Tag Archives: research

Do you have an “Appetite for Life?”

The University of North Carolina Nutrition Research Institute (NRI) hosts regular events as a part of a program they call “Appetite for Life.” It’s an initiative to “unlock the promise of personalized nutrition for proactive health management.” In other words, their mission is to show people how to eat for their health, specific to individual genetics and environmental experiences.

zeisel-afl

The speaker at the event on September 13 is Steven Zeisel, MD, PhD, and Director of the NRI. Zeisel is world-renowned, a pioneer in the field of personalized nutrition. A nutrient you’ve probably heard of, called choline, is essential for human health, especially concerning pregnant women, and Zeisel is the scientist credited with this discovery.

“I’m not going to tell you what to eat today,” Zeisel says as he begins his talk. Tonight’s event is called “Genetics and Health: Your nutrition needs are as unique as you are,” and the venue, local eatery Restaurant 46, is packed with members of the local community and employees from the neighboring North Carolina Research Campus (NCRC), a 350-acre research center located in Kannapolis, North Carolina.

Zeisel goes on to describe the true meaning of personalized, or precision, medicine and the past, current, and future studies the NRI has in place to make personalized medicine a reality for everyday people concerned with their health.

“Diet can be changed to bypass nutrient deficiencies depicted by the genetic code,” Zeisel goes on. He starts by breaking down the specifics of nutrition science, starting with genetics. He describes single nucleotide polymorphisms (SNPs), common genetic variation that occurs uniquely in all humans, as “spelling errors” in the DNA. Considering that a majority of the audience have a limited understanding of current genetics, Zeisel presents his description of SNPs in an accurate yet simplified manner. After all, what’s the point of talking about bringing personalized medicine to the public if the lay people can’t understand what you’re talking about?

img_0500

Zeisel and his colleagues at the NRI are preparing for the future of genetic testing, a technology they predict as being able to sequence an individual’s genetic code to provide a complete record of specific “spelling errors” in the DNA that might make the individual at risk for certain nutrient deficiencies. Being aware of nutrient deficiencies would then allow the individual to change their diet to eat more or less of a certain type of food.

There are companies that exist now, like 23andMe, that can provide genetic information from a DNA sample. However, the product a 23andMe customer gets in return for their money and a cheek swab is just pages and pages of combinations of “AGTC” that’s essentially meaningless unless the customer also happens to be an expert in nutrigenetics with a lot of free time.

Zeisel goes on to talk about choline, folate, and other studies from the NRI and other institutions concerned about health and nutrition. He leaves plenty of time for community members to ask their own questions, many about their health and the health of their loved ones.

The NRI’s story is far from over, but after a while questions subside. For now, people head home with a new perspective on individualized nutrition. The next Appetite for Life event is now something to look forward to, a talk by NRI scientist Stephen Hursting on October 18.

img_0496

Images from UNC NRI and Kara Marker

Advertisements

Gluten: The Protein, The Trend, The Choice

In the five years since her rheumatoid arthritis diagnosis, Bailey Brislin can attest to the increase of gluten’s appearance in public discourse and on social media. A poll I conducted asking 34 random participants various questions about gluten revealed a lot about public opinion and knowledge surrounding the gluten-free trend. Collectively, it seems like these are the two opposing misconceptions about gluten:

  1. Gluten is an unhealthy component of food and should be avoided by everyone
  2. The gluten-free diet is entirely a conspiracy; no one should have to avoid gluten

Although a strong majority of the participants did not actually follow a gluten-free diet themselves, 90% knew at least one other person who did. Two-thirds of these people known to be gluten-free either had celiac disease or another gluten intolerance. Other participants listed their gluten-free friends as simply following the fad or trying “to be healthy.”

“I think people who are gluten free by choice with no medical need for it just don’t understand the science of gluten very well.” Becky Turner, a senior biology major at UNC-Chapel Hill, has often pondered with me the cause behind the growing popularity of the gluten-free diet. “Your diet is your choice, but uninformed choices are causing those who don’t have a choice to suffer from the subsequent bad reputation of being gluten-free.”

Although true gluten-free individuals like Brislin may receive criticism from a few skeptics, at least the growing trend in the gluten-free diet is increasing the number of gluten-free products on grocery shelves. In 2014, the U.S. Food and Drug Administration (FDA) defined “gluten-free” as products containing less than 20 parts per million of gluten (FDA, allergens). However, since this labeling is voluntary, there has been an increase of marketing products as “gluten-free” even though their contents have always been naturally absent of gluten (example: hummus).

Rebecca Houser, a weight-loss consultant with a degree in nutrition science from North Carolina State University, predicts the future of the gluten-free trend: “Unless you have an actual sensitivity to gluten, the hype will die down and we will move on to the next fad diet.”

So, after all of this clarification on what gluten is and who is truly impacted by it, how do we ascertain how the craze began? Ultimately, the beginning of the focus on gluten when talking about nutrition cannot be pinpointed to one study or one patient. However, it is possible and reasonable to think that technology and research have enhanced in the past decade to the point where disorders like celiac disease and rheumatoid arthritis are better understood. I hypothesize that it is this increased understanding that has led to a new light being shined upon gluten as a harmful product. When scientists were able to pinpoint gluten as a cause of illness, people with celiac disease and other gluten intolerance disorders begin to eat gluten-free as instructed by their doctors. Friends and family who heard about their lifestyle change may not have connected the aversion to gluten to become healthier with a unique medical condition. Hence, the association of “gluten” with “unhealthy.”

This, my friends, is an example of a classic health misconception. The bigger picture lesson here: ask why. If someone (not a doctor) tells you gluten is bad, do not take their word for it. Do the research yourself – be informed! And if eliminating gluten from your diet makes you feel better, that’s great! Shrug off any criticism. You know how you feel better than anyone else.

Autoimmune Disorders and Gluten Intolerance

Some medical conditions require a patient to eliminate gluten from their diet.

Celiac disease, which affects about 1% of the population of the United States (Mayo Clinic), is an autoimmune disorder based on an intolerance of gluten proteins. Autoimmune disorders occur when the immune system attacks particles that are normally not harmful to the body, either ingested food proteins or the body’s own cells.

Celiac disease occurs when the immune system attacks the body’s own cells after gluten is ingested. Specifically, the cells of the small intestine are targeted. Celiac disease-related attacks on the small intestine damage the cells that absorb nutrients during digestion (Celiac Disease Foundation).

Celiac disease is hereditary, meaning it runs in families. The pattern of inheritance is unknown (NIH). However, 95% of people with celiac disease have the same gene specific for celiac disease predisposition (Medscape, Genetics of Celiac Disease).

Rheumatoid arthritis is another autoimmune disorder relating to gluten intolerance. However, gluten is only one of many potential signals that can lead to an autoimmune attack. Rheumatoid arthritis causes inflammation of the joints – resulting in swelling, pain, and decreased movement ability (Arthritis Foundation).

Bailey Brislin, a UNC-Chapel Hill sophomore biology major preparing for medical school, was diagnosed with juvenile rheumatoid arthritis during her first year in high school. “My ankle had been swollen for months. We went to multiple doctors that couldn’t tell me what was wrong,” Brislin recalls of the time before her diagnosis. Finally, an ankle specialist ordered an MRI and referred Brislin to a rheumatologist after blood test results indicated Rheumatoid factor (RF) in her system. RF is an antibody characteristic of rheumatoid arthritis patients as well as people with other autoimmune disorders (Medscape, Rheumatoid Factor).

The next step to calculating Brislin’s proper treatment was a 5-week series of food sensitivity testing. Although the cause of rheumatoid arthritis is not fully known, potential factors triggering joint inflammation are food proteins, pathogens, female hormones, obesity, stress, and other environmental factors (Arthritis Foundation).

The results of Brislin’s sensitivity tests showed intolerance of gluten and dairy: typical occurrences among rheumatoid arthritis patients. After a while, Brislin realized that eliminating gluten from her diet had a much stronger impact on reducing  her joint inflammation than eliminating dairy.

“After a month off of gluten, I felt better. I was able to stop taking pain medication just by eliminating gluten alone,” Brislin says, “but I should be dairy-free too.” Many years later, Brislin still regularly takes immunosuppressant drugs to improve her condition.

After many years of maintaining a gluten-free diet to ensure her joint inflammation does not return, Brislin has also gathered an opinion on the growing trend of a gluten-free diet. Brislin compares people going gluten-free for no necessary reason to people trying a vegetarian diet just to see if they can do it. “There are people glorifying the gluten-free diet. It’s just bread,” Brislin says, in response to people going gluten-free for supposed “just to be healthy” reasons.

“So gluten-free becomes this very popular trend… and I get all of this criticism for being gluten-free. My rheumatologist always talks about how you don’t have to find the specific scientific data you want, just work with what has been proven in your own case,” Brislin says as she describes her encounters with gluten-free skeptics. Brislin experienced the growth of the gluten-free trend from a very unique perspective. She understands the necessity of eliminating gluten from the diet in certain circumstances but is also critical of the diet in other instances.

Her evaluation below perfectly sums up my goal in writing this series on the growing obsession with gluten:

“There are a lot of people who are very healthy who also eat gluten. I don’t think there’s anything inherently wrong with gluten – it’s not an evil food. Not eating a lot of bread is probably a good thing, but stopping eating bread and replacing it with gluten-free bread doesn’t make much sense… I’m not sure what dietary benefits people think that’s providing…”

Stay tuned for my third and last segment of my series on the gluten-free trend. This last post will contain further analysis on the development of the gluten-free trend, data from a poll of opinions about it, and an interview with Raleigh allergist Dr. Vaishali Mankad.

What is gluten?

Contrary to what you may have heard, gluten is not harmful for most people to ingest.

(0:44)

Let me set the record straight. Gluten refers to a specific set of proteins. Proteins are large molecules made up of amino acids that perform a vast range of actions necessary for life in all living organisms. In this case, gluten proteins contribute to vital life functions for the plants of wheat, barley, and rye.

The word “gluten” comes from the Latin word for glue, and rightly so. Gluten proteins are responsible for the qualities in bread such as elasticity, chewiness, and shape1. When baking bread and other products containing these proteins, the mixture thickens and rises because of thousands of gluten proteins sticking together as the temperature increases.

Foods containing gluten:

(Not a comprehensive list)

  • Pasta
  • Bread
  • Crackers
  • Baked goods
  • Cereal and granola
  • Pancakes and waffles
  • Flour tortillas
  • Beer
  • Milkshakes

While reflecting on this list, it may seem that going gluten-free could be a way to reduce fat intake and lose some weight. After all, beer and bread are notorious for contributing to weight gain. Avoiding these foods could help you lose weight, but gluten is not at all the only ingredient contributing to this circumstance. If you choose instead gluten-free substitutes for the food items listed above, you are not improving your chances at weight loss. In fact, you are more likely to gain weight by changing your diet to eating the gluten-free form of these foods.

In a study done last year in Spain, scientists looked at the nutritional differences between gluten-containing products and their gluten-free alternatives.2 Gluten-free bread was found to contain less protein, but two times the amount of fat (a lose-lose situation). Similarly, gluten-free pasta exhibited these changes, and in addition it contained more sodium and less fiber (more bad news). Cereal bars and flour followed this same trend.

Although it has been shown that food altered to be gluten-free is less nutritious than its natural form, fortunately there are plenty of naturally gluten-free options to choose from for people suffering from Celiac disease, rheumatoid arthritis, and other conditions in the realm of gluten intolerance. Fruit, vegetables, rice, corn, and potato are all naturally gluten-free options for healthy eating.1

Now that I have established what gluten is, what food it is found in, and the nature of gluten-free substitutes, hopefully your opinion of gluten has been fine-tuned. In the next part of this series about gluten, I will discuss Celiac disease as well as rheumatoid arthritis – and why people living with these conditions live a gluten-free lifestyle.

References:

  1. Gluten-Free Diet – Celiac Disease Foundation. (n.d.). Retrieved June 9, 2015, from http://celiac.org/live-gluten-free/glutenfreediet/
  1. Miranda, J., Lasa, A., Bustamante, M.A., Churruca, I., and Simon, E. March 2014. Nutritional Differences Between a Gluten-free Diet and a Diet Containing Equivalent Products with Gluten. Plant Foods for Human Nutrition. 69(410).

Image source:

berrycart.com/blog/wp-content/uploads/2014/08/gluten.png

Special thanks to Christine Rardin for the video reference!