Tag Archives: science

Science For Celiacs

22 Jun

For many people living with Celiac Disease, having Celiacs and being an advocate for awareness often times are synonymous. We are a demographic of people who cannot eat one of the most commonly consumed foods: bread. So, naturally, when people come across a Celiac for the first time they have a lot of questions.  Wheat has played an incredibly large role in our political, religious and culinary histories. As a result, it may seem pretty odd or even unbelievable when you encounter a person biologically designed to reject it.  Whenever I meet someone who has not heard of Celiac Disease or the gluten free diet I am unfailingly asked one of three questions:

  1. What is gluten???
  2. So…what happens to you if you eat bread?
  3. Celi-what disease?

It is important to be able to answer these questions coherently and knowledgeably. Why? Because otherwise the gluten free diet gets a bad rap! If people living with Celiacs or gluten intolerance do not speak up, the media and fad-dieting celebrities control the narrative about what it means to be “gluten free”.   That being said, if you have Celiac Disease or gluten intolerance, what should you know??

A Celiac in the know should have a basic and celiac-specific understanding of Physiology, Plant Biology, Biochemistry, Immunology and Genetics. As a Science teacher and GF blogger it is about time I merged my two favorite things into a blog post!  I won’t be offended if you simply skim the rest of this post because things are about to get a bit nerdy :)

Physiology
K_htbw_stomach1

Physiology is the study of biological functions eg how the digestive system functions. Given that Celiac Disease is a digestive disease it is important for us to know how the digestive system works! The  purpose of the digestive system is to digest and absorb.  There is a common misconception that people with Celiac Disease struggle with digestion but this isn’t really true: we struggle with absorption.

For example, someone who is lactose intolerant cannot digest dairy products, their body cannot break it down. Celiacs are great at breaking things down, in fact, we have a whole class of biological soldiers (antibodies) that attack gluten. If this were merely a matter of digestion, the symptoms of Celiac Disease would not be so varied and at times debilitating.

Digestion is the process of breaking down food into biologically usable parts. Your cells don’t need pepperoni pizza, they need glucose, amino acids, vitamins and minerals etc. The digestive process transforms food into these usable components.  Once the food is broken down (aka digested) it will reach your small intestine, which is where the absorption takes place.
Celiac2

Your small intestine is lined with villi, finger-like projections that absorb those usable components from the food into the body/blood stream.  When the villi are damaged they look stub-like and can longer efficiently absorb nutrients.  Someone with Celiac Disease may eat an incredibly healthful diet and yet not receive the benefits of those foods because their villi are damaged!  Luckily, the villi can repair themselves overtime which is why living gluten free can often reverse almost all of the pre-diagnosis symptoms. For example, I went from being severely anemic to having normal iron levels about five months into being gluten free.

Plant Biology

How many times have you answered the “what is gluten” question with “You know…bread, pasta, cookies, anything with flour…basically.” Although that simplification may be best in some contexts, it is still nice to know what it really is! Gluten is a group of proteins that is responsible for the elasticity of dough aka the chewy goodness that I sometimes miss so much.  Gluten is made up of two proteins: gliadin and gluteninin (gluten = gliadin + glutenin). Interestingly, Celiacs are only sensitive to “gliadin” but for whatever reason we use the term “gluten-free” to describe a diet that is not harmful to people with Celiac Disease.   pro-43

Did you know that wheatgrass is gluten free? The wheatgrass is immature wheat. Though the same origin, Triticum aestivum L., the grass forms before the grain and does not contain the harmful proteins we discussed above. NOTE: if you buy wheatgrass make sure it is labelled  gluten free because otherwise there is a risk that the grass has been contaminated with the mature grain.

Biochemistry

protmol-aminoacid-v4

The very first day of my Biochemistry class in college my professor warned me that I would have to memorize the structure and names for all 20 amino acids used in the body to form proteins.  Don’t worry, these structures didn’t make my list of things Celiacs should know but the basic concept that proteins are made up of a string of amino acids definitely made the list.

We know if you are Celiac you need to be gluten free. We know that gluten is made up of two proteins and Celiacs are mostly sensitive to gliadin.  So what is it about the protein called gliadin that is harmful?

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A protein is made up of a string of amino acids. The sequence, or order, of these amino acids is what determines what type of protein it is.  There is a specific part of gliadin, a sequence of 19 amino acids, that trigger the autoimmune response in Celiac patients.  Proteins with similar sequences, even if not exact, can cause reactions as well. This is why people with Celiac Disease typically cannot eat rye, barley, malt and sometimes even oats because the amino acid sequences can cause a reaction!

Immunology

K_htbw_immune-cells1

The immune system has two parts: innate immunity, the body’s first and more generic line of defense, and adaptive immunity, our specific response. When it comes to Celiac Disease we are mostly interested in adaptive immunity because it is this part of the immune system that is triggered by gluten.

In someone with Celiac Disease, the body perceives gluten as a threat and produces antibodies to attack and eliminate it called Anti-gliadin antibodies (also called AGA). You probably recognize that word from the tests you were given for your diagnosis. Some doctors will test the blood for the presence of AGA in order to determine if someone has Celiac Disease.

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Why does it matter if the body creates an antibody specific for gluten? Doesn’t that just mean that the gluten is attacked? The immune system is very complex and yet imperfect.  Autoimmune diseases are conditions where the body’s defense systems begin to attack healthy cells. In Celiac Disease, the Anti-gliadin antibodies end up attacking the lining of the small intestine (among other areas in the body), damaging the ability of the villi to absorb nutrients.

In short, the immune system creates specific proteins that target foreign and unwanted invaders in the body. People with Celiac Disease develop antibodies in response to consuming gluten that attack and destroy healthy cells in the body causing damage, inflammation and symptoms of Celiacs.

Genetics

genetics

The reason it is important to understand the genetic aspect of Celiac Disease is all about getting people tested.  If you or a family-member are diagnosed with Celiac Disease it is really important that the rest of the family get tested as well.  If a family-member has Celiac Disease, your chances of having it are much higher than the average person in the general population. Family-members may be asymptomatic or may have symptoms that have been misdiagnosed (I used to have a juvenile arthritis diagnosis on file before going gluten free).

I can’t tell you how many of my readers have told me that they found out they needed to be gluten free because a family-member was diagnosed first. My grandmother found out she had Celiac Disease after I was diagnosed and has experience improved health since going gluten free! There is no way to get around the fact that Celiacs is genetic. I know many families that are resistant to getting tested because they do not realize that they have a risk of having or developing Celiac Disease.

Being in the know is not just important for spreading accurate awareness, it can actually help you stay motivated. When you understand what happens to the body on a molecular level in response to even trace amounts of gluten you may find yourself even more committed to taking those extra steps like avoiding cross contamination to be completely gluten free.

Have a great rest of the weekend, readers!

-CC

Should being gluten free impact your politics?

24 Oct

The election is right around the corner! Make sure your vote is an informed one!

Although the issue of food policy was under highlighted in the Presidential debates, it is nonetheless of political importance. From the farm bill, which impacts the cost and availability of food, to USDA public health promotional campaigns, to FDA food regulations, there are many avenues US leadership can take to change the way we access food in this country.

So what are the issues that a savvy Celiac should consider before casting their vote? The farm bill, food safety programs and access to and promotion of nutritional foods are the key issues that I want to explore so that I can make an informed decision at the polls.

This post is not an endorsement of either candidate.

FARM BILL

The farm bill impacts a population much broader than US farmers. When (or should I say if?) the farm bill is passed it will impact the cost of food as well as our access to certain foods. The next President will not only have to deal with getting the farm bill passed but will also play a role in shaping it.

As someone who is gluten free, the availability of gluten free food is a very important issue. Since gluten free foods tend to be more expensive than products made with wheat flour it would be in our best interest to support policies that make farming more economical, especially for small farmers. Here is the catch: the farm bill attempts to support all farmers, making all food more accessible and affordable. Cheaper brown rice would be great but if wheat flour is also made more accessible and even more affordable than it already is we are likely to see some unintended consequences.

If wheat flour is made more expensive don’t you think that restaurants might think twice about dredging their meats in flour? They might consider using an alternative like cornmeal or rice flour. Cost and accessibility shape our food options both at the market and when dining out.

The President has repeatedly articulated the importance of passing a farm bill this year. He calls for adequate protection of American farmers from draught and natural disasters and promotes diverse, specialty crops like fruits, nuts and veggies (which is great for us!).

Romney has taken jabs at Obama during the campaign about his failure to get the House the pass the bill. Romney thinks that Obama does not have the leadership skills necessary to get a bill passed. He argued that “[P]eople have been waiting a long time for a farm bill. And the president has to exert the kind of presidential leadership it takes to get the House and the Senate together and actually pass a farm bill.”

Romney supports disaster relief as well but also indirectly supports subsidizing American farmers. Romney says that other nations subsidize their farmers and if the US is to compete we will need to do the same.

When you get down into the nitty-gritty of both candidates’ farm bill positions there are more similarities than differences. Both candidates will cut about $30 billion out of agricultural spending by eliminating many of the subsidies that currently go to crop insurance companies. Much of the farm bill is allocated towards food stamps. Here lies the biggest difference between an Obama supported farm bill and a Romney supported bill: Romney/Ryan support decreasing the amount of people using food stamps. They said that they don’t need to cut the program to reach their goal. Romney said, “I want to make sure we get people off food stamps, not by cutting the program but by getting them good jobs.”

FOOD SAFETY

President Obama created several programs that promote food safety. He established the Food Safety Working Group, which is a group that focuses on updating and improving US food safety systems. Obama also increased the authority of the FDA so they can more effectively enforce food safety regulations.

Although Romney believes in the importance of access to safe foods his approach to securing such food is very different from Obama’s approach.

Romney supports a more hands off approach to preventing food-borne illnesses. He argues that “preventative practices” are the best way to prevent outbreaks. These practices/protocol would be developed by the private sector because Romney believes that the people in the fields are the best equipped to handle this issue. Romney’s campaign states that it is most cost efficient and effective to allow food growers, handlers and processors to create food safety protocol. As for the role of the FDA, Romney’s campaign said that the Romney Administration would prioritize collaboration between the FDA and the private farm sector on this issue.

NUTRITION

The Obama family is very committed to promoting healthful food choices in schools and encouraging people of all ages to lead active lifestyles. Michelle Obama worked to get more salad bars into schools, President Obama supported the USDA’s new food pyramid, MyPlate as well as their Fresh Fruit and Vegetables Snack Program and both of the Obamas encourage cities to get involved with the Let’s Move! program which provides local towns and cities with tools to get community members exercising. President Obama believes that partnering with the private sector and supporting federal programs to promote healthful lifestyles is the best way to improve the health of the public.

Romney does not support nanny-laws and is committed to making sure the federal government does not overstep its role in American lives. These beliefs about the role of the government shape Romney’s strategies for tackling public health.

In response to questions about promoting nutrition the Romney campaign gave a quick and short response:

“The federal government should not dictate what every American eats… An emphasis on a balanced diet will be crucial to addressing this crisis and public health programs in a Romney Administration will highlight the importance of healthy eating.”

Romney and his campaign have not articulated a plan nor a specific commitment to promoting nutrition and healthful lifestyle choices.

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Now that we know where each candidate stands on these issues the next question is “Does it matter?” As someone who studied Public Health it greatly matters to me but this post isn’t about public health (in general) it is about whether or not being gluten free should impact the way you vote.

The answer is: probably not. The gluten free diet, though more popular and well-known than ever before, is far from the norm. A farm bill that cuts the profitability of wheat farmers is not going to change the fact that people love their gluten. It is an ingredient that has dominated palates across continents. Although I do believe it is important for voters to take the issues I described above into consideration when casting their vote, I do not think that our gluten free fate is in the hands of the future President.

Ultimately, it comes down to constant vigilance, commitment and willingness to speak up for your needs. There is no quick-fix solution to the lack of awareness about gluten intolerance, Celiacs and food allergies in this country but every time you explain it to a waiter at a local restaurant or to a new acquaintance you are making a difference. It isn’t just about being gluten free! I am talking about spreading awareness about restricted diets and cross contamination, issues that make the lives of millions so challenging in the US. Not many people can say that when they dine out they help change the world but we can.

-CC

Sources

http://www.unitedfresh.org/programs/wppc/presidential_nominees_responses

http://articles.aberdeennews.com/2012-08-24/farmforum/33373582_1_farm-bill-programs-that-benefit-farmers-farm-safety

http://cornandsoybeandigest.com/issues/obama-romney-weigh-more-agriculture-priorities

http://insidetrade.com/Inside-Trade-General/Public-Content-World-Trade-Online/romney-hits-obama-on-farm-bill-gridlock-reiterates-trade-policy-plans/menu-id-896.html?S=SM

Public Health 198: Changing the Restaurant Industry

8 Mar

UC Berkeley, one of the world’s finest public universities, allows undergraduate students to design and teach their own courses offered for academic credit.  I took advantage of this incredible opportunity offered by the university to promote Celiac Disease awareness and make an impact on both my campus and local communities.

Public Health 198 is a course offered for 2 academic units called Changing the Restaurant Industry.  The course focuses on how the restaurant industry accommodates customers with restricted diets.  By thinking of the restaurant’s ability to accommodate restricted diets as a public health issue, I was able to design an intervention strategy based on public health theories to improve the quality of food service in the Bay Area.

Public Health 198 is a series of 14 lectures all focused on promoting allergy awareness in the restaurant industry.  We covered the theory of Community-Based Public health Initiatives, concluding that the best way to improve our community is to have community-members take action.  The course requires that all students (40 students enrolled) recruit at least one restaurant to undergo a training program designed by the students.

Some well known members of the gluten free community have guest lectured for my class including Dr. Emily Nock of Walnut Creek Kaiser, Tom Herndon, the Executive Chef at Hipp Kitchen and owner of Full Fridge and Beckee Moreland from NFCA and GREAT Kitchens amongst many other speakers!

Topics of the course include: community-based public health initiatives, law and liability, peanut, egg, shellfish, corn, soy and dairy allergies, the gluten free diet, veganism, Diabetes Management and an introduction to entrepreneurship in the context of public health and the restaurant industry.

Check out this lecture given by Dr. Emily Nock about Celiac Disease.

Celiac Disease Lecture Part 1

Celiac Disease Lecture Part 2

Check out this lecture by CC about safe kitchen practices and restaurant concerns for gluten free food preparation.

Restaurants: Gluten Free Preparation Part 1

Restaurants: Gluten Free Preparation part 2

Please note these videos were made for students to review, not for professional purposes so please excuse the poor editing

The most important takeaway point from my experience creating this class is the importance of, what I like to call, contextual activism.  It is important to take ownership of your health and your gluten free diet.  One way to do this is to engage in awareness promotion and activism.  Contextual activism is where you base your actions on your personal life context.  I am currently a college student so I used campus resources to create a class to promote gluten free awareness.  You can do this too!  If you are a mom of a Celiac kid, create a play group for kids with allergies.  If you are a lawyer, consider guest blogging on a gluten free blog about law and liability in the context of “being glutened” at a restaurant.  There are countless examples of ways to get involved with awareness promotion: the trick is, creativity!

Take ownership of your life and your health.  Engage in contextual activism to promote Celiac Disease awareness.

-CC

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