There was an interesting article in the New York Times this Sunday about celiac disease and gluten intolerance. Celiac disease is seemingly clearly defined by specific genes. However, it is much more than just genetics. Celiac disease is the perfect storm for autoimmunity.
Researchers are finding that although 30% of people with European ancestry carry predisposing genes, more than 95 percent of the carriers tolerate gluten without any problems.
The genes may be present, but they do not cause celiac.
It’s not just genetics or the presence of gluten. It takes a combination of events to trigger celiac disease.
Studies show that celiac is on the rise, especially in adults. There are many reasons for this, including a dramatic change to the wheat in the past fifty years (check out this source for ancient Einkorn wheat) and the widespread use of gluten in many processed foods.
But that is also not the complete answer.
There are two cellular receptors called the human leukocyte antigen (H.L.A.). Having these receptors indicates an increased response to gluten. However, studies have shown that mice with these H.L.A. genes still need a trigger in order to develop a problem with gluten.
Importantly, a comparative study between genetically similar Russians and Finns – in the now bisected Province of Karelia – has shown that one in five hundred Russians express celiac while one in one hundred Finns are affected.
According to Velaquez-Manoff, the same pattern holds for other autoimmune and allergic diseases.
Finland ranks first in the world for Type 1 autoimmune diabetes. But among Russian Karelians, the disease is nearly six times less frequent. Antibodies indicative of autoimmune thyroiditis are also less prevalent, and the risk of developing allergies, as gauged by skin-prick tests, is one-fourth as common.
The researchers believe that because Karelia is a remote area of Russia,
The prevalence of transglutaminase antibodies and celiac disease is lower in Russian Karelia than in Finland. This may be associated with a protective environment characterized by inferior prosperity and standard of hygiene in Karelia.
We know that exposure to bacteria and other microbes is protective. People who live on farms and are exposed to multitudes of bacteria seem to have fewer allergies.
In fact, the investigators found that 75% of Karelian children host Helicobactor pylori, which is implicated in ulcers – but new research suggest that H. pylori is protective against asthma.
If they looked, I bet they would probably find plenty of helminthes as well.
In 2007, Spain, Dr. Sanz, a researcher at the Institute of Agrochemistry and Food Technology in Valencia, Spain, published a study that showed that bifidobacteria were decreased in celiac children and other bacteria, particularly, E.coli, were increased and virulent.
In rats, the E. coli … intensified inflammation to gluten, prompting what’s sometimes called a “leaky gut” — the milieu suspected of contributing to celiac disease. Conversely, bifidobacteria protected the intestinal barrier. Microbes, it seemed, could influence the immune response to gluten.
In February 2012 in the journal, Clinical Reviews in Allergy and Immunology a paper called Leaky gut and autoimmune diseases was published. The author, Alessio Fasano, M.D., had been researching this topic in relationship to celiac disease and gluten sensitivity. The review paper he wrote is focused on the role of impaired intestinal barrier function (leaky gut) on autoimmune pathogenesis.
In short, he was trying to get to the real causes of autoimmunity.
In this paper, Dr. Fasano proposed a new theory that suggests that autoimmune disease is not only preventable, but also reversible.
It involves a perfect storm of three conditions:
What this means is that people who have a leaky gut, as well as the genetics for celiac disease, can develop autoimmunity when they eat gluten.
This will cause intestinal damage.
The increased intestinal permeability that is part of the leaky gut, allows the environmental trigger (which in this case is gluten) to access the body and this triggers the genetic predisposition.
Conventional understanding of celiac included variable numbers 2 and 3, but instead of leaky gut, the third variable was the presence of circulating autoantibodies to the enzyme tissue transglutaminase. Using these antibodies excludes many people who do not test positive for them – however, they still have problems with gluten.
Acknowledging that autoantibodies are present does not explain why they are there.
Fasano’s theory does explain this.
Furthermore, it suggests that if you can cure the leaky gut, you can cure the autoimmune disease.
Breast feeding supports the development of bifidobacteria in infants. This is illustrated by an epidemic of celiac disease that occurred in Sweden 30 years ago.
Looking back, they realized that just before the spike in celiac occurrences, the government instructed parents to delay the introduction of gluten until the babies were 6 months old – which is when many children are weaned.
At the same time, companies had increased the amount of gluten in baby formula so the babies were getting a large dose of gluten without the protection of breast milk.
According to Velaquez-Manoff,
Among Swedes born between 1984 and 1996, the prevalence of celiac disease tripled to 3 percent. The epidemic ebbed only when authorities again revised infant-feeding guidelines: keep breast-feeding, they urged, while simultaneously introducing small amounts of gluten. Food manufacturers also reduced the gluten content of infant foodstuffs… partly as a result of Sweden’s experience, the American Academy of Pediatrics now recommends that infants start consuming gluten while still breast-feeding.
Best said by Dr. Hyoty, a scientist at the University of Tampere in Finland:
We could probably prevent celiac disease if we just give the same environment to the Finnish children as they have in Karelia… but there’s no way to do it now, except to move the babies there.
The researchers are saying that the Russian Karelians are living as the Finns lived 50 years ago.
To me that means that they are eating their traditional diet with lots of fermented foods. This supports their intestinal microbiome and protects against autoimmunity and leaky gut.
The gluten-free diet is conventional treatment for celiac. Some people do very well with this but there is research that shows that only 66% of celiacs fully heal on the gluten-free diet after 5 years.
Those 66% need to go beyond gluten-free
Research also shows that celiacs have a four fold increase in morbidity and mortality. That means that even with a gluten-free diet, celiacs will be sicker and die younger.
The solution is to start on a real food diet, go completely grain-free and eat a diet that includes foods that are very easy to digest and assimilate. These foods are full of the nutrients so desperately needed in order to heal and seal the gut.
Source: Who Has the Guts for Gluten? Written by Moises Velaquez-Manoff, the author of An Epidemic of Absence: A New Way of Understanding Allergies and Autoimmune Diseases – a book about the hygiene hypothesis and the use of helminthes as a therapeutic modality.
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