1368550803996Dr Carrie Decker ND, explores the potential management of indavertent ingestion of gluten, which for those people needing to exclude exposure to these proteins and lead a life that includes eating foods that have not been prepared at home, can be a significant risk to well being.

Coeliac disease (CD) is the most studied and broadly recognised disease associated with the immune reaction to gluten consumption, however other types of ‘gluten sensitivity’ also exist. These conditions are broadly known as Non-Coeliac Gluten Sensitivity (NCGS). The immune response to gluten proteins and polypeptide regions varies, but may involve the innate immune system, class I or class II mediated reactions, and antibody recognition.[1] The topic of NCGS is being increasingly studied, as is evidenced in the following quote extracted from an article in Nutrients:- “Non-Celiac Gluten Sensitivity: The New Frontier of Gluten Related Disorders”[2]:

8.coverUnless you have been hiding away from all published materials you will be aware that Monash University in Australia have proposed and others have supported that for people with irritable bowel syndrome, that following a diet low in FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols content will result in symptom resolution.

Yet here at Clinical Education we have stressed that following this diet has risks of key nutrient insufficiencies and in particular those foods rich in aryl hydrocarbon receptor agonists, which are vital for gut mucosal immune balance and competence. In effect the use of a low FODMAP diet for long term health is not justified, but short term intervention may be helpful.

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JBS3One of the recent developments in risk assessment for cardiovascular disease has been the updated version of the JBS2 calculator to the JBS3.

This is an online or app based piece of software to help you determine your risk for future cardiovascular disease. Ideally it is used as a tool to moderate lifestyle and diet along with behaviour to guide an individual based on a modest range of markers on how they may reduce their risk to a minimum.

indexEncapsulating relevant, informative information into a humorous and well structured presentation is a real art. In this unusual Clinical Education team recommendation I have selected the work of comedian Simon Evans, who on the 29th July 2015 (radio 4) gave a half hour or so summary on the consequences of eating too much sugar, how that happened and why it is so difficult to stop, despite its miserable health consequences. His witty, articulate and informative summary is one of the best I have heard and suggest that you pod cast it, or save it for a car journey or activity, where you have chance to enjoy and share the experience.

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SmallLogoThe simple observation that associated mental health with food choice, ingestion and availability were apparent to the earliest of clinicians and for many people the use of foods and food concentrates have been both a help and a hindrance in managing mood and more complex neurological challenges.

Nutritional Therapists familiar with the work of Dr Abram Hoffer will be aware that some of the early work looking for bio-markers linked to nutrient need and supra dose supplementation has produced remarkable improvements in some people. However the pharmaceutical industry drove the attention of relevant clinicians towards pharmaceutical intervention, and whilst some surgical approaches have long been abandoned, talking therapies and drug therapy remain the primary point of intervention.

journal_logoThe use of Saccharomyces Boulardii as a therapeutic intervention in people with alterations in their microbiota and local immune responses has been explored for over 50 years. The multiple points of action this simple yeast initiates in terms of mucosal barrier function and immune competence has made it an attractive and safe product for many clinicians. This study published in Jun 2014 in the American Society for Microbiology explores its role in a mouse model, but opens some interesting prospects for human health.[1]

elderly exercisingEven exercise of short duration and low intensity has life expectancy benefits for the elderly. Such conclusions have been well examined in the general population, where a recommended exercise program of 30 minutes at least five days a week (or 150 minutes per week) has been shown to reduce the average risk of death by 30 percent.

However, such a correlation between the level of physical activity and risk of death has not been so clearly determined in the elderly. Indeed, most physical activity guidelines are the same for the middle-aged adults as for the elderly, even though it is estimated that over 60% of the elderly are unable to achieve this same level of exercise.

Scientific AmericanA Review and open critique of Michael Shermer’s article “Are Paleo Diets More Natural than GMOs?” published in Scientific American magazine, March 2015

Editor’s Introduction: As noted in AMA (American Medical Association) Manual of Style: A Guide for Authors and Editors, 10th edition, the practice of publishing unsigned or anonymous editorials provides editorialists protection from enemies and freedom of expression. More importantly, any article should to be able to stand on its own merit and not depend on the buttressing of credentials nor support of affiliations. The authors of this paper wish for this information to stand on its own merit, unsupported by credentials and affiliations. Further, this article is offered in complete open-access and can be reproduced freely, without citation.

ajg_cimageA paper in the American Journal of Gastroenterology looks at various markers to see if it is possible to use them to differentiate between IBS and IBD.[1]


Irritable bowel syndrome (IBS) is viewed as a diagnosis of exclusion by most providers. The aim of our study was to perform a systematic review and meta-analysis to evaluate the utility of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), faecal calprotectin, and faecal lactoferrin to distinguish between patients with IBS and inflammatory bowel disease (IBD) and healthy controls (HCs).

cover_natureA study in Nature suggests that common food additives could be contributing to the development of chronic inflammatory diseases. Chassaing et al.[1] report that dietary emulsifiers induce low-grade inflammation in mice by disrupting the composition of their intestinal microbiota, thereby predisposing these animals to the development of metabolic syndrome and colitis. This builds on an earlier paper they published in the Journal of Toxicologic Pathology.[2]

To explore the effects of emulsifying agents on the intestinal mucosa, the authors administered carboxymethylcellulose (CMC) or polysorbate 80 (P80), which are emulsifiers commonly used in human foods, to mice in their drinking water. Compared with control mice, animals that received the emulsifiers showed reduced mucus thickness and increased gut permeability.