Friday, March 18, 2011

Gluten Sensitivity -- Promises And Problems

by Chris Masterjohn

This year has been a great year so far for research into the possibility of non-celiac gluten sensitivity.  Most exciting, Stephan Guyenet is now reporting the survey results of participants in Matt Lentzner's Gluten-Free January (see part I and part II).  I'm especially glad that of all people this survey fell into Stephan's hands, because like few other scientists I believe he'll treat the data very fairly, treating hypotheses optimistically while also honestly recognizing the limitations of the data, as part I has already proved.  The Wall Street Journal also recently gave the topic some attention, and a new double-blind, randomized, placebo-controlled trial recently provided some very weak evidence supporting the phenomenon's existence.

That trial will be the main subject of this post.  I was going to title the post "New Study Provides Incredibly Weak But Nevertheless Supportive Evidence that Gluten Might Cause Problems in Some Non-Celiacs If It Has Been Chemically Modified to Resemble the Inside of a Celiac's Intestines," but I thought I'd go with something less sarcastic in order to offer a more constructive attitude in a field that desperately needs — and deserves — more research.

So let's take a look at that study.



Researchers from the Department of Medicine and Gastroenterology at Monash University in Australia published it in the American Journal of Gastroenterology.  They gave it the title, "Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial."  Their overall conclusion in the abstract is a fair summary of their research:

"Non-celiac gluten intolerance" may exist, but no clues to the mechanism were elucidated.
 
I have no doubt in my mind that many people do not tolerate wheat.  And I think it is a very reasonable and deserving hypothesis that some of this intolerance may be due to gluten.  But much of it may not, as there are other things in wheat that could potentially be a problem.  Automatically attributing all wheat intolerance to gluten is likely to hamper someone's ability to resolve any residual health problems they might have, because a better and more accurate understanding of just what they are reacting to might help them more easily identify other foods that are a problem.

This new Australian study is, to my knowledge, the first well controlled study demonstrating harmful effects from consuming wheat gluten in live people without celiac.  The study was conducted extremely well, although the reporting of the data was poor and the effects were not very impressive.

One of the strengths of the study is that the investigators actually controlled for the possibility of intolerance to non-gluten aspects of wheat by adding pure gluten to gluten-free muffins and bread.  They randomly allocated half the subjects to a group that ate the gluten-free muffins and bread with nothing added, and the other half to a group that ate the same muffins and bread but with 16 grams per day of pure gluten added.


They were particularly concerned about fructans, which include the shorter-chain fructooligosacharides and the longer-chain inulin, and they cited a study showing that both fructose and fructans induce symptoms in patients with irritable bowel syndrome.


The main source of fructans in the American diet is wheat:



Moshfegh AJ, Friday JE, Goldman JP, Ahuja JK.  Presence of inulin and oligofructose in the diets of Americans.  J Nutr. 1999;129(7 Suppl):1407S-11S.

As Stephan pointed out, a good way to tell if you don't tolerate fructans well is if you don't do well with onions.  Other sources include bananas, asparagus, chicory root, dandelion greens, garlic, globe artichoke, Jerusalem artichoke, leeks, barley, and rye.  Out of these, bananas, globe artichokes, and the non-wheat grains contain the least.  

Unfortunately, a study's greatest strength can sometimes also be its greatest limitation.  It turns out that the gluten used in this study was deamidated.  

As I pointed out in my last gluten post, "Wheat: In Search of Scientific Objectivity and New Year's Resolutions," this is the process that normally occurs in the intestine of someone who has celiac disease.  The enzyme tissue transglutaminase ordinarily does not exist inside the intestinal lumen, but when the intestine suffers tissue damage, cells release it.  The enzyme's molecular action is to convert the amino acid glutamine to the amino acid glutamate within proteins in order to cross-link proteins as part of the tissue repair process.  However, it also manages to make a gluten fragment immunoreactive.  This fragment stimulates the immune reaction in celiac disease only after being deamidated, which suggests that there may be something besides gluten, such as a virus or some other pathogen, that may be involved in causing intestinal damage before the reaction to gluten actually sets in.  However, once celiac gets going this enzyme hangs around perpetually, since celiac involves perpetual intestinal damage.

So this gluten, it turns out, was chemically deamidated instead.  

How did I find this out?  Well, first I looked at the company's web site.  The actual product used in the study, GemTec 1160, was nowhere to be found.  It turns out that the company no longer makes it.  


I have to admit, I've never eaten anything with a name like "GemTec 1160" and the name made me suspicious.  If they used "Bob's Vital Wheat Gluten" or something like that I probably wouldn't have put so much effort into figuring this out.

I also saw that many of the company's wheat gluten products were treated enzymatically, and I wondered whether some might be treated with tissue transglutaminase, since the food industry often uses this enzyme and at least sometimes, as in the case of Japanese noodles, actually treats wheat with it.  So I asked the corresponding author listed on the study, who responded very politely and very professionally but not very helpfully.  After all, the investigators had no idea how the gluten was treated and suggested I contact the company.

So I did.  A representative of the company told me that although he couldn't divulge the specifics, GemTec 1160 is a "chemically modified protein" that is "definitely deamidated."

So it turns out that this "gluten" is the type of gluten you'd find in the intestine of someone with celiac disease, who has been mis-behaving and eating all sorts of bread.  The type of gluten you'd only find after they ate it.


(Of course, the specific digestive pattern might be different, but the deamidation is the same.)


So unfortunately, while the study was well controlled, it's not entirely clear that its findings are relevant to anyone eating bread, as bad as most bread may be.  Providing they aren't having a friend with celiac disease eat it first.


That said, let's take a closer look at what the study actually found.


First, they recruited people who had already decided to go gluten-free.  These were people who were already convinced they had a problem with gluten.  This makes the study very vulnerable to a placebo effect.  Or, more accurately, a nocebo effect.

Thankfully, the investigators not only used a placebo control, but even assessed the efficacy of that control by asking the subjects to guess which group they were in.  This is a sign of a high-quality study performed by conscientious and rigorous scientists.  The authors reported a statistical analysis that suggested the blinding was effective, but the corresponding author did helpfully inform me that 58 percent of the subjects correctly guessed their group.  This is hardly better than tossing a coin. 

The authors, however, reported no details about how they tested blinding efficacy.  Ideally, the investigators would urge the subjects to report the truth rather than an answer they consider socially acceptable, and would give them the option of saying they didn't know which group they were in, or even rating their confidence about which group they belonged to if they were guessing.  In a truly successful blinding, most of patients would honestly state that they didn't know what group they were in.  This is quite different from having everyone guess and finding that the proportion of people who guessed correctly is not statistically significantly higher than half.

Ineffective blinding does not necessarily invalidate a study's conclusions, because it could have been the intestinal symptoms that gave away the blinding rather than the taste of the muffins.  That is why it is best to also include a question about why the subjects thought they were in a particular group in the questionnaire.  In a study of the role of fish oil in depression where 60 percent of the participants guessed correctly whether they were in one group or the other based on the taste of the capsules, we'd be much less convinced than if they guessed correctly based on whether their depression improved.  The same principle operates in this study, but we don't have any of these details.



Fifty-eight percent may not be statistically better than a coin toss if people are forced to guess one way or the other, but it's certainly enough people to bias the results in one direction in the placebo group and in the opposite direction in the gluten group, if there is in fact a placebo or nocebo effect going on.




And that is particularly concerning because there was no biochemical evidence to back up the self-reported symptom ratings.

There were no changes in serum antibodies to gluten, C-reactive protein (a marker of inflammation), or intestinal permeability.



Granted, this in no way rules out that the chemically processed, deamidated gluten had a real effect.  These markers are very limited and there could have been a real effect mediated by innumerable other pathways.  And a recent paper by gluten researcher Dr. Allesio Fasano and colleagues recently concluded that people whom the investigators judged to be gluten-sensitive but without celiac or wheat allergy actually had reduced intestinal permeability.

This certainly contradicts the idea that zonulin-mediated intestinal barrier dysfunction has any relevance to non-celiac gluten sensitivity, but it also makes it clear that the inability of the Australian study to show a change in intestinal permeability in no way invalidates their findings or proves that all they discovered was a nocebo effect.



Nevertheless, the way that the authors present their data is rather frustrating and it is difficult to disentangle just how much of an effect there actually was.

The main endpoint was "the proportion of patients answering 'no' on more than half of the symptom assessments to the question, 'Over the last week were your symptoms adequately controlled?'"  They asked this question for each of the six weeks of the study.


But here is how they reported the data for their main endpoint:
Significantly more patients in the gluten group (68%; n=13/19) reported the answer, “no” (the primary outcome question) compared with those on placebo (40%; n=6/15) for more than half of the study therapy duration (P=0.001; generalized estimating equation).
The first disturbing thing is that there was a very high rate of people who did not have their symptoms under control in both groups.  But the most frustrating thing is that the authors do not report the raw data and we have no idea who had these symptoms under control at the start of the study, nor whether the groups became more divergent or more similar over the study period.

If few people at the beginning of the study answered no, this number increased over time in the gluten group, and the difference between the gluten and placebo groups continued to diverge over the duration of the study, this would be quite convincing.  If the rate of answering "no" was high to begin with, and if the difference between groups was greatest in the first half of the study but diminished over time, this would not be very convincing at all.


Likewise, they reported increased severity of symptoms in both groups, but a greater increase in the gluten group.  They never reported the actual values, so it is impossible to judge whether this is likely to be a true effect or likely to be regression to the mean — the tendency for extreme values to gravitate towards "average" values over time.  

In order to make the differences in change from baseline meaningful, we would want assurance that symptom severity was similar between the two groups at baseline, and we would also want assurance that the absolute severity of the symptoms and not just their change from baseline was also different by the end of the study.  Unfortunately, this report does not provide that assurance.


Overall, I am left with the following impressions from the study:
  • While the study was well controlled, the data were not thoroughly reported and it is difficult to tell how convincing the effects are. 
  • The possibility that many people knew which group they were in raises concerns about a nocebo effect, which is the opposite of a placebo effect.
  • The failure to corroborate any of the self-reported symptoms with biochemical evidence further supports concerns about a nocebo effect.
  • The fact that many people reported poor control of symptoms during the study even in the placebo group and that symptoms worsened in both groups suggests either a nocebo effect or a harmful effect of the gluten-free bread and muffins, both of which are very plausible.
  • The relevance of chemically deamidated gluten to someone without celiac who is eating bread is highly questionable.


Despite these imperfections, this study is encouraging because it shows that rigorous experimental evidence can and will be used to investigate the possibility of non-celiac gluten sensitivity.  Now we can begin to move away from cell culture studies with questionable physiological relevance and move into studying the real effects of gluten in live people.  This study marks a milestone in non-celiac gluten sensitivity research and shows that the quality of research is increasing.




The relevance of gluten to people's apparent intolerance to wheat remains an open question that deserves and needs more attention and investigation.

I will eventually write a more in-depth post about wheat in my series on food toxins and food intolerances.   In the mean time, I have a few quick observations:
  • People who react to gluten are likely to have an equal or worse problem with white bread than with whole grain.  White bread should have a greater proportion of gliadin than whole grain bread.
  • You can probably best test whether you react to wheat germ agluttinin by trying wheat germ, as it would be most concentrated in this fraction.
  • If you react to wheat bran, this would seem to implicate the fructans, or at least some portion of the fiber.  Fructans are present in whole flour at similar concentrations, but at least the bran has less of the other confounders.  If you react to onions and other foods high in fructans, this is also supportive.  However, different foods have fructans of different chain lengths, and these different fructans could affect people differently.
  • Gliadin ("gluten") is sort of a non-specific lectin that binds a number of different sugars including mannose polymers, N-acetyl-glucosamine, galactose, arabinose, and rhamnose.  Wheat germ agglutinin is specific for N-acetyl-glucosamine, but also reacts with galactose.  I have talked to a few people who found that supplementing with these sugars help them tolerate gluten.  While this is not going to provide a very specific test and should be considered quite speculative, if supplementing with these sugars proves helpful, this would seem to make it more likely that gliadin or wheat germ agglutinin is the culprit.
I'm definitely looking forward to reading more of the Gluten-Free January results, and I'm excited to see more and more direct research in humans coming out on this issue.  This should prove to be a good year for understanding more about wheat.

Read more about Chris Masterjohn, PhD, here.

38 comments:

  1. There is a very good chance than anyone who claims a "gluten" sensitivity should be treated for psychiatric problems.

    But that is my opinion, and your level headed approach is appreciated.

    A few questions:

    1. Gluten as a hard protein to digest. Agree -- I mean it is basically glue, no? Does eating with certain other types of food help? Conversely, eating it is sugar is very bad (the largest caloric intake of Americans is grain based desert)

    2. Frutans are inulin? The only time I've had a "wheat allergy" is eating this double fiber bread that had inulin added. (The allergy was just some gas and bloating. Nothing serious.)

    3. What is a "safe" level of wheat intake?


    I fully believe that eating too much bread or bread will make you a bit fat. Quality is a big issue too. I've noticed cheap pasta is this ugly grey color vs. high quality pasta which is yellow.

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  2. great job. i am curious why white bread would have more gliadin than whole grain bread. i would have thought i would be the opposite.

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  3. Anonymous,

    Gliadin is from the endosperm, which is the part concentrated in white flour. A quick Google search, for example, yields this:

    ==========
    http://tinyurl.com/6jdarv2

    Salcedo et al., Low MW gliadin-like proteins from wheat endosperm.

    "The term gliadins was originally used to designate the prolamine fraction from wheat endosperm, a mixture of protein components that is extracted with 70% ethanol [1]."
    ==========

    Robert,

    Yes it is hard to digest, although in most people full digestion occurs intracellularly within intestinal cells, and oral bacteria may initiate the process. Presumably consuming it with the sugars that bind it should help, and fermenting it should help, as well as choosing lower-gluten varieties. Yes, inulin is a fructan, generally referring to fructan polymers of longer chain length. It's most notorious effect, even among those who advocate it for intestinal health, is farting. I don't know the answer to 3, but it is very clear it depends on the individual as well as the type and processing of wheat. I doubt there is any satisfactor answer to it that can be expressed in one or a few sentences.

    Chris

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  4. Hmm. Chew your food?

    In terms of bright lines rules, I think there are good reasons to be careful about eating wheat based on weight gain. Having grain be your largest caloric intake is probably not good from a micro-nutrient perspective. Worrying about it from an allergy is a waste of time.

    Starch > grains > sugar

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  5. Can you clarify the meaning of the Enterolab stool tests and the claim about approximately 1/3 of Americans having gluten sensitivity based on the antibodies from that test? The percentage of celiacs just seems so low in comparison. Why aren't the antibodies decisive evidence of gluten sensitivity, independent of the celiac condition? Sorry if you've already explained this in another article!

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  6. "since celiac involves perpetual intestinal damage." It's not the first time you say something along these lines. Could you please expand on this? I thought that, provided that a celiac stopped eating gluten and dealt with any secondary intestinal ailment, the intestine could regenerate in a couple of years. If you have bad news I would like to know.
    Thanks for the article.

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  7. Some where, maybe gluten free planet, it says that humans cannot digest gluten, so why would anyone want to eat it? Just for the taste? Wake up people, food is to provide energy only. It it gives us problems, just stop eating it, along with sugar, all grains, excess omega 6 oils and all manufactured eatable products. Studying the problem is where the money is at. But what do I know.

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  8. Any chance you could do a post of the connection between gluten and Hashimoto's? I have Hashi's and was scared into going gluten-free based on what I read about that from various sources. I was hoping to see some big difference in how I feel or in my weight but 6 months later, there has been no change, which is very disappointing, because being GF is a big pain! Now I cannot decide if I should go back to eating some wheat occasionally. I trust you to be totally objective and explain it clearly :)

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  9. Responses to many anonymous comments.

    Anonymous, most researchers, to my knowledge, consider IgA antibodies in the gut to be protective. This is supported by the fact, for example, that people with IgA deficiency have a ten-fold increased risk of celiac. Antibodies do not necessarily do damage. It depends on the Fc region in the tail of the antibody, which is what determines the antibody class. In general, IgA seems to "mop things up," rather than elicit inflammation. I have seen a hypothesis that IgA might somehow facilitate transport of undigested gluten particles to the space where the immune system will recognize them, but to my knowledge there is no strong support for this. It is common for gut IgA antibodies to be polyreactive. For example, one antibody might bind single-stranded DNA particles, E. coli, and mouse chow. This further supports the idea that IgA in the gut has a "mopping up" function. Dr. Fine's results on his web site indicate that his test has little specificity for predicting who will and will not improve on a gluten-free diet; therefore, I do not consider it definitive evidence of anything. I will post on this in the future perhaps.

    Anonymous, sorry, I meant active celiac, not healed celiac. That said I will have to dig further to see if tTG expression changes with gluten withdrawal, and how much.

    Anonymous, I am not advocating eating gluten. However, it is incorrect that it is not digested. It is more difficult to digest, but in healthy individuals complete digestion can take place intracellularly in the intestine.

    Anonymous, yes, thyroid health will be a major portion of this site and blog eventually! And connection to gluten will have to be investigated.

    Chris

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  10. As a celiac who knows a lot of gluten sensitive people, your article is interesting and appreciated (I saw the study, but would never have known to dissect it like you did). What's more interesting is that it's being studied at all, and FINALLY!

    Have you heard of Cyrex Labs? They have new serum tests for other gluten proteins and much more. Here's an overview by a random dr I found online: http://bit.ly/hMtO0B.

    Here're the Cyrex arrays available at this time: http://bit.ly/f4QTYT.

    Here is Dr. Tom O'Bryan's info about the tests (comprehensive): http://bit.ly/drobryangworldtests

    Test prices: http://bit.ly/gu3NaJ


    I'm looking forward to a few of these tests myself (leaky gut, maybe cross-reactive foods), and have asked my doctor to investigate/open an acct w/the lab. I do not know anyone who has had them, but have heard Dr. O'Bryan promise them for some time.

    I hope this helps in some way.

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  11. Great analysis, thanks! Glad that you took up fructans. Their role in inducing gut symtomps may be generally underestimated.

    Some people who think they have wheat intolerance may also have IBS and be sensitive to other FODMAP carbohydrates such as fructose, polyols, galactans etc.

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  12. Enjoyed your post on the Monash University trial; I agree the trial was methodological one of the best yet looking at a role for gluten. Looking at the Biesiekierski paper, they also suggested a few other potential routes of effect for their results including mast cell activation and a potential role for 'neurally-active' gluten peptides (I assume this means gluteomorphins et al perhaps along the same lines as Dohan's hypothesis circa 1960s). It is a shame they were not able to comment/study these issues further.

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  13. Chris, I can bookmark your blog, but not individual articles, when I click on the title it still shows http://www.cholesterol-and-health.com/cholesterol-blog.html even though it becomes the only article I can see and I can now see the comments.

    There are many individual articles on your blog I'd like to bookmark so I can reference them easily in the future. Any thoughts?

    P.S. I have some of your articles at weston price bookmarked.

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  14. Walter,

    What browser are you using? In Firefox, I just go to "bookmarks" in the toolbar at the top, and select "bookmark this page," which it says you can also do with control + D. I can achieve the same in Internet Explorer by selecting "favorites" and then "add to favorites."

    Chris

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  15. Walter, I don't use Chrome but this should work the same way. If you open a blog post in a new window/tab, the address for that article will show up in the address bar.

    I do this anyway because I don't like the "frame within a frame" format of the blog and opening a blog post in a new tab gets rid of the frame.

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  16. Walter and Frosty -- that explains the discrepancy. I always read it in full frame the way Frosty does, so that's how it was when I successfully tried bookmarking it. I will try to change the format so this occurs automatically when I have some time.

    Chris

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  17. Thanks Frosty.
    It works just like you said within the same tab, the address does not change, if I open it in a new tab, the address does change and then I can bookmark the individual page.

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  18. European researchers compared 1,238 people who had been diagnosed with colon cancer with a similar number of adults without that history. They found that the higher the HDL level, the lower the risk of developing colon cancer over about four years.

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  19. I recently stopped eating wheat (about 5 months) and have eliminated acid reflux symptoms present for nearly 25 years, problem present since mid 20's. I also have hated onions since childhood. I have within the last 10 years realized that boiled onions do not effect me such as those in abondigas soup. What does boiling do to the fructans?? I would seem these are the common denominater.

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  20. This comment has been removed by the author.

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  21. I'm thinking of re-testing myself on wheat. I have been near wheat free (one small serving of Baklava 4 to 6 months apart) for 4 years and initially got rid of the wheat because I felt significantly better during 2 one-month runs with no wheat.

    I didn't control for the amount of fish oil I was taking at the time, among other things.

    Most importantly, I used the very coarse measurement "how I felt"; that's the point of this post - are there finer ways to measure these things - does anyone reading this have links or other info on good ways of running this type of self-experiment?

    I've been reading more Seth Roberts and feel motivated to try more of this type of thing, but want to be more rigorous about it.

    I doubt that I have any kind of classic gluten sensitivity - I ate wheat daily for the 1st 30 years of life and there's celiac in my family but distant relatives, no close relatives I know of (the closest I know of is a second cousin)

    re: celiac and schizophrenia

    Just a wild idea: Anyone seen any link between celiac and greater risk of Toxo?

    Maybe (more wild ideas) celiac sufferers are more likely to have cats?

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  22. I have problems with regards to gluten and in your post I am sure I fall into the problem side. But if modifications can be made maybe it would be a promise for sufferers like me.

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  23. I make an effort to no touch in gluten.
    Gluten and milk make me aloft of problems with my stomach.

    P.S: you have a great blog

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  24. Interesting! I identified a gluten sensitivity problem several years ago and try hard to avoid it. Recently, following Ray Peat recommendations and eating more fruit, I started getting frequent bouts of diarrhea, gas, bloating, stomach pain. It took me a while to connect it to the fruit. What helped me make the connection was when I nearly passed out from the cramps and pain after eating some cooked onions recently. I did some research and saw this was probably due to a fructose malabsorption problem, and that is when I realized the other bouts of diarrhea were caused by consuming various fruits and juices. After reading your article, now I understand why the wheat was such a problem for me! Now I will have to investigate the fructans in other grains, since I react to most of them also.. Thanks for the info!

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  25. Cathy & others,
    "...eating more fruit, I started getting frequent bouts of diarrhea, gas, bloating, stomach pain"
    Did you have those simptoms after eating fruits alone (not less then an hour before eating something else and only when your previous meal is fully digested)?
    I have numerous problems with my digestive system, including various intolerances, LGS, IBS and other stuff (If Robert Evans' reading this I have little doubt he thinks that I should be treated for psychiatric problems, right, Robert? I wish YOU had some serious form of allergy, then you wouldn't make such judgements so easely...), but almost never had the problems mentioned above if I ate fruit alone (unless they are too rough (green apples, for example) or eating them wiht peel, cold, unripe, unsoaked (if dried) or if they treated with some shit derived from GM-corn (even "organic" aren't safe in this case) or whatever). But when I eat fruit with other foods (and some better not to combine even with other friuts), I do suffer from bloating, gas, pains and so on nearly every time I do (did) so (not without some exeptions - rice & raisins usually do well, sweet apples and pumpkin (both cooked) are OK). It's also true for most people I know who claim they can't tolerate fruits.
    If I were Robert Evans it could lead me to a conlusion that those who claims a "fructose" sensitivity/malabsorption should be treated for psychiatric problems. Happily, I'm far from it.
    Just wondering how much people that having problems with digesting fruits wouldn't have them if they ate them right? It seems to me that "real" "fruit intolerance" (and if it really takes place, not only fructose malabsorbtion but also a reaction to some naturally occuring toxins or antinutrients might be a reason) is very rare (but I DON'T deny it and (unlike Robert Evans) I DON'T think that if someone's expiriencing something uncommon or smth that I hadn't, (s)he needs psychiatric treatment).
    P.S. Adding some "sweet" spices like vanilla, cardamom or cinnamon will aid fruit digestion. By the way, those who have problems with pancreas should eat cinnamon with sugars (and without too - 1/2-2+ tsp daily).
    P.P.S. Sorry for bad english.
    P.P.P.S. from this day "robertevans" becomes a common noun to me
    P.P.P.P.S. some white-coat robertevanses have invented new "mental disease":
    http://www.naturalnews.com/029098_orthorexia_mental_disorder.html

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  26. I also have some problems in digesting Gluten so I try to avoid eating it even if I don't have Celiac disease.


    herbal remedies

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  27. Their like you go through my mind! You peer to understand a great deal concerning this, for example you wrote the particular information inside as well. I feel that you simply might use several s.chemical. to be able to energy the message home a little bit, even so besides that, that is outstanding weblog. A great go through. I?ll undoubtedly come back.

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  29. I feel that is a fascinating point, it made me suppose a bit. Thanks for sparking my considering cap. Now and again I am getting such a lot in a rut that I just really feel like a record.

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  30. I don't seem to have any ill effects from gluten. However I noticed that my energy level seems to be higher without it.

    natural health products

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  31. I will have to investigate the fructans in other grains, since I react to most of them also.. Thanks for the info!

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  32. Great analysis, thanks! Glad that you took up fructans. Their role in inducing gut symtomps may be generally underestimated

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  33. yes this is hitting all the nails on the head

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  34. A great lesson in how to read a paper, rather than just relying on the title or the distortions often found in press releases.
    Great sleuthing on the chemically deamidated gluten, too! I am amazed that the authors used this material for their study, rather than plain old gluten.
    I should stress that chemical treatment will potentially modify ALL the glutamines in a protein, while the enzyme tissue transglutaminase is much more specific and will leave many glutamines intact. This means to me that the chemical treatment might have actually BLOCKED the response that they were looking for!

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    Replies
    1. Thanks! Interesting point at the end -- do you know of any studies showing that tTG-deamidated gliadin is immunogenic but chemically deamidated gliadin is not?

      Thanks,
      Chris

      Delete
  35. Here's the latest (as far as I know)on T. Gondii and Gluten:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3510169/

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  36. Good job with the post. Thank you so much for sharing the same.

    ReplyDelete

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