Gluten Sensitivity: What Does It Really Mean?
By Julianne Wyrick
March 4, 2013
"Are you the nurse? You look so young," I said to my mom as I slowly emerged from my anesthesia-induced slumber, apparently not coherent enough to know who she was (but thankful that my drugged speech was so complimentary). I'd just undergone an endoscopy, meaning a doctor had inserted a small, flexible tube through my mouth down into my small intestine. After sampling the intestinal tissue, he'd be able to tell me whether I had celiac disease, an autoimmune disease in which eating gluten-containing food causes the destruction of the small intestine's inner lining.
Soon, the diagnosis came: negative. My doctor explained that, rather than celiac disease, a "gluten sensitivity" was likely the cause of the bloating and abdominal pain I'd been experiencing. If I removed or reduced the gluten in my diet, I could probably reduce my symptoms. So I did. And for the most part, staying away from gluten meant the discomfort stayed away too.
But eventually my science background got the better of me, and I had to know what was really happening in my body. What does "gluten sensitivity" really mean?
Unfortunately, there's no easy answer. When patients without celiac disease exhibit symptoms that improve with a gluten-free diet, they are often categorized as "gluten-sensitive." These symptoms may range from abdominal pain to bloating to fatigue.
In the past, the very existence of the condition has been questioned because of its unclear diagnosis. However, as the New York Times notes, new studies suggest that gluten sensitivity does exist.
What this and other recent articles haven't mentioned is that researchers have gained some interesting insights into how it may work. They've also discovered that so-called "gluten-sensitivity" may not be caused by gluten at all.
To understand new research on gluten sensitivity, it's first important to understand the other two gluten-induced conditions, celiac disease and wheat allergy. Both conditions involve the immune system.
In celiac disease, the presence of gluten in the small intestine triggers a response by the adaptive immune system, which is the part of the immune system that reacts to specific invaders by producing antibodies. The unwanted immune reaction ultimately leads the body to attack its own healthy enterocytes, or cells lining the small intestine.
One reason this unwanted response occurs is because individuals with celiac disease have a "leaky gut." Enterocytes lining the small intestine are normally "glued" together by tight junctions. In people with celiac disease, the glue doesn't hold. Gluten fragments can sneak through these gaps and provoke an adaptive immune response that damages the intestinal lining (the full mechanism is described in great detail in this 2009 Scientific American article).
The second type of gluten-induced condition, wheat allergy, is also mediated in part by the adaptive immune system. In this condition, gluten results in synthesis of IgE antibodies that cause an inflammation. Inflammation can cause local discomfort and damage to healthy tissue.
People with "gluten sensitivity," on the other hand, do not show evidence for the type of immune reactions that occur in those with celiac disease or wheat allergy.
So what is causing gluten sensitivity? Some recent research suggests the issue still lies with the immune system. However, instead of the adaptive portion being to blame, the innate immune system is thought to be the culprit.[3,4]
If the adaptive immune system is a tailor who designs custom jackets, the innate immune system uses one-size-fits-all ponchos. Instead of making antibodies that recognize specific invaders, cells of the innate immune system have receptors known as TLRs that recognize broad patterns present on a variety of invaders. Then, the TLRs trigger a quick inflammatory response.
A 2011 study found gluten-sensitive patients have higher expression of the TLRs compared to control patients. This finding suggests the involvement of the innate immune system. In addition, the study supported the idea that the adaptive immune system is not involved in "gluten sensitivity." Enterocytes of gluten sensitive patients are tightly glued together, unlike those of celiac disease patients. As a result, gluten fragments can't get in between the cells to activate the adaptive immune system.
But is this innate immune response actually caused by gluten? Data from another study published in December suggest that a family of proteins in wheat may be to blame. The proteins, amalyse-trypsin inhibitors, or ATIs, activated one type of TLR and caused an innate immune response in human immune cells and in live mice.
Interestingly, the ATI content in wheat has dramatically increased in recent years. ATI proteins naturally protect wheat from pests. As wheat is bred to be increasingly pest-resistant, ATI content also increases. An increase in ATIs might explain what appears to be a growing amount of gluten-sensitive people.
ATIs aren't the only non-gluten molecule accused of being behind so-called "gluten-sensitivity." Wheat carbohydrates, known as FODMAPs, have also been implicated. However, these molecules don't cause abdominal discomfort and other symptoms by provoking an immune response. Instead, the indigestible nature of these carbohydrates might cause water retention and gas production in the small intestine, leading to bloating.
While we've made some progress towards better understanding what may cause "gluten sensitivity," many questions remain. In the meantime, for those whose doctors recommend a diet sans gluten, there will be plenty of food to choose from, as the gluten-free market continues to boom.
1. Aziz, I., Hadjivassiliou, M., & Sanders, D.S. (2012). Does gluten sensitivity in the absence of coeliac disease exist?. British Medical Journal, 345, e7907.2. Fasano, A. (2009, August). Surprises from Celiac Disease. Scientific American, 301(2), 54-61.3. Junker, Y., Zeissig, S., Kim, S., Barisani, D, Wieser, H., Leffler, D., ... Schuppan, D. (2012). Wheat amylase trypsin inhibitors drive intestinal inflammation via activation of toll-like receptor 4. Journal of Experimental Medicine, 209 (13).4. Sapone A., Lammers, K.M., Casolaro, V., Cammarota M, Giuliano, M.T. ... Fasano, A. (2011). Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity. BMC Medicine 2011, 9(23).5. Shepherd, S.J., Parker, F.C., Muir, J.G., & Gibson, P.R. (2008) Dietary triggers of abdominal symptoms in patients with irritable bowel syndrom: randomized placebo-controlled evidence. Clinical Gastroenterology and Hepatology, 6, 765-71.
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Gluten Free Easter Egg Pops Rice Crispy Treats
With Easter only days away, here is an easy and yummy Easter treat your kids will love. My three-year-old helped me mix them up so you can make it a fun and learning experience also.
Thanks to Kelloggs Gluten Free Rice Krispies, this recipe is gluten free. If you are not on the gluten free diet, then simply use the regular Rice Krispies.
What you need:
6 cups of Gluten Free Rice Krispies
3 tablespoons of butter
10 ounce bag of marshmallows or 4 cups mini marshmallows 1 bag of Chocolate candy melts (you will not use the whole bag, only what you need)
Plastic Easter eggs
Cake pop sticks (use only if you want the pops on sticks, otherwise put the treats on a tray with wax paper)
Styrofoam or tall cups filled with rice. (this is to put your egg treats in if you use the cake pop sticks)
Large bowl, measuring cup, tablespoon
The recipe is off the back of the Gluten Free Rice Krispies box, the Easter egg pop is my creativity.
In a sauce pan on low heat melt the butter, then add the marshmallows and melt them together. Make sure you stir often and keep on low heat, so as not to burn the surgery mixture.
Into a large bowl pour the Gluten Free Rice Krispies. When the butter and marshmallow mixture is completely melted pour the surgery liquid over the cereal. Grease your utensil with butter or cooking spray to ease the mixing of the rice crispy treats, or you can use your hands.
When mixture is a sticky mess, and it will be sticky, grab the plastic Easter eggs, and then spray or butter the insides of the egg. Stuff each side with rice crispy treat mixture, and then snap them closed. Do this on as many eggs as you want, and then place them in a bowl and put into your refrigerator to harden.
If you do not want to do Easter eggs simply grease a pan and lay the rice crispy treats in the pan and put in the refrigerator to harden.
After an hour your eggs will harden, and you can start the decorating process. Make sure you have your sprinkles, cake pop sticks, Styrofoam or cups of rice ready. Melt whatever amount of chocolate melts you need, because it can go terribly wrong like when I made these pops for my daughter’s third birthday earlier this month.
Take a plastic egg and open it up to remove the egg-shaped rice crispy treat. Use a tooth pick to make a hole for the cake pop stick so you will not break the egg by pushing with too much force.
Take your egg shaped treat and dip the bottom half in the chocolate candy melt, tapping off any excess. Take a cake pop stick and dip one end into the chocolate, and push it into the pre-made hole. Then quickly shake sprinkles over your egg and put them into the Styrofoam or tall glass with rice. If your eggs get too soft you will need to put them back into the refrigerator to harden again. Once you have a few eggs decorated, make sure you put them back into your fridge until they are ready to serve or they will fall off the stick. I discovered the bigger your egg the more likely it WILL fall off the stick. So it is best to use small to medium sized plastic eggs.
This is an easy, but messy and sticky treat that your kids will love.
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SEARCHING FOR ROGER FEDERER’S BRAIN
by Margaret Emory
Brain World Magazine
When it comes time to step onto the tennis court, who wouldn’t want Roger Federer’s brain? Well, brain, yes, and other physical attributes, too, for sure. Like his footwork, his serve, his volley…Can you tell I’m obsessed? But since the brain is the command center driving the body’s performance, it’s a pretty good place to start. How the brain functions affects an athlete’s focus, reaction speed, motor movement, emotional reactivity, ability to mentally recover after an error, and even quality of sleep. When the brain functions well, i.e., efficiently, an athlete can perform better under pressure. Wasn’t it Yogi Berra who said, “Baseball is 90 percent physical—the other half is mental”?
We can practice our sprints, lunges, build up our aerobic capacity and strengthen our hip flexors, but how do we train our mind? How can we sharpen our focus, sustain concentration, shrug off the sting of mistakes more quickly and
get ourselves into that “zone” the players talk about when they’re seeing the ball “big”?
Enter Neurotopia, a relatively new performance brain-training system which utilizes EEG (electroencephalography) and neurofeedback. Originally a medical group founded in 2008, Neurotopia’s research and development has led to partnerships with several sports teams (Arkansas Razorbacks, New York Red Bulls) as well as professional tennis players and golfers. And it’s even available for regular folks like you and me.
I spoke with Neurotopia’s chief science officer, Leslie Sherlin, PhD, to get the rundown. Initially, you sit in a chair while sensors are placed on your head. You then watch a video
screen and take a simple test where you are asked to recognize signals and push buttons when you see them. The sensors read your brainwave patterns and create an EEG map of brain activity. “We take the EEG and we develop algorithms
that will give us insight into things related to sports-performance functioning. It’s a bit of a tweak on the general concept of a traditional QEEG [quantitative electroencephalography]. We’re looking at specific areas of the brain and how those areas respond to an activation task.”
Then comes the fun part—devising a training based on your brain’s performance. Neurotopia is establishing the largest brain-databank of professional athletes in existence, which
provides an abundance of successful strategies of brain performance. Says Sherlin, “What we know from the database is patterns, styles and approaches and the types of behaviors that brains produce when they are successful. In terms of brain training, it’s never a one-sizefits-all situation. You could take two people in the same position in the same sport, but they come at it from a different place. Their style is very different.” Neurotopia meets the individual athlete where they are at that moment. “Making your brain like Federer doesn’t make you play like him,” says Sherlin. “How does your brain work dynamically? How does an elite athlete’s brain work? Next step would be comparing your style to a style-group of elite athletes.There are thousands of patterns in the database. Which one’s closest to yours? When we know that, we ask how can we enhance certain characteristics to maximize the kind of approach you have.”
Dr. Sherlin deals with many professional football players. Recently he sat with a Division 1 football team, going over their profiles and describing what was going on in a certain athlete’s brain to create certain behaviors. “The athlete had no idea that his brain was controlling that experience, so it was an educational and insightful moment for him. He didn’t know that what was making things happen outside was happening inside his head.”
THE TRAINING PARADIGM
There are four steps to Neurotopia’s brain training. The first step creates brain states. According to Sherlin, “Some people have a one-speed brain. "They approach every problem the same way. Your brain should be doing something very different from when you’re at practice than when you’re in a match.” Step 1 teaches you how to make the different brain states—like focusing or calming down—happen in your brain.
The second step teaches you something called volitional control—how to switch between brain states. You learn how to decide what you need and then create that. Sherlin gives an example: “You need to know that when it’s a competition you naturally get overaroused, so you need to manage yourself and come in a little more chilled out. Since you know what chilled out feels like in your brain, you are able to put yourself in that state. So you feel in control.”
The third step teaches you how to intensify what you’ve learned in Steps 1 and 2, and the fourth step provides maintenance. Sherlin imparts, “Whether we’re an executive, a mom or an athlete, our environment calls us to react to it,
and sometimes when we don’t purposefully think about what’s the best approach here and just react to a situation, that may not be the best way to handle it, so we get into bad habits.” Maintenance is a process where we remember how to do it correctly by practicing over and over until it becomes automatic without thinking.
VIDEO GAMES AND NEUROFEEDBACK
Now to the actual training. Sensors are attached to your head. You sit in front of a video screen and watch a video game with perhaps a car at its center. You are instructed to concentrate, and the car starts moving. It moves over all sorts of terrains, up and down hills, in and around corners. It goes faster, crashes into other cars.
Sherlin explains that the car represents when you are producing the correct electrical activity. When you do, the car will move forward. If you are distracted, the car will stop. “Your job is to be an observer,” Sherlin says. “When the car is moving, what is that like? What are you doing? What is the strategy that got you there? What is the thought process? What is the emotion? What does it feel like when you are successful, compared to when you’re not?” He says that in the beginning you’re just an observer and have no idea. “We’re putting things in your awareness you never knew existed.” After a couple of sessions, however, you begin to be aware of the strategies you use to make the car go… perhaps “visualization techniques, maybe more cognitive, you might remember a particular circumstance, it’s like [a professional football player shared recently], ‘When I’m on the line and listening to the quarterback’s signals.’” You imagine the cognitive mental strategy you utilize to make that happen, and by recreating that experience over and over to make the car move forward, you are creating and strengthening a
certain brain state.
What’s really going on here is based on two principles that have been around for decades: operant conditioning and classical conditioning. Remember B. F. Skinner’s mouse?
Through repetitive experience, the mouse learned that when a light came on, and it pressed a button, it was given a treat. Same concept with Neurotopia and human beings, except it’s done with brainwaves. “When they produce the brain activity…that is most conducive to being in the state we want, when their brain shifts, we give them a reward. That reward is in the form of a visualization of a video game. When the screen
moves—when the spaceship flies, the ball goes back and forth, whatever the feedback is—they know that they did the right thing. They know that was a reward for them and they know they have to reproduce that correct process. And so what’s happening…We have them do the training, we make it more challenging, so we’re gradually nudging that brain activity into a stronger position, and they begin to recognize
it. That’s the process of operant conditioning. You do something, I give you a reward. You try to figure out what you did for the reward and try to replicate it.”
Classical conditioning puts the training into action. Sherlin explains, “Okay, now you know how to focus….How does that apply to your serves [in tennis]? So you begin to carry this over, pairing these two things together. When I’m focused, I’m more accurate. When I’m more relaxed and my brain is deactivated, I can focus on the play I’m in, rather than the play two times ago. What did it feel like…let me try to recreate that brain state. There comes a time when you don’t think, the brain has that capability. It just happens.”
In 2002, Gordon A. Uehling III, a 40-year old former tennis professional, established Courtsense Tennis Academy in Tenafly, New Jersey. This is a multi-site tennis and health
complex with state-of-the-art everything. One of the arms of the complex is the Magnus training center, which offers clients a three dimensional platform of fitness training, metabolic
(nutritional) function and brain training. Magnus is one of three centers in the United States to offer Neurotopia brain training.
Eric Jon Maiss, a certified personal trainer and performance-enhancement specialist, is Magnus’s general manager. Both Uehling and Maiss are big fans of Neurotopia. “It is like using a
stethoscope on the brain,” says Uehling. "The training is not invasive.There are no drugs.The brain adapts to the stimulus in a case of mind over matter. [In fact,] numerous studies on the clinical side indicate that neurofeedback is more effective than medication on some disorders, like ADHD. This has more permanence.”
Magnus and Neurotopia agree that everybody’s brain and body are different and that training should be tailored to the individual, which means constantly evolving. The Magnus slogan, If we can measure it, we can train it, is the backbone of the holistic approach they apply to training an individual’s fitness, metabolic and brain function. A teaching pro for 15 years, Uehling notes that teaching players how to move their feet, swing, transfer weight is one thing, but it is another thing entirely teaching athletes how to use their minds. “When it comes to learning how to focus,” he says, “Neurotopia really helps.” Having spent a lot of time meditating in the mountains of Idaho and teaching in Asia, Uehling believes that Neurotopia is a “modern version of meditating. Getting immediate feedback on how much you [are] in the present moment. How much were you focused? Or thinking about the past, focusing on that error.”
Maiss notes how clients are often surprised by the results of the QEEG. “Many times, they don’t realize where the strengths or weaknesses exist in their brain.” He likens it to someone
struggling with math in school, not knowing that suboptimal brainwaves, which they are fighting, could be the source of that problem. “They wouldn’t know that,” says Maiss, “and they wouldn’t know they could change it through training. Neurotopia provides the real picture and a way to make it better.”
Neurotopia is evolving quickly. With a convenient headset, dry sensors and mobile app, the training can travel with athletes, even onto the field or place of sport. Of course, it’s always good to have trainers and teachers like Uehling and Maiss on hand to help put together a performance-training strategy and monitor growth with challenges. “Ultimately,” says Dr. Sherlin, “five years from now, we won’t know where it will be. It will be in multiple domains, classrooms, home, businesses. The potential and opportunities are unlimited.”
Debunking 10 Brain Fitness and Brain Training Myths during Brain Awareness Week 2013
By: Alvaro Fernandez
March 11, 2013
In honor of Brain Awareness Week 2013, which starts today, let’s debunk ten myths about brain fitness and brain training that remain surprisingly popular.
Top 10 brain fitness and brain training myths, debunked:
Myth 1. Genes determine the fate of our brains. Fact: Lifelong brain plasticity means that our lifestyles and behaviors play a significant role in how our brains (and therefore our minds) physically evolve.
Myth 2. We are what we eat. Fact: We are what we do, think, and feel, more than what we eat.
Myth 3. Medication is the main hope for cognitive health and enhancement. Fact: Non-invasive interventions can have comparable and more durable benefits, and are also free of side effects.
Myth 4. There’s nothing we can do to beat Alzheimer’s disease and cognitive decline. Fact: While nothing has been shown to prevent the pathology of Alzheimer ’s disease, there is abundant research showing we can delay the onset of symptoms for years –a very meaningful outcome which is often overlooked.
Myth 5. There is only one “it” in “Use it or Lose it”. Fact: The brain is composed of a number of neural circuits supporting a variety of cognitive, emotional, and executive functions. Using or exercising just one (like “memory”) is unlikely to be of much help.
Myth 6. Brain training can help reverse your brain age 10, 20, or 30 years. Fact: “Brain age” is a fiction. Some brain functions tend to improve, and some decline, as we get older. And there is considerable variability across individuals, which only grows as people get older.
Myth 7. Brain training doesn’t work. Fact: Brain training, when it meets certain conditions, has been shown to improve brain functions in ways that enhance real-world outcomes.
Myth 8. Brain training is primarily about videogames. Fact: Real, evidence-based brain training includes some forms of meditation, cognitive therapy, cognitive training, and biofeedback. Interactive media such as videogames can make those interventions more engaging and scalable, but it is important to distinguish the means from the end, as obviously not all videogames are the same.
Myth 9. Heart health is brain health. Fact: While heart health contributes significantly to brain health, and vice versa, the heart and the brain are each crucial organs with their own set of functions and preventive and therapeutic interventions. What we need now is for brain health to advance in a decade as much as cardiovascular health has advanced over the last several decades.
Myth 10. As long as my brain is working fine, why should I even pay attention to it? Fact: For the same reasons you should add gas to your car and change the oil regularly – so that it works better and performs longer.
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