Get email alerts Get Celiac.com E-mail Alerts  




Celiac.com Sponsor:
Celiac.com Sponsor:




Ads by Google:






   Get email alerts  Subscribe to FREE Celiac.com email alerts

Celiac In The News
0

2 posts in this topic

Article in Thursday's San Jose Mercury News

Cracking the code: Genetics reshapes medicine

When food turns toxic

ILLNESS MAKES EVERYDAY GROCERY ITEMS OFF-LIMITS

By April Lynch

Mercury News

Hungry and tired after a high school tennis match, Kelly McKenna raids the family kitchen. Her little sister, Laura, pulls out a few snacks, combing through a pantry designed just for the two girls.

In this stash of teenage-friendly food, there are no everyday crackers, commonplace cookies or most of the wheat-filled fare found in American cupboards. The pasta is made from rice flour, as is the brownie mix. The sisters grab a bag of corn chips and dig into a bowl of guacamole.

Kelly and Laura choose their food specifically for their bodies because they know what's in their genes. The girls have celiac disease, a genetic digestive illness that turns wheat and other grains into a gut-destroying poison.

By letting genetic knowledge guide their meals, the sisters avoid pain, anemia and malnutrition. As gene-based medicine develops, more people will be able to join Kelly and Laura in crafting their best possible personal diet.

This blend of genetics and food, known as nutritional genomics or nutrigenomics, is gradually changing everything from shopping habits to heart disease research. ``You are what you eat'' is evolving into ``eat for who you are.''

Food-related conditions as common as lactose intolerance start in the genes, scientists have learned, and can be treated by controlling what a person eats. In other cases, food choices can trigger genetic responses that flare into high cholesterol, cancer or other serious illnesses.

Personalized plans

Ultimately, scientists hope to give people their own personalized food pyramids, steering them toward an individual menu plan for their health.

``This can help us design better drugs, better nutrition, and understand diseases better,'' said Wasyl Malyj, co-principal of a leading U.S. nutrigenomic research center at the University of California-Davis. ``We'll be able to tune our nutrition in ways we can't right now.''

Until the emergence of gene-based medicine, nutrition rarely got such sophisticated scrutiny. Dietary advice usually comes in very general terms -- calcium from dairy products is good, lots of fat is bad, sugar is unhealthy.

But genetic research has revealed plenty of exceptions to those rules. Lactose intolerance, a gene-based condition, requires many people to look beyond milk to get calcium. Some people, genetically prone to cholesterol trouble, suffer more from the effects of dietary fat. In people prone to diabetes, sugar isn't just unhealthy -- it can be deadly.

In researching celiac disease, scientists have uncovered how genes turn some of the world's most common foods into poison.

Celiac patients carry at least one gene that leaves their bodies unable to tolerate gluten, a protein in wheat, rye and barley. Gluten is found in everything from bread and soy sauce to bottled salad dressings and candy.

Some people with celiac genes may never have a problem. But in others, the immune system mistakenly identifies gluten as an intruder and attacks it in ways that damage the lining of the small intestine.

The intestinal damage limits the body's ability to absorb nutrients and often causes painful abdominal bloating. Patients with the condition, also called celiac sprue, usually lose weight. Their hair can fall out. Many are thin, anemic and perpetually tired. If not diagnosed, celiac disease can eventually stunt growth, weaken bones or trigger cancer.

Kelly, 17, who lives in Woodside, discovered her condition in November after a long bout of unexplained illness. She was so thin and anemic that her doctors asked whether she was anorexic.

``They talked to me like it was all in my head,'' Kelly said. ``I knew it was real.''

After her mother, Molly, did her own research on Kelly's symptoms and pushed for celiac disease tests, Laura was tested and diagnosed as well.

``I would out-eat my dad, but I was still this big,'' said Laura, 13, holding out a slender pinkie finger. ``They'd wonder where it was all going.''

Discoveries

Researchers are using their understanding of the genetic underpinnings of celiac disease to develop treatments. In the process, they say, they are also uncovering wider links between genes and nutrition.

``We are learning some very interesting and important things about the interplay between genetics, nutrition and health,'' said Chaitan Khosla, a chemistry professor at Stanford University who started doing celiac research when his wife and son were diagnosed with the condition.

He heads the Palo Alto-based Celiac Sprue Research Foundation, which is researching a celiac disease treatment. While there is currently no way to fix the genes that drive celiac disease, the foundation is getting ready to start tests on a pill that would help celiac patients tolerate gluten.

``I have become a lot more tuned in to things that used to just fly by me before,'' Khosla said. ``When someone tells me her daughter can't tolerate strawberries, and neither can she, I don't dismiss it the way I used to. I ask lots of questions, wanting to know more.''

At UC-Davis, doctors and scientists are already looking beyond individual nutritional diseases.

The university's nutrigenomics center, a combined effort among UC-Davis, federal scientists and researchers from Children's Hospital Oakland Research Institute, is funded by $6.5 million in federal grants. Racial differences in genes, diet and health form a key focus of the group's work. The center is also probing broader genetic factors linked to some of the country's most common health problems, such as heart disease and high cholesterol.

Millions of Americans have high cholesterol, but not everyone develops it the same way. Scientists already know that some people's cholesterol shoots up if they eat certain types of fat. Dr. Ronald Krauss, an East Bay scientist and cholesterol specialist affiliated with the center, is studying another genetic type -- people with cholesterol problems triggered by a low-fat, high-carbohydrate diet.

Krauss emphasizes that this trait isn't found in everyone, and he doesn't push wide use of the low-carbohydrate diets so popular in recent years. What his findings do make clear, he said, is that there is no one correct cholesterol-limiting diet for everybody.

``No one should expect all individuals to respond in a given way to any set of dietary recommendations,'' Krauss said. ``That expectation is a thing of the past.''

But neither, he said, should people expect to hear about genomics from their nutritionist in the near future. What people are more likely to see in their doctor's office is a growing range of genetic tests that can pinpoint specific nutrition-related diseases.

Getting tested

New genetic tests are available for lactose intolerance and celiac disease. Doctors who specialize in intestinal illness say they are especially interested in the celiac test, as the condition can be difficult to diagnose.

The condition is believed to affect as many as one out of every 150 people -- about 2 million Americans in all. For reasons doctors still don't understand, it can flare up suddenly in people who never had symptoms before.

To get a solid diagnosis, most patients have to undergo blood tests and intestinal biopsies. If a diagnosis is positive, relatives then need testing. Some are turning to genetic screening to try to avoid a biopsy of their own. The genetic test, which uses a blood sample, looks for genetic variations found in almost all celiac patients.

If relatives of a celiac patient don't have the variation, they will rarely develop celiac disease. Those with the variation need further testing and monitoring.

The test, offered by San Diego-based Prometheus Laboratories, costs $440. Results take about four days. Insurance sometimes covers it, Prometheus spokeswoman Beth Kriegel said.

The test has limits. A celiac gene is no guarantee a person will develop the disease. For now, that leaves genetics as just one part of pinpointing the illness and choosing a healthy diet.

``With some of these tests, you have to be careful how you interpret the results,'' said Dr. Eric Sibley, a pediatric gastrointestinal doctor and researcher at Lucile Salter Packard Children's Hospital at Stanford. ``You may not want to drop something from your diet just because of one genetic test.''

Still, those wondering about their genes and food welcome any glimpse into the code that shapes them. As a precaution, Kelly and Laura's younger brother, Michael, will undergo the celiac genetic test.

``He has been fine,'' their mother, Molly, said. ``But it would be good to know more.''

The girls, in the meantime, say they are happy to follow their genes when they eat. They miss pizza. But they have learned to scrutinize food labels and cookbooks. Kelly has created videos to educate medical students about celiac disease. The sisters have ready answers for people who misunderstand their careful choices and ask whether they aren't too young to count carbs.

And they eat well, knowing that the food they reach for truly blends with their bodies.

``I was so sick before,'' said Kelly, digging into a salad topped with cheese and olives. ``I'm so happy to know that this works. It would be cool for everyone to know this much.''

------------------------------------------------------------------------

Contact April Lynch at alynch@mercurynews.com or (408) 920-5539

0

Share this post


Link to post
Share on other sites


Ads by Google:

Thanks so much for the great article!

0

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!


Register a new account

Sign in

Already have an account? Sign in here.


Sign In Now
0

  • Forum Statistics

    • Total Topics
      104,641
    • Total Posts
      921,558
  • Topics

  • Posts

    • They are big on selling books -. They try to spam a lot forums and FB groups. why can't you eat nuts, nut flours, quinoa, hummus and beans? I think I missed that. Those are a good source of protein.  If you can't digest lactose look for a lactose free cheese - like one made from yogurt. at first,I thought life was over.  But with a few years of experience, I have found it isn't that big of a deal. It helps to have an attitude of "I am not here for the food.  I am here for the wine ( or the company . ). Also helps to not care what people think - "I don't care if you think it's odd that I brought my own lunch to the funeral luncheon. "( And it helps that my lunch looks better than theirs lol.)
    • Gracey, It am a mother and I am going to give you some  valuable advice.  You need to keep and document everything related to your health.  Every lab test result, notes from your doctor's visits, etc.  Why?  Because only you are your best health advocate (except for your mom).  Doctors come and go, but it is up to you to manage your health.   When I changed insurance and doctors, I had copies of all my medical records in hand.  My new PCP was impressed.  There was no doubt that I had celiac disease, fractures, Hashimoto's and diabetes, anemia, etc.  I had physical proof.  As an result, she was quick to refer me to a new GI  and order tests to measure my progress  (e.g bone scans).  My family health history chart helped not just me, but other family members.   So, find out if biopsies were taken during your endoscopy.  Get the pathologist's report.  See if your doctor checked for other issues besides celiac disease.   Hugs!  
    • I don't do grieving, bad enough for something that's been taken away in the past but to know my future is pretty much gone now just feels too much. The only time I've forgot about the unfolding nightmare was during my hour or so of sport so need to cling onto that at the moment or I fear going to a very dark place indeed. Yup that SCD site is terrifying, still can't make up my mind if they're giving out useful information to genuinely help people or using scare tactics to sell their books etc. 
    • I agree with all the advice you have been given.  It is excellent!   I just want to add that things will get better.  There is a huge grieving process to go through.  Do not fight it.  You have a right to grieve as your health and lifestyle will change, but you will adapt!  Exercise gently until you feel a bit better.  There is plenty of time to exercise hard later.  Taken this advice from a gal who just rode 40 miles (no biggie you say) this morning  on her bike through the Santa Ana winds (better known as the Devil's winds!).  But I am three years into my recovery.  I took it easy the first six months because I was anemic.  I teach few exercise classes, bike, swim and run and I am in my 50's.   The SCD website?  It can scare the (bleep) out of you.  There was one point that I took from the site and that was to stick to whole nourishing foods.  No rocket science -- just common sense.    
    • Thanks for the replies so far everyone, much appreciated Great, another doctor gets it wrong, how many more times can they make a mess of this diagnosis process?! Bloating had gone down a bit in these first few days of cutting the gluten so I guess expect that to come back. It's one way to have a farewell tour of the gluten foods I guess - if a little or a lot makes no difference may as well go all-in... The doctors didn't diagnose this at all, Google did. If I trusted in the health professionals I'd be blaming the symptoms all on stress and having counselling for it whilst the fire raged on inside me due to a clinical condition they'd missed. Just glad one of doctors agreed to run the test on second time of asking to keep me quiet as much as anything. Believe me I've read that newbie thread multiple times, as well as numerous others around the web. Been doing nothing but since Tuesday when the blood test results came back and each time I go into the comments sections a little bit more of me gives up inside. Seems so many don't ever heal and so many associated complications too. The reality looks bleak apart from a lucky few it seems. In the nicest possible way the vegetarian choice is non-negotiable, it's a core part of what I believe and the thought of eating any form of animal \ fish flesh would make me physically sick (sorry meat eaters) so will have to find some way around it, how I don't know yet. Perhaps lots of this... http://www.pulsin.co.uk/pea-protein-isolate.html The cooking bit is a concern as it's something none of us do well at home, adds to the feeling of being completely lost right now. I kick myself for the decision that lead to the stress as I could've avoided all this. The only thing I can cling onto there is that I was having some pains in the side before that time which I blamed on a muscle strain... maybe that was the early stages, in which case I could feel a bit better knowing it had just come on gradually. With the biopsy and gluten from what I read the villi take a long time to heal up so they'd still see that. With the blood test result as definitive as it was surely the disease is pretty much confirmed? How can it heal enough for non eating gluten to throw a biopsy result yet on the flip side take over a year to heal (that sounds like the best case scenario time-wise from what I've read). Not suggesting anyone is wrong for one second but need to understand how that works with what's going on inside to make any sense of this situation.
  • Upcoming Events

  • Blog Entries

  • Recent Status Updates

  • Who's Online (See full list)

  • Member Statistics

    • Total Members
      61,644
    • Most Online
      3,093

    Newest Member
    Jross69
    Joined