Zonulin

We in the last blog were talking about Dr Fassanos research.

He also discovered Zonulin which is a protein that modulates the permeability of the tight junctions between the cells that line our digestive tract.

Zonulin is a leak insets regulator and a biological door to inflammation and auto immunity.

In food poisoning,Zonulin is triggered via immune system by bad bacteria you ate promoting diarrhea to flush bacteria out.once bacteria are gone Zonulin levels decrease and intestinal junctions become tight and close.

Gluten or any of its 50 epitopes is a strong trigger of Zonulin

Nobody can completely digest gluten.Undigested gluten can trigger release of Zonulin.

Once gluten is removed from diet,Zonulin leve,s decrease and healing starts.

Other variables that increase Zonulin are ,

Parasitic infections

Bacterial or fungal dysbiosis

Small intestinal bacterial overgrowth( SIBO)

So to treat gut,

Remove foods and stress factors that damage gut.

Replace with digestive enzymes and healing foods

Repair with supplements

Rebalance with probiotocs

Autoimmune disease

Let us name some autoimmune diseases

Hashimoto's thyroiditis

Crohn's disease

Multiple sclerosis

Rheumatoid arthritis

Type 1 diabetes mellitus

Lupus

Sjögren's syndrome 

Dr Alessio Fasano PHD of Mass general hospital published a paper bringing in the concept that 3 things are necessary for autoimmune disease to develop.

1. Genetic susceptibility 

2. Environmental trigger

3.intestinal hyper permeability

He states genetic susceptibility is the gun,environmental triggers load the gun.

Intestinal hyperpermeability fires the gun.

Previously,it was thought that once autoimmune process was activated there were only relapse and remissions.

However Dr Fassanos research reveals the process can be modified and modulated by interrupting one of the triad.

The easiest to alter is the intestinal permeability.

The supplements that modify intestinal permeability are,

L glutamine

N-acetyl glucosamine

Mucilaginous herbs( fenugreek,licorice,marshmallow root,slippery elm.)

Direct acting antiinflammatory botanicals( oregano,berberine,artimesia)

Quercetin

Zinc carnosine

Omega3 fatty acids

Vitamin D

Digestive enzy

Digestive enzymes

Digestive enzymes are from 3 sources,

Animals,plants,microbes.

Animal sources include,

Pancreatic,pepsin,trypsin,chyme trypsin.

Pancreatic is most widely used and has most of the enzymes necessary for digestion in small intestine.

It has protease to breakdown proteins into aminoacids,amylase to to cleave complex carbohydrates to simple sugars,lipase to break down lipids.

Plant sourced enzymes

Bromelain( from pineapple)

Papain from papaya

Ficinfrom fig tree latex

Actinidin from kiwi fruit 

These are proteolytic enzymes which break down proteins

They also help reduce inflammation.

Papain is contraindicated in Pregnancy.

Microbial sourced enzymes

Usually from fungi and bacterial sources can be used by vegetarians,vegans.

They survive well in stomach.

The microbial enzymes include Amylase,glucoamylase,protease,lipase and various saccharidases.

The latter include lactase to digest lactose,Alfa- galactosidase ( for digesting beans,legumes,Cruciferous vegetables.

These also have cellulose to digest cellulose,along with hemicellulase ,xylanase,pectin apse imp 

for digesting plant components.

Formulas with high cellulose activity( 2000-4000CU is of big help in digesting legumes and high fiber 

plant foods.

FODMAPS

What are fodmap so anyway?

They are short chain carbohydrates.

Originally coined by researchers at Monash university,Australia.

These are natural components of many foods

Fodmap a are poorly absorbed.

The reason of poor absorption is related to reduced or absent digestive enzymes( hydrolases),

or to slow transport across intestinal mucosa.

Excess fodmaps in the distal small intestine and proximal colon exerts osmotic pressure,drawing more water in the lumen.

Fodmaps are rapidly fermented by colonic bacteria,producing gas,bowel dissension,altered motility.

Fructans are fructose polymers that are not absorbed in human intestines.

Most dietary fructans are consumed from wheat and onion.even if these do not have high amount of fructans,as people consume in higher amounts,it is a problem.

Galacto-oligosaccharides are available for colonic fermentation after eating due to lack of human alpha galactosidase.

Lactose is poorly absorbed in patients with lactase deficiency.It is mostly in dairy products,but also is 

added to breads,cakes.

Fructose is most abundant in Fodmaps.

It is present as a free sugar or generated from digestive breakdown of sucrose.

In the intestines this fructose is absorbed via a direct low capacity glucose transporter(GLUT) 5

and through GLUT -2 which is much efficient but needs the coexistence of glucose.

Because of this ,fructose is more likely to be malabsobed when present in excess of glucose

As in people with sucrose deficiency.

Main sources of fructose are fruits and fruit products,honey,foods with added high fructose sweeteners.

Polyols are sorbitol and mannitol are absorbed slowly by passive diffusion as they have no active transport system.They are in fruits and vegetables.

Sugar free chewing gum is high source of sorbitol.

www.med.monash.edu/cels/gastro/fodmap.

www.ibsfree.net/what-is-fodmap- diet.

Shoes for knee arthritis

Recently there has been some research on special shoes for people with arthritis of knees,a very common problem.

Walking shoes with triple density,variable-stiffness midsole stand mild lateral wedge insoles designed to unload the medial knee seem to be the way to go.

Unloading shoes which have stiffness laterally than medically reduce knee loads medically.

Examples of the shoe system include,

ABEO SMART system(the walking company),

GEL- Mrlbourne OA or GEL -Melo(Asics)

The research did not prove that these shoes worked better than others but patients did show less pain and more comfort.

It's worth a try!

Cinderella is a proof that a new pair of shoes can change your life

I always wondered why I could not ever get it right when buying walking shoes!

 I always went for open toed sandles or chappals.

I came across a resesearch about special shoes and helping with arthritis of the knees.

Non steroidal medicines can help but too many side effects.

Physical therapy is time consuming?

I will inform you of some shoes that were studied to help with knee joint pain.

Protein sources for vegetarians

Every body is always worried about not eating protein or rather not getting enough protein if one adopts a vegetarian diet.

I think it is a misunderstanding!

All green vegetables have protein,

All lentils have protein.

Recently the industry is focusing on chickpeas.

Chickpeas or garbanzos are a very good source of protein.

Chickpeas are very popular in Vegetarian Indian cuisine.

Chickpeas are washed and soaked overnight and I cook it in slow cooker over 6 to 8 hours on high and are ready and done when I return from work.

I sauté some tomatoes and onions in some coconut oil and then add chickpeas and add some salt,pepper,cumin powder and dried mango powder and we have a plateful of cooked garbanzos.

Garnish it with pomegranate arils.

Another source is black beluga lentils which are easier to cook in shorter time.

Tofu of course is a great source.

Have you heard of Halloumi?it is a meaty, semi hard cheese made from cow and goat and sheep milk.

It can be grilled and pan fried.Serve it topped with chimichurri

What about  Einkorn?

It is a relative of wheat,easier to digest,has lot of vitamins and minerals specially B vitamins,zinc,iron.

It has a nutty taste.

I will introduce you to more lentils and protein sources next few blogs.

Fodmap diet : continued

So now what is low fodmap?

Oligosaccharides:(fructans,galacto oligosaccharides)

Bamboo shoots,bell peppers,bok choy,carrots,celery,chard,chayote,chives,choy sum,corn,eggplant,green beans,lettuce,parsnips,pumpkins,spring onions( green parts only),tomatoes,

Garlic infused oils.

Fruits:Bananas,blueberries,cantaloupes,carambola,durian,grapefruit,grapes,honeydew melon,kiwi,lemons,limes,mandarin,oranges,passion fruit,pawpaw,raspberries,strawberries,tangelos.

Gluten free and spelt bread and cereal products.

Canned chickpeas are ok.

Lactose free milk and yogurt,rice milk,

Hard cheeses,butter,icecream substitute like gelato and sorbet.

Maple syrup,golden syrup.

Sweeteners: sucrose and glucose.

FODMAP Diet

What is this fodmap anyway?

Fermentable oligosaccharides,di saccharides,monosaccharides and polyols.

Irritable bowel syndrome or IBS is a very common medical problem.

A diet change can help significantly.

I will list foods that are high fodmap first.

Oligosaccharides:  vegetables :Artichokes,asparagus,beets,Brussels sprouts,broccoli,cabbage,fennel,garlic,leeks,okra,onions,peas,shallots.

Fruits: watermelon,Apple,white peaches,persimmon.

Wheat and rye eaten in large amounts( bread,pasta,couscous,cookies,crackers,biscuits)

Legumes: chickpeas,lentils,kidney beans,baked beans,soy beans.

Disaccharides (lactose)

Milk,yogurt,soft cheese,custard,icecream

Monosaccharides (fructose)

Fruits: apples,Asian pears,pears,mango,peaches,sugar snap peas,watermelon,canned fruit in natural juice,dried fruit,fruit juices,

Honey

Sweeteners: high fructose corn syrup

Polyols: 

Vegetables: avocados,cauliflower,mushrooms,snow peas,sweet corn.

Fruits:apples,apricots,Asian pears,cherries,longon,lychee,nectarines,peaches,pears,plums,prunes,watermelon.

Sweeteners: isomalt,malt it'll,mannitol,sorbitol,xylitol