What is gluten?

Gluten is protein substance found in cereal grains, barley, rye, and triticale, especially wheat, which is responsible for the elastic texture of dough, an ingredient that “glues” the dough together. It is actually a mixture of two proteins, gliadin and glutenin. Gluten causes illnesses in persons with celiac disease.

What is celiac disease?

This is a lifelong autoimmune genetic disorder where the small intestine is hypersensitive to gluten, causing problems in digesting food. The two main genes affected are HLA DQ2 and HLA DQ8. One in 133 Americans has celiac disease. About 30% to 40% of Americans have one or both genes, but not everyone with the genes develop celiac disease, and about 1-2 percent of them do not have either of those two genes either. First degree family members usually have circulating antibodies characteristic of celiac disease.

What does gluten do?

Among these patients, the reaction triggered by gluten (which is metabolized to phytic acid) causes inflammation and damages the lining of the small intestine, leading to malabsorption of nutrients, resulting in weight loss, bloating, and diarrhea anemia, malnutrition, adversely affecting all organs, including the brain, liver and kidneys. Among children, this condition affects growth and development. There is no cure for this disorder. Strict abstinence from gluten is the only treatment for celiac disease.

Are there gluten-free grains?

Some natural gluten-free grains are brown rice, wild rice, quinoa, oats, sorghum, millet, buckwheat, corn (polenta), teff, and amaranth. Today, there are many food items the have been prepared to make them gluten-free. The food label should state so.

Why is gluten-free food popular?

Besides people with celiac disease, many are opting for gluten-free diet (GFD), boosting the gluten-free food industry even greater, catapulting to 135 percent from 2013-2015 with sales up to $11.6 billion. Celiac disease is also increasing globally.

What are the hidden sources of gluten?

The “stealth” gluten are found in processed food items, like artificial coffee creamer, imitation seafoods, malt and white vinegar, hydrolyzed vegetable proteins, starch binders and fillers, garlic salt, mustard powder, onion salt, emulsifiers, flavoring, flavored tea and coffee, and soy sauce. Those with celiac disease and those who opt to avoid gluten must avoid bread (almost all of them made with wheat), cakes, pasta, crackers, cookies, luncheon meats, gravies and sauces with flour, some preservatives, and all food made with wheat. The Celiac Disease Center at Columbia University listed the following as safe foods: meat, fish, fruits, vegetables, rice, potatoes, lentils, and natural seeds and nuts, specially prepared breads, cakes, cookies, and gluten-free ready meals. Gluten-free food items are widely available today.

Is gluten-free diet good for all of us?

For those with Celiac Disease, strict abstinence from gluten is standard treatment proven to be effective. Whether gluten is really toxic even for people without celiac disease is still an open question.

What are the side-effects of GFD?

The Columbia University group stated “there is no proven benefit of avoiding gluten, unless a person had CD or a wheat allergy….avoiding gluten could mean a higher fat and calorie intake, because packaged GF goods often contain more fat and sugar than their conventional counterparts, potentially contributing to obesity and prediabetes…andavoiding gluten can also lead to nutritional deficiencies, especially of the B vitamins, folate, and iron, because GF products often lack fortification.” For those with CD or wheat sensitivity/allergy, the wisest and healthiest choice, albeit a bit more expensive, is a gluten-free diet. Before starting any diet or regimen, it is always best to discuss your plan with a physician.

Junk foods can damage kidneys

Junk foods and high fat diet, like improperly managed type 2 diabetes, can damage the kidneys, says a new study at the Anglia Ruskin University in United Kingdom. Persons with severely damaged kidneys usually require kidney dialysis, a cumbersome, uncomfortable,  and expensive treatment, in order to survive. The increase in blood sugar levels among junk food and high-fat eaters is comparable to that seen in type 2 diabetes. That’s how serious the metabolic side-effects of junk food and high-fat diet are. This does not even include the fact that junk foods and high-fat diet also increase the risk for heart disease, stroke, type 2 diabetes, Alzheimer, and cancer.

Hunger and behavior

Why we care cranky, grouchy, impulsive when we are hungry has always eluded defined scientific explanation. Studies at the Sahlgrenska Academy, University of Gothenburg, Sweden, has finally pinpointed a hormone, Ghrelin, that is secreted in the gastrointestinal tract that acts on the hypothalamus of the brain to induce the feeling of hunger. When we are hungry, ghrelin is produced which interferes with our behavior, rationality and decision-making. This hormone transmits a message to our brain and our brain gives us the hunger sensation telling us its time to eat. If neglected, the hunger leads to more ghrelin which aggravates the adverse effects on our personality. Once the stomach is filled, secretion of ghrelin stops. People with discipline and self-control are less affected by the ghrelin hormone and could sustain hunger longer with composure.

Deep brain stimulation

There are about 10 million people with Parkinson’s Disease worldwide. One million Americans live with this neurological diseases, mostly treated with medications. Available today is a minimally invasive procedure, Deep Brain Stimulation (DBS) even for advanced Parkinson’s, done under local anesthesia, which implants a small battery under the skin below the collar bone and places electrodes in specific areas of the brain to block abnormal brain circuitry seen in patients with Parkinson’s disease, dystonia, or tremors. My son-in-law, Dr. Jeremy Greenlee, Associate Professor and Director of Residency Program in Neurosurgery at the University of Iowa, who was on the list of America’s Best Doctor 2013, is the only neurosurgeon who does DBS in Iowa. He reported great success with DBS, which, unlike pallidotomy and thalamotomy, does not destroy brain cells. The battery lasts for about 3 to 5 years, depending on the setting and usage, before it needs replacement. The health insurance usually covers this $30,000 to $50,000 surgery. The control of the symptoms is simply amazing, providing a vast improvement in the quality of life (physical, social and emotional) for the patients and their families.

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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA,  a 501(c)(3) humanitarian foundation in the United States. Email: [email protected]

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