Celiac.com 03/09/2016 - Many of us continue to struggle with a wide range of health concerns, digestive complaints, neurological symptoms, and/or apparently unrelated wellness issues such as low energy levels or continuing episodes of brain fog. Yet, we are gluten-free to the best of our ability. Some of us expend inordinate periods of time preparing all our own meals to ensure the strictness of our diets. Yet the symptoms persist or continue to escalate. For many of us, our health care providers are unable to help. They order more and more testing as they seek more and more obscure possible causes for our repeated visits. You may even be one of those people who simply gives up on the medical profession, and either continues to seek answers on your own, or just tries to accept your current, less than optimal state of health. Many of us continue to believe the faulty information in the "Food Pyramid" and "My Plate". These and other such guides erred with respect to our celiac disease, but we continue to accept flawed claims about the health benefits and dietary importance of grain fiber. Thus, while having eliminated gluten grains, we continue to consume other grains for these benefits. Yet, if the authors of My Plate, etc., could be so wrong about the gluten grains, surely all of their claims should be suspect. Or, if we have great faith in them, we should at least examine the evidence that supports their claims.
We know, by virtue of the celiac's leaky gut, that additional food sensitivities are common among those who were diagnosed as adults. Similarly, those who strayed from careful gluten avoidance will also be likely to have triggered immune reactions to a variety of other food proteins and peptides. Further, Dr. Marios Hadjivassiliou and colleagues have long reported that when there are neurological symptoms that are associated with either celiac disease or non-celiac gluten sensitivity, those individuals need to be even more vigilant than most celiacs about avoiding even tiny traces of gluten. Thus, whether you are continuing to experience celiac symptoms, neurological symptoms, or other health problems that may be driven by diet, I have some good news. There is a new kid on the block.
Dr. Osborne's plain language explanation of the differences between selective and innate immune reactions, and how they impact on the protein and peptide sensitivities we develop is really quite impressive. I have never read a clearer, more concise explanation of these two facets of human immune systems and how they can interact when things go awry. He presents a series of compelling case histories that show the very dynamics he identifies as problematic, also explaining exactly what these individuals did to recover from their painful symptoms. And this is the most ingenious facet of his book. Osborne identifies the dynamic, then provides an illustrative case history to show both how and why the ailments developed, and how and why the patient gets well again.
He also acknowledges that each of us is unique, making such statements as "Never make the assumption that a food is safe or healthy for everyone." That, I think, is the most telling statement in his aptly titled new book: "No Grain No Pain". His explorations touch on the bacteria that populate our intestines, for good or ill, and how grain consumption can alter those populations. He also explores the elegant interplay between various critical vitamins, minerals, bacteria, and macronutrients that is both unique to each of us, and can have a profound impact on each of our immune systems. His discussion of imbalanced intake of omega 3 and omega 6 oils is another important feature of our individuality.
While excess omega 6 oils will induce inflammation in anyone, and adequate omega 3 oils will counter inflammation in all of us, each of us has her/his own unique capacities for emulsifying, absorbing, and metabolising these fats. Nonetheless, Osborne provides some clear guidelines for balancing our intake of these essential fats toward reducing inflammation. Most of us are currently getting more omega 6 fats than we need, and not enough of the omega 3 fats. That leads to unnecessary inflammation and pain.
I must admit that I was initially put off by the book's central argument, especially since it was presented before the enormous body of supporting information. After all, there is a limit to how many foods I can stop eating! However, I soon warmed to the topic as I saw that it is not much of a step to eliminate the other grains he identifies as problematic. After all, that still leaves us able to eat many healthful fruits, vegetables, berries, and meats.
I was also taken by his discussion of what he calls "grainbesity". The explanation of AGEs is, I think, critical to understanding how important these substances are to the extensive damage they can wreak on all parts of the body and brain.
Similarly, zinc and magnesium, while very important to the proper function of our immune systems, are also critical to managing blood glucose and insulin levels. And unwanted weight gain is often accompanied by deficiencies in these minerals. As we gain weight, our joints are compressed, resulting in joint damage and pain. Weight loss, is the obvious answer, but without these critical minerals, that task may be close to impossible. Further, additional food sensitivities may also be a factor in the vicious, downward, weight-gain spiral.
Dr. Osborne also explores the broad world of unintended consequences from a variety of over-the-counter and prescribed medications. I was aware that many NSAIDs can cause or increase gut leakage of food proteins and peptides into the bloodstream, resulting in autoimmunity and other damaging dynamics. However, I also learned that Ibuprofen can damage the stomach lining and small intestine. Since vitamin B12 deficiency is common in my family, with many members getting regular shots because their intrinsic factor appears to be compromised, it may be worthwhile looking at their ibuprofen use. Similarly, he examines a variety of dietary deficiencies that can be corrected with supplements, and he provides a host of recipes along with a dietary program that gradually weans the follower off the gluten-free, standard American diet.
He has a revolutionary, detailed view of the whole field of gluten sensitivity and he assures the reader that if they will just follow his dietary plan for 30 days, she or he is very likely to discover a pathway that will reduce or eliminate their chronic pain.
On a personal level, many readers are already aware of the substantial relief that my mother got just from avoiding gluten grains. She was able to stop taking morphine, go back golfing, and lose one hundred pounds. (Accumulating that much extra weight is no small feat on a woman who wasn't quite five feet tall.) She lived a much longer life than was likely more than twenty years ago. Yet, when she arrived at the first of two seniors' homes, to live in what is called "assisted living", her dietary needs were not met. In theory, a gluten-free diet was available. In reality, she watched while others consumed tasty treats for dessert, while she was given the same old fruit plate, or Jello. Predictably, she started to cheat. By six years ago, she was frequently eating gluten-laden desserts. In an attempt to "start over" and be closer to my wife and I, she and my step-father moved to another assisted living facility. I spoke with the chef before they agreed to move. He assured me that he would address my parents' needs.
Yet after he had seen my mom cheat a few times, he stopped providing for her gluten-free diet, as he said that if she wasn't making the effort, why should he? I was sympathetic to his point of view until I discussed it with the community health nurse. She said that "We don't stop accommodating diabetics' needs just because they falter on their diet. Why should he do that with her?" Having thought about it, I returned to the chef and pressed him to provide her with gluten-free food. He promised to do so. It was not long before my mother was lapsing into more and more pain. I then spoke with the manager of the facility. She agreed to provide mom with gluten-free food.
By two years ago, mom's mind was going, she couldn't remember what foods had gluten in them, and she forgot to ask for gluten-free alternatives. She steadily re-gained about fifty pounds. Concerned about her weight and her pain, she wanted to return to the diet, but was simply unable to do so. She would forget and eat treats with her neighbors. I watched her eyes light up when one of them brought yet another such deadly treat to share with her.
My own experience is that pain is very forgettable. I doubt that women would give birth to a second child, in this day of available birth control, if pain weren't so easy to forget. It is only when I revisit a particular source of pain that I recall its intensity. I suspect that is true for my mom as well. If so, it is my hope that Dr. Osborne's book, and all the subsequent publications about dietary grain and the pain it causes will enlighten enough folks that cooperation at such extended care facilities will become easier to enlist.
In the meantime, I find myself reading every book on the subject of celiac disease and/or non-celiac gluten sensitivity that comes my way, especially those that explore chronic pain and/or weight gain. In the case of No Grain No Pain, I had the privilege of reading it before its publication. A representative of Simon and Schuster contacted me with a copy of this book, asking me to write a promotional blurb for it. I was happy to read it. Then, I was very pleased to be able to give her the positive blurb she requested, in time for its release late in January 2016. Doubtless, they have contacted many others who have provided similar comments, and I hope that they found it as valuable and compelling as I did.
My mom passed away on June 30, 2014, from a massive stroke. I authorized that she be unplugged from life support systems, as the doctors believed that she would not have any intellectual capacity in the unlikely event that she did recover. She had told me, many times, that she was tired of the pain, tired of the confusion, and tired of living. I'll miss my mom, and I have many second thoughts about how I handled or failed to handle the situations she found herself in. I'll never know, for sure, if my decisions were right or wrong. For myself, I'm pleased that she is no longer in pain, and I have re-dedicated myself to the dietary re-education of as many people as I can. And I hope that Dr. Osborne's new book will help others to avoid the "extended care" trap that my mom fell into.
1. Osborne P., NO GRAIN, NO PAIN. Touchstone, New York. 2016.