Antibiotics and Celiac Disease : Any Connection?

Do Antibiotics Make Celiac Disease More Likely?

Antibiotics Disrupt Gut Ecology, Metabolism

Today's Gluten-Free Blog entry was inspired as I was reading an interesting article that discussed the findings published in materials originally provided by the American Society for Microbiology, whereby researchers from Canada described many of the interactions between the intestinal microbiota and host [in their testing, the "hosts" were mice], and showed that antibiotics profoundly disrupt intestinal homeostasis (i.e., equilibrium as maintained by physiological processes). So, what happens when your intestinal equilibrium is potentially compromised by antibiotics?

Could there be a connection to gluten-intolerance and/or Celiac disease? Some portions of their findings sure made me wonder. Given how massive shifts were observed in the levels of things like hormones that affect our immune system, sugar metabolism, and more, I could not help thinking that there could be a connection with gluten-sensitivity and/or Celiac Disease.

I have also heard the term "leaky gut syndrome" thrown around by some people (though not a "recognized diagnosis", it is a hypothesis that your gut wall suffers increased permeability from exposure to toxins, infections, and medications like antibiotics). This term has been used alongside Celiac Disease and/or gluten-intolerance, autism, and chronic fatigue syndrome to name a few. Whether it is a really the cause of any of these conditions is unknown, but the theory (in relation to celiac / gluten-intolerance) is that while your intestine is in a state of increased permeability, gluten proteins (e.g., Gliadin glycoprotein) can cross into the blood where the proteins would be targeted by antibodies, and thus eventually induce an allergic/immune-response to gluten as a result of stimulating the release of cytokines (I will come back to the cytokine thing later in this blog).

Why Intestinal Microbes are Important

Normal, healthy humans each carry around several pounds of microbes in their gastro-intestinal tracts. As gross as this may sound, we need these beneficial microbes. As stated in the article (on Science Daily):

"Intestinal microbes help us digest our food, provide us with vitamins that we cannot make on our own, and protect us from microbes that make us sick, amongst other things,"

So, how profoundly do antibiotics interact with these necessary and beneficial microbes?

Antibiotics Caused Huge Changes, Including Hormone Shifts

Researchers examined over 2000 molecules present in mouse excrement before and after (administration of antibiotics to the mice) to see what changes were observable and induced by antibiotics. The "after" (antibiotics) exam showed some really amazing (perhaps scary) results where:

The second round of mass spectroscopy revealed a very different metabolic landscape. The levels of 87 percent of the molecules detected had been shifted up or down by factors ranging from 2-fold to 10,000-fold. 

The most profoundly altered pathways involved steroid hormones, eicosanoid hormones, sugar, fatty acid, and bile acid. "These hormones have very important functions in our health," says Antunes. "They [hormones observed here] control our immune system, reproductive functions, mineral balance, sugar metabolism, and many other important aspects of human metabolism."

OK, I don't know about you, but the thought of antibiotics profoundly altering various hormone levels in my body is a bit frightening. The quotation above really got my attention with regards to my interest from a gluten-intolerance / Celiac Disease standpoint, particularly  the words "control our immune system".  Given that Coeliac disease is an autoimmune disorder of the small intestine, and that the researchers observed huge shifts in the metabolic landscape that included hormones that control our immune system, one really has to start wondering if there IS a connection between Antibiotic use and Celiac Disease.

This is where I also made a mental jump back to the associated (hypothesized) "leaky-gut syndrome" and the proposed step where leaky-gut leads to the stimulated release of cytokines. Well, Cytokines are cell-signaling protein molecules secreted by the nervous and immune systems. And, more interesting may be the fact that (as Wikipedia notes): "Biochemists disagree as to which molecules should be termed cytokines and which hormones. As we learn more about each, anatomic and structural distinctions between the two are fading."    So, if cytokines are essentially a class of hormone, and antibiotics have been shown to substantially alter hormone balances, could this "leaky gut" view of Celiac Disease, Autism, and such have some merit? Hmmm... sure seems there could be some connection.

Antibiotics Can Lead to Bad Things (for Human Health)

If you have read this Gluten-Free Blog entry to this point, you are probably already thinking: "antibiotics may be causing issues for people". Well, I was sure thinking that as I read the study that inspired me to write this, and there is a nice summary-statement included in that scientific article that will confirm this line of thinking:

The findings have two important implications, says Antunes. "First, our work shows that the unnecessary use of antibiotics has deleterious effects on human health that were previously unappreciated. Also, the fact that our gut microbes control these important molecules raises the possibility that manipulating these microbes could be used to modulate diseases that have hormonal or metabolic origins (such as inmmunodeficiency, depression, diabetes and others).

The bottom-line (as I took it to be): avoid unnecessary exposure to antibiotics. Simply put, there are risks with taking them. Sure, there are some types of infections that may absolutely require treatment with antibiotics, but all too often they are over-prescribed because we (the end-user) go in to see our doctor and make a big fuss about "needing" antibiotics, or perhaps we encounter a doctor whose first line of "treatment" is antibiotics for everything (been there before!). Fact is, we need to be educated (medical) consumers and understand what antibiotics can do for us and what they can not.

Although this is just my opinion, I personally think there IS a connection between antibiotic use and Celiac Disease / Gluten-Intolerance. I developed this condition soon after being given a course of antibiotics for a supposed sinus infection (one which a week later another doctor decided I never had!), and it just makes me that much more curious as to whether there is a connection. Also, I know a LOT of people that also "developed" Celiac Disease and are now on a mandatory gluten-free diet for life, soon after a round or two of antibiotics (especially in people that normally did not take antibiotics). This is perhaps purely anecdotal evidence, but I have encountered enough such "evidence" to make me wonder. And, this scientific study just helped provide a foundation for at least a portion of my concerns.

Continue to read this Gluten-Free Blog for all sorts of gluten-free recipes, product-reviews, and related information. In addition, visit my Gluten-Free Recipes Site where many of the recipes I have featured on this blog are available.

Gluten-Free Cookies Review:

Enjoy Life’s Line of Crunchy Cookies

[by Kate — guest gluten-free blog author] 

Gluten-Free Cookies : Can Store-Bought Taste Good?

I’m always a little skeptical that I’ll end up enjoying the experience when I bite into a store-bought, pre-packaged, factory-produced gluten-free cookie. My pessimistic orientation to factory-produced GF cookies has been inculcated in me by many attempts to, in good faith, acquire such products — only to discover that the texture resembles that of sandpaper slowly disintegrating on the palate, or that what was advertised as chocolate flavored actually tastes like a wicked assortment of artificial flavors and chemicals, or that there is one overpowering flavor (for example, dates) that masks the intended flavor of the cookie.

However, I feel like I had a rather successful experience eating a couple varieties of Enjoy Life’s line of crunchy cookies, including their Crunchy Double Chocolate Cookies (my favorite), their Crunchy Vanilla Honey Graham cookies, and Crunchy Chocolate Chip cookies. Each of the varieties and, indeed, Enjoy Life’s line entire of products is designed to be safe for persons not only with celiac disease or what intolerance, but who also suffer from other (often concomitant) allergies. Allergens omitted comprise a long list, including: wheat/gluten, nuts (peanuts and tree nuts), dairy, egg, soy, fish, shellfish, casein, potato, sesame and sulfites.

Gluten-Free, and quite Crunchy

But, enough about allergens, let’s get back to the eating experience. The cookies are very crunchy, which I like, but if you prefer softer cookies you’ll want to seek out Enjoy Life’s line of soft baked cookies which I have not yet tried. I feel like part of why these cookies are able to succeed, however, is due to their crunchiness which I think makes them fairly versatile—you can eat them plain, dunk them in coffee, put vanilla ice cream in between two to make a homemade, GF ice cream sandwich, or crush the cookies to form the basis of a cookie-crust if you’re making a GF pie.

The flavor of the cookies is spot on in line with the way they are advertised, which is quite refreshing. The Double Chocolate Cookies offer a potent chocolaty taste that is augmented by the inclusion of little chocolate chips throughout the cookie which offer a soft, melt-in-your-mouth goodness that compliments the otherwise crunchy texture of the cookie. The Vanilla Honey Graham Cookies also live up to their name; I definitely feel as I munch on them that I’m eating a thinner, round version of a traditional graham cracker but I noticed that there was one flavor in the mix that threw me off a bit. Not necessarily because the flavor was disagreeable, but it conflicted with my imagination of how a traditional graham cracker ought to taste. Looking at the ingredients I think I’ve narrowed the culprit down to Rosemary Extract.

[Mike's Comments] I too found the "Graham" taste not quite what I remember a graham cracker being; and, I will add that I much preferred the chocolate variety over the other.

That being said, the flavor of the Rosemary is subtle and rather than unpleasant it, as I said, merely stands out as an exotic ingredient for a graham cracker cookie. Ultimately, it’s a flavor that I have found it easy enough to embrace and enjoy. The Chocolate Chip cookies were perhaps my least favorite. Not because they didn’t taste good—I happily ate every last one of them — but because I yearned for more chocolate.

GF Product Review Summary:
Good, but you can do Much Better Baking Your Own

Although I am overwhelmingly impressed by these cookies and think they’re a nice, quick alternative to baking your own when you don’t have the time, I do feel that I have not only to judge the cookies on their own terms (which I’ve done above) but to judge them in comparison with the cookies I can make using Gluten-Free recipes, like those found on this blog (or, its associated online Gluten-Free Recipes Library).  I’ve also made a pretty killer selection of cookies ranging from biscotti to pumpkin chocolate-chip cookies and peanut butter chocolate-chip cookies out of the Wheat-Free and Gluten-Free Gourmet Desserts book featured here, which has gotten similarly raving reviews from Amazon reviewers as well as sites like The Gluten Free Cooking School blog which reviewed it and called the recipes in it The Best Gluten-Free Desserts You've Ever Had.

When comparing Enjoy Life’s line of crunchy cookies to the cookies I’ve baked on my own, I’d have to cite one major critique: the fact that Enjoy Life’s crunchy cookies are verging on being wafer thin. They lack a heartiness and substantive feel when compared with a traditional cookie — something you wouldn’t guess by looking at the [photo on the] outside of the packaging which represents the cookies as having a robustness that, in reality, isn’t really there. There’s just something lacking in the experience of biting into a cookie that is really just a hard little wafer, albeit a pretty tasty hard little wafer.

[Mike's Summary Comments]

As I said earlier in this blog, I liked the gluten-free crunchy-double-chocolate version the best, particularly after I accepted it as being a very thin and very crunchy cookie (or, as Kate called it toward the end: wafer).  I actually had a secondary experience to add here... I let one cookie sit out for a bit accidentally, and the Houston humidity quickly softened it up some... I actually didn't mind that, as it made me forget about the super-crisp/wafer-like texture, and it was still fine as a "softer" cookie. 

I too prefer baking my own cookies, but if you feel the "need" for very crunchy gluten-free cookies in a hurry and don't have time to bake your own alternative, these may be quite acceptable.  I would have liked to get feedback from *kids* on these to see how they compare them to "real" (gluten-containing) cookies.  I will personally be sticking with my homemade cookies, as I can usually budget an hour in which to bake them — especially when I tend to bake a double-batch and put some in the fridge for the coming weeks; saves money too.

Gluten-Free Diet for Stamina and Performance

Gluten-Free Stamina in Sports

If you are looking for a way to gain a performance edge over your competition (sports) would you consider adopting a gluten-free diet to achieve added stamina, endurance, and excellence?  Well, it sure sounds like some professional sports stars at the top of their game are now playing under the influence of a gluten-free diet to gain a competitive edge.  And, I am quite serious about this.

Gluten-Free Wins Wimbledon 2011

In a recent interview with NPR (National Public Radio), Mr. Jon Wertheim of Sports Illustrated was discussing the Serbian professional tennis player, Novak Djokovic (the player that just won Wimbledon 2011), and how Mr. Djokovic attributes much of his on-court success to going gluten-free!  Seriously!

If you are not a tennis fan, Novak Djokovic has risen to become king of the court lately, winning 48 of 49 matches this year so far. He has taken the number one tennis player position from Rafael Nadal, another very accomplished player.  And, how did he do it?  Well, certainly he has a lot of skill, but he also has adjusted his eating habits...

When Mary Louise Kelly (NPR host) asked Mr. Wertheim about Novak's fitness regime, she posed an interesting query: "I understand he's [Novak Djokovic is] on a gluten-free diet"... to which Mr. Wertheim responded as follows (quoted from the interview on NPR):

It's been a very bad year for gluten in tennis. All the players are going to want to do this now. But you know, it's funny because a year ago if we had this conversation, people would say, oh, Djokovic, very talented player but we question his stamina. And now the stamina's really one of the strengths of his game. And he [Djokovic] said, look, I've cut these glutens from my diet and it's made all the difference in the world. 

And you know, some people are having a - if you'll pardon the pun - a hard time swallowing that explanation, but the proof is in the gluten-free pudding. I mean at some level he's really shown it on the court, that he's had much better lasting power than he used to have. And it's hard especially in tennis, 'cause you go to these players' lounges and the only thing they have to eat half the time is pasta and carbs. So you know, I'm not sure how easy it is to be gluten-free, but he [Djokovic] really says, look, that's been the key to my successes here.

Professional Sports: Gluten-Free Future?

You just can not ignore press like this.  And, who would have guessed a professional athlete would voluntarily adopt a gluten-free nutrition plan for working out and achieving top performance?  Like the SI person said, "all the players are going to want to do this now [i.e., try a gluten-free regimen in hopes of obtaining similar performance gains and stamina]".  Really, what do they have to lose?

Sure, the athlete may have to stop eating mounds of "normal" pasta, pizza, breads, and such, but I think that any professional athlete willing to train at the level they do to compete worldwide at the upper reaches of any sport is also willing to adhere to any diet that may give them an edge.  So, perhaps gluten-free foods are the future "secret weapon" (or not so secret) of performance enhancing diets for professional athletes.

One way or the other, it sure makes for interesting news for all of us that must live by a strict gluten-free diet due to Celiac Disease or other allergies and/or dietary restrictions.  I personally find new like this fantastic for all of us as it brings more attention to gluten-free foods and nutrition in general, and makes some people simply ask: "what is gluten-free?"  Now more people will certainly know the answer as they start reading about it

Introduction: What is Gluten-Free?

If you happened across this article and are interested in adopting a gluten-free diet, here are a quick few bullet-points to help you see what all you have to change (with regards to your food list and eating habits) to join Mr. Djokovic in his pursuit of stamina:

• Do not eat wheat or wheat-derived products (generally) - this means no whole-wheat flour, no "white flour" (which is wheat-flour without the bran), no semolina pasta, no "normal" breads, no spelt (still has gluten)
• Do not eat barley and its derivatives (like barley malt for example); thus, "normal" beer is out of the picture too - sorry.
• Do not eat rye
• Do not eat oats, unless "certified gluten-free" (i.e., free of cross-contamination)
  
• Instead you will have to rely on alternative gluten-free grains, flours, meals, like those that follow (of course, you need to adjust the following list based on any additional allergies and dietary requirements you may have)...
  
• Eat Buckwheat (pure buckwheat that is; not some "buckwheat pancake mix" from the store that contains wheat-flour!)
• Eat nut meals like almond meal, chestnut, walnut, or coconut flour for example
• Eat flax, amaranth, teff, millet, and chia-seed
• Eat soy, chickpea (garbanzo), lentils, lupin, and other bean-flours / proteins
• Eat quinoa : it is wonderful :)
• When you need basic starches, you can eat sorghum, corn starch, rice flours (including white, brown, glutinous rice / sweet rice / sticky rice), potato starches, tapioca starch
• And, like any good diet: eat plenty of healthy vegetables and fruits.

OK, time to get started with that stamina-inducing gluten-free diet! Keep the normal rules of proper balanced diet in mind and track your total carbs, protein intake, and fats... and get busy exercising.  In the end, let's hope we all can enjoy some competitive edge and stamina-boost from this diet (for those of use for who it is mandatory or otherwise).

Continue to read this Gluten-Free Blog for all sorts of gluten-free recipes, product-reviews, and related information. In addition, visit my Gluten-Free Recipes Site where many of the recipes I have featured on this blog are available.