Rheumatoid Arthritis: It's the food!

I had an email query about Rheumatoid Arthritis, so off to PubMed I went.

From http://www.webmd.com/rheumatoid-arthritis/ss/slideshow-ra-overview

I found Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis.

"Fasting is an effective treatment for rheumatoid arthritis, but most patients relapse on reintroduction of food."
This suggests that rheumatoid arthritis (RA) is an ongoing process, triggered by something that's consumed.

"After an initial 7-10 day subtotal fast, they were put on an individually adjusted gluten-free vegan diet for 3.5 months. The food was then gradually changed to a lactovegetarian diet for the remainder of the study."
Are you thinking what I'm thinking? I'm thinking Gliadorphin-7, as per Wheat, Constipation, Ischaemic Heart Disease, Type 1 Diabetes, Schizophrenia and Autism.

This suggests that RA is caused by peptide chains passing through loose "tight junctions" in the gut, triggering an (inappropriate) autoimmune response. For ways to improve gut integrity, see Cow's milk, Schizophrenia and Autism.

BCM-7 can be avoided by drinking A2 milk. Most cheeses are made from A1 milk, so should be avoided. Swiss cheeses like Gruyère and Emmental are probably made from A2 milk, so suck 'em and see.

To reduce inflammation in joints, consuming oily fish may help, as an adjunct to prescribed anti-inflammatory medications.

Continued on Fibromyalgia: It's the food, again! (probably).

Things that make you go "Struth!"

I was wading through my Facebook News Feed when I spotted THIS. That article led me to New approach to coeliac testing identifies more Australians at risk, which in turn led me to A novel serogenetic approach determines the community prevalence of celiac disease and informs improved diagnostic pathways (provisional pdf), where I saw: "HLA-DQ2.5, DQ8, or DQ2.2 was present in 56% of all women and men in the community cohorts."
HLA-DQ2.5, DQ8 & DQ2.2 are the alleles for Coeliac/Celiac Disease (CD).

Image from http://www.clker.com/clipart-tango-face-surprise.html

"Transglutaminase (TG)-2 IgA and composite TG2/deamidated gliadin peptide (DGP) IgA/IgG were abnormal in 4.6% and 5.6%, respectively, of the community women and 6.9% and 6.9%, respectively, of the community men, but in the screen-positive group, only 71% and 75%, respectively, of women and 65% and 63%, respectively, of men possessed HLADQ2.5, DQ8, or DQ2.2."
There were abnormalities in ~5% of Australian women & ~7% of Australian men, even in those who didn't carry CD alleles.

"...but based on relative risk for HLA-DQ2.5, DQ8, or DQ2.2 in all TG2 IgA or TG2/DGP IgA/IgG screen-positive subjects, CD affected 1.3% or 1.9%, respectively, of females and 1.3% or 1.2%, respectively, of men."
~1.6% of Australian women & ~1.3% of Australian men have CD.

From the discussion: "The concept of a ‘celiac iceberg’ has been important in drawing attention to a large, unrecognized group of patients with CD who do report symptoms considered ‘typical’ of CD [29]. Investigators have proposed expansion of the ‘iceberg’ to encompass patients who are genetically susceptible to CD, but show only raised IEL counts or an isolated abnormal CDspecific serology and normal intestinal histology [30-32]. Consequently, there is considerable uncertainty regarding the true extent of gluten-mediated disease in the community.

Random thoughts: About 1 in 20 Australian women & about 1 in 15 Australian men have some kind of a gut problem (IBS?) due to gliadin, even in those who don't carry CD alleles. The following made me smile.
"Making a diagnosis based on a blood test alone or commencing a gluten-free diet without a confirmatory bowel biopsy is inappropriate and can impose an unnecessary and lifelong treatment."
'Cos life without wheat, rye, barley & oats is such an imposition (undue burden) and everyone just loves to be given a bowel biopsy. <- sarcasm alert.

From Ancestry of Australian population: "More than 92 percent of all Australians descend from Europeans. Anglo-Celtic Australians (English, Scottish, Welsh, Cornish or Irish ancestral origin) make up 74 percent of the Australian population."
Most Australians have genes that originate from Britain & Europe. Uh-oh!

Why do only a small percentage of people carrying the CD allele go on to develop CD? I believe that it's down to luck. During digestion, gliadins are snipped into fragments & amino acids by the peptidase enzymes pepsin, trypsin & chymotrypsin. Gliadin fragments that contain the wrong triplet of amino acids and that manage to slip through excessively-loose tight junctions may trigger CD. Once the "damage is done", it only takes a tiny amount of gliadin to provoke an immune response.

False dichotomies: moderation.

Feel like you're walking a tightrope? I sang this at Open Mic night on Wednesday, including the orchestration!


There's another internet "punch-up" over moderation in what people eat. Apparently, there are only two options:-

Everything in moderation,

Image from http://www.deltadentalarblog.com/2013/07/ditch-the-junk-help-your-kids-eat-better/

or Nothing in moderation.

As always, it's a case of "It all depends". If, when you're at home, you keep raiding the chocolates from the box or sweets/candies from the tin and you don't want to, don't have them in the house. However, if when you're not at home, someone offers you a chocolate or a small sweet/candy, unless you're so desperate that you'll steal some more or go to a shop and buy some more, eat the chocolate or small sweet/candy. Five grams of sugar won't harm you, even if you're diabetic.

If you have Coeliac Disease and mustn't eat any significant gluten, moderation isn't an option. Ditto, if you have impaired gut integrity and you feel better avoiding gluten. If consuming stuff doesn't cause you medical problems or make you desperate to consume even more, moderation is fine.

EDIT: Sometimes, I ramble in a way that makes it hard for people to understand what I'm talking about. I've emphasised the word "Apparently", as this post is about a perceived false dichotomy (perceived by the "Nothing in moderation" group).

Diet, Nutrition & Fitness: Whatever the question, the right answer is "It all depends".

The carbohydrate pendulum keeps on swinging! Bloggers keep on fighting!

Carbohydrates are good. No, they're bad. Wait, they're good again. Nope, bad again. Good again. Aargh!

See also http://wholehealthsource.blogspot.co.uk/2012/09/more-thoughts-on-macronutrient-trends.html
 
So, are carbohydrates good or bad? See the title. Gluten? See the title.

As Everyone is Different, whether "X" is good, bad or indifferent all depends on genes (including gender), the expression of those genes, environment (i.e. birth weight, exposure to pollutants in the womb & after birth), general diet (i.e. nutrients, anutrients & anti-nutrients), lifestyle (i.e. sunlight exposure, stress, sleep etc) and type, level & volume of activity.

The proteins are the problem: Safe proteins for people with compromised gut integrity.

First, Matt Lalonde Ph.D's video "The Science Behind the Paleolithic Diet."

The title of this post comes from Matt Lalonde. As mentioned in Keep 'em tight., about 10% of healthy blood donors have antibodies in their blood to something that shouldn't be in their blood - gliadin. How do gliadin fragments get into the blood? Compromised gut integrity (a.k.a. Leaky gut).

It's possible to repair compromised gut integrity, as mentioned in the above post. In the meantime, it's advisable to avoid "problem proteins" and eat only "safe proteins". Which proteins are the problem?

1) Prolamines: Prolamines are a group of plant storage proteins having a high proline content and found in the seeds of cereal grains: wheat (gliadin), barley (hordein), rye (secalin), corn (zein), sorghum (kafirin) and as a minor protein, avenin in oats.

2) Casein: Of the six major protein types in cow's milk, four are casein proteins and the other two are whey proteins. The caseins usually make up about 80% of the protein in cow's milk. Cheese is ~100% caseins. As Matt said, caseins are also high in proline. Whey is rapidly digested (which is why it's used by bodybuilders post-workout) so it's pretty safe.

3) Anything that makes you feel ill: As everyone is different, this could be anything (peanuts, eggs, shellfish, tomatoes etc). If "X" makes you feel ill, stop eating "X" until your gut is working 100% correctly. There's a possibility that your gut will never work 100% correctly. Which proteins are safe?

Rice, quinoa & amaranth contain generally safe proteins. Properly-cooked legumes (peas, beans & lentils) contain generally safe proteins. Seeds contain generally safe proteins, but most types are very high in omega-6 fats (except for chia & linseeds). Tubers, root veggies & buckwheat contain pretty safe proteins. Meats & fish contain pretty safe proteins.

Pigging-out on safe proteins, (resulting in significant amounts of incompletely-digested proteins reaching the lower intestine) is asking for trouble. Ditto for eating excessive amounts of fruit with or shortly after eating safe proteins, as this increases the speed of peristalsis, which increases the amount of incompletely-digested proteins reaching the lower intestine.

That's all for now. If anything else comes to mind (or if you come up with a bright idea), I'll add it.

Wheat? Oh, dear!

Someone on the BBC Healthy eating food board recently asked about gut problems brought on by eating wheat so I decided to have a rummage through some of the blogs that I read, searching for "wheat". This is what I found. Updating this post may be a never-ending task!

The Heart Scan Blog:
Are you a skinny fat person? , Blood pressure with exercise , Low-fat diets raise triglycerides , American Heart Association stamp of approval , The wheat-free life , Wheat belly , Oat vs. wheat , Sugar for breakfast , Niacin and blood sugar , When niacin doesn't work , Wacky statin effects , Success--Slow but sure , Wheat-free and weight loss , The small LDL epidemic , Wheat and the hunger factor , Niacin vs. low-carb weight loss , Appetite stimulants , The many faces of LDL , Triglyceride traps , No-flush niacin kills , Low-carb eating for diabetes , Wheat-free is not gluten-free , "I gained 30 lbs from one cracker" , Wheat addiction: 140 lbs lost , Wheat withdrawal , "I lost 30 lbs and my triglycerides went . . . up?" , Vitamin D and HDL , Triglycerides divided by five , What's worse than sugar? , Are you wheat-free? , Wheat withdrawal: How common? , Quieting the insulin storm , Nutritional approaches: Large vs. small LDL , Can CRP be reduced? , The Wheat Deficiency Syndrome , Flush-free niacin kills , Flat tummy . . . or, Why your dietitian is fat , Thiazide diuretics: Treatment of choice for high blood pressure? , How to Give Yourself Hashimoto's Thyroiditis: 101 , CIS: Carbohydrate intolerance syndrome , Dr. Michael Eades on the Paleolithic diet , Wheat hell , Can millet make you diabetic? , Wheat Belly Revisited , Cholesterol effects of carbohydrates , Blast small LDL to oblivion , "Hey buddy, wanna buy some exorphins?" , Triglyceride Buster-Update , The statin-free life , Goodbye, fructose , Who lost weight? , Weight loss and vitamin D , Why obese people can't fast , Unexpected effects of a wheat-free diet , Name that food , Why does fish oil reduce triglycerides? , The disastrous results of a low-fat diet , The Paleo approach to meal frequency , Track Your Plaque challenges , Small LDL: Perfect index of carbohydrate intake , This is your brain on wheat , To track small LDL, track blood sugar , If you take niacin, you must exercise , A wheat-free 2010 , De Novo Lipo-what? , Look like Jimmy Stewart , To get low-carb right, you need to check blood sugars , More on blood sugar , Diabetes from fruit , Blood sugar: Fasting vs. postprandial , Is glycemic index irrelevant? , Saturated fat and large LDL , Genetic vs. lifestyle small LDL , "I dream about bread" , Psssst . . . There's sugar in there , Timing of blood sugars , Fat Head, Wheat belly, and the Adventures of Ancel Keys , Normal fasting glucose with high HbA1c , Slash carbs . . . What happens? , LDL glycation , Rerun: To let low-carb right, you must check POSTPRANDIAL blood sugars , What to Eat: The diet is defined by small LDL , Small LDL: Simple vs. complex carbohydrates , Man walks after removing wheat , Glycemic gobbledygook , Blame the gluten? , Emmer, einkorn, and agribusiness , Super-carbohydrate , In search of wheat , Low-carb gynecologist , Ezekiel said what? , In search of wheat: We bake einkorn bread , In search of wheat: Einkorn and blood sugar , Wheat aftermath , In search of wheat: Another einkorn experience , In search of wheat: Emmer , Life without Lipitor , How to have a heart attack in 10 easy steps , To lose weight, prick your finger , Carbohydrate-LDL double whammy , China fiction? , What increases blood sugar more than wheat? , LDL pattern B , This is your brain on wheat II , Men's lingerie is on the second floor , Wheat hip , What's for breakfast? , Extreme carbohydrate intolerance , Homegrown osteoporosis prevention and reversal , Can I stop my Coumadin? , Surviving a widow maker , Let go of my love handles , Human foie gras , Bosom buddies , Noodles without the headaches , Einkorn now in Whole Foods , The Anti-AGEing Diet , New Track Your Plaque record! , Dwarf mutant wheat , Can I see your linea alba? , Why do morphine-blocking drugs make you lose weight? , Why does wheat cause arthritis? , Statin buster? , Wheat one-liners , Put lipstick on a dwarf , Wheat-free pie crust , Do your part to save on healthcare costs , Wheat-free pumpkin bread , The two kinds of small LDL , I lost 37 lbs with a fingerstick , Genetic incompatibility , Is einkorn the answer? , A glycation rock and a hard place , No more cookies , High blood pressure vanquished , Thirteen catheterizations later , The five most powerful heart disease prevention strategies , Heroin, Oxycontin, and a whole wheat bagel , What do Salmonella, E coli, and bread have in common? , Diarrhea, asthma, arthritis--What is your wheat re-exposure syndrome? , The perfect Frankengrain , Diarrhea, runny noses, and rage: Poll results , Why is type 1 diabetes on the rise? , Construct your glucose curve , 90% small LDL: Good news, bad news , Be gluten-free without "gluten-free" , Wheat brain , Don’t wet yourself , Have some more , Bet you can’t fast , and so on...
Do you get the impression that Dr Davis really has it in for wheat?
EDIT: Now that Dr Davis has changed the site's url, most of the above links no longer take you to the right place. I'm not updating them!

Dr John Briffa's Blog:
Understanding Food Cravings , Dealing With Childhood Ear Infections , Does Fibre Protect Us From Colon Cancer? , Natural cures for migraine , Natural approaches to asthma , Natural approaches to eczema , Dietary approaches to autism , Why a lot of breakfast fodder are nothing but cereal killers , Why eating a grain-based diet will do nothing for your ‘vitality’ , Natural approaches to arthritis , Avoiding certain foods can really help the symptoms of irritable bowel syndrome (IBS) , Could vinegar actually reduce the tendency of certain foods to cause weight gain? , Practical advice for those wanting to construct healthy lunchboxes for their kids , Older dads at risk of fathering autistic children – and the diet that can help those affected by this condition , Jamie Oliver calls parents “tossers” for putting sh*t in their kids’ lunchboxes. Do healthy packed lunch options exist? , Are wholegrain breakfast cereals really good for the heart? , Men with migraine found to be at increased risk of heart attack , What really causes irritable bowel syndrome? , Health professionals ignore their patients at their, and their patients’, peril , Probiotics found to be helpful for sufferers of IBS , Peppermint oil comes out top in review of treatments for IBS , BMJ letter reminds doctors of limitations of science and the importance of clinical experience , Just because someone doesn’t have coeliac disease, doesn’t mean they don’t have a problem with gluten , Can wheat cause diabetes? , What is food combining good for? , Rye bread helps relieve constipation, and other tips for bowel regularity , Gluten and milk linked with constipation in kids , My advice for those looking to have an energised and productive afternoon , ‘Food for Thought’ – nutritional advice for those preparing for and taking exams , Why we can’t rely on epidemiological evidence , Think bran is good for the bowels? Think again , Antiobiotic found to relieve IBS, and what might work better , New study shows that it’s possible to react to gluten but not have coeliac disease
Ditto for Dr Briffa.

PāNu Weblog:
6s and 3s and the logic of grain avoidance , The Argument Against Cereal Grains , 1) Eliminate sugar and refined carbohydrates like white flour. , Where are all the healthy whole grains? , Avoid Poison or Neutralize It? , The argument against cereal grains II , 12 Steps update Mar 2010 , The China Study - Polish a turd and find a diamond? , Statins and the Cholesterol Hypothesis – Part I , N = 1? , More N = 1 , FODMAPs , No Such thing as a macronutrient part II - Carbohydrates (revised) , Thoughts on Ketosis - I , William Munny eats his vegetables , Polyphenol Hormesis follow-up ,
Ditto for Dr Harris.

Whole Health Source:
Ischemic Heart Attacks: Disease of Civilization , Paleolithic Diet Clinical Trials Part IV , Dr. Rosedale Replies , The Body Fat Setpoint, Part IV: Changing the Setpoint , Interesting Articles in the AJCN , Grains as Food: an Update , Traditional Preparation Methods Improve Grains' Nutritive Value , Fermented Grain Recipes from Around the World , China Study Problems of Interpretation , Real Food XI: Sourdough Buckwheat Crepes , Can a Statin Neutralize the Cardiovascular Risk of Unhealthy Dietary Choices? , Dr. Mellanby's Tooth Decay Reversal Diet , Paleolithic Diet Clinical Trials, Part V , Eating Wheat Gluten Causes Symptoms in Some People Who Don't Have Celiac Disease , Blinded Wheat Challenge , Assorted Thoughts About the 2010 Dietary Guidelines , My Gluten-Free January , Gluten-Free January Survey Data, Part II: Health Effects of a Gluten-Free Diet

Hyperlipid:
Food Pyramids, food and pyramids , Heroin and IBS , Niacin and adrenochrome , How toxic is wheat? , Gluten ataxia , Essential fatty acids are essential , Wheat and lactose , Casein vs gluten , Wheat and lactose and Cordain , Fiber, inulin and cancer , Gluten and rheumatoid arthritis , Weight loss; when it's hard , Casein, gluten and gastric pH , Gluten: Does coeliac disease require an infection? , Wheat Germ Agglutinin; how little is enough? , Wheat and lactase

Cooling Inflammation:
Cure Acne, Back Pain, Tendonitis, Depression , Anti-inflammatory, Gluten-Free Diet for Celiac , Arthritis, Autoimmunity and Arginine Deimidation

Raw Food SOS:
The China Study, Wheat, and Heart Disease; Oh My!

Perfect Health Diet:
Category Archives: Autoimmune

The above makes my criticisms of over-refined wheat products seem rather tame. See also The problem with "Whole Grain" cereals etc , I am NOT the anti-carb! and Anthony Colpo's The Whole Grain Scam.

From Ataxia, peripheral neuropathy, and anti-gliadin antibody. Guilt by association?

"However, anti-gliadin antibodies lack disease specificity being found in 10% of healthy blood donors."

10% of the population that are healthy enough to donate blood have gut walls permeable enough to let fragments of gliadin pass through. Hmmm. If fragments of gliadin can pass through, maybe fragments of other hard-to-digest proteins can, too (e.g. casein).

Gluten - more than just a pain in the guts?

Remember the advert "I'm feeling a bit bloated". "Here, have some Bifidus Digestivum!"? I wonder what percentage of the population suffers from bloating, gas pains, constipation, IBS or some degree of failure to absorb the nutrients from their food?

People with Coeliac Disease (CD) or Dermatitis Herpetiformis (DH) (intensely itchy spots on pressure points) have to avoid gluten as much as possible, as it produces an auto-immune response with antibodies that attack their own bodies. However, gluten is also implicated in other conditions due to molecular mimicry. Sjogren's syndrome (dry eyes & other bits) and cerebellar ataxia (brain damage) are mentioned in a huge article by Loren Cordain Cereal Grains: Humanity’s Double-Edged Sword.

This article suggests that there are conditions other than CD & DH which can be helped by switching from gluten-containing grains (wheat, rye, oats, barley & spelt) to non gluten-containing ones (rice, corn, quinoa, buckwheat, millet & amaranth). Luckily, supermarkets like Tesco, Waitrose and Sainsbury's now have a large "Free from" section, which makes finding gluten-free substitutes for breads, cakes, biscuits & breakfast cereals etc a lot easier.

EDIT: See also Keep 'em tight.