“Hi Julianne, I love your site, eating this way has absolutely changed my life.

I was very very unwell and hospitalised so many times and took the advice of Doctors and politically correct nutritionists before I decided to take things into my own hands and sort out my health. I have recently started a petition to stop the Heart Foundation promoting margarine and processed foods and get saturated fats back into our diet. I know this is something you are passionate about and I want to ask for your help in getting the message out, maybe you could write a blog, share with your followers. Let’s do whatever it takes to stop the lies and the money-making bullshit. Enough is enough, they have gotten away with poisoning people far too long! Hope you can help. Here is the link http://www.change.org/en-AU/petitions/the-heart-foundation-stop-promoting-margarine-and-processed-food”

Intrigued – I asked Jessie to elaborate as I wanted to share her story with a wider audience. She wrote back with the following. What astounded me was that not one medical Doctor or specialist stopped to look at her diet or test her for deficiencies. This to me is a huge indictment on the state of our training for medical doctors, and frankly I’m appalled. I know Jessie’s story is not unique, I hope in future we will have doctors that look at the food that makes the person first.
“I used to eat loads of junk food, I was seriously addicted to sugar and at school they served basically processed food (sausage rolls, lasagna, hot chips etc) bags of chips, lollies and soft drink. I would have weet bix for breakfast, eat all that crap during the day, go to the 7 eleven after school for more coke/chocolate/chips and eat McDonalds a few times a week as well. I thought because I was skinny and a dancer I could eat whatever I wanted and get away with it, I thought after all if food could harm us they wouldn’t serve it in the school and the government would control what was ok! Haha – naive as anything.

In school we were taught the food pyramid (proudly sponsored by Kellogg’s and the meat and dairy industry) I thought that I was relatively healthy because I ate plenty of bread, pasta and cereal, drank loads of milk and loved my cheese, had some meat in my Bolognese and burgers and had some mashed vegetables now and then with my sausages. I drank loads of apple juice and had mango weis bars by the truckload for my fruit intake haha.. my sugar addiction was out of control. I did however thankfully still consume butter, however it was butter soft (butter mixed with canola oil and less fat)

All around me everyone was obsessed with fat, they refused to have anything with fat in it but consumed all the sugar in the world! Crazy stuff. I began to develop skin problems and intestinal problems, I also had high levels of anxiety, felt very low and would often have panic attacks. I was diagnosed years later with leaky gut- this means that the lining of the digestive system becomes more permeable then it should be, like tiny holes, allowing particles of food and other toxins to enter the blood stream and wreak havoc all through the body.

Jessie at a low point at 38kg

In the mean time I became more and more unwell, my immune system was not functioning correctly.  Once I turned 18 I was going out drinking vodka double blacks on the weekends (loaded with sugar) and eating McDonald’s, triple choc muffins, hot chocolates and all the sugar I could get my hands on. I had a very severe case of tonsilitis which took three rounds of antibiotics to fix (further adding to the leaky gut), I became thinner and thinner and felt exhausted constantly.

In 2011 I was hospitalised again and again, I kept getting vomiting bugs and I got adeno virus (the killer cold) and Epstein barr virus. At my lowest weight I was 38kg, I couldn’t get out of bed and I felt like I was dying.  I had migraines and started having severe reactions to food, at one stage I could only eat about 10 things, literally. Every Dr I went to told me I was depressed and prescribed Zoloft, I was also taking sleeping pills for some time. The hospital didn’t say anything about food and the Drs said the food I ate had nothing to do with it. Even specialists couldn’t help me.

Finally I saw a Naturopath who did a full blood analysis. I was EXTREMELY zinc deficient, manganese and potassium deficient, had several viruses and the beginnings of an autoimmune disorder, leaky gut, malabsorption issues and a whole host of other abnormalities.

I was told to completely cut sugar from my diet which I found extremely difficult, as well as bread, pasta and cereal, I was to have a wholesome diet consisting of real food, vegetables, small amounts of fruit, some soaked seeds and nuts, organic grass fed meat and REAL healthy fats, mostly coconut oil for it’s immune boosting function and it’s antiviral and antimicrobial properties. It has taken a long time to heal as I have done years of damage but each day I get better, I only drink pure filtered water and no longer have any processed food in my diet. I cook with healthy saturated fats as well as some organic, virgin cold pressed olive oil, coconut oil and eat good quality meat and chicken.

This is a photo of me in 2011 at 38kgs, scary shit huh? This is why I want to help everyone understand the importance of real food, not having loads of processed crap filled with sugar and including real, healthy, natural fats.

So please – get online and support this petition! Heart Foundation: Stop endorsing margarine and review the ‘tick of approval’ program

Please share, facebook and tweet to get this message out there Thanks!

Jessie kindly supplied a recent picture, she is back up to 44 kg and working on gaining more weight:

 You can learn more about Jessie from her blog www.thehealthyjessie.wordpress.com and my page is www.facebook.com/getafreshstart

In this post I will look at studies that show gluten grains are not the only food to cause problems for those with celiac:

• Casein and dairy products can inflame the gut
• Non gluten grains and pseudo-grains have been confirmed to trigger the same anti-bodies as gluten grains
• Refractory Celiac disease type 1 (Severe celiac disease, that does not resolve with a gluten free diet) goes into remission with a paleo type diet.

Up to 30% of people with celiac disease do not go into remission on a gluten free diet, that is they continue to show anti bodies to gliadin and transglutaminase, and / or have on-going gut inflammation.

One study showed after a gluten free diet for 6 months only 8% of individuals showed complete normalisation of villous architecture (the gut cells, and all the folds).

A subset of those with celiac disease continues to suffer severe gut inflammation and on-going deterioration of the villous architecture. This is called refractory celiac disease, type 1 (mild), and type 2 (severe)

There are two theories as to why a standard gluten free diet does not stop all celiac disease:

1. Many foods, particularly processed food and other grains may be contaminated with tiny amounts of gluten and the gut is continually reacting to this
2. Some foods cause a similar anti-body triggering response to gluten, or inflame the gut cells, and increase gut permeability (leaky gut)

It appears both of these happen.

Contamination of ‘gluten free’ foods by gluten

A study that measured contamination by gluten tested 22 single-ingredient inherently gluten-free grains, seeds and flours, and found 32% of these products contained >20 ppm gluten and one product contained 2,925 ppm of gluten. The products tested that were positive for gluten included soy, millet, buckwheat, rice and sorghum flour. This is sufficient gluten to cause on-going symptoms in many celiac disease individuals.[1]

Other foods cause an immune or inflammatory reaction just like gluten

A number of studies have shown that those with celiac cross-react to other grains (i.e. react to other foods in the same way as gluten)

As well other foods besides gluten grains inflame the gut cells of those with gluten intolerance

Casein – inflames the gut just like gluten

In this study 20 people with CD who had been on a gluten free diet for more than 2 years were tested to see if they reacted to cow’s milk.  Half of these were only in partial remission and still showed abnormal bowel biopsies, but negative gliadin and TG antibodies. Fifteen controls (15 people without CD) were also tested. A rectal (i.e. up the back passage) tube was inserted with a balloon and patches of cow’s milk and casein which touched the mucosal wall. They were left for an hour. Fifteen hours later inflammatory responses were tested for.  In 10 of the 20 CD patients the inflammatory response to casein or milk was similar to their reaction to a gluten rectal challenge. There was no or slight reaction in the controls. Casein has similarities to gliadin, high in proline and resistant to digestion, and has some similar amino acid sequences .[2]

Maize and some types of Quinoa and Oats have proteins similar to gliadin and cause an auto-immune reaction

Maize has similar proteins to gluten and has been shown to act just like gliadin peptides in some people with CD. Maize prolamins (zeins) also contain proline rich amino acid sequences similar to immunodominant gluten peptides that like gluten are not able to be broken down by human digestive enzymes. When tested, IgA from some celiac patients with HLA-DQ2 or 8 recognised two alpha-zeins peptides after they had been digested by gut enzymes.  Several zein peptides have been isolated that can be bound to HLA molecules involved in CD pathogenesis. This means that these peptides can be picked up and presented as foreign proteins in a similar way that gliadin is in those with CD. [3]

Quinoa

Most would think of quinoa as being a safe grain to eat in place of wheat. However some cultivars have peptides which elicit a reaction similar to gluten in cell tests.[4]

Oats

Some cultivars of oats also have specific peptides from their prolamine avenin that are immunotoxic for those with CD. [5]

Alpha gliadin antibodies (celiac disease antibodies) react to a number of non-gluten foods

One of the tests for celiac disease is a blood test to check the levels of a-gliadin antibodies. This is the antibodies that your body makes in reaction to gliadin, in effect treating it as a pathogen or dangerous invader that it has to kill.

In this study the immune reactivity of these antibodies was tested against a range of different food proteins and antigens and the response was measured. Here is a chart of those reactions. You can see the control protein has virtually no reaction and a-gliadin (the protein from gluten) as expected the largest reaction. You will also note the two different oat cultivars were tested ; one reacted and one didn’t.  Milk, casein and whey proteins all reacted (although whey was far less).

Instant coffee caused a reaction, but notably for those who love their espresso, several types showed no reaction (yay!), and neither did cocoa or dark chocolate. [6]

c

A paleo type diet puts people with unresponsive celiac disease into remission

In this study patients were chosen who had persistent villous atrophy despite following a strict gluten free diet. (Dietician checked) Of these, 5 patients had refractor celiac disease (RCD) This is a severe inflammatory form of celiac, which is particularly non responsive to a gluten free diet and can lead to cancer and early death.

Seventeen patients participated, eating a strict Gluten Contamination Elimination Diet (GCED) for 3 – 6 months.

Here is the diet:

As you see both brown and white rice were allowed as were dried beans and dairy. The diet contained whole unprocessed food, so that there was no chance of cross-contamination.

What were the results of eating a paleo type diet for those with hard to treat celiac?

Of the 17 patients who adhered to this diet, 14 responded to the diet, and 4 of 5 of those diagnosed with RCD. That is they stopped having clinical symptoms of celiac disease.

Interestingly of these 14, 11 were able to revert to a standard gluten free diet without recurrence of celiac symptoms. (They were followed for 20 months after the GCED trial). The other 3 needed to stay on the GCED diet to stop symptoms returning. [7]

All these studies bring up some interesting points and room for further research:

Given the cross-reactivity tests – should a diet free of all dairy and all grains including rice, be trialled for those with RCD? I think so.

Did this diet fail a small number of people because it contained rice (which has been shown to be contaminated with gluten), and dairy which is inflammatory of 50% of those with CD?

Does a paleo diet heal the gut enough for some people to resume eating foods they previously reacted to? It appears so.

Do you have celiac disease that is unresponsive to a standard gluten free diet? If so I highly recommend you try this GCED diet, a paleo diet or an auto-immune paleo diet.

1.            Thompson, T., A.R. Lee, and T. Grace, Gluten Contamination of Grains, Seeds, and Flours in the United States: A Pilot Study. Journal of the American Dietetic Association, 2010. 110(6): p. 937-940.

2.            Kristjansson, G., P. Venge, and R. Hallgren, Mucosal reactivity to cow’s milk protein in coeliac disease. Clinical and Experimental Immunology, 2007. 147(3): p. 449-455.

3.            Cabrera-Chavez, F., et al., Maize Prolamins Resistant to Peptic-tryptic Digestion Maintain Immune-recognition by IgA from Some Celiac Disease Patients. Plant Foods for Human Nutrition, 2012. 67(1): p. 24-30.

4.            Zevallos, V.F., et al., Variable activation of immune response by quinoa (Chenopodium quinoa Willd.) prolamins in celiac disease. American Journal of Clinical Nutrition, 2012. 96(2): p. 337-344.

5.            Real, A., et al., Molecular and Immunological Characterization of Gluten Proteins Isolated from Oat Cultivars That Differ in Toxicity for Celiac Disease. PLoS ONE, 2012. 7(12).

6.            Vojdani, A., Cross-Reaction between Gliadin and Different Food and Tissue Antigens. 2013. 4(1): p. 20-32.

7.            Hollon, J., Trace gluten contamination may play a role in mucosal and clinical recovery in a subgroup of diet-adherent non-responsive celiac disease patients. BMC Gastroenterology. 13.

The Paleo Diet is soaring in popularity in New Zealand as it is on other countries, primarily in the main centres – Auckland, Wellington and Christchurch. To illustrate here is a google trends graph for NZ, Paleo compared to the Vegan diet

A number of interesting and new blogs, by NZ doctors and nutritionists who have embraced a paleo lifestyle:

Jamie Scott (although temporarily in the land of OZ, with his lovely partner Dr Anastasia Boulais, check out her latest post on resistant starch) has written some great rants lately on some of the nonsense spoken and written by high profile nutritionists (heard of Claire Turnbull anyone?) You can find his enlightening rants here:The Spread of Tax Avoidance,   Tedious, Men, Women, Paleo, Protein, and Stupidity, More of the Same

Dr Pam Olver is a GP in Wellington whom I recently met (whilst in Wellington) and spend a great hour chatting on all things paleo and family has started a blog: check out her latest post: Is Paleo a threat to your health?

Mikki Willidin PhD, Registered nutritionist, lecturer/researcher at the Human Potential Centre at Auckland University of Technology (AUT), and an avid runner.  Mikki has recently started a blog, please read her entertaining posts on her transition to paleo from the standard ‘healthy’ diet. So…have you gone all Paleo? (part 1)  So…have you gone all Paleo? (part 2)

And speaking of AUT: Did you see this? A piece on NZ television about Nigel Harris,PhD, a lecturer at AUT and the studies they have done on a low carb paleo diet with endurance athletes.

Whole9 Foundations of Nutrition Seminar Wellington 9th June (DON’T miss this!)

This is a seminar you should definitely make the effort to attend

Jamie Scott (who has post grad diplomas in both sport & exercise and nutritional medicine) and Dr Anastasia Boulais (a medical doctor) are delivering a Whole9 Nutrition and lifestyle seminar in Wellington on 9th June.

They spend 7 hours giving you in-depth knowledge bombs on nutrition and lifestyle for optimal health. I went to their first seminar in Cairns Australia, and thought it outstanding. Of all the flavours of paleo out there, in my view Whole9 is one of the most scientific and relevent – their seminar is applicable and entertaining, and references evolutionary biology and the most current nutrition, health, and sports science.

Don’t miss it – it will be some time before another Whole 9 seminar is scheduled in New Zealand. (And flights to Wellington are dead cheap – make the effort – seriously!)

Here is the Whole9 South Pacific Facebook Page

More about the seminar and to sign up: Whole 9 Foundations of Nutrition Seminar Wellington

An attentive audience at the Cairns Whole 9 workshop

Paleo meetup groups – get together with others who follow a paleo lifestyle:

There are now two paleo meetup groups in New Zealand, a particularly active one in Wellington (a great group to whom I recently delivered a Paleo Seminar): Wellington Paleo Meetup group

And one in Auckland: Paleo, Primal, Low carb, Caveman lifestyle meetup group Auckland

(If you know of any others let me know)

Paleo support and chat:

Lo Carb Cooking NZ has recipes and an active Forum with a large number of paleo posts http://www.lowcarbcooking.co.nz/

An interesting post from NZ:

Crystal Graham, Marketing Manager for Les Mills, has been experimenting with paleo eating for past few months. She notes: “My recent trip to my Crohn’s Disease specialist for my annual check up was extremely positive. He was amazed at my health and vitality and the fact that I’ve now been off all medication for 6 months and continue to stay in remission. The only factor helping me is the healthy food that I’m eating. Food really is my medicine.” More here The Paleo Diet – diet fad or way of life?

Paleo Meals to go in Auckland:

More good news – there are two companies making paleo meals here that I am happy to recommend:

That Good have a small range of very tasty frozen meals available through some of the CrossFit Gyms in Auckland http://www.thatgood.co.nz/collections/frontpage

Fit Me In will send out a whole week of ready to eat meals, they are very tasty and reasonably priced: https://www.facebook.com/pages/Fit-Me-In/118756801636315

My (Julianne Taylor’s) Paleo Guidebook

For those who want yet another paleo guidebook: I have put together a 50 page booklet. It’s the reference book I give to seminar attendees. It is not a recipe book, but is full of practical information on paleo eating. It also contains all the omega 6 omega 3 charts as well as carbohydrate and protein amounts in different foods. (see the my blog posts on these)

If you would like a bound copy – you can order online here: (New Zealanders and Australians). http://zonediet.co.nz/shop/viewsubcategory.aspx?id=4

Worldwide: If you would like a PDF, simply donate via my PayPal button and I’ll email you a copy.

Paleo 2.5 hour Seminar:

I have had a number of requests for another in Auckland – I promise I will be scheduling one soon!

I am taking one out in Panmure on Saturday 18th May (late afternoon) if anyone would like to come – email me for details.

If you would like to host one (anywhere in the country) please contact me. For out-of-town seminars a minimum of 20 people are required to cover costs at just $45.00 per person which includes the guidebook.

I do receive great feedback – here is a little from the last couple of seminars:

“Really well worth going to one of Julianne’s seminar’s. Very Informative and well presented. I learnt a lot. Thank you Julianne.
I highly recommend” David

“Absolutely brilliant, informative and helpful. A++” Sarah

“This was great! Thanks for organising the seminar. Quite a few things were eye-opening and I’ll be applying them to my take on Paleo ” James

“Fabulous. Tonnes of info, and also all those little questions that been getting me thinking have now been answered..great seminar, thx for organising, and thx to Julianne” Karen

Twitter and Facebook: keep up to date with daily info:

And lastly:  – if you are a twitter or Facebook type, there is an active group who tweet paleo and nutrition related info. Just start to follow me and look at who I follow to get in on the many interesting links posted on a daily basis

@juliannejtaylor

And my Facebook page: https://www.facebook.com/pages/Paleo-Zone-Nutrition/194546637282256?

If I have missed any interesting New Zealand Paleo info out – please let me know!

And how – if you keep eating gluten a vicious cycle of damage will ensue.

In this post I will set the scene for future posts on dietary strategies to treat celiac disease. A number of recent studies have shown that just avoiding gluten is not enough for many, and they also need to avoid other foods in order to reduce the gluten antibodies and inflammation in the intestine.

In this post I will explain why and how gluten is a problem for those who have a specific genotype that predisposes them to celiac disease. I won’t be tackling gluten sensitivity in this post.

Celiac disease (CD) is an immune response to gluten proteins that happens in genetically vulnerable people.  Gluten is found in wheat and related cereal grains e.g. wheat, rye, barley, triticale. Gluten is a protein – not a carbohydrate – even though it is found in grains.

Protein digestion: we usually break down proteins into single amino acids

Proteins are constructed with very long chains of amino acids. There are 20 standard amino acids; imagine these being 20 different coloured beads and linked like long chains– like those beads that children snap together.  Every protein molecule is constructed with a particular sequence of amino acids (i.e. the beads are in a specific pattern or arrangement).  These long chains are folded and coiled, and sometimes crosslink to make a specific protein.

When we eat proteins our digestive enzymes (think of these as being chemical scissors) cut the links between the amino acids (pull the beads apart). Each different amino acid requires a different enzyme to disconnect it from its neighbour.

When these are broken down into single amino acids they then go into gut cells (enterocytes) where they are either used or sent on their way out the other side of the cell around the body to other cells. Under genetic instructions the single amino acids are joined into a specific sequence to make them into any tissue, protein or enzyme etc. that the body needs at the time.

Problem: Gluten does not get properly digested into single amino acids

The problem with gluten is that is contains a large number of 2 particular amino acids – glutamine and proline (think of these as green and purple beads), (we call these types of proteins ‘prolamines’). Humans don’t have the enzymes to break proline apart from its neighbour, so instead of breaking the long string of amino acids onto singles, it stops at a peptide, a short chain. Gluten protein breaks down into a number of different peptides that cause problems. [1]

It’s not gluten that is the issue – it is these short strings of amino acids that we can’t digest further. In people with celiac there is a vicious circle of effects, each peptide causing a problem that increases the toxicity of other peptides. This diagram shows a number of different parts of the gluten molecule, that cause problems.[2]

Problem: Gluten peptides pass through the gut cell barrier from one side to the other intact where we react to them as a foreign ‘invader’.

I want you to stop and imagine your gut as being a continuation of the outside of your body, basically one big long tube coiled up inside your body,  and think of the cells lining your gut as a skin.(Picture source)

The ‘skin’ of your gut is very wrinkled and folded, in fact if you took the skin of your gut and spread it out it would spread to the size of a tennis court. The large pink sheet below represents the surface area of the gut (the red is lung surface area and the green your skin):

The inside of this tube is called the lumen. It contains huge numbers of bacteria, and of course a constant flow of food and fluid. The cells in your gut secrete acid (in the stomach) and enzymes (in the stomach, pancreas and small intestine) to break down food into simple units that your body can absorb. It is only when a food particle is broken down into the simplest unit (a fatty acid, glucose molecule or amino acid) that it can be transported through the enterocyte into the fluid and bloodstream on the other side. This way we keep out large things like bacteria and viruses from getting underneath the ‘skin’. If large things do get through we have a whole host of ‘fighter’ cells waiting to nab them and deactivate them or digest them so they don’t cause trouble in the body.

You see – gluten and gluten peptides are not really a problem if they stay inside the lumen, they just end up going down the toilet. But this doesn’t happen in people with celiac disease.

Gluten peptides get through in two ways; either through the cell (transcellular) or between the cells (paracellular).

How does gluten get through the gut barrier? Scientists are fairly sure they have worked this out.

First – transcellular transport: how gliadin passes through the cell undigested

In mucous membranes there is one particular antibody called secretory IgA (SIgA). This is a first line defence responsible for keeping toxins and pathogens (bad bacteria etc.) from getting to the gut cells, it is a bit like a bouncer in a nightclub blocking the entrance so undesirables can’t get past. SIgA can also take pathogens to special areas where they can be deactivated by immune cells (sub epithelial dome), like a bouncer escorting an undesirable to the police station to get locked up. SIgA increases in your gut when there is inflammation (as there is with Celiac disease), because it needs to get to work reducing whatever undesirable is causing the inflammation.

In celiac disease something happens that shouldn’t: the SIgA (the protein that should be protecting from invaders) transports the gliadin through the cell and out the other side undamaged. How does it do this? First the gliadin peptide forms a complex with SIgA, which should take it off to get processed as a ‘baddy’ but it doesn’t – there is a doorway in the gut cell than allows the SIgA and gliadin complex to get transported in one side of the cell and out the bottom. Why does this happen when it shouldn’t?

Unfortunately in people with celiac a doorway is available for the IgA to enter with its new buddy gliadin – a doorway that normally shouldn’t be. This doorway results from the person having an iron deficiency (anaemic). People with celiac are often anaemic, as their inflamed gut does not absorb iron properly.  In order to try to absorb more iron the gut cells send special iron transporting units (transferrin CD71) up to the surface of the gut cell. For some reason this receptor hooks up with the ‘bouncer’ and the ‘baddy’; the SIgA-gliadin complex,  (think of the ‘bouncer’ acting like a Trojan horse that protects and escorts the gliadin) and takes it from one side of the cell to the other.  From the outside of the body to the inside. Sneaky! Once on the other side the SIgA releases the gliadin.[3]

Gliadin peptides linked to  SIgA, ( secretory IgA)  getting taken into cell and passing out the other side via TfR, (transferrin receptor);TG2, (transglutaminase 2) takes peptides and alters them, HLA-DQ2/8 molecule picks it up and presents it to immune cells to set up ‘kill’ response. (Source)

Paracellular pathway: How gluten creates gaps between cells so it can sneak through.

A gut cell needs to be tightly glued to its neighbour in order to prevent any undigested food or pathogens getting through this barrier. Each cell binds to its neighbour with a complex of proteins called a tight junction. This acts like glue, it lets fluid through but no large molecules. The gut cells are able to release a chemical that tells the gates to open. This chemical is called zonulin, and its release is triggered by bad (pathogenic) gut bacteria – this will let the bacteria through below the surface where it can reach the ‘fighter’ (immune) cells and get them into action.

In celiac disease, gliadin proteins interact with the gut cell, (the CXCR3 receptor, which people with celiac have more of than unaffected people), and the gut cell sends out zonulin – which ‘tells’ the tight junction to loosen up, literally opening up a pathway between cells. Now that the gate is open gliadin peptides can bypass the gut cell barrier and make their way down into the area chock full of fighter cells waiting to pounce and quell an assumed infection. [4]

Once through the gut cell barrier, the gluten peptide gets transformed into an even nastier peptide that triggers an immune reaction

One more thing happens in people with celiac disease. Once the gliadin gets through the gut wall it comes into contact with an enzyme called transglutaminase 2 (TG2). TG2 modifies proteins i.e. changes them a little, but it only changes some proteins, gliadin just happens to look like a one of the proteins that TG2 is supposed to change. So it gets on and does the job very efficiently, and changes it into just enough so that it fits into a little pocket on antigen presenting cells.[5]

Bear with me – this is important but a little complicated.

Whenever we have an infection an antigen presenting cell (APC) takes a section of protein (a peptide) from a broken down bacteria, holds it in a little pocket and presents it to fighter cells.  The fighter cells then go off and make anti-bodies to this so they can begin the process of spreading throughout the body and killing that specific protein (the invading bacteria). Once the invaders are killed the antibodies disappear, however the dormant fighter cells ‘remember’ this protein so if it invades again it recognises it and can replicate an army of antibodies to go fight very quickly.

People with celiac disease present a bit of protein from gluten as though it is an invading pathogen

People with CD have a particular type of APC specific to their genotype, and the gliadin altered by TG2 fits in perfectly into the little presenting pocket. (The genotype is HLA-DQ2 , specifically HLA-DQ2.5 and HLA-DQ8 which about 30% of the population has. If you don’t have this genotype – you can’t pick up gluten as it doesn’t fit in the APC’s pocket) So as soon as TG2 changes the gliadin protein in a specific way, the APC picks it up (it’s like a key that fits perfectly into a lock) and shows it to the fighter cells. (CD4+ T cells) They then go to work to fight this invader and make numerous antibodies to try to kill it off. (Gliadin antibodies) [6] Below is a diagram of the APC with the gliadin showing it to a T-cell.

People with CD also make anti-bodies against the important transglutaminase enzyme – Why?

The other problem is that not only do people with celiac make antibodies against gliadin, they make antibodies against the enzyme TG2 that transforms the gliadin. (Anti-transglutaminase antibodies) They do this because gliadin is able to bind to TG2, so the body then thinks this combo is a threat, and it then attacks the TG2. This is not great as TG2 has other important roles throughout the entire body.  These anti-TG antibodies have been shown to induce apoptosis (suicide) in neuronal (nerve) cells and trophoblasts (cells that form the placenta of an embryo) which explains why there is neurological damage and fertility problems in celiac disease.

The upshot of all these anti-bodies being made to gliadin and TG2 is that inflammation increases in the gut. Think of a time when you have a skin infection – you get red inflamed weeping skin. This happens in your gut. [7]

But wait there’s more…

Still another type of gluten peptide causes trouble for the gut cells

Yet another gluten peptide causes problems, this time though it directly ‘attacks’ the epithelial cell, which sends out stress signals, fighter cells get called in and inflammatory chemicals get sent out to try to stop the ‘attack’.

As long as gluten is eaten, the body reacts as though it is under a never ending attack, and doesn’t give up the fight

If this invader were a bacteria, our body would eventually kill them off and the attack would die down and the anti-bodies and inflammation would disappear. However in celiac disease the attacking agent can’t ever get killed off – it keeps coming and coming, as long as gluten is being eaten. So the body keeps up a never ending fight against an invader that it will never win. The loser is our own epithelium which is in a constant state of inflammation and eventually becomes damaged and non-functional. Also the more inflamed it becomes the more leaky the gut becomes and a never ending stream of pathogens can get through what should be an impenetrable barrier. The more pathogens you let through, the more fighter cells get activated, and anti-bodies can be made to a bigger range of invaders. What’s more the constant damage can eventually lead to cancer. [8]

Normal versus damaged epithelium in celiac disease

The ONLY way out of this vicious cycle is to stop the attack from the primary antigen gluten. This means eating a STRICT gluten free diet for the rest of your life.

However for many with celiac disease a gluten free diet is not enough to stop the gut inflammation, and reverse the anti-bodies.

I’ll talk more about this in my next post and how to deal with it.

1.            Hausch, F., et al., Intestinal digestive resistance of immunodominant gliadin peptides. American Journal of Physiology-Gastrointestinal and Liver Physiology, 2002. 283(4): p. G996-G1003.

2.            Fasano, A., Intestinal Permeability and Its Regulation by Zonulin: Diagnostic and Therapeutic Implications. Clinical Gastroenterology and Hepatology, 2012. 10(10): p. 1096-1100.

3.            Matysiak-Budnik, T., et al., Secretory IgA mediates retrotranscytosis of intact gliadin peptides via the transferrin receptor in celiac disease. Journal of Experimental Medicine, 2008. 205(1): p. 143-154.

4.            Fasano, A. and C. Catassi, Current approaches to diagnosis and treatment of celiac disease: An evolving spectrum. Gastroenterology, 2001. 120(3): p. 636-651.

5.            Klöck, C., T. DiRaimondo, and C. Khosla, Role of transglutaminase 2 in celiac disease pathogenesis. Seminars in Immunopathology, 2012. 34(4): p. 513-522.

6.            Koning, F., Celiac disease: quantity matters. Seminars in Immunopathology, 2012. 34(4): p. 541-549.

7.            Klöck, C., T.R. DiRaimondo, and C. Khosla, Role of transglutaminase 2 in celiac disease pathogenesis. Seminars in Immunopathology, 2012. 34(4): p. 513-522.

8.            Bethune, M.T. and C. Khosla, Parallels between pathogens and gluten peptides in celiac sprue. Plos Pathogens, 2008. 4(2).

Today’s post is just a quick cut and paste. (I’m head down writing at the moment as I’m doing post grad nutrition science papers, currently ‘advanced disease and nutrition’ paper – I’ll be sharing some interesting things I’ve been learning later.) In the meantime this study confirms that a reduced carbohyrate diets is very effective in the treatment for Type 2 diabetes. The strength of this study is that it was controlled for calorie intake, again confirming that its not about the calories. From Medscape

Low-Glycemic Diet Seen to Reverse Diastolic Dysfunction of Diabetes

Steve Stiles

Apr 23, 2013

VIENNA — A diet that was short on carbohydrates and long on protein, given to diabetic patients engaged in a supervised exercise and weight-loss program, appeared not only to cut proinsulin levels and postprandial glucose and triglyceride levels, it seemed to improve LV diastolic function^[1].

In the study that compared the “low-carb” diet to a traditionally recommended low-fat diet, the one designed to flatten out resulting insulin and glucose curves also allowed them to take far fewer oral diabetes medications and apparently cut both systolic and diastolic pressures. The low-fat diet had no apparent effect on diastolic function or med use or on blood pressures.

On the other hand, the two diets led to about the same declines in weight and waist circumference and lipoprotein-cholesterol levels, reported Prof Helene von Bibra (Technical University Munich, Germany) here at the Prediabetes and the Metabolic Syndrome 2013 Congress .

Many patients with insulin resistance, diabetes, or both have subclinical diastolic dysfunction, with severe prognostic implications if it becomes symptomatic, von Bibra reminded heartwire . About 65% of the 32 patients in the study had abnormal diastolic function as defined echocardiographically by low early diastolic myocardial velocity. That measure in most cases nearly normalized after the low-carb diet, but not after the low-fat diet, she said.

Prof Helene von Bibra

Of 32 overweight or obese diabetic patients (mean body-mass index, 34) without cardiac disease who were engaged in a “rehabilitation program in order to lose weight” that included two hours of supervised aerobic exercise per day, half followed a low-glycemic diet (25% carbohydrate, 45% fat, 30% protein) and the other half a low-fat diet (55% carbohydrate, 25% fat, and 20% protein) for three weeks. The diets provided the same amount of calories. Those on the low-fat diet then switched to the low-glycemic diet for an additional two weeks. Cardiac function by echo and metabolic parameters were assessed daily before and after a 400-kcal breakfast.

From baseline to three weeks, patients on the low-carb diet reduced their use of conventional oral antidiabetic medication by 86%. Those on the low-fat diet reduced them by only 6% by the end of three weeks, but intake went down another 57% by the end of their two-week low-glycemic diet phase. “And still they had improvements in glucose,” von Bibra said. Medications other than oral ones for diabetes, such as antihypertensive drugs, were not changed in anyone during the study.

In the low-glycemic-diet group, mean systolic blood pressure declined from 127 mm Hg to 118 mm Hg (p<0.002) after three weeks; diastolic pressures also fell (p<0.04). Neither changed after three weeks for those initially on the low-fat diet, but both “improved in the same direction” as those in the low-glycemic group after two weeks on the low-glycemic diet, von Bibra said.

Laboratory and Echo Changes in Overweight/Obese Diabetic Patients Assigned to Low-Glycemic (n=16) and Low-Fat (n=16) Diets

The gains in diastolic function probably were not independently related to the associated blood-pressure reductions; rather, she proposed, they reflected improvements in myocardial energy utilization on the low-glycemic diet. Insulin resistance can lead to diastolic dysfunction via several pathways, she noted, but the most prominent seems to be myocardial energy deficiency secondary to microvascular dysregulation and mitochondrial imbalances of glucose vs fat oxidation.

I moved away from blocks; I didn’t really like teaching such a pedantic method of measuring and weighing food, it really doesn’t fit with my philosophy that food should be enjoyable and nourishing, and a meal plan should be simple and flexible.

I moved towards teaching a plate template; a method for balancing meals based on a Zone diet template, and using your own hand as a guideline to portion control.

When I switched to Paleo food choices, I continued to use this template, in a loose way and found it to worked really well for appetite control, and the portion amounts maintain a healthy weight.

I’ve continued to evolve the meal template as I’ve studied, read and worked with clients. As well I’ve put this template and food choices into a food analysis programme, and it works well for getting a high nutrient diet, with the right amounts of macronutrients.

So here then is the template that I found works well for the majority of people. It covers all the required nutrients and is flexible enough that you can use it whatever food you have available. Eat 3 – 4 meals per day and don’t snack.

Click here for a PDF that you can download and print off:  Paleo Meal Template, Julianne Taylor, 2013

Forest and Bird New Zealand has put together a handy guide to help you choose fish to eat.

This comprehensive guide takes into account the state of fish stocks, the amount of seabird, marine mammal and non-target fish bycatch, the damage done to marine habitats and other ecological effects caused by the fishing to decide on it’s rating.

Forest and Bird have this chart as an IPhone Ap and Wallet guide

Wellington: Sunday April 21st, 5.30 – 8.30, Thistle Hall.

Auckland: Sunday April 7th, 1.30 – 4.00pm. Grey Lynn Community Centre, 510 Richmond Rd.

$45.00 (includes Paleo Guidebook)

See this post for more information on Seminar contents: Paleo Seminar

To book a place: Contact me by phone or email to book a place juliannetaylor at xtra dot co dot nz or +64 9 3781573

Testimonials:

In the last few days I recieved feedback from 2 clients who had a one-on-one consulation with me, one client over a year ago and the other recently. Both suffered numerous health issues, and a switch to a paleo diet made a huge difference.

“As a tall skinny person I’d never really worried about not eating healthily. I’d had I.B.S. since late teens I suspect brought on by almost 3 years of constant antibiotic use until I had open heart surgery at 16 years old. So eating a lot of fibre and fruit often caused me problems. However my health was adversely affected by prolonged stress so that I had adrenal fatigue and the start of Hashimoto disease in my early forties.

When I sought help with Julianne I was not sleeping well, both not getting to sleep easily or able to stay asleep the whole night, easily angered, crying and having trouble concentrating and remembering things. I had debilitating PMT and depression and hypoglycaemia. I’d been hospitalised twice for irregular heatbeat. Given that my personality is usually calm, logical and organised I was really struggling in my job.

As an analytical person I had done quite a bit of research into diets etc but it can be so confusing when unwell and when there is so many different opinions. Also I was looking for a quick fix; a supplement or therapy that would “cure” me.

Julianne was very kind, I think I was crying when I turned up because my foggy brain got me lost.

She listened to my worries and concerns and reassured me when I thought it seemed too hard or wasn’t working. I had tried gluten free before but Julianne told me I could feel worse before I felt better and encouraged me to push on. What a great help just to know that!

It’s been just over a year now and I don’t need to get a test for my thyroid, I know it’s better as I can swallow in the morning without pain and I have been in a job as a Manager for nearly 6 months which would have been impossible a year ago. I love not having fat days and being able to think in the afternoon instead of fuzzy thinking.

Sometimes I get lazy with my planning and don’t eat good quality meat or maybe have items with gluten too often but generally my body tells me now, “I need some fresh veggies!”

Julianne’s advice and encouragement from her seminars to her blog and articles she shares on Facebook are all part of my road to health. Julianne has taught me that everyone is different (in what works for them) and if I’m going to change something to stick with it for long enough to see if it is helpful.”

Raquel

“Hi Julianne

I want to let you know I’ve made a start on eating Paleo and am finding it a lot more simpler than I first thought.  It has been made so easy due to your lovely explanations which I have been able to clearly understand.  Thank you for taking the time to study on this complicated subject but to also being able to help others like me to understand it well and so quickly.

I of course I am still adjusting insulin intake but am finding the whole blood glucose control a lot, lot easier than ever before.Within the last few short days I have already been feeling a whole lot better and actually nourished.  I thought I was ok and managing okay before, but now I realise just how unwell I’ve feeling for most of my life.  Having a good clean out of the pantry and fridge of all harmful grains, seeds, beans, pulses and oils I’ve been eating without knowing they were doing more harm than good, what an enlightening experience.  Without your knowledge and time in talking with me I’m not sure I would have understood it the way I do now.

Again, thank you for your wonderful explanitive help and support.

Kindest regards.

Irene ”

(Irene has type 1 diabetes, and other auto-immune conditions)

Like many paleo people I eat a lot of vegetables (problably more than your average vegan)

Just thought I’d post a pic of my dinner last night:

Sicilian Chicken (recipe to come), 100 grams chicken breast (about a palm size = approx 25 g protein)

Cauliflower rice, about 1/2 cup

Sweet potato and kumara, about 1/2 cup

Beetroot and carrot salad with lemon juice about 1/3 cup (total starch / root veg about 1 cup)

Mesclun salad with herbs – a handful

Seaweed (good for iodine and minerals)

Brocolli

Leeks, cooked in a little water then satueed in a little olive oil, about 1/2 cup

Olive oil and balsamic dressing on the salad.

All up about 2.5 cups veg although I didn’t measure

The seminar is constantly evolving and I’ve had great feedback with respect to current seminar contents:

Adam Brakey of BrakeFit had this to say after I delivered a seminar to his clients:

“Julianne’s presentation exceeded my expectations, she astounded my athlete’s with her in depth explanations and insights. It is not often that you meet some one who has a passion & strong belief with what they do. Julianne is one of those people and I congratulate her and the work she does. It has had a profound effect on myself and those of my athlete’s. The presentation itself was an even spread of science with application to everyday life and performance. Even after the seminar was over, if I or my athlete’s had a question, she would go out of her way to give the answer via text, email or smoke signal. It was my pleasure and that of my athlete’s to host, listen and learn from Julianne. There are plenty of challenges throughout the year, more athlete’s to teach, Julianne will be my first port of call for teaching healthy living with Nutrition.”

Kind Regards

Adam Brakey

BRAKEFIT

Here is the outline of the 2.5 hour Paleo Seminar:

Paleo Science:

• What 7 major ways does today’s diet differs from the diet that best suits our genes.
• The consequences of eating todays food: Addictions, overeating, disregulated appetite, nutrient deficiences, gut issues, metabolic syndrome, auto-immune disease, inflammation and diseases of aging, poor athletic performance.
  
• I explain how and why modern foods cause these problems

• How and why our ancient brain cannot deal with modern food.

• Which foods mess with our blood sugar, hormones and appetite regulation, causing overeating and fat gain?
• What foods cause gut irritation? How do they cause gut distress and trigger auto-immune disease in vulnerable people?
• Which fats and foods cause harm and inflammation, which are healthy and which ones to we need more of?
• The Omega 3 to 6 ratio and how to balance them in your diet
• Fibre, which type and what foods to eat
• Carbohydrates – how much do you need? Pros and cons of very low carbohydrate diets.
• Protein – getting what you need for health and appetite control. How much is too much? Best choices and why
• Understanding the drives of our stone-age brain, and why today’s modern environment will constantly sabotage your efforts.
• Common mistakes people make when eating a paleo diet

Paleo Eating for health and performance- the how to’s:

• What foods to must eat to get a high nutrient diet,
• What are the best protein, fats and carbohydrates to eat and why

• How much carbohydrate, protein and fat should YOU eat?
• A guide to portion size for you, taking into account body type and exercise
• Eating for athletic performance, pre and post workout nutrition
• What fluids to drink
• Recommended supplements or food high in those nutrients
• Lifestyle factors: sun, sleep, and exercise, why they matter – a lot
• Setting up your enviroment for success

Cost: $45.00 which includes paleo Guidebook.

Monday 11th March, 6.30 – 9.00 pm

Grey Lynn Community Centre, 510 Richmond Rd

Cost: Just $45.00 (includes Paleo nutrition guidebook)

Please contact me – Julianne to book a space.

09 3781573 or 021 680703. or email on juliannetaylor at xtra dot co dot nz