According to a team of researchers from the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center, in collaboration with colleagues from UCLA, the pepper component caused human prostate cancer cells to undergo programmed cell death or apoptosis.

Capsaicin induced approximately 80 percent of prostate cancer cells growing in mice to follow the molecular pathways leading to apoptosis. Prostate cancer tumors treated with capsaicin were about one-fifth the size of tumors in non-treated mice.

“Capsaicin had a profound anti-proliferative effect on human prostate cancer cells in culture,” said Sören Lehmann, M.D., Ph.D., visiting scientist at the Cedars-Sinai Medical Center and the UCLA School of Medicine. “It also dramatically slowed the development of prostate tumors formed by those human cell lines grown in mouse models.”

Lehmann estimated that the dose of pepper extract fed orally to the mice was equivalent to giving 400 milligrams of capsaicin three times a week to a 200 pound man, roughly equivalent to between three and eight fresh habañero peppers – depending on the pepper’s capsaicin content. Habañeros are the highest rated pepper for capsaicin content according to the Scoville heat index. Habañero peppers, which are native to the Yucatan, typically contain up to 300,000 Scoville units. The more popular Jalapeño variety from Oaxaca, Mexico, and the southwest United States, contains 2,500 to 5,000 Scoville units.

As described in their study, the scientists observed that capsaicin inhibited the activity of NF-kappa Beta, a molecular mechanism that participates in the pathways leading to apoptosis in many cell types.

Apoptosis is a normal cellular event in many tissues that maintains a balance between newer replacement cells and aged or worn cells. In contrast, cancer cells seek to be immortal and often dodge apoptosis by mutating or deregulating the genes that participate in programmed cell death.

“When we noticed that capsaicin affected NF-kappa Beta, that was an indication that we might expect some of the apoptotic proteins to be affected,” said the study’s senior author, Phillip Koeffler, M.D., director of Hematology and Oncology, Cedars-Sinai Medical Center, and professor at UCLA.

The pepper extract also curbed the growth of prostate cancer cells through regulation of androgen receptors, the steroid activated proteins that control expression of specific growth relating genes.

In prostate cancer cells whose growth is dependent on testosterone, the predominant male sex steroid, capsaicin reduced cell proliferation in a dose-dependent manner. Increased concentrations of capsaicin caused more prostate cancer cells to freeze in a non-proliferative state, called G0/G1.
Prostate cancer cells that are androgen independent reacted to capsaicin in a similar manner. Capsaicin reduced the amount of androgen receptor that the tumor cells produced, but did not interfere with normal movement of androgen receptor into the nucleus of the cancer cells where the steroid receptor acts to regulate androgen target genes such as prostate specific antigen (PSA). Capsaicin also interfered with the action of androgen receptors even in cells that were modified to produce excess numbers of androgen receptors.

The hot pepper component also reduced cancer cell production of PSA, a protein that often is produced in high quantities by prostate tumors and can signal the presence of prostate cancer in men. PSA content in the blood of men is used as a diagnostic prostate cancer screening measure. PSA is regulated by androgens, and capsaicin limited androgen-induced increases of PSA in the cancer cell lines.

More men in the United States develop prostate cancer than any other type of malignancy. Every year, more than 232,000 new cases of prostate cancer are diagnosed in the U.S., and more than 680,000 develop the disease worldwide. Approximately 30,000 men die from prostate cancer in the U.S. each year, which is about 13 percent of all new cases. Worldwide, there are 221,000 deaths – approximately 31 per cent – among men with prostate cancer.

Lehman conducted the studies in Koeffler’s laboratory in collaboration with UCLA cancer researchers Akio Mori, James O’Kelly, Takishi Kumagai, Julian Desmond, Milena Pervan, and William McBride. Mosahiro Kizaki, a former post-doctoral fellow in Koeffler’s laboratory who initiated the capsaicin studies, is currently at the Keio University School of Medicine, Tokyo, Japan.
American Association for Cancer Research

Russell Vanderboom, Ph.D.
215-440-9300 ext. 120

http://www.aacr.org/home/public–media/aacr-in-the-news.aspx?d=583

Capsaicin Comparison ~ Scoville Units
Jalapeño 2,500 ~ 8,000
Tabasco 30,000 ~ 50,000
Habañero 150,000 ~ 575,000

When my nephew was born in a Seoul suburb, my Korean in-laws decorated their front door with a cluster of bright red chili peppers, a neighborhood announcement that a son had been born to their household.

But why chili peppers? Some Koreans say the peppers’ phallic shape is the message and, as a bonus, folk wisdom says peppers eaten regularly enhance male potency.

Others, especially those acquainted with Korea’s corps of herbalists and Chinese Medicine Practitioners, say that because a diet that includes chili peppers ensures a long and healthy life, the door decorations symbolize a wish for a healthy, robust child.

It’s no secret that Korean food is often very spicy, especially kimchi, the national dish. At least one of this fiery condiment’s many varieties is served with virtually every meal. And every one is loaded with the fiery seeds and ribs of red chilis.

The complex chemical substance that gives chilis their bite is capsaicin, arguably  nature’s most health-enhancing herb. Applied topically in a cream, capsaicin soothes sore muscles, the aches of rheumatism and the pain of bruises. Ingested
it becomes a wonder drug, lowering blood pressure, releasing brain endorphins, speeding up lipid (fat) metabolism, improving digestion, acting as a gentle laxative, reducing cholesterol—just a few of the long list of its beneficial effects.

And recently, scientists at the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center, Los Angeles, and their UCLA Medical School colleagues, observed that capsaicin causes human prostate cancer cells to undergo programmed cell death or apoptosis.

In studies using human cells implanted in mice, Sören Lehmann, M.D., Ph.D., a visiting scientist at Cedars-Sinai and the UCLA, concluded that capsaicin not only retards the growth of human prostate cancer cells, it also slows the development of prostate tumors.

Dr. Lehmann’s study also showed that the growth of both kinds of prostate cancer cells—those dependent on testosterone for growth and those that don’t—is frozen.

That’s right: Eat enough chili peppers and your prostate cancer cells commit suicide.

As it happens, I was diagnosed with prostate cancer a few years ago, a result, my doctors think, of my exposure to Agent Orange while serving in Vietnam. So how many peppers do I have to eat to get rid of my cancer?

Well, Pilgrims, that depends on what kind of peppers. Jalapeños, like those used in many popular hot sauces, or tabascos, from which the most popular hot sauce takes its name, have a fair amount of capsaicin. But neither can hold a candle to a tiny, heart-shaped orange pepper called the habañero. That one nears the top of the Scoville heat index, which measures capsaicin content.

Which is why when I make my extended-family-famous T‘n’T chili (turkey and tofu, patent pending, no explosive qualities) I don’t use Tabasco. Instead, I throw in a couple of finely minced habañeros.

Lehmann estimates that his lab mice ingested capsaicin in amounts equivalent to a 200 lb man eating between three and eight fresh habañero peppers a week.

That’s a lot of fire to swallow. As I recently discovered, there’s an even more delicious way to get capsaicin down the hatch: Brother Bru-Bru’s African Hot Pepper Sauce. Made with habañeros, it’s four-alarm hot. I’ve started using it in my chili and a dozen other dishes; my daughter and her Korean-American cousins can’t get enough of it.

And Brother Bru-Bru’s has NO salt. So those with hypertension or other reasons for a low-sodium diet can safely satisfy their quest for fiery food.

Brother Bru-Bru’s is available in health food and specialty stores in all 50 states and, west of the Rockies, in Whole Foods Markets. It may also be ordered from www.brobrubru.com. A portion of company profits go to help provide clean water for African villages.

November is National Prostate Cancer Awareness Month

Zero – The Project to End Prostate Cancer

10 G Street NE, Suite 601
Washington, DC 20002
(888) 245-9455
(202) 463-9455
(202) 463-9456 Fax
info@zerocancer.org
www.zerocancer.org

Screenwriter and author Wolf is based in Los Angeles and is working on a mystery novel.

Young and healthy African-American men have higher central blood pressure and their blood vessels are stiffer compared to their white counterparts, signs that the African American men are developing hypertension early and with little outward sign, according to a new study. While the study found that central blood pressure — the pressure in the aorta, near the heart — was higher in the African-American men, the study found no difference in brachial blood pressure — measured on the arm — between the two groups.

Taken together, the findings suggest that hypertension (high blood pressure) may be developing undetected in young African-American men and that measuring central blood pressure may be a better means of detecting the problem as it develops.

“Central blood pressure holds greater prognostic value than conventional brachial blood pressure as central pressure more aptly reflects the load encountered by the heart,” the authors explained. “Thus, brachial blood pressure may neglect important information on cardiovascular burden and response to therapy in African-American men.”

The study, “Racial differences in central blood pressure and vascular function in young men” was carried out by Kevin S. Heffernan, Sae Young Jae, Kenneth R. Wilund, Jeffrey A. Woods and Bo Fernhall, at the University of Illinois, Urbana-Champaign. The study appears online in the American Journal of Physiology-Heart and Circulatory Physiology, published by The American Physiological Society. Dr. Heffernan has since moved to Tufts Medical Center in Boston. Dr. Jae is also affiliated with the University of Seoul.

‘Silent killer’

African-American men have higher levels of hypertension than white men. Hypertension is known as the silent killer because it can develop without the individual knowing it. According to the U.S. Centers for Disease Control and Prevention, hypertension is a major risk factor for heart disease, stroke, congestive heart failure, and kidney disease. In 2002, hypertension was listed as a primary or contributing cause of death for 277,000 Americans.

The University of Illinois researchers hypothesized that the blood vessels of the black men would show greater dysfunction than the white men, even though both groups were young and equally healthy and fit. The vascular damage they looked for included stiffening and thickening of the blood vessels. These conditions result in pulsatile (not smooth) blood flow (and at higher pressure) to organs. The pressure can damage the organs over time.

Both Groups Healthy

The study included 55 young men, 30 white and 25 African-American. Most were university seniors. The average age was 23. There were no differences between the groups on a variety of measures, including heart rate, cardiorespiratory fitness, body mass index, body fat, blood lipids and glucose levels.

The researchers measured vascular function in a variety of ways, including:

• aortic blood pressure and stiffness
• brachial blood pressure
• carotid artery blood pressure
• carotid artery thickness and stiffness

They found the African-American men had similar brachial blood pressure, compared to the white men, but they had significantly higher:

• Central blood pressure, a measure of the pressure found in the artery, near the heart. The researchers used an instrument that takes blood pressure at the wrist and then calculates the central blood pressure.
• Carotid artery pressure. The carotid artery runs through the neck.

The African-American men, unlike the white men, also showed signs of early vascular damage that could lead to hypertension. For example, they had:

• Thicker carotid arteries, a sign of vascular damage that is usually found in older individuals and associated with atherosclerosis.
• Stiffer arteries, which are associated with high blood pressure. When the heart beats, blood flows through stiff arteries at greater speed and pressure. Elastic arteries provide a smoother blood flow and help prevent damage to organs receiving the blood and place less stress on the heart.
• Less change in diameter of the arteries when the heart beats, another measure of vascular stiffness. A healthy artery is more elastic will change in size as the blood flows through with each beat of the heart.

“Although having a similar cardiovascular risk factor profile as young white men, diffuse macrovascular and microvascular dysfunction is present at a young age in apparently healthy African American men,” the authors wrote. “Values seen are comparable to values often reported in older individuals or individuals with more advanced hypertensive disease,” they said.

These results do not shed light on why this happens to young and fit African-American men, Heffernan said. There may be environmental differences, such as differences in diet, which were not examined as part of this study, he said.

A fuller audio interview with Dr. Heffernan is available in Episode 15 of the APS podcast, Life Lines, at http://www.lifelines.tv.

Funding: American Heart Association and the American College of Sports Medicine

Physiology is the study of how molecules, cells, tissues and organs function to create health or disease. The American Physiological Society (APS) has been an integral part of this scientific discovery process since it was established in 1887.

http://www.newswise.com/p/articles/view/546498/

American Physiological Society (APS)

4 pounds or so of chicken wings
Some ground pepper
A little salt if you want, but I think the butter has plenty
4 cups of vegetable oil
4 tablespoons butter
1/2 to whole of a 5 oz bottle of Brother Bru Bru
1 tablespoon white vinegar

Sprinkle salt (optional) and pepper on the wings. Heat oil in fryer or large cast iron pot until it’s very hot. Add half the wings and cook for 10 minutes, stirring occasionally, until they are golden brown and crisp. Remove them and drain. Cook the other half in the same oil the same way.

Melt the butter in a saucepan and add two to five tablespoons of Brother Bru Bru (I like it hot, so I add five!) and the vinegar. Put the cooked wings onto a serving platter and pour the sauce over them, coating all of them well.

Serve with this blue cheese dressing.

1 8 oz container of sour cream (1 cup)
1 4 oz package blue cheese, crumbled
1/4 cup chopped fresh parsley
1/4 cup mayonnaise
1 tablespoon milk
1 tablespoon lemon juice

Mix all the ingredients together. Add salt if you want, but I don’t think it’s necessary. Let the mix chill for awhile.

Serve with the wings and sticks of celery and carrots. You might also serve it with bread, and a good beer to cool the mouth.

I get many requests for these wings, and your sauce makes them!

Hypertension has been called the “silent killer” because it can cause damage to many body organs without any symptoms. Uncontrolled high blood pressure can cause a heart attack, stroke, kidney failure, vision problems and even death.

Statistics

African Americans and people of African descent in the United Kingdom have among the highest rates of hypertension of any race or ethnic type in the world.¹

35% of African Americans have hypertension, which accounts for 20% of the African American deaths in the United States – twice the percentage of deaths among whites from hypertension.¹

Compared with whites, hypertension develops earlier in life and average blood pressures are much higher in African Americans.²

African Americans with high blood pressure have an 80% higher chance of dying from a stroke than in the general population.²

African Americans with high blood pressure have a 20% higher chance of developing heart disease than in the general population.²

African Americans with high blood pressure have a 4 times greater risk of developing hypertension related end stage kidney disease than the general population.²

¹ CDC, National Center for Health Statistics.

² “The Puzzle of Hypertension in African Americans,” Scientific American.

http://www.netwellness.org/healthtopics/aahealth/hypertension.cfm

Vegetarian Diet

Vegetarians, in general, have lower blood pressure levels and a lower incidence of hypertension and other cardiovascular diseases. Experts postulate that a typical vegetarian’s diet contains more potassium, complex carbohydrates, polyunsaturated fat, fiber, calcium, magnesium, vitamin C and vitamin A, all of which may have a favorable influence on blood pressure.

Fiber

A high-fiber diet has been shown to be effective in preventing and treating many forms of cardiovascular disease, including hypertension.
The type of dietary fiber is important. Of the greatest benefit to hypertension are the water soluble gel-forming fibers such as oat bran, apple pectin, psyllium seeds, and guar gum. These fibers, in addition to be of benefit against hypertension, are also useful to reduce cholesterol levels, promote weight loss, chelate out heavy metals, etc.

Take one to three tablespoons of herbal bulking formula containing such things as oat fiber, guar gum, apple pectin, gum karaya, psyllium seed, dandelion root powder, ginger root powder, fenugreek seed powder and fennel seed powder.

Sugar

Sucrose, common table sugar, elevates blood pressure. Underlying mechanism is not clearly understood. It is possible that sugar increases the production of adrenaline, which in turn, increases blood vessel constriction and sodium retention.

Take a diet that is rich in high potassium foods (vegetables and fruits) and essential fatty acids. Daily intake of potassium should total 7 grams per day. The diet should be low in saturated fat, sugar and salt. In general, a whole food diet emphasizing vegetables and members of the garlic/onion family should be consumed.

In an NIH sponsored research called “Dietary Approaches to Stop Hypertension (DASH),” researchers tested the effects of nutrients in food on blood pressure. The results showed that elevated blood pressures were reduced by an eating plan that emphasized fruits, vegetables, and low-fat dairy foods and was low in saturated fat, total fat, and cholesterol. The DASH diet included whole grains, poultry, fish, and nuts. It employed reduced amounts of fats, red meats, sweets, and sugared beverages.

Reduce Salt and Sodium in Your Diet

A key to healthy eating is choosing foods lower in salt and sodium. [Brother Bru Bru’s has 0 mg Sodium.] Before the widespread availability of medication to control high blood pressure, people with serious hypertension had only one treatment option, a drastically salt-reduced, low-calorie “rice diet.” Some people can significantly lower their blood pressure by avoiding salt.

Studies show that people in countries that use a great deal of salt in their cooking tend to have higher blood pressures than people in countries that use little salt. For example, the Japanese, whose cuisine is among the saltiest in the world, also have the highest blood pressure; and so do Americans. Americans take it for granted that blood pressure will rise as we age. But in countries with low per-capita salt intake, blood pressure does not rise significantly after puberty. For example, blacks in Africa, who typically eat a low-salt, high-fiber diet, have relatively low blood pressure, but for African-Americans, just the opposite is true. Nearly 50 percent of all African-Americans have high blood pressure, often beginning early in life.

Excessive consumption of dietary sodium chloride (salt), coupled with diminished dietary potassium, induces an increase in fluid volume and an impairment of blood pressure regulating mechanisms. This results in hypertension in susceptible individuals.

A high potassium-low sodium diet reduces the rise in blood pressure during mental stress by reducing the blood vessel constricting effect of adrenaline. Sodium restriction alone does not improve blood pressure control; it must be accompanied by a high potassium intake.

Most of us consume more salt than we need. NIH recommends limiting the sodium consumption to less than 2.4 grams (2,400 milligrams [mg] ) of sodium a day. That equals 6 grams (about 1 teaspoon) of table salt a day. The 6 grams include ALL salt and sodium consumed, including that used in cooking and at the table. Recent research has shown that people consuming diets of 1,500 mg of sodium had even better blood pressure lowering benefits. So, your doctor may advise eating less salt and sodium if you are suffering from high blood pressure. The lower-sodium diets also can keep blood pressure from rising and help blood pressure medicines work better.

In a clinical study, researchers looked at the effect of a reduced dietary sodium intake on blood pressure as people followed either the DASH diet or a typical American diet. Results showed that reducing dietary sodium lowered blood pressure for both the DASH diet and the typical American diet. The biggest blood pressure-lowering benefits were for those eating the DASH diet at the lowest sodium level (1,500 milligrams per day). This study showed the importance of lowering sodium intake in your diet.

Watch what you eat. Do not add additional salt to your food. If you have high blood pressure, avoid eating certain highly processed, overly salted foods, such as frozen pizza, canned salted vegetables, meals from fast-food restaurants, and the like.

Beneficial Vegetables and Spices for Hypertension

A number of common vegetables and spices have beneficial effects in controlling hypertension. Incorporate these into your cooking. Alternately, you can make a tea or a vegetable soup.

Celery (Apium graveolens). Oriental Medicine practitioners have long used celery for lowering high blood pressure. There are some experimental evidence that shows that celery is useful for this. In one animal study, laboratory animals injected with celery extract showed lowered blood pressure. Eating as few as four celery stalks was found to be beneficial in lowering blood pressure in human beings.

Garlic (Allium sativum). Garlic is a wonder drug for heart. [Brother Bru Bru’s is loaded with Garlic.] It has beneficial effects in all cardiovascular system including blood pressure. In a study, when people with high blood pressure were given one clove of garlic a day for 12 weeks, their diastolic blood pressure and cholesterol levels were significantly reduced. Eating quantities as small as one clove of garlic a day was found to have beneficial effects on managing hypertension. Use garlic in your cooking, salad, soup, pickles, etc. It is very versatile.

Onion (Allium cepa). Onions are useful in hypertension. What is best is the onion essential oil. Two to three tablespoons of onion essential oil a day was found to lower the systolic levels by an average of 25 points and the diastolic levels by 15 points in hypertension subjects. This should not be surprising because onion is a cousin of garlic.

Tomato (Lycopersicon lycopersicum). Tomatoes are high in gamma-amino butyric acid (GABA), a compound that can help bring down blood pressure.

Broccoli (Brassica oleracea). This vegetable contains several active ingredients that reduce blood pressure.

Carrot (Daucus carota). Carrots also contain several compounds that lower blood pressure.

Saffron (Crocus sativus). Saffron contains a chemical called crocetin that lowers the blood pressure. You can use saffron in your cooking. (It is a very popular spice in Arabic cooking.) You can also make a tea with it. Many Indians add a pinch of saffron in the brewed tea to give a heavenly flavor. Unfortunately, it is very expensive.

Assorted spices
Spices such as fennel, oregano, black pepper, basil and tarragon have active ingredients that are beneficial in hypertension. Use them in your cooking.

http://www.holisticonline.com/Remedies/Heart/hypert_diet_therapy.htm

Gluten-free food has become more popular partly because doctors are diagnosing more cases of celiac disease, an autoimmune disorder whose symptoms are triggered by gluten, the protein content in wheat, barley, rye, and spelt (an ancient form of wheat that’s catching on as a health food). Celiac specialists say the disease isn’t diagnosed as often as it should be. As a result, many people suffer with it for years, often after getting other — and incorrect — diagnoses and useless treatments.

But a growing number of the people dodging gluten fall into a gray area: they don’t have celiac disease but seem to be unable to digest gluten properly. There are no tests or strict criteria for this problem, aside from simple trial and error with a gluten-free diet. Often people self-diagnose. It’s hard to know what’s going on. Some people may be getting caught up in a food fad. But many others probably do have a real problem digesting gluten or perhaps the sugars in some of these grains, a condition akin to the lactose intolerance that makes it hard for many people to digest dairy foods. Their problem is not as well-defined or well-understood as celiac disease but they have a problem nonetheless.

There’s a third group of gluten-free converts: people who are blaming gluten for a wide range of medical conditions, not just gastrointestinal distress. For example, there’s a fairly loud Internet “buzz” about autistic children improving once they’re on a gluten-free diet.

There’s good, solid evidence of an overlap between celiac disease and other autoimmune disorders, particularly type 1 diabetes. And celiac disease and other autoimmune disorders sometimes have neurological effects — peripheral neuropathy, for example, which involves nerve damage that results in numbness and pain.

But based on what is currently known, it’s a big leap to attributing autism and other problems to gluten, and an even bigger one to prescribing gluten-free eating as a treatment. It’s possible that some people benefit from a gluten-free regimen for reasons that have less to do with gluten and much more to do with the structure involved in planning and sticking to such a strict eating plan.

Misreading the situation

Gluten is an imprecise term that shifts meaning depending on the context. Gluten comes, not surprisingly, from the Latin word for glue, and cookbooks define it as the protein-based substance that makes dough resilient and stretchy. If you’re making bread, you want gluten in the dough, so that when it’s baking the walls of the little air pockets formed by yeast expand but don’t burst open. But if you’re making cookies or a pie crust, you want to keep the gluten content of the dough and batter low. Otherwise, your results will be tough and gummy.

In the context of celiac disease, gluten refers to the protein of grains capable of provoking an autoimmune response. Other grains also contain protein, but wheat, barley, rye, and spelt contain varieties that aren’t broken down by digestive enzymes. In wheat, the difficult-to-digest protein is gliadin; in rye, it’s secalin; and in barley, hordein.

These proteins don’t faze the guts of most of us. But in people with celiac disease, when they get absorbed into the walls of the small intestine, the immune system misreads the situation, views them as intruders, and unleashes a furious inflammatory response that damages tissue (see illustration). The inside of a normal, healthy small intestine is carpeted with millions of fingerlike projections called villi that produce digestive enzymes and soak up nutrients. The misguided immune response triggered by the gluten proteins sometimes attacks these villi, so they lose their slender shape and become short and stubby, even flat. When that happens, the villi produce fewer digestive enzymes and absorb fewer nutrients.

Symptoms — classic and non

The classic and most immediately noticeable symptoms of celiac disease are, not surprisingly, gastrointestinal: bloating, flatulence, and diarrhea, sometimes with smelly stools. People who can’t digest gluten or grain sugars may have similar symptoms.

Celiac disease can severely impair the absorption of nutrients. In children, this may lead to stunted growth; in adults, the consequences include anemia (because iron isn’t being absorbed) and weaker bones (because calcium and vitamin D aren’t getting into the body). Anemia causes fatigue and malaise, but some people with celiac disease feel that way without anemia.

Doctors sometimes miss the celiac disease diagnosis because they’re looking for the classic gastrointestinal symptoms, not the vaguer ones that stem for the most part from malabsorption of nutrients.

One major difference between celiac disease and grain-related digestion problems is that when it’s just a digestion problem it typically doesn’t lead to malabsorption and nutritional deficiencies.

Women with untreated celiac disease have higher-than-normal rates of menstrual abnormalities and infertility. A large study published in 2007 found an increased risk of pancreatitis in people with celiac disease. It’s not clear whether a cause-and-effect relationship can be inferred from these associations or if celiac disease and these conditions happen to be consequences of a shared, common cause.

According to some research, several of the nongastrointestinal conditions associated with celiac disease might be caused by an overabundance of antibodies that the immune system churns out, especially those it produces in response to an enzyme in the small intestine called tissue transglutaminase. The antibodies travel to other parts of the body through the bloodstream. Perhaps the clearest example of one of these antibody-related symptoms is a skin condition, dermatitis herpetiformis, which causes itchy red bumps. Less certain is whether the anti–tissue transglutaminase antibodies might get into the brain and cause neurological problems, such as loss of muscle control (ataxia).

A blood test and a biopsy

Compared with other autoimmune disorders (such as Crohn’s disease and rheumatoid arthritis), the diagnosis of celiac disease is pretty straightforward. In the United States, the issue has been getting doctors to consider the celiac diagnosis as a possibility. That’s changing. For example, the guidelines for irritable bowel syndrome were revised to include testing for celiac disease.

The diagnosis begins with a blood test for the antibodies generated by the immune response that gluten provokes. Tests exist for several different types of antibodies, but the one for the antibodies against the tissue transglutaminase enzyme is the most reliable and accurate. If the blood test is positive, the next step is biopsy of tissue from the small intestine to see if the villi have been damaged. Collecting the biopsy involves snaking an endoscope — a flexible tube with a tiny camera on the tip — down the throat and through the digestive tract and snipping out small pieces of tissue that can be examined under a microscope.

Dr. Daniel Leffler, a celiac disease expert at Harvard-affiliated Beth Israel Deaconess Medical Center in Boston, says the biopsies show, on average, that over 90% of people with positive antibody tests and celiac symptoms have intestinal damage, and the presumption is that they have celiac disease. But if the biopsy shows a lack of intestinal damage, that usually rules out celiac disease as a diagnosis.

In people with symptoms, judging whether there’s a favorable response to a gluten-free diet isn’t difficult: the turnaround from illness to health can be quite dramatic. But Dr. Leffler notes that many — indeed, perhaps most — people with a positive antibody test and intestinal damage do not have symptoms or have atypical ones that are subtle and vague. These patients raise some important questions. Is this a case of test results in need of a disease, rather than the other way around? And from the patient’s perspective, why bother with a diet that’s inconvenient — despite the growing number of choices — and expensive if you don’t have symptoms?

Celiac disease experts have a three-part answer. First, if doctors and patients were more aware that problems like anemia and fatigue can be traced back to celiac disease, they’d see that a gluten-free diet improves these symptoms. Second, if symptoms are subtle, so might be the improvement. Third, like many so-called silent diseases, celiac disease may not have showy symptoms, but if left alone, it may result in serious problems down the line related to poor nutrition. And some data suggest that the risk of developing other autoimmune conditions (including thyroid disorders like Hashimoto’s thyroiditis and Graves’ disease) may be related to how long someone with celiac disease has been eating gluten.

The super six

We’re often too quick to depend on pills instead of first working to change our diet and exercise habits. But with celiac disease, there’s no pill, and a fairly radical change in diet is the only treatment. Ironically, doctors who treat celiac disease lament the lack of pharmaceutical industry involvement. Drug companies have started to take some interest in the disease, and treatments that would block the absorption of gluten are being investigated, but none so far are close to gaining FDA approval.

Gluten-free eating is a two-way street: getting the gluten out while bringing in healthful — and palatable — alternatives. Some foods are obviously made with wheat and the other gluten-containing grains. Conventional bread, bagels, pizza — they’re out if you have celiac disease. But until you need to avoid gluten, you probably don’t realize how ubiquitous it is. Gluten is used as a thickening agent and filler in everything from ketchup to ice cream. The inactive ingredients in many medications are gluten-based. And even when gluten isn’t an ingredient, it may inadvertently get into a food because a wheat-based food was processed in the same factory, or wheat was grown in a nearby farm field. At home, wooden utensils and toaster ovens are gluten “hot spots.” Oats don’t contain gluten, but many people with celiac disease avoid them because of contamination problems.

The gluten-free diet has traditionally depended on starch from rice, corn, and potatoes. Food makers have also learned how to use xanthan and guar gums to replace gluten’s elasticity: a common complaint about gluten-free baked goods is that they are powdery. But these formulations can also leave diets short of fiber and B vitamins. Melinda Dennis, the nutrition coordinator at the Beth Israel Deaconess Medical Center Celiac Center, encourages patients to eat foods made with unconventional but nutritionally well-rounded substitutes, including amaranth, buckwheat (no relation to wheat), millet, quinoa, sorghum, and teff. She calls them the “super six” because of their high vitamin and fiber content.

Eating out is one of the biggest issues for people with gluten problems, says Dennis. Vegetables get contaminated because they are steamed over pots of pasta water. Fish and chicken are floured to hold seasonings. But many restaurants are beginning to offer gluten-free items. And there are some celiac-friendly cuisines, even if they are not overtly gluten-free. Dennis put Ethiopian (which uses teff), Indian, Mexican, and Thai in that category.

Harvard Health Letter, June 2009

http://www.health.harvard.edu/newsletters/Harvard_Health_Letter/2009/June/Getting-out-the-gluten

By following the DASH diet, you should be able to pare 5.5 to 11.4 points off your systolic pressure (the top number in a blood pressure reading) and 3 to 5.5 points off your diastolic pressure (the bottom number in a blood pressure reading). Research also suggests that the diet reduces blood levels of homocysteine, a toxic amino acid that may increase the risk of heart disease, stroke, and peripheral vascular disease.

The DASH diet gives you 2,000 calories a day divided among 4 to 5 daily servings of vegetables, 4 to 5 servings of fruits, 2 to 3 servings of low-fat or nonfat dairy products, 7 to 8 servings of grain products, and only 2 small servings of meat. You’re also allowed 4 to 5 small servings of nuts, beans, or seeds per week

Other strategies for lowering blood pressure are losing excess weight, exercising regularly, and reducing daily stress through meditation, breathing exercises, yoga, progressive muscle relaxation, or biofeedback.

The diet I recommend in my book Healthy Aging: A Lifelong Guide to your Physical and Spiritual Well-Being is similar to the DASH diet with the addition of omega-3 fatty acids and natural anti-inflammatory spices such as turmeric and ginger. Both are similar to the Mediterranean diet, which emphasizes fresh fruits and vegetables, crusty breads, whole grains, and olive oil as well as more fish and legumes and less meat and poultry than the typical Western diet contains. Whether you’re trying to lower blood pressure or simply eat well, you can’t go wrong with the DASH diet, or with the alternatives mentioned above.

Andrew Weil, M.D.
http://www.drweil.com/drw/u/id/QAA400035

I use about a cup and a quarter to a cup and a half of water or chicken broth.  Mince finely a bunch of carrots, celery and a strong onion (don’t waste your time with Walla Wallas, or the like), and a little garlic.  Boil the veggies in the broth for a couple minutes (just to soften them a little).  Add a cup of whole wheat couscous and a liberal dousing of Brother Bru-Bru’s African Hot Pepper Sauce.  Stir.  Remove from heat and cover.  Wait five minutes.  Fluff with a fork, and viola’!  The best couscous you’ll ever have.

Make bigger batches if you want to make it a main dish.  I like it with garbanzo beans and apricots.  Just make sure you have plenty of Bru-Bru’s on hand.

• 6 cups water
• 1 3/4 cups yellow corn meal
• 1/2 teaspoon Brother Bru Bru’s African Hot Pepper Sauce
• 3 tablespoons unsalted butter

Bring the water to a boil in a heavy large saucepan. Stir in the cornmeal gradually, using a wire whisk. Add 1/2 teaspoon Brother Bru Bru’s African Hot Pepper Sauce. Reduce the heat to low and simmer until the mixture thickens and the cornmeal is cooked, stirring often, about 15 minutes. Turn off the heat. Add the butter, and stir until melted.