Genetic links to celiac disease identified: Commentary

Well, I thought we had already established that celiac disease was genetic, but just a couple of days ago it was announced that according to London scientists,  new genetic links to celiac disease have been discovered. An international team of researchers found close to “40 different inherited risk factors which predispose to the disease” (DNA India, boldface added).

We all know that genetics are pretty much entirely responsible for our physical makeup, but I find it interesting that there are so many risk factors that make celiac disease something for which we may be “predisposed.” Just the fact that there are so many millions of people around the world that have CD fascinates me, and it is relatively new disease, historically speaking… rumor even has it that it has something to do with the genetically modified super-gluten that has crept into almost all mainstream food products.

In her book "Harvest for Hope: A Guide to Mindful Eating", famed primatologist Jane Goodall said of genetically modified foods:  "We simply do not know the long-term effects of genetically altering foods" (2006, p. 46).  She also sadly pointed out that "The children of North America have now become the world's lab animals on whom to study the long-term effects of eating GM [genetically modified] products" (p. 62).  We are predisposing ourselves, I often think.

The British-led team of medical researchers identified “four aspects of immune system disturbances that lead to the development of celiac disease” (United Press International).

"We can now shed light on some of the precise immune disturbances leading to coeliac disease. These include how T cells in the body react to toxic wheat proteins, how the thymus gland eliminates these T cells during infancy, and the body's response to viral infections.

"We now understand that many of these genetic risk factors work by altering the amounts of these immune system genes that cells make.

"The data also suggests that coeliac disease is made up of hundreds of genetic risk factors, we can have a good guess at nearly half of the genetic risk at present" (Prof. David van Heel, professor of gastrointestinal genetics at Barts; DNA India; Nature Genetics journal, boldface added).

Toxic wheat proteins…. I’m all for the advancement of science and particularly in medicine, but when our food supply becomes toxic to our own bodies (at least as our body sees it), it is time to stop tampering with what goes into our bodies and start focusing on preventative medicines and treatment, that are both natural and non-toxic, regardless of what levels the FDA deem safe. 

It is good news that the scientific and medical communities are spending the time in research considering celiac disease is becoming so prevalent around the world. According to Reuters, these new findings may help “speed the search for better ways to diagnose and treat the gluten-intolerance disorder” (Reuters.com).

The bad news is that the “study also shows that there is substantial evidence to indicate a shared risk between the gene associated with coeliac disease and many other common chronic immune mediated diseases” including diseases such as type 1 diabetes and rheumatoid arthritis (DNA India, Reuters).

With my own research, I already know that CD is caused by an abnormal immune response to gluten, which can be found in wheat, rye, and barley products and can be hidden just about anywhere —from medicines and vitamins to lip balms and lipsticks. I know that the reaction causes damage to the lining of the small intestine, essentially flattening the villi, which are the tiny, hairlike projections that normally stand upright (mental image: a field of grass moving with the breeze). Each tiny little villi absorbs nutrients which then get absorbed into the blood stream. When the villi are flattened, the body can no longer properly absorb nutrients.... and you may never know it is happening until the damage has already been done.

You may be eating to your heart’s content, but as long as your body cannot receive nutrients on a cellular level, your body will be literally starving to death. This is why the disease affects so many organs and systems in the body—it affects your entire body. You may end up with weakened bones, anemia, chronic fatigue syndrome, weight loss or weight gain, or any one or combination of over 300 symptoms.

In simplest terms for me, gluten is the alien that created crop circles in my gut, substantially reducing my nutrient harvest. There is no cure for it and that the only treatment is a life-long diet free of gluten and avoiding all hidden sources of gluten.  So I have CD.  I live, and I move on.  Do I miss all those bread products and over-processed snacks and addiction to sugar?  Actually.... surpisingly, no.  I don't.  What's to miss?  Horrible stomach pain, a weakened heart, failing organs and a reduced standard of health (i.e., living)?

I think not.  Keep plugging away, researchers!

Emulsifiers: Gluten-Free or Not?

As a self-confessed chocoholic, I am having a hard time finding convenient sources of chocolate that I can safely eat. I heard that Hershey’s Kisses were gluten-free and I munched on them freely during the Christmas holidays, but ended up sick almost the entire week. Whether it was actually the Kisses, I can’t be certain, but they are the only "questionable" candies I ate with consistency between Christmas and New Year’s.

Looking at the ingredients of Hershey’s Kisses, the only term that I could not find on any gluten-free "Safe List" was “emulsifier” and the more chocolate I looked at, the more emulsifiers I found. Could this be my particular problem with so-called gluten-free chocolates? I had to find out.

So what is an emulsifier in the first place? Well, to put it simply, when you mix water and oil together and shake it as hard as you can, you get little droplets of oil and water together, but sooner or later, once the shaking stops, the water and oil will begin to separate again.

To get a better picture, think of it like this: An emulsifier is shaped something like a lollipop with a round head and a thin tail. The head is water-loving, and the tail is oil-loving. It gets between the oil and water (the head holding onto the water and the tail holding onto the oil), and helps stabilize the mixture, the little droplets remain suspended—you get an emulsion.

“When an emulsifier is added to the system, the droplets remain dispersed, and a stable emulsion is obtained” (Emulisifiers.org).

The emulsifier also has “the ability to interact with other food ingredients. In this way, various functionalities can be obtained, for example, interaction with proteins or carbohydrates. The emulsifier may be an aerating agent, starch complexing agent and/or crystallization inhibitor” (Emulsifiers.org).

According to Jeanne Turner of Baking-Management.com: “Dried whole eggs help emulsify and strengthen sweet dough properties, such as in a cinnamon roll. Other emulsifiers have anti-staling properties.” Emulsifiers have a very positive role in foods because they also improve texture and aeration (think: Three Musketeers candy bar) and can even extend shelf life.

Emulsifiers are everywhere, and not just in food products. You will also find emulsifiers in soaps and detergents: how else is Dawn going to pull grease away from your dirty dishes and Tide going to pull stains out of your laundry?

OK, so what kinds of things are emulsifiers? Common emulsifiers include such ingredients as egg yolks, and lecithin (which is a type of fat found in eggs, soy, and other food products) and mono- and diglycerides (Hozey, Rachel, Ehow.com). Other examples include honey, mustard in which the mucilage surrounding the seed hull acts as the emulsifier (Wikipedia), as well as the locust bean gum (from carob beans), and gelling agents and thickeners, such as pectin (Food.gov.uk).

Tragacanth is one of the oldest known natural emulsifiers. Many sources, such as CSPI (Center for Science in the Public Interest) believe this can cause severe allergic reactions (Wilson, Lester, csaceliacs.org). Hydroxypropyl methylcellulose is a gum from a modified plant fiber used as an emulsifier (gluten-free) for thickening.

And what do emulsifiers have to do with gluten? According to csaceliacs.org, “Emulsifiers alter the surface properties of other ingredients they contact… and may contain gluten from grain.”

Emulsifiers are everywhere: ice cream, breads and other foods made with grain, soft drinks, chewing gum, mayonnaise, and creamy dressings (Hozey). They can also be found in vegetables, whether fresh, frozen, dried or canned “unless they contain thickening agents to evaluate” (Wilson). Additionally, “canned products may contain emulsifiers, preservatives, stabilizers, and food starch not defined by source" (Wilson).

As well, popular drinks contain emulsifiers and include “coffee, tea, chocolate made from cocoa, fruit juices, carbonated drinks and some nut and rice drinks. Instant or processed drinks without malt, additives, stabilizers, or emulsifiers added that must be evaluated” (Wilson). Some root beers are gluten-free, and some are not, so be sure to check.

Be sure to also check any medication you take. If you have a prescription, ask the pharmacist to call the manufacturer to make sure it is gluten-free. I warn you, not all pharmacists are happy to do this, but it is necessary for your health. I have had some pharmacists say “That is your job, not mine!” Other times, they just give a heavy sigh, and sometimes roll their eyes and sometimes do all three. Just be sure you do it during the day time because at night, there is no one for them to call and you are stuck. “All medications have fillers or dispersing agents, some of which may include wheat starch” (dietsite.com).

GI Care.com states that any of the following on food labels "usually means that a grain containing gluten has been used:"

• stabilizer
• starch (some starch, such as from corn, is okay)
• flavoring
• emulsifier
• hydrolyzed
• plant protein

Bottom line-- Are emulsifiers safe, or not?  Unless you are absolutely sure of the exact source, you might consider staying away from emulsifiers because they can be made from grains which contain gluten.

When it Doubt, Do Without!!

Week 2: G-Free Recap

Getting through the holidays completely gluten-free while still trying to figure out how to live g-free has proven very difficult. Though I am eating g-free to the best of my abilities, somehow something is still creeping into my diet that is not allowing me to return to that wonderful feeling those first five days I went completely g-free. I seem to have a chronic stomach-ache, a general feeling of malaise, and extreme fatigue.

I am sure that my fatigue is due in part to the fact that I wake up every night for hours before finally falling asleep shortly before dawn, only to get up an hour or so later. Yet I remember when I first went g-free, I had an amazing energy level for which even a sleepless night seemed of little consequence-- I still felt energetic!

Over the New Year's Eve weekend, the only foods I ate that I did not know for certain contained gluten were Tostitos chips and Sour Cream & Onion chips-- but I did read the ingredients and couldn't find anything off-limits to a g-free diet. Additionally, I grabbed a few Hershey's Kisses from time to time (which are supposed to be g-free). Those are the only foods I've eaten differently than the first five days I went g-free and felt great.

So this third week I will eliminate chocolate, and of course have not eaten chips since New Year's and won't again without knowing for certain that they are g-free. On top of that, I hope to find some answers to a couple of blood draws: my cholesterol (which was done three weeks ago) and hopefully the results to the tTG test which would indicate the presence of celiac disease. If I don't receive any news by Wednesday I will go ahead and call the clinic.

In the meantime, I deal with what feels like chronic fatigue syndrome on a daily basis. I wonder if this is yet another aspect of CD? And why is it taking so long for me to recover from a gluten diet?

Figuring out Gluten

It is time to expand my repertoire of gluten-free recipes. If this is a life-long disease, then it is high time I learn how to make the best of it and work with it.

I was looking at a book by Carol Fenster, Ph.D. that I bought a couple years ago, called "1,000 Gluten-Free Recipes." Dr. Fenster is widely recognized as an expert on g-free cooking, and her recipes have appeared in numerous publications. She is also the founder and President of Savory Palate, Inc., a company that provides cooking information for anyone who wants to live g-free.

In the beginning of the book, Dr. Fenster discusses gluten in depth, as well as some obvious places where gluten can be found, and some not-so-obvious places. For example, the more obvious sources of gluten would include most baked goods such as bagels, breads, cakes and crackers, as well as cereals, pancakes, tortillas, pastas, and anything made with flour whether from wheat, barley, rye, spelt, or kamut.

Some not-so-obvious sources of gluten include:

• Bouillons
• Broths
• Deli meats
• Imitation seafoods
• Licorice candy
• Malt vinegar
• Salad dressings
• Seasonings
• Soup and soup mixes
• Tea

Dr. Fenster describes gluten as such:

"Gluten is that mysterious protein that food experts talk about in terms of baking. For example, gluten provides wonderful elasticity in bread dough, but it can toughen pie crusts and biscuits if you handle the dough too much.

"From a scientific standpoint, gluten is actually a storage protein of wheat. For people with celiac disease it is the gliadin fraction of gluten in particular that is problematic. For those who are sensitive to wheat but don't have celiac disease, there may be other proteins in gluten that affect us but we don't know which proteins are actually the culprits."

In all the research I have done, the key to staying g-free lies in reading the labels on everything you buy, whether it be edible, or cosmetic. Though there seems to be some confliction in the medical community as to whether gluten can be absorbed through the skin or not, if you are extremely sensitive to gluten, it is always better safe, than sorry.

According to Dr. Fenster:

"Gluten is in many products, but it doesn't always appear as 'gluten'. It is often listed as all-purpoase flour, unbleached flour, bread flour, cake flour, whole-wheat flour, graham flour, farina, semolina, bulgur, or durum-- all of which indicate the presence of wheat and, therefore, gluten. The Food Allergen Labeling and Consumer Protection Act (FALCPA) requires that wheat-containing foods must list the word 'wheat' on the ingredient label."

Of course, there is also the issue of cross-contamination within factories as well. You will most likely need to ask questions about your favorite products that don't actually contain gluten-- in other words-- how is it processed? Is there any possibility that contamination may occur in the equipment? Some product labels will list whether it is processed with gluten-containing foods, so always check. If you are not sure, ask. Also, not all products that are actually gluten-free make that declaration on the label.

I still have a lot to learn about gluten and its hidden sources. For instance, I have learned that there is something in the Christmas chocolates I have been eating that is making me sick-- though I don't see any obvious offending ingredients listed (I suspect it is the mini peppermint patties that are causing me distress, I still have my homework cut out for me in finding the culprit. I gave in to temptation, and now I get to deal with the pain).

My next step in enlarging my recipe collection includes learning what flours or mixtures of flours to use in place of traditional all-purpose flour in our favorite family recipes. I will post the recipes and their modifications here as I work through them. Chances are, if my finicky family members will eat them, so will yours. :)