 500 generations, we still suffer far more than certain rodents and birds, who have had thousands of generations longer to adapt to this way of eating.

We are mostly exposed to lectins from grains, beans, dairy products and nightshade plants, such as potato, tomato, and chili peppers. However, bread wheat (Triticum aestivum) has a prominent role to play in lectin-induced adverse effects, due to the fact that it is a relatively new form of wheat, and contains wheat germ agglutinin (WGA) – a particularly resilient and problematic lectin, considering it is not eliminated through sprouting and is actually found in higher concentrations in whole wheat.

Sugar

A new report from the Environmental Working Group (EWG) revealed that many popular children's cereal brands contain more sugar than snack cakes and cookies. For instance, one cup of Kellogg's Honey Smacks, which is nearly 56 percent sugar by weight, has more sugar than a Twinkie, while a one-cup serving of 44 other children's cereals analyzed contain more sugar than three Chips Ahoy! cookies.

If you need a recap of why sugar is a health disaster, we have posted other blogs on this topic. However, as it pertains to leaky gut, you should know that sugar, like grains, can upset the balance of bacteria in your digestive tract, encouraging damage to your intestinal lining that can lead to leaky gut. So, sugary children's cereals are a double-edged sword, assaulting your gastrointestinal tract with both damaging sugar and grains.

For breakfast, try focusing on healthy protein choices, quality fats and fruits and vegetables to get your body and brain started off in high gear and fueled for the day to come!

In Health, 

Dr. Brad Niewierowski 

4 Health Tests You Should Have Monitored Regularly

If you aren’t regularly paying the best attention to your health, issues are likely to creep up on you before you know it. Everything from your diet, exercise routine (or lack thereof), water intake, sleep habits and stress levels will either positively or negatively affect your state of well-being. The best way to safeguard your long-term health is to catch troublesome issues early, so monitoring certain lab values regularly can tell you whether you are going in the right or wrong direction.

BLOOD SUGAR
Produced primarily from the carbohydrates you eat, blood sugar (a.k.a. glucose) is the primary source of your body's fuel. To use this fuel for energy, your body needs the hormone insulin to take sugar from the bloodstream and produce energy inside the cells. With pre-diabetes and type 2 diabetes (the most common form), the cells have decreased their sensitivity to insulin and less gets inside the cells. Glucose then builds up, leading to problems with the heart, kidneys, eyes, nerves, brain, muscles and blood vessels. Early warning signs are you might feel thirstier and hungrier than usual, become tired and cranky, or have to make more trips to the bathroom. In fact, 7 million Americans have diabetes but don't know it.
YOUR TARGET: Hemoglobin A1c below 5.7 (ideally around 5.1), Glucose in the 85-100 mg/dL range.

CHOLESTEROL
Cholesterol is a waxy, fatty substance that is necessary to produce most of your hormones, build healthy cell membranes and protect nerve cells in your brain. But whatever the body doesn't use to perform those vital jobs can cause harm. The "bad" form (LDL) cattaches to the arteries when oxidized or the vessels are damaged due to inflammation, sabotaging blood flow to your heart and triggering more inflammation. The "good" form (HDL) removes excess cholesterol and protects the vessels. Proper lifestyle modification will help keep the numbers in good balance.
YOUR TARGET: Total cholesterol 150-200 mg/dL; LDL below 100 mg/dL; HDL above 60 mg/dL

IRON
Iron is the key ingredient to the production of hemoglobin, which carries oxygen from the lungs to every cell in your body. If hemoglobin is low, you may experience symptoms such as increased fatigue, lack of energy, muscle soreness, achy joints, and sliding performance. Other values like your serum ferritin, which indicates your storage capacity for the iron you absorb, may also be low. Insufficient iron may indicate poor intake, poor absorption or be a result of increased loss, so it is always important to know the cause as supplementation alone may not fix the problem. If iron stores aren't returned to a healthy state, heart problems may arise.
YOUR TARGET: Ideally between 85-135 ug/dL

THYROID-STIMULATING HORMONE
An underactive or overactive thyroid can make major changes to your quality of life. That's because the thyroid hormone regulates how much energy reaches all cells: Too little TSH (hypothyroidism) can leave you feeling weak, foggy, cold and gaining weight while high levels of thyroid hormones (hyperthyroidism) speed up your heartbeat, cause excessive weight loss and can make you jittery. There are many levels to assessing the thyroid, including checking that T4 is being properly converted to the active T3 form and making sure that there isn’t an autoimmune component by checking thyroid antibodies. It’s a good idea to perform a full panel if thyroid complications are suspected.
YOUR TARGET: TSH level are optimal between 1.8 and 3.0 mIU/L

In Health, 

Dr. Brad Niewierowski 

This Popular Beverage Can Increase Your Stroke Risk

Is Drinking Diet Soda Worth Increasing Your Stroke Risk?

Diet soda is often perceived as being "healthier" than regular soft drinks because it contains artificial sweeteners in lieu of sugar, and therefore has no calories. Sugar, and particularly the sugar often used to sweeten regular soda, is clearly something you need to limit for optimal health. In fact, before you reach for another can, you might want to get up to speed on the latest research, which shows that drinking diet soda results in an increased risk of vascular events such as stroke, heart attack, and vascular death.

Diet soda can be addictive, so if you need incentive and motivation to quit this habit, ask yourself whether the pleasure you get from drinking it is worth having a stroke. This is a very real scenario, as researchers found that people who drank diet soft drinks daily were 43 percent more likely to have suffered a vascular event, including a stroke. This significant association persisted even after controlling for other factors that could increase the risk, such as smoking, physical activity levels, alcohol consumption, diabetes, heart disease, dietary factors and more.

According to the authors:

"This study suggests that diet soda is not an optimal substitute for sugar-sweetened beverages, and may be associated with a greater risk of stroke, myocardial infarction, or vascular death than regular soda."

Vascular events like strokes and heart attacks typically occur suddenly without any warning, which is why prevention is so important. I like to refer to the most common type of stroke as a brain attack, which is similar to a heart attack; the only difference is that the blood clot blocks blood flow to your brain instead of your heart. As a result, brain cells begin to die. Naturally, the longer your brain goes without oxygen, the greater your risk of lasting brain damage.

In order to be effective, you typically need to get treated within one hour. This is clearly one of the miracles of modern science, however it all goes to waste if you do not address the underlying conditions after the stroke. Again, prevention is your best option, and research is now suggesting that eliminating diet sodas may be an important way to dramatically reduce your stroke risk. Up to 80 percent of strokes are preventable by making lifestyle modifications; this includes not only diet but also optimizing your vitamin D levels, as research recently found that people who got less than the midpoint level of sun exposure were at a 60 percent increased risk for stroke.

Need Even More Incentive to Ditch Diet Soda? It Can Make You Fat!

If potentially lowering your risk of heart attack and stroke doesn't spur you to ditch this dangerous habit, maybe the fact that diet soda will make you fat will. A study by researchers at the University of Texas Health Science Center at San Antonio, ­­­­presented at the 2011 meeting of the American Diabetes Association, followed 474 diet soda drinkers for nearly 10 years. They found that their waists grew 70 percent larger than the waists of non-diet soda drinkers. Furthermore, those who drank two or more diet sodas a day had a 500 percent greater increase in waist size! A second study by some of the same researchers also revealed that mice eating food laced with the artificial sweetener aspartame had higher blood sugar levels than mice eating food without it, which suggests it may increase your risk of diabetes and metabolic syndrome. In a statement, the researchers noted:

"These results are consistent with data from community-based epidemiologic studies in which the consumption of diet sodas was shown to be associated with increased incidence of metabolic syndrome and diabetes. They suggest that aspartame exposure may in fact directly contribute to increased blood glucose levels, and thus may contribute to the associations observed between diet soda consumption and the risk of diabetes in humans."

Artificial sweeteners also tend to trigger enhanced activity within your brain's pleasure centers, yet at the same time providing less actual satisfaction. This separation of the taste of sweetness from caloric content means that when you consume artificial sweeteners, your brain actually craves more of it because your body is not satisfied at a cellular level by the sugar imposter! This can actually contribute to overeating and weight gain. To best protect your health, ditch the sodas all together and grab some water the next time you need to quench your thirst.

In Health, 

Dr. Brad Niewierowski

Posted By Dr. Mercola | February 20 2012

REFERENCES

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• ⁱ Journal of General Internal Medicine January 27, 2012
• ⁱⁱ Study presented at the meeting of the American Diabetes Association, San Diego, California, June 26, 2011
• ⁱⁱⁱ Study presented at the meeting of the American Diabetes Association, San Diego, California, June 26, 2011
• ^iv Study presented at the meeting of the American Diabetes Association in San Diego, 2005
• ^v Study presented at the American Stroke Association's International Stroke Conference in New Orleans, February 2012
• ^vi Neurology March 4, 2008 vol. 70 no. 10 788-794