Eating Wheat Gluten Causes Symptoms in Some People Who Don't Have Celiac Disease

Irritable bowel syndrome (IBS) is a condition characterized by the frequent occurrence of abdominal pain, diarrhea, constipation, bloating and/or gas. If that sounds like an extremely broad description, that's because it is. The word "syndrome" is medicalese for "we don't know what causes it." IBS seems to be a catch-all for various persistent digestive problems that aren't defined as separate disorders, and it has a very high prevalence: as high as 14 percent of people in the US, although the estimates depend on what diagnostic criteria are used (1). It can be brought on or exacerbated by several different types of stressors, including emotional stress and infection.

Maelán Fontes Villalba at Lund University recently forwarded me an interesting new paper in the American Journal of Gastroenterology (2). Dr. Jessica R. Biesiekierski and colleagues recruited 34 IBS patients who did not have celiac disease, but who felt they had benefited from going gluten-free in their daily lives*. All patients continued on their pre-study gluten-free diet, however, all participants were provided with two slices of gluten-free bread and one gluten-free muffin per day. The investigators added isolated wheat gluten to the bread and muffins of half the study group.

During the six weeks of the intervention, patients receiving the gluten-free food fared considerably better on nearly every symptom of IBS measured. The most striking difference was in tiredness-- the gluten-free group was much less tired on average than the gluten group. Interestingly, they found that a negative reaction to gluten was not necessarily accompanied by the presence of anti-gluten antibodies in the blood, which is a test often used to diagnose gluten sensitivity.

Here's what I take away from this study:

1. Wheat gluten can cause symptoms in susceptible people who do not have celiac disease.
2. A lack of circulating antibodies against gluten does not necessarily indicate a lack of gluten sensitivity.
   
3. People with mysterious digestive problems may want to try avoiding gluten for a while to see if it improves their symptoms**.
4. People with mysterious fatigue may want to try avoiding gluten.
   

A previous study in 1981 showed that feeding volunteers a large dose of gluten every day for 6 weeks caused adverse gastrointestinal effects, including inflammatory changes, in relatives of people with celiac disease, who did not themselves have celiac (3). Together, these two studies are the most solid evidence that gluten can be damaging in people without celiac disease, a topic that has not received much interest in the biomedical research community.

I don't expect everyone to benefit from avoiding gluten. But for those who are really sensitive, it can make a huge difference. Digestive, autoimmune and neurological disorders associate most strongly with gluten sensitivity. Avoiding gluten can be a fruitful thing to try in cases of mysterious chronic illness. We're two-thirds of the way through Gluten-Free January. I've been fastidiously avoiding gluten, as annoying as it's been at times***. Has anyone noticed a change in their health?


* 56% of volunteers carried HLA-DQ2 or DQ8 alleles, which is slightly higher than the general population. Nearly all people with celiac disease carry one of these two alleles. 28% of volunteers were positive for anti-gliadin IgA, which is higher than the general population.

** Some people feel they are reacting to the fructans in wheat, rather than the gluten. If a modest amount of onion causes the same symptoms as eating wheat, then that may be true. If not, then it's probably the gluten.

*** I'm usually about 95% gluten-free anyway. But when I want a real beer, I want one brewed with barley. And when I want Thai food or sushi, I don't worry about a little bit of wheat in the soy sauce. If a friend makes me food with gluten in it, I'll eat it and enjoy it. This month I'm 100% gluten-free though, because I can't in good conscience encourage my blog readership to try it if I'm not doing it myself. At the end of the month, I'm going to do a blinded gluten challenge (with a gluten-free control challenge) to see once and for all if I react to it. Stay tuned for more on that.

20/365 - My FAVORITE Soup of the Day

A few weeks ago, I went to my go-to Betty Crocker Cookbook searching for a new soup to add to my winter arsenal.  This cookbook has always been my favorite--obvious because it's falling apart.  I probably should go on eBay and try to replace it, but then I would have to transfer all my notes. Not fun. So, I guess I will milk out as much life as I can from it.

The following recipe was first introduced to our family about a month ago and so far, we've made this soup three times.  I double the recipe so we have enough for left overs the next day because it's just as yummy reheated.

Best part of this soup is it's low in calories, inexpensive and makes a not-so-kid-friendly, powerhouse vegetable delicious.  My hubby and I aren't big fans of Brussels sprouts either, but we both agree they are fantastic here.  The key point to remember, DO NOT OVER COOK THEM.

Throw the sprouts in at the end, just before serving. Turn off the boil, toss them in, cover and let sit for about 5 minutes.  They should be bright green.  Who going to eat  dark, mushy, ugly and over done Brussels sprouts anyway?

STEAK SOUP WITH WINTER VEGETABLES

1 pound beef boneless sirloin steak, 1 in thick. (Stew meat works fine here)
2 cans (14 1/2 oz ea) beef broth
1/4 tea. pepper
1 cup Brussels sprouts, cut lengthwise in half
1 cup sliced shiitake or domestic mushrooms (Go with the shittake)
2 med carrots, cut into 1/2 in pieces
1 lg sweet potato, cubed (about 1 cup) (We've been substituting bottleneck squash)
1 clove garlic, finely chopped
1 tea chopped fresh or 1/2 tea dried marjoram leaves
1 tea chopped fresh or 1/2 tea dried thyme leaves

Trim excess fat from beef.  Cut steak into 1in pieces. (Unless you bought stew meat) Cook beef steak in 3 qt saucepan over medium-high heat about 10 minutes, stirring several times, until brown.  Add beef broth and pepper.  Reduce heat and simmer 20-30 minutes or until beef is tender.

Add remaining ingredients. (Remember what I said about the sprouts)  Heat to boiling; reduce heat.  Cover and simmer about 15 minutes or until vegetables are tender.

I'm so excited about....Hawaii!

I just got off the phone with my niece that lives in North Pole, Alaska (near Fairbanks, AK). It's currently -32 degrees (that's below zero). We're planning a girls' trip to Hawaii in March, my two nieces, my sister and myself. We kind of talked about it when I was there in December, but we decided to make it happen. It's going to be super fun.

The only trick is I have to be back by March 20 for the Big Climb, and we plan on leaving for Hawaii March 11.

I haven't gone on a "girls only" trip since college!

I skipped the gym this morning, on purpose. I've only had two days off in the last 16 days. I had a 7:30 a.m. breakfast date with my two best girlfriends at IHOP (ugh!). I had the Slim and Fit Mushroom and Tomato Omelet with fresh fruit for 5 Points (330 calories). It was actually pretty good, and I had them use egg substitute so maybe even a little less on the calories.

I love that they put the calories on the menus now. I think that's just about the coolest thing ever. Of course, it was only calories (and my girlfriends' breakfasts were 1,200 calories each!). I still had to go to the website to get all the nutritional info for the Points calculation. The calories alone really helped me make a good choice.

Even though no gym today, I managed to walked our 60 steps of stairs at work during lunch, twelve times, or 720 steps. Part of my training plan for the Big Climb is to do this twice a day (in addition to my gym workout). The Big Climb is 1,311 steps, with no stops. I'm a little worried about what I got myself into with this thing. I just hope I don't totally embarrass myself and need a medic to resuscitate me when I'm halfway to the top!

About Hawaii, I've been to the islands many times in my life, maybe eight or nine. I can't really remember for sure, but it's been a lot. Remember, I'm from Alaska and that's where people from Alaska go for a vacation. Also, I've worked for an airline for 27 years. I even went to college over there for a year. I totally and completely love Hawaii. And I love my sister and nieces so this trip is going to be a blast!

Now not only do I have to get in shape for the Big Climb, but also for the beach!

Coriander, Cumin and Caraway Crackers

(makes 35-40 crackers)

Ingredients:

• 1½ cups all-purpose flour
  
  


• ¼ tsp ground coriander
  
  


• ½ tsp ground cumin
  
  


• 1 tbsp caraway seeds
  
  


• ½ tsp baking powder
  
  


• ½ tsp salt
  
  


• ¼ cup butter, cut into small pieces
  
  


• ⅓ cup non-fat milk
  
  


• 1 egg white, slightly beaten
  
  

Preparation:

• Preheat oven to 350 degrees F.
  
  


• In a large bowl, combine all-purpose flour, coriander, cumin, caraway seeds, baking powder and salt. Add butter pieces a little bit at a time until incorporated.
  
  


• Add non-fat milk and continue mixing until it forms a doughy consistency. If mixture is too dry, add a tbsp or more of non-fat milk.
  
  


• Transfer dough to a floured surface and flatten slightly with the palm of your hand. Let sit for about 10 minutes to rise then using a floured rolling pin, flatten dough to about ⅛” thick.
  
  


• Use a 2” diameter rounded to cut out shapes. Place cut-out crackers onto an ungreased cookie sheet. Using a pastry brush, brush the surface of each cracker with egg white, then prick the surface with a fork and bake for 15-20 minutes or until golden brown.
  
  


• Use a spatula to remove crackers and cool completely on a rack.
  
  


• Keep crackers in an airtight container.
  
  


• Tip: Serve crackers with your favorite low-fat dip, with smoked salmon, or break them into smaller pieces, sprinkled over salad.
  
  

Make 40 Servings:

Weight loss recipes Amount Per Serving (1 cracker (9 g)): 29 Calories, 1 g Protein, 4 g carbohydrates, 0 g Dietary Fiber, 1 g fat, 1 g saturated fat, 3 mg cholesterol, 55 mg sodium

Internetless tonight

I've been without internet connection for the past five hours (except my phone, but that doesn't really count). It was almost as bad as when the electricity goes out.

I even tried to watch a Netflix movie through the box thing we have when it displayed "your internet isn't connected" message. Oh yeah, no internet, I forgot. So no Netflix. It makes me wonder how I ever lived without the internet.

My husband finally fixed it about 20 minutes ago, but it's 10:30p .m. It's past time my bedtime so I'm not writing much. I've been working on a post of why I gained 100 pounds. I'm too tired now to proof it before I post it. Tomorrow.

Caramelized Onion and Green Olive Tapenade

(makes 3 cups)

Ingredients:

• 1 tbsp olive oil
  
  


• 1 small onion, chopped
  
  


• ½ tsp dried basil
  
  


• 2 cups pitted green olives
  
  


• 2 tbsp white wine vinegar
  
  


• 4 garlic cloves, minced
  
  


• ¼ cup dry white wine
  
  


• ¼ tsp freshly ground black pepper
  
  

Preparation:

• Heat olive oil in a small saucepan with medium heat.


• Add onion and cook for 7-8 minutes until softened, stirring occasionally.
  
  


• Stir in basil and garlic and cook for 2 minutes.
  
  


• Add vinegar and white wine, bring to a boil then reduce heat and cook for an additional 7 minutes or until most of the liquid volatile, stirring occasionally.
  
  


• Place onion mixture in a food processor, then add the green olives and black pepper. Process until smooth.
  
  

Make 28 Servings:

Weight loss recipes Amount Per Serving (1 tablespoon (14 g)): 18 Calories, 0 g Protein, 0 g carbohydrates, 0 g Dietary Fiber, 2 g fat, 0 g saturated fat, 0 mg cholesterol, 228 mg sodium

My story and my trigger

I read a really great post this morning written by Lynn at Lynn's Weigh (love her, she's another one of my heroes). She tells the story about the one thing that triggered her start towards being a weight loss success story. She realized she was worthy of good health.

Even though I'm not yet a weight loss success story, I will be one day. Here's the story of my one thing...

Flash to February 2006
After years of crash diets, Jenny Craig, NutriSystem, South Beach (the list goes on and on) I weighed 240 pounds. This was the heaviest I had ever weighed. In college I got up to 145 pounds and I remember how I thought I was such a fat pig. When I met my husband 25 years ago I was 132 (I'm 5' 6"). I was trying to starve myself to what I thought was my ideal weight of 125.

How did I get to 240 pounds at the age of 51? More importantly, why? I had difficulty walking. I wouldn't even attempt to climb the two flights of stairs to my office, I'd take the elevator. I was uncomfortable and miserable. The clothes that did fit looked terrible on me. My self-loathing was at an all-time high.

I remember when I ripped the seat out of two pairs of size 18 jeans trying to squeeze my very ample behind into too small clothing. Both times the ripped jeans incident happened while I was at work. Those were two of the most embarrassing moments of my life. The fabric simply couldn't stretch to fit my size 20 (probably more like size 22) bottom. I bought my first pair of size 20 slacks, and I was horrified. I was more depressed than at any other point in my life. Yet I still wouldn't or couldn't get motivated to do anything about my weight. It was like I was frozen in some sort of self-made hell.

Then I starting having strange pains in my joints. They came on suddenly one night as I was sitting in my recliner watching TV (we no longer own recliners). The agony started as shooting, knife cutting pains in my left knee. It was excruciating. I could barely stand up. I had no idea what was wrong. The pains lasted for a few hours and then went away. It happened again the next night and the next. Then the pain just disappeared.

A few days later the same type of pain started in my left elbow, again, at night while sitting in my recliner. It scared me. I thought I must have some horrible, life-threatening disease. The pain would move around to different joints every few days. Left knee, right knee, shoulders, elbows. Yet I refused to go to the doctor, because, well, you probably guessed, I was embarrassed about my weight gain of 60 pounds since the previous year. I know that sounds crazy, but it's the truth.

One day around this time of the strange pains I was walking by the pharmacy in a drugstore. I stopped to take my blood pressure at one of those free machines. I'd always prided myself on my great blood pressure and low cholesterol levels, even during my fat phases in my life my blood pressure was always around 120/60. The reading on the machine:  180/110. Seriously? Could that even be possible and still stand upright? I thought the machine must be broken. I went to two different drugstores and used their blood pressure machines, all the readings were very close to 180/110.

I was scared to death. This time I knew I really could die. I was 51. I called my doctor and she told me to get a free BP check at the fire station where they would use a regular blood pressure cuff (I never knew why she did this, I have medical insurance). She said maybe the machines were inaccurate. That was another really embarrassing moment when me, the fat, middle-aged woman asked the gorgeous, hunky firefighter to take my blood pressure. When he had to get the extra large sized cuff because of my fat upper arm, I wanted to die. The results were once again 180/110. He looked at the number and told me I needed to see my doctor immediately.

This time I knew my life was in danger, and I saw my doctor. She immediately put me on blood pressure medicine. I'm off of the medication now, and I check on my own blood pressure all the time at home. Lately it's been a little on the high side, 128/73. I know it's the last 25 pounds I gained back.

My doctor also talked to me about my weight. She held one of my hands in her hands, she looked me in the eye and said "Diana, you're a beautiful woman. Why are you doing this to yourself? You have to lose the weight or you are going to die." The "you are going to die" part really shook me up. I could see her concern, and knew she was saying this to help me. I knew I had to do something about my weight.

I immediately started a diet. South Beach, a diet I'd done the year before and lost 40 pounds before giving up and gaining it all back, plus some. It was the first "diet" that I actually felt like I could probably live with the rest of my life.  However, after several months of South Beach, but still counting calories, I had only lost 20 pounds. I was stuck and finding myself slipping back to old habits.

That's when a friend at work asked me to join the Weight Watcher "at work program". Reluctantly I joined with her since I was stalled on my own, but I secretly knew it wouldn't work for me. The first week I did everything perfectly, eating all my Points, my activity Points and my Weekly Points. I was sure this was too much food, and I'd gain even more weight. I lost seven pounds the first week following the plan exactly. I proceeded to lose a total of 60 pounds in seven months and then, I'm not sure why, I just quit. I gained it all back very quickly.
February 2008, this time it is for real
There I was again, February of 2008, sitting at 240 pounds. I needed to lose 100 pounds. Why did I do this to myself over and over? I never once tried to answer this question and really thought I just didn't have any willpower. When in reality, I have willpower of steel.

Once again I joined Weight Watchers because it felt like the right thing to do. I knew it worked. This time I did something different, I started using my gym membership, going almost every day. I'd had that membership since 1996 but had probably only been to the gym ten times in 12 years. Now I go almost every day for an hour or more, I really believe the exercise and Weight Watchers is what has changed my life.

You're probably thinking, but Diana, it's been almost three years and you're still not at goal. You are correct. I've been struggling for months, in fact, pretty much for all of 2010. I'll call that my lost year. I started the year at 180 pounds and ended it at 180 pounds. I dropped down during the year to 162 but never got back to my 2009 low of 152. True, 2010 wasn't my greatest year, yet I take great pride in the little fact that I didn't go back up to 240 pounds. My goal was and still is 135 pounds.

I still believe Weigh Watchers is the best plan for me. I know it doesn't work for everyone, and we each have to find the thing that works for us. Whether it's counting calories or even a surgical procedure, there's something out there that will work. In truth, they all work.

What I'm finding out is that the real work is looking inside of ourselves and really finding out the "why" of our overeating. Why did we get overweight in the first place? That's the real question.

To say "well, I just love food and I can't help it" is not the answer. I said that same thing for years. Nothing wrong with me, I just lov efood. The truth, most people love food yet they don't have the issues of overeating like the morbidly obese. Without self-examination we can still lose weight, but it's very questionable whether we can keep it off forever. You know how I know? Because I've been there, done that....more times than I can count. Now I'm working from the inside out, versus just focusing on the outside.

Like Lynn asked, what was your one thing that triggered you into starting a weigh loss plan, and this time you know it's for good? Have you figured out what caused you to become overweight in the first place? I'll share with you in a later post what I think caused me to gain 100 pounds, lose it several times, and never keep it off in the past.

Pictures
A before picture, 240 pounds. This was right before the stange pains started. I didn't think I was a person worthy of good health. I just thought I was fat, ugly and stupid (I had just started a new job). When I saw this picture I was horrified but it still didn't make me try to lose weight. It took a death threat to make me take action.

Now I'm working on learning to like myself, and acknowledging that I am worthy of being healthy.  It's not just about gaining the weight, it's about so much more.

240, from the backside:

I don't have an after picture because I'm not at goal. Today I weigh 179, so I found this picture where I weighed 175 from 2008. My hair is different now, a little shorter, but I'm too lazy to put on makeup and take a picture today. I still have a lot of work to do on myself, inside and out, but I'm working on it. It's a multi-faceted project. :)

2011 is going to be my year!