Can Gluten Sensitivity Cause Obesity?

Does Weight Correlate to Celiac or Gluten Sensitivity?

When celiac disease was originally described, one of its classic hallmarks was extreme underweight. Along with diarrhea, digestive pain and bloating, the severe weight loss was understood to ‘always’ be present. Fast forward over 100 years and things have changed. Not only are many celiacs overweight, but those with gluten sensitivity are increasingly falling into that category as well.

Sadly, too often doctors miss testing for these life-long conditions because of a patient’s weight status. Stuck in the outdated historical definition, these doctors have missed the current face of celiac and gluten sensitivity – a person can be any weight, and they often have weight to lose.

We often speak of the leaky gut, or increased intestinal permeability, found in the small intestine. This situation is seen most often in those with an intolerance to gluten who genetically upregulate a protein only made by humans, called zonulin. Zonulin was discovered by Dr Alessio Fasano and his team.

Why Humans Get Leaky Guts
 

The zonulin molecule dictates the opening and closing of the ‘gates’ of the small intestine. With a surface area of over 3,000 square feet, that involves a lot of gates!

While only humans make zonulin, not all humans produce it. Twenty percent do not at all, 50 percent make a single copy of the gene and 30 percent of the population has both copies of the gene. Those with both copies are in the unenviable position of being two times more likely to die from all causes, and the diseases they do get tend to be more severe.

When a lab test was done on rats highly predisposed to develop type 1 diabetes, two thirds of them never developed the disease when they were given a drug that inhibited zonulin. I know you’re going to ask, so here’s the answer: A drug does not yet exist for humans that performs this function. It is being worked on, along with a test for zonulin, by Dr Fasano.

The Leaky Gut Sets Us Up for Obesity

How does a leaky gut link to obesity? Read on...

A study published last Fall in Nutrition Research titled “Potential mechanisms for the emerging link between obesity and increased intestinal permeability” and lead by TF Teixeira, found a link that could well explain the obesity issue so commonly seen.

Those with an intolerance to gluten not only tend to have a leaky gut due to the above mentioned zonulin connection, but they also have weakened immune systems due to the constant assault of gluten. The weakened immune system, predominantly housed in the small intestine, is thus less able to defend the body against the normal barrage of bacteria, amoeba, parasites and the like. Why do I call the presence of these organisms ‘normal’? Because it is. Now, with that said, it is NOT normal for such organisms to gain a foothold in the intestine and procreate there, but their presence is a normal byproduct of eating food, putting one’s fingers in one’s mouth, etc. (These are microscopic organisms so don’t get too grossed out.) The point is, that a healthy immune system easily kills them; an unhealthy immune system is unable to do its job. The result is a gut full of endotoxins (toxins released from inside bacteria when they disintegrate) or other inhospitable organisms.

Good Bacteria vs. Bad - Who's Winning in YOUR Gut?
 

These bad organisms thereby fight against the good ones. The good bacteria in the gut (called the microbiome) literally have a population that exceeds the number of cells in the human body by 10 times. The genes associated with this population, exceeds that of the human body by 100 times. We are talking about a part of the human body, long underappreciated, that is being considered influential enough to be considered an ‘organ’ in its own right.

Emerging research reveals that when this organ is overwhelmed with toxins in the gut, its composition changes as far as the balance of certain organisms (probiotics), as does its ability to absorb nutrients and expend energy (burn calories). The result is not only weight gain but increased cholesterol, triglycerides, and insulin resistance – the latter leads towards diabetes, heart disease and obesity.

Intestinal permeability is also thought to be influenced by a high fat and high fructose diet, plus certain nutritional deficiencies such as zinc.

Another study from the Journal of Parenteral and Enteral Nutrition titled “Gut Microbiota, Intestinal Permeability, Obesity-Induced Inflammation and Liver Injury” found much the same data.

They found that eating a poor diet (high fat, high fructose) could affect the microbiome in as little as one to two days – the result being obesity, heart disease and obesity.

How We Create a Happy Gut
 

Let's look at how we can keep our microbiome happy:

            1. Discover if you have a gluten or dairy intolerance and avoid those foods.

2. Avoid excess, bad fats including fast food, trans fats, preprocessed, prepackaged foods, etc.

     3. Avoid ALL fructose. I’m not talking about the natural fructose in fruit, of course, but all added fructose, especially high fructose corn sweeteners.

4.   If you can, get your gut tested for the presence of any inhospitable organisms that have gotten a foothold in your system. This same test will evaluate the health of your microbiome.    
5.  Another test that’s good, as a verifier that you’re on the right track, is one for a leaky gut. We tend to recommend this one once you’ve been on a reparative program for a while, to confirm that we are accomplishing our goal.    
 6. Do ingest 9 servings of organic vegetables and fruits each day. These are naturally healing and prebiotic, meaning that they give strength and nourishment to your probiotic population.

       7. Ensure that you are not deficient in any major vitamins and minerals such as Bs, D, zinc, magnesium, calcium, etc.

8. While it seems like a ‘no brainer’ to take probiotics, here’s a couple of things to keep in mind.

a.     Use a human strain

b.     Get a combination of organisms such as acidophilus, bifidus, etc.

c.      Due to dairy products being such a commonly sensitive food, get probiotics that are free of all dairy.

d.     Sometimes if you have an infection in the gut, you may feel worse on probiotics. If this occurs, stop them, of course, but realize that you should look into step 4 above. I’m happy to help you!

9.  Don’t cheat. I’m sorry, but being ‘good’ Monday through Friday and going crazy on the weekends just isn’t going to cut it if you want to be healthy. And if your health is already compromised somewhat, cheating just isn’t worth the dangerous repercussions. 

That microbiome can change in a matter of a day or two when you’ve been eating a poor diet, remember that. It's apparently not very tolerant of poor choices, unfortunately!

Let Me Know How I Can Help You

 I hope you found this helpful. It is interesting how much we are discovering that the health of the gut dictates so much about our health or tendency towards disease. And it’s also quite revealing how much of a culprit gluten can be when trying to optimize the function of the small intestine and its immune system.

Please send me your questions or comments. I am here to help!

Visit us at www.RootCauseMedicalClinic.com. If you have questions or need any help, I’m here for you! Call 408-733-0400.

I look forward to hearing from you.

To your good health,

Dr Vikki Petersen, DC, CCN, CFMP


IFM Certified Practitioner

Founder of Root Cause Medical Clinic
Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”

Reference:

Nutrition Research. 2012 Sep;32(9):637-47. Potential mechanisms for the emerging link between obesity and increased intestinal permeability.Teixeira TF, Collado MC, Ferreira CL, Bressan J, Peluzio Mdo C.

Journal of Parenteral and ENteral Nutrition 2011. Gut Microbiota, Intestinal Permeability, Obesity-Induced Inflammation and Liver Injury. Thomas H. Frazier, MD1; John K. DiBaise, MD, and Craig J. McClain, MD

Volume XX Number X

Following Your Gluten Free Diet But Still Feeling Sick?

Following Your Gluten Free Diet But Still Feeling Sick?

As a clinical nutritionist, I constantly here from frustrated patients who, despite being vigilant about their gluten-free diet, continue to suffer health problems. In fact, it's the most common reason patients contact us and visit our destination clinic. Either they have diagnosed celiac disease or gluten sensitivity (often self-diagnosed) and while they experienced initial improvement on a gluten-free diet, they are now suffering with returning or new symptoms. The bottom line: they're not healthy and they are not getting any help to improve their condition.

I have been involved in the field of celiac and gluten sensitivity for over 15 years and am delighted by much of the recent increased awareness and attention given to the area.  Where my concern arises is that after the diagnosis and the advice to follow a gluten-free diet, there is no follow-up program designed to address and treat the secondary effects of gluten sensitivity. Such an oversight condemns many to ongoing ill health.

In this post I wish to focus on some of the ongoing conditions we see in patients despite following a gluten-free diet, some research that supports our 'Secondary Effects' program, and steps you can take to address some of these problems.

Leaky Gut

Also known as increased intestinal permeability, a leaky gut refers to a loss of integrity of the lining of the small intestine.  The small intestine, you may recall, is approximately 23 feet in length and has the surface area of a tennis court. Why so large? It is responsible for turning food into fuel and 'feeding' the body's 10 trillion cells. That's a lot of 'hungry mouths' to feed. Therefore, if the small intestine is not performing this very important function effectively, cells starve and ill health is a result.

Gluten, in the sensitive individual, is a known cause of leaky gut. In a perfect world the elimination of gluten would allow healing to occur resulting in an intact, healthy intestinal lining.

But alas we are often not in a perfect world and other factors contribute to the health of the gut.  Such things as infections in the form of parasites, amoebas, bacteria and the like can certainly be a factor in continued increased permeability.  Likewise, other food reactions, chief amongst them dairy, can cause persistent irritation and thereby prevent healing.  Imbalance of the good bacteria or microbes comprising the microbiota (population of probiotics) of the intestine also are suspected to be a cause of lack of healing, as well as a deficiency of pancreatic enzymes and nutritional deficiencies.

Let’s take a look at these individually:

Infections

Whether one has celiac disease or is gluten sensitive, one thing is for sure, one’s immune system has been overtaxed due to the presence of gluten in the diet.  Depending on the age of diagnosis, the immune system has often undergone several decades of stress .

Such an overburdened immune system is unable to be as vigilant as a healthy one and as a result it allows such organisms as parasites, amoebas or bacteria to infiltrate the intestine and, as a result of a leaky gut, the body as a whole.  It is estimated that the digestive tract is normally exposed to a pathogenic organism every 10 minutes.  A healthy intestinal immune system is able to identify and eradicate those organisms as part of its normal activity.  The unhealthy immune system is ineffective at eradicating such organisms and they happily take up residence in the small intestine.

Interestingly, some of these organisms create crypt hyperplasia and villous atrophy (as seen on an intestinal biopsy) the same as gluten.  Imagine the frustration of a patient who is being told by their doctor that they are not following their diet when indeed they are.  What’s being missed?  The presence of an infectious agent.

In the American Journal of Gastroenterology in 2003, researchers reported a high percentage of small intestinal bowel overgrowth (SIBO) in celiac patients with persistent GI symptoms despite adherence to a gluten-free diet. These patients were disciplined at following their gluten-free diet, but were still having diarrhea due to the presence of inhospitable organisms in their intestine.

This segues nicely into the next area I want to discuss – Dysbiosis or imbalance of the friendly bacteria in the small intestine.

Dysbiosis

The population of organisms found in the intestines of celiac patients (treated with a gluten-free diet or not) is different from that of healthy control groups.  The ratio of good bacteria to bad was found to be reduced in celiacs regardless of whether they were in an active or inactive disease state.  Because the “bad” bacteria are pro-inflammatory in nature, they can not only be responsible for creating some of the initial problems with the disease, but also for continuing them despite following a gluten-free diet.

In the August 2009 Scientific American, Dr Alessio Fasano made a very interesting statement regarding these microbes or probiotics as relates to the age of initiation of celiac disease.  He stated: “Apparently they [probiotics] can also influence which genes in their hosts are active at any given time.  Hence, a person whose immune system has managed to tolerate gluten for many years might suddenly lose tolerance if the microbiome changes in a way that causes formerly quiet susceptibility genes to become active.  If this idea is correct, celiac disease might one day be prevented or treated by ingestion of selected helpful microbes.”

Isn’t this fascinating?  If you haven’t read the complete article I encourage you to, but suffice to say there is scientific discussion that entertains the notion that a healthy microbiome or probiotic population is not only anti-inflammatory (a good thing to help prevent many diseases) but may actually act as a “switch” that turns on and off gene expression.

Thereby, part of our program is to examine the population of the microbiome through laboratory testing and supplement as needed to support a healthy anti-inflammatory population. In the past we typically prescribed probiotics only for a few short months following the eradication of a pathogenic organism. But in the last several years it has become clear that our patients’ clinical profile is much more stable with continuous probiotic supplements.

Dairy Sensitivity

It can be difficult to confront major changes in one’s diet.  Removing gluten is definitely a big one and sometimes my patients look at me so very forlornly when I simultaneously recommend the elimination of dairy products.  I try to keep them uplifted by sharing some of my favorite recipes along with coconut ice cream, cheese and milk substitute suggestions.

There is excellent documentation to backup what we’ve seen clinically for years - gluten and dairy are truly not our friends.

The majority of our planetary residents are lactose intolerant.  Populations such as Asians, African Blacks, those of Jewish descent, Mediterraneans, Mexicans and North American Blacks all exceed 70% intolerance to lactose.

Note that many drugs and supplements may contain lactose as well, so be vigilant.

It is estimated that we have the enzyme to digest our human mother’s milk for 2 to 5 years only. Human milk, mother's perfect food, is very low in protein but rich in essential fatty acids.Interesting to note from the viewpoint that milk from other mammal's tends to have a very different composition. Other mammal's milk is likely toxic because it’s too high in protein and phosphorus, making proper digestion by humans  impossible.

The protein casein from milk is highly associated with immune-based allergic reactions. Therefore, putting lactose and casein together presents double jeopardy to the body.  Compound the substance itself with the fact that, in this country, milk contains more toxins per gram than any other food, and you can see that there’s cause for great concern.

Earlier we spoke of leaky gut.  Dairy stops the formation of glucosamine in the intestine making it one of the primary causes of leaky gut in addition to gluten.

Nutritional Deficiencies

When we eat, the ultimate goal is to efficiently and correctly nourish the body.  Discovering that one is sensitive to gluten and eliminating it goes a long way towards achieving this goal, but a roadblock can still persist in the form of nutritional deficiencies. 

Folic acid, vitamin B12, iron, calcium, magnesium, zinc and vitamin D levels are all very important to measure. Supplementation is often needed to optimize the levels of these substances while follow-up testing ensures that optimum levels have been achieved. If supplementation fails to normalize levels of certain nutrients, suspect some of the secondary effects we have discussed above. There is a reason the body isn't assimilating the nutrition that it's being given. The reason must be discovered and addressed.

Discovering that you’re gluten sensitive and following the diet should be rewarded with dramatically improved health.  If that is not the result it simply indicates that other factors need to be isolated and treated. Such a program is not difficult and well worth the effort. Here at HealthNOW we call it treating the "Secondary Effects" of gluten. In addition to what we discussed above, the other potential issues are cross-reactive foods, toxins and hormonal imbalance. The nice thing about the program is that it truly gets to the root cause of why the gluten-free diet isn't working.

If this post describes what you're experiencing, consider calling us for a free health analysis - call 408-733-0400. We are destination clinic and we treat patients from across the country and internationally. Therefore you don't need to live local to us to receive assistance. We're here to help!

Need Help? We're Here for You! 

If you felt as if I was describing you above, you are not alone. As I mentioned earlier, adrenal fatigue/exhaustion is almost epidemic. If you would like assistance and don’t have a clinician whom you feel can assist you, consider contacting us for a FREE Health Analysis. We are a Destination Clinic and treat patients from across the country and internationally. We would be delighted to help you as we have been doing so for over two decades.

Visit us at www.RootCauseMedicalClinic.com. If you have questions or need any help, I’m here for you! Call 408-733-0400.

I look forward to hearing from you.

To your good health,

Dr Vikki Petersen, DC, CCN, CFMP


IFM Certified Practitioner

Founder of Root Cause Medical Clinic
Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”

Gluten Intolerance & Overweight - Why They Go Together

Gluten intolerance used to be synonymous with celiac disease, and celiac disease was synonymous with being underweight. Times have changed and being ‘locked in’ to the notion that unless someone is very underweight their chance of being gluten intolerant is next to nil, is obsolete.

Unfortunately, patients continue to be refused testing from ill informed doctors who simply observe their patients physique and from that decide that gluten sensitivity or celiac disease isn’t a likely diagnosis.While I must admit that I truly am tired of hearing stories of doctors refusing to test individuals because they don’t fit the classic celiac profile of extreme diarrhea, abdominal pain and underweight, today I wanted to address an association that isn’t typically looked at - gluten intolerance and overweight. 

Those with the classic type of celiac disease tend to be underweight because they have been suffering with a small intestine that has been incapable of absorbing much in the way of nutrition. We now know that the ‘classic’ celiac disease is not the most common and therefore we see celiac and gluten sensitive patients who have weight to lose.

The human body is very intelligent. If it perceives that it’s under physiological stress, it will tend towards ‘holding on’ to everything it can. Much in the way squirrels store nuts for the cold winter, the human body will burn very few calories when under stress. While it’s ‘smart’ for the body to conserve, it also can  result in weight gain.

Identifying the major stressor for the gluten intolerant patient, gluten, goes a long way towards resolving that stress, and often patients begin to see weight loss occur as a result of initiating a gluten-free diet.

For others the secondary effects of gluten intolerance must be addressed as well. These are such things as:

1.       Hidden infections in the intestine

2.    Nutritional deficiencies

3.       Cross reactive foods

4.       Hormonal imbalance

5.       Enzyme deficiency

6.       Probiotic imbalance

7.       Toxins such as heavy metals

Lifestyle factors can also contribute to overweight in the gluten intolerant patient. Removing gluten from the diet is not an easy task, no argument there.  But ‘being gluten-free’ is not the only important factor when adopting a healthy diet. A daily checklist of good, highly nutrition food consumption would include:

1.       8-10 glasses of purified water, depending on your weight (1/2 your weight in ounces of water is the formula)

2.       7 – 9 servings (or more) of fruits and vegetables, depending on your sex - men need 9

3.       Whole non-gluten grains if they suit you – some people suffer cross reactive problems

4.       Beans and legumes

5.       A small amount of good oils such as olive, coconut oil and fresh nuts

6.       A small amount of hormone-free animal protein, unless you’re vegetarian/vegan

7.       No dairy products

8.       Little to no sugar and no high fructose corn sweeteners

9.       Little to no processed, pre-packaged foods

          10.   Little to no caffeine 
          11.   No fast food 
          12.   No artificial sweeteners – they actually cause you to gain weight and are toxic 
          13.   No soda

Does that sound like a lot of ‘don’ts’? I’m sorry, but I wanted to be thorough. You can concentrate more on the ‘dos’ to stay on the positive side of the equation, but at least look over the things you should avoid, so you are aware of what they are.

Some patients think they are eating a healthy diet but ‘live on’ artificial sweeteners and caffeine, as an example, because they don’t consider it a problem due to their low calorie count.

I am glad that there are so many gluten-free options available to us in our grocery stores. But the truth of the matter is that unless it’s naturally gluten-free, such as vegetables, fruits, nuts, etc then it often falls into the category of a highly refined, pre-packaged food that you should only consume rarely.  The gluten-free breads, cakes, cookies and the like are great for birthdays and holidays, but they should definitely not be part of your daily diet.

Please don’t let this advice overwhelm you. Take it in baby steps and make small changes to start. See how you feel and let me know of any questions you have. 

Finally, I must advise you that some of gluten's secondary effects such as hidden infections, nutritional deficiencies and cross-reactive foods, to name a few, do require the help of a doctor to diagnose and treat. If you feel that you may be suffering from any of these issues or just don't feel good and don't know why, consider taking us up on the offer of a free health analysis. Just call us at 408-733-0400. Our destination clinic treats patients from across the country and internationally. You don't need to live local to us to receive assistance.

Need Help? We're Here for You! 

If you felt as if I was describing you above, you are not alone. As I mentioned earlier, adrenal fatigue/exhaustion is almost epidemic. If you would like assistance and don’t have a clinician whom you feel can assist you, consider contacting us for a FREE Health Analysis. We are a Destination Clinic and treat patients from across the country and internationally. We would be delighted to help you as we have been doing so for over two decades.

Visit us at www.RootCauseMedicalClinic.com. If you have questions or need any help, I’m here for you! Call 408-733-0400.

I look forward to hearing from you.

To your good health,

Dr Vikki Petersen, DC, CCN, CFMP


IFM Certified Practitioner

Founder of Root Cause Medical Clinic
Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”