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Date: 09.06.2015
From: Sean

Subject: Just a Patient Case Study - but further food for thought

I found this last week and thought it was quiet on here - so adding some food for thought...

This case report is of a sufferer of a rare disease called Meniere's disease - where the patient also had OA with some deformity of the hands (Hebdern Nodes). ALL TESTS FOR CELIAC WERE NEGATIVE!

Abstract here -

http://www.ncbi.nlm.nih.gov/pubmed/23374485

Full paper here -

http://www.researchgate.net/profile/Federica_Di_Berardino/publication/245022764_case_report/links/0c96051d58e34f2081000000.pdf

In the paper it says -

- After 6 months diet change it stopped progression of the arthritis and most of the other condition

- They were still in remission after 4 years diet change

- Pain and other symptoms returned after trial of wheat nearly 5 years later
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Date: 10.06.2015
From: lois

Subject: Re: Just a Patient Case Study - but further food for thought

Hi Sean I have just received a lot of information from my hospital. There is a diet they say to follow which is a Mediterranean Diet.
Lots of salad fish oil and bread. Any thoughts?
I am trying to arm myself with as much info before I see a Rhuemy Team.

I would appreciate some easy reading as I have so much pain right now and my concentration level isn't great.

I hope you are doing well. Thanks in advance. Take care.
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Date: 11.06.2015
From: Sean

Subject: Re: Just a Patient Case Study - but further food for thought

Hi Lois,

My personal view is that the Mediterranean Diet has even less scientific standing as the much heralded 'China Study' that compare disease prevalence and diet across China. There are good things about the diet - with the fish, Olive Oil but the factors that control disease are much more complex than just diet.

Also the Mediterranean Diet was not a study of the Mediterranean as a whole it was based on few Italian towns I believe.

This is sort of backed up by the European studies on arthritis - to be honest the figures are all over the place - Greece has high incidence of RA, France low, with Sweden, Denmark, Finland all high - UK very high. The hygiene hypothesis (more diverse gut bacteria!) also seems to come in to play with prevalence of RA lower in rural communities.

http://www.eumusc.net/myUploadData/files/Musculoskeletal%20Health%20in%20Europe%20Report%20v5.pdf

People in the Mediterranean have developed more defense against the proteins in wheat than many of us northern Europeans. They also lost a larger number from their gene pool to plague / disease in the middle ages at the rise of the agricultural revolution - and it will have been those that were weakened by the 'new diet' that would have succumbed - the genetically stronger ones survived.

I have a strong biased view :) that we can trace some of the of mass disease such as plague to introduction of new proteins in to the diet - a loose link is that new strains of high yield wheat that was imported from Egypt - (the same fertile plain that had caused mass arthritis amongst the Egyptians centuries before)
for
http://en.wikipedia.org/wiki/Plague_of_Justinian#Origins_and_spread

So a personal view, but a common one - I would not put bread at the heart of any diet for anyone with any auto-immune disease. There is simply too much evidence that it is an inflammatory food for virtually everyone, but of course some people do tolerate the onslaught (but only if they have the genes, strong protective gut bacteria).

The only diets I would recommend are ones that focus on gut health (with 100% grain free, with the possible exception of trialing GF oats and Sourdough Rye Bread) and my very strong view now is that NSAIDs are complete poison - maybe a necessary poison at a time of crisis - but long term they destroy any chance of recovery (for some long term users it might be too late to regain gut barrier).

And today in the studies they show it's not just Celiac and arthritis - The amino acids in wheat have been shown that how they contribute to neurodegenerative conditions such as Multiple sclerosis, Alzhemierās, Huntingtonās disease, and other nervous disorders such as Epilepsy, Attention Deficit Disorder and Migraines.

For me it's a no brainer.. I had brain fog most of the time before I went GF

As regards other foods - I've been shot down too many times to say salad is good or fish is good - understanding the mechanism of autoimmune disease I can see that with a distinct flow of events that many proteins in any food could become problematic - for a given individual.

So starting with an elimination diet with a few foods that are very unlikely to cause an immune response is a good way to go -

Mackerel
Cod
Lamb
Turkey
Pears
Rice
Sweet Potatoes
Bananas
Gradually introduce herbs and spices

In fact I saw this which ties up with my top of my head list... So easy reading for diet...

http://www.uccs.edu/Documents/healthcircle/pnc/health-topics/Allergy%20Elimination%20Diet.pdf

It says you MUST eliminate always to start...

*Dairy products (lactose and casein) - (I would say include Sheeps and Goats Yogurt)
*Wheat (and other gluten-containing foods)
Eggs (whites particularly)
Corn
Peanuts
Tomatoes
Shellfish
All citrus fruits and juices (I would say omit peaches too)
Sugar
Chocolate
Coffee
Black tea
Alcohol
Soy
Artificial sweeteners
Yeast

Your Rheumi team are likely to say the usual... 'there is no evidence' etc etc... my view is what do they know about it - they did 2 weeks on diet in medical school!

Perhaps show them this study - It suggests that wheat proteins DO get in to the synovial fluid in the joints and cause an immune response 33% for RA - 42% for PsA and 11% for OA !!!! What they are describing here is a Celiac type reaction of the bones....

http://www.ncbi.nlm.nih.gov/pubmed/12563369

I am going to study for BCNH Nutritional Degree - starting with a Science Foundation in September - then 3 years and a 1 Year Clinical Practice course for nutrition. One of my daughter friends Mum has been doing the course and is about to enter her last year - she told me last week that I had more knowledge than some on the course already. BTW - This lady doing the course reacts to RICE!

Good Luck with you rheumi visit!
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Date: 11.06.2015
From: lois

Subject: Re: Just a Patient Case Study - but further food for thought

Hi Sean, thanks for the information and a big thanks for an easy read. The list of can have are all foods I enjoy so that is good and I am sure I could try that for weeks with little effort. Some of the can't have looks a bit more difficult but I will have a good go. I have to do something to get this pain down to bearable.

Thanks again. I hope you are relatively well.
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Date: 13.06.2015
From: Sean

Subject: Re: Just a Patient Case Study - but further food for thought

Just been reading that from its discovery in 1887 to 1953 - some 67 years later! that Celiac disease was just another autoimmune disease of unknown origin. Up til then it had no association with gluten or diet.

Then a doctor on the basis of examining 6 orphan children had a theory.

There were no double blinded placebo controlled studies - just a theory and a gluten free trial on the children.
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Date: 21.06.2015
From: Julie

Subject: Re: Just a Patient Case Study - but further food for thought

Good for you Sean, if anyone can do the degree it is you. For us it means we have our own nutritionist, we have you now with your fantastic knowledge but you will get to know even more.

I hope you enjoy it and know you will excel above all the others.

Still trying (stumbling!!) to get my chocolate habit under control, but I have come to realise its that chocolate is the thing that stops me sleeping. My other love is bread which if I gave up I don't know what I would eat instead. Bread, chicken, potatoes, fish (haddock) and salad is what I mainly eat, so I have a lot to learn.

Julie
xx
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Date: 21.06.2015
From: Sean

Subject: Re: Just a Patient Case Study - but further food for thought

Thanks Julie, :)

The course is going to cost me 18,000 over a 5 year period. I'm worried I'll be an old man (54) before I finish it. I need to have an entrance interview with the course - as they are a bit choosy.

Spoke to my Dad today who is nearly 70 - and his arthritis (AS) has had a big relapse this last few months, now with his thumbs, shoulder and also his skin flaring up again. He still cycles though.

I did the usual diet sales pitch - but he knows already and said that he knows his joints and skin are better when off of the wheat - and I know my skin would flare if I had cows milk every day like he does. He says he is too set in his ways to change. You can lead a horse....

Chocolate in itself isn't usually a problem food - in fact dark chocolate is v high in Magnesium. Too much sugar though too often is obviously not good.

Take care - and hope you are doing ok..

I promised my wife's Gluten Free Chocolate Almond Cake recipe a few weeks ago -

200g butter
250g sugar
5 large eggs
200g ground almonds
1 lemon zest

Preheat oven to 190c
Butter a 9" spring base tin
Melt butter and chocolate (usually done in the microwave on low)
Beat in egg YOLKS and sugar
Fold in almonds and lemon zest
Whisk egg whites to soft peaks - then fold in to the mixture

Place in tin in centre of oven for 40 to 45 minutes - it will look v brown on top

It is best cold, with raspberries on the side - if you can wait that long!
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Date: 22.06.2015
From: sleek Fox

Subject: Re: Just a Patient Case Study - but further food for thought

Looks good, sean. How much chocolate?
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Date: 22.06.2015
From: Sean

Subject: Re: Just a Patient Case Study - but further food for thought

oops - thanks sleekfox

200g dark chocolate

We sometimes use Green and Blacks (Maya Gold - which is Spiced Orange) - makes it extra special
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Date: 22.06.2015
From: sf

Subject: Re: Just a Patient Case Study - but further food for thought

I'm rather fond of Maya Gold.
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