SUMMARY: Quinoa is a whole grain substitute that is gluten-free though it actually is a seed, commonly termed pseudograin. Most simply rinse, drain, then toss quinoa into a pot and simmer for 12 minutes calling that cooked. Though cooked, it may not be very digestible, and this method may be downright harmful to your gut. So how do you properly prepare soak quinoa? Learn here that quinoa is super easy to properly prepare although it does require, as a minimum to reduce anti-nutrients, a 12 to 24 hour acid soak prior to cooking. I’d do the quinoa soak purely for the culinary taste improvement truth be known as it removes bitterness from quinoa’s anti-nutrients in addition to making it easier on your gut! For more science, see below the recipe for quinoa’s: Impact to the microbiome, nutrient (including protein) punch, anti-nutrients and impact on those due to quinoa processing, and label de-coding for a Kind bar containing quinoa!
“Fire in the gut is fire in the brain — Dementia, Alzheimer’s.SUMMARY: A recent study found risk of dementia in PPI users aged 75 and over. Previous studies had found that Histamine H2 antagonists (H2RAs) also have adverse cognitive impact in the elderly but the mechanism differed… it was due to anticholinergic effects; I wrote about that here.Can the heartburn drugs, dementia, Alzheimer’s risk associations be extended to younger ages?
What may be possible mechanisms? This post lists the PubMed studies finding that heartburn drugs put fire in the gut; they
Skew microbiome — PPIs microbiome skew is so severe it increases the risk of CDiff and HALF of users have small intestinal bowel overgrowth, aka SIBO. Regarding the H2RA impact on the microbiome, there is only a paucity of data though studies are now ongoing. However, given that it too is an acid reducer, microbiome impact is likely similar to PPI. And
Both PPIs and H2RAs mug nutrients, especially B12 which is associated with cognition.
Both of these mechanisms are not age dependent. “Fire in the gut is fire in the brain”.
With dementia known to be associated with B12 deficiency, and if dementia is shown to be associated with microbiome skew in humans, (this mouse study also suggests such) are heartburn drugs (that skew microbiome and deplete B12), dementia, Alzheimer’s a risk for all ages? Can impaired cognition for Type 2 Diabetes (T2D) irrespective of age, many of whom also take acid reducers, be the canary in the coal mine suggesting YES? Read on; it may be time to re-think grandma, your dad, yourself, and your child on heartburn drugs.
Last, this post shows another mechanism for dementia for all ages — high blood sugar with or without diagnosed diabetes. Diet guidance (with links) that lowers blood sugar for all is provided.
Realize however, dementia and Alzheimer’s risks are multi-factorial. It is certainly worth reducing their risk by focusing on risk factor associations.
If gut microbiome is found to be associated with dementia, reducing/eliminating the acid reducer factor which is contributing to skewed microbiome, with physician guidance, knocks down a big contributor to microbiome skew. Check outDr. Mark Hyman’s post here to begin to self educate yourself on reducing heartburn drugs.
We now know that acid reducers are associated with cognition impairment in the elderly.
Results A total of 73 679 participants 75 years of age or older and free of dementia at baselinewere analyzed. The patients receiving regular PPI medication (n = 2950; mean [SD] age, 83.8 [5.4] years; 77.9% female) had a significantly increased risk of incident dementia compared with the patients not receiving PPI medication(n = 70 729; mean [SD] age, 83.0 [5.6] years; 73.6% female) (hazard ratio, 1.44 [95% CI, 1.36-1.52]; < .001). The association was slightly more pronounced in men than women (HR 1.52 versus HR 1.42), though both were statistically significant
SUMMARY: Learn impact of FODMAPS, Stomach Microbiome, Rifaximin… FODMAPS Diet helps over 70% of IBS likely because long term diet changes the microbiome in the stomach & gut. FODMAPS isn’t a life long diet; you reintroduce & learn your individual dosing limits.
Many now realize the need, if not necessity, to transition to a whole foods diet.
Foods from restaurants or cafeterias, prepared foods (even at sites considered healthy such as Whole Foods), and the obvious boxed foods make it tough for consumers to avoid caloric dense non nutritive foods with industrial seed oils and added chemicals, pesticides, and GMOs. The diet — health connection is becoming apparent; many suffering chronic disease(s) are trying to change diet and lifestyle to improve health and wellness. Eating whole foods can be daunting but the safest bet is making it yourself and to do so in quantity so as to make this lifestyle change sustainable:
I am going to walk you through and example using a typical low fat diet, to show how easy it is to need to turn to the whole foods table to remedy digestive health issues. Low fat dieters inadvertently increase carbohydrate loading in order to eat low fat; in doing so, they do not increase carbohydrate loads by eating more vegetables and low fructose fruits, rather grains and fructose dominant fruits dominate most low-fat diets. Top that off with the quality issue inherent in low fat prepared or processed foods as they generally contain many questionable ingredients, chemicals, GMOs and pesticides. The below slide drives home the macronutrient skew so you can see what30 grams of carbs really looks like, two ways:
Many are now literally feeling the effects of such macronutrient skew either due to gluten sensitivity (or it could be due to another grain protein; we now realize that immunologic reactivity in celiac disease may not be limited to wheat gluten, but can involve certain nongluten proteins, too, see Nongluten wheat proteins triggered immune response in celiac patients), fructose malabsorption, or some other food intolerance/sensitivity). The end result is that many suffer with Irritable Bowel Syndrome (IBS) which is second to missed work days only to the common cold.
Irritable bowel syndrome affects approximately 10-15% of the European population and up to 70% of individuals with IBS may not be formally diagnosed. (Quigley et. al. 2006)
IBS results in more than $10 billion in direct costs (eg, office visits, medications) and $20 billion in indirect costs (eg, through work absenteeism and reduced productivity) each year.
(IBS – Review and What’s New, Foxx-Orenstein A. 2006)
IBS patients are more likely than others to have their gall bladder removed unnecessarily and with no positive effect on their IBS symptoms. IBS have an increased risk of cholecystectomy that is not due to an increased risk of gallstones, but rather to abdominal pain, awareness of having gallstones, and inappropriate surgical indications. (Gallstones, cholecystectomy and irritable bowel syndrome (IBS) MICOL population-based study, Corazziari et. al. 2008)
The physician must realize that a strong physician–patient relationship will be the foundation for effective treatment and realistic expectations. Many patients with IBS have bounced around the medical field for many years with varying diagnoses because of the lack of interest or profound frustration by the physician in treating IBS, possible stigma of this disease as being a psychiatric entity, or lack of clinical, physical, or laboratory diagnostic criteria… The physician should also emphasize the chronic nature of this syndrome because nearly 75% of patients continue to have a diagnosis of IBS 5 years later.13–Irritable Bowel Syndrome: A Review and Update, 2012
A lot more citations to top IBS articles can be found at: Food Allergy and Intolerance Foundation (Selected Research Articles on IBS, Food Allergies, and Related Issues.Top Articles).
Rifaximin antibiotic treatment for IBS, seriously?!?
Patients with IBS commonly complain that specific dietary misadventures contribute to their symptoms of abdominal discomfort, bloating, or exaggerated gastric-colic reflex (urgent bowel movement after eating a meal). The truth is that no specific food is likely the culprit because true food allergies are rare. It is merely the act of eating that most likely initiates these postprandial symptoms. Patients may begin to associate ingestion of certain foods such as fatty foods, caffeine, alcoholic beverages, carbonated foods, or gas-producing foods as the etiology of their complaints.2The physician does not want to restrict the patients’ diet excessively because of the risk of encountering nutritional deficiencies. However, it may be a good idea to instruct the patient to limit suspected foods and slowly reintroduce these items individually to see if similar symptoms reoccur… [recommend] maintaining a daily food diary.
Soaking and dehydrating nuts is EASY and it makes them more digestible since anti-nutrients are neutralized and enzyme inhibitors are eliminated. If you are like many of my clients, you have no clue what the significance is of what I just said. So another way of saying this is, unlessyou soak nuts, you will block mineral uptake, and this totally defeats the purpose of trying to eat nuts for nutrient density.
A surprising plus of proper nut preparation is that the process takes out the bitterness in taste making nuts taste incredibly sweet and delicious, which is what they are supposed to taste like. I’d soak and dehydrate nuts solely for this culinary taste improvement truth be told. Clients do too after they sample them. I am always amazed to see what the filtered water looks like after a soak. Someday I’ll do a lab analysis, and we’ll learn what actually is in that yuck. One thing I do know, nuts blow up in size by the end of the soaking period leaving no doubt that they have absorbed the salt soaking medium:
Slide source: biomeonboardawareness.com
Those following PALEO/SCD/GAPS/AIP – to soak or not:
Elaine says it is not necessary. See the post from the Official Website for Breaking the Vicious Cycle and Specific Carbohydrate Diet, NUTS – BLANCHED OR UNBLANCHED: Elaine Gottschall, author of Breaking the Vicious Cycle: Intestinal Health Through Diet: “For lots of information on nuts and the very beneficial effects of almonds see Going Nuts! (article is posted at time 1/7/06 11:28 AM) by Stephen Byrnes, PhD. Update: I found the article posted on thisMen’s Health Forum under “Nuts?????”. However he suggests soaking nuts which I do not believe is necessary. I believe that the almond nut flour we use is perfectly fine and has proven to be tolerated very nicely bringing thousands back to health without the soaking process which complicates life to no end.”
Byrnes, inGoing Nuts!says to soak: “All nuts should be purchased raw and unsalted from stores that rotate their stock fairly quickly. Canned, salted, or packaged roasted nuts are not appropriate due to processing. You can purchase raw nuts of all types at any good whole foods market. Raw nuts are desired for their high enzyme content… [but] nuts have high amounts of enzyme inhibitors and phytates that should be broken down before consuming them. How does one do this? By soaking the nuts in salted water for 6-8 hours [except cashews which soak for no longer than 6 hours]. After this time, one will drain out the water, place the nuts on a cookie sheet, and dry them on low heat in the oven. Nuts prepared this way have been “predigested” by soaking and will give quick energy and a full gamut of nutrients. These “Crispy Nuts” are excellent snack foods, particularly for athletes or for those with hypoglycemia.”
Interpretations can vary, but Elaine said soaking isn’t needed since SCD uses almond flour. SCD uses blanched skinless almond flour which by default, would be subjected to a soak in order to remove the skin. Some interpret Elaine’s comment to additionally mean that whole nuts do not need soaked. Perhaps the greatest argument for soaking whole nuts for PALEO/SCD/GAPS beyond neutralizing anti-nutrients and enzyme inhibitors, is due to the fact that whole nuts are considered anadvanced food:
Introduction guidance at The Stages of SCDnotes: “In BTVC, Elaine cautioned against using homemade nut milks before 3 months into the diet so that people would not use too much of the same nuts. If nut milk and nuts butter and/or flours are not used in excess and are balanced with other foods, then the nut milks can be cautiously added after the intro diet. The nut milk should have all pulp/fiber removed; it should be diluted and the total amount of one type of nut should be balanced with other foods/food groups.” In the article’s table, nut milks are introduced after intro at Stage 1, nut butters are introduced at Stage 2, and nut flours are introduced at Stages 3 & 4. Nut pieces are introduced at Stage 4 while whole nuts are introduced last, at Stage 5.
SUMMARY: Learn Why and HOW to dehydrate apples and preserve the enzymes! Spoiler alert: Properly dehydrating apples at a low temperature preserves maximum nutritional density and natural live enzymes since you can use organic apples picked seasonally and locally at their peak of ripeness, and the internal temperature of the fruit stays below 118Fwhich maintains active enzymes! The total dehydration time for this recipe is about 12 hours!
How to Dehydrate Apples to Preserve Live Enzymes
My directions incorporate the Excalibur-9-Tray-Digital-Controller-Dehydrator-76970-User-Manual.pdf,Raw and Living Food Guidelines, Excalibur Dehydration Guide. This manual explains that nutritional value AND enzymes are preserved if the INTERNAL temperature of the fruit is kept UNDER 118°F/48°C:
“One of the most important characteristics of raw foods, is they are easier for your body to digest than cooked food. The enzymes are what make raw foods easier to digest than cooked foods. When food is cooked the enzymes become deactivated by heat. During the digestive process, the natural food enzymes assist your body’s digestive enzymes in breaking down food into digestive proteins. By eating more raw foods, your body does not have to work as hard to digest the foods, which gives your body more vibrant energy in other areas, making you feel stronger, healthier and happier. Dehydration is the best way to preserve the essence of raw fruits and vegetables. Dehydrating does not subject foods to the high temperatures associated with cooking, or traditional canning methods. When raw food is heated to an internal food temperature of 118ºF/48ºC or higher, for an extended period of time, its nutritional values begin to deteriorate, especially enzymes. Canning also leaches out water-soluble vitamins and minerals, which also depletes the healthy qualities of the raw-living foods.”
Summary: It is time to share what a successful professional autism dietary intervention program can look like for autism management.
“Special Diets and Nutrition For Autism: Why They’re Cost Effective,” is such an interesting read from Judy Converse MPH RD LD, a registered dietitian since 1989, who then self taught herself, beginning in 1996, diet impact for her son’s growth, feeding, and developmental challenges at birth. She then expanded training to learn biomedical intervention for autism, becoming a DAN practitioner, and ultimately provided instruction in nutrition for Autism Research Institute, US Autism and Aspergers Assocation, National Autism Association, and many others. She has lectured for many local and national audiences about the profound impact nutrition and a healthy gut have on the developing brain as well as authoringthree books and created the first web-interface accredited learning module for health care providers on nutrition and autism in 2007.
Actually, there is a lot of science on the success of dietary intervention for autism:
Readers of my work are no stranger to the published science and ongoing studies looking at the food – autism interactions. Some of the latest of such are summarized in posts:
SCD in 20 children ages 2-6 years with gastrointestinal problems that have been diagnosed with autism.Enrollment is now closed; they will eat a SCD diet for 16 weeks (all food is provided) and blood, stool, and questionnaires will be obtained. The contact for more information on this study is intake@johnson-center or call 512.732.8400.
Performing a retrospective study of 600 children with a diagnosis of autism, ages 2-21 years, who were seen on an outpatient basis at the Nutrition Clinic at Thoughtful House Center for Children in 2009. The will compare the intake of calories, carbohydrates, protein, fat, vitamins, and minerals from food at baseline and follow-up dietary consultations and assessments. The prevalence of dietary inadequacy of these nutrients in this patient population diagnosed with failure to thrive (FTT) will also be evaluated. Enrollment is now closed.
This prospective treatment study is enrolling up to 50 children, ages 2-21 years, diagnosed with ASD with documented evidence of ileitis, colitis, and/or duodenitis, and lymphoid nodular hyperplasia. They are evaluating the tolerability and efficacy of an Elemental Diet in the amelioration of gastrointestinal symptoms by conducting a prospective open trial of administering a nutritionally adequate elemental diet in this patient population. They will quantify symptomatic changes in GI presentation as well as quantify anthropometric and biochemical changes. Enrollment is now closed.
Assess bone mineral density status for 80 boys, ages 4-8 years, diagnosed with autism or neurotypical controls. This study will determine if bone mineral density is correlated with: nutritional status, vitamin and mineral levels, symptomatic GI presentation, and antropometric measurements. Enrollment is now closed. Slide Source: biomeonboardawareness.com
Collaborating institutions include:
The Johnson Center for Child Health & Development : Research
Another study, Gastrointestinal abnormalities in children with autistic disorder”, Horvath, et al, 1999, for 36 participants: 25 (69.4%) had Grade I or II reflux esophagitis, 15 had chronic gastritis, & 24 had chronic duodenitis. Additionally the number of Paneth’s cells in the duodenal crypts was significantly elevated in autistic children compared with non-autistic control subjects, and low intestinal carbohydrate digestive enzyme activity was reported in 21 of 36 children (58.3%), although there was no abnormality found in pancreatic function and 75% of the autistic children (27/36) had an increased pancreatico-biliary fluid output after intravenous secretin administration.
And this most recent post, “2 AUTISM STUDIES ARE SEEKING PARTICIPANTS: MICROBIOME & CONSTIP,” which shares a new food study, funded by Autism Speaks, looks are remedying chronic constipation and the effects on autism symptoms (and another study noted on this post looks at the microbiome).
My favorite autism researcher, Paul Whiteley, is also a member of ScanBrit, which was/is a meeting of minds between the group he works with and other research groups based in Denmark and Norway, who want to experimentally examine the question of whether a diet devoid of foods containing gluten and casein might be able to impact on the presentation of autism in children. This post on his blog entitled “Autism and the GFCF diet: ScanBrit episode 2″ speaks to what seems to be working for many autism and notes“These preliminary observations on potential best responder characteristics to a gluten- and casein-free diet for children with autismrequire independent replication” “That sentence, taken from a recent (pre-print) publication I was very peripherally involved in writing, isprobably the most important thing to take from the paper by Lennart Pedersen and colleagues* and certainly is a message that I would be very keen to promote.”
Last, Whiteley authors two blogs: Questioning Answers is where he describes and discusses various research into autism spectrum and related conditions.Gutness Gracious Me is where he discusses various gastrointestinal research. Nuff said there about how important this expert feels diet is to autism management.
You’ve seen the slide belowbut it bears repeating here as it demonstrates the success of eliminating certain food groups for autism:
“Autism – Part 4: Digestive Function”,Dr. Nicholas Anhorn, BSc, ND. http://www.ndaccess.com/MonctonNaturopathic/Page_Detail.asp?PageID=22&CommentID=20
Despite all the above… diet intervention for autism, in 2014, is still NOT recommended mainstream, which is incredible realizing that 1 in sixty-eight US children have autism (with prevalence increasing alarmingly)
Slide Source: biomeonboardawareness.com
This 2014 paper, Practice Parameter for the Assessment and Treatment of Children and Adolescents With Autism Spectrum Disorder continues to NOT recommend dietary intervention for autism (despite noting that 90% of parents use complementary and alternative medicine for such) and instead focused on teachers, behavorial psychologists, and speech and language pathologists support. The rationale was (see the paper for the actual citations):
“Although most alternative or complementary treatment approaches have very limited empirical support for their use in children with ASD, they are commonly pursued by families.155 It is important that the clinician be able to discuss these treatments with parents, recognizing the motivation for parents to seek all possible treatments. In most instances, these treatments have little or no proved benefit but also have little risk.7 In a few instances, the treatment has been repeatedly shown not to work (e.g., intravenous infusion of secretin156 and oral vitamin B6 and magnesium157[rct]), or randomized controlled evidence does not support its use (e.g., the gluten-free, casein-free diet,158 ω-3 fatty acids,159 and oral human immunoglobulin).160[rct] Some treatments have greater potential risk to the child directly (e.g., mortality and morbidity associated with chelation161[cs]) or from side effects owing to contaminants in “natural” compounds or indirectly (e.g., by diverting financial or psychosocial resources). For a detailed review of alternative treatments, see Jacobson et al.162 and Levy and Hyman.163 Although more controlled studies of these treatments are needed, it is important that the family be able to voice their questions to health care providers. Families may be guided to the growing body of work on evidence-based treatments in autism.164 “
Digestion: we all do it though most take it for granted unaware that improper digestive enzymes and subsequent digestion is the root cause of most disease which is epidemic at the moment:
Slide source: biomeonboardawareness.com
Those with digestive dysfunctional symptoms (GERD, heartburn, bloat, gas, bowel Bristol Chart type issues…) don’t take it for granted. Neither should you.
Any blimp in the digestion trek, from brain to elimination, has upstream and downstream ramifications particularly affecting the microbiome community bacterial species balance. Most, if not all disease, is now being connected to microbiome community shifts.
This post focuses on autism specifically only because there are many current studies documenting the autism digestion dysfunction. The overall message however applies to all of us.
The slides below summarize Digestion 101. Basically, large food molecules are broken into smaller for absorption. Different enzymes are needed for metabolizing carbohydrates, fats and proteins.
Impaired digestion (such as due to lack of effective digestive enzymes) contributes to abnormal gut flora. Improperly digested food feeds the bacteria in your gut shifting the community balance in a detrimental manner. Consequences of improper digestion include:
Chronic malabsorption and micronutrient insufficiency leading to Leaky gut.
The body does not have the basic nutritional building blocks it needs; health and ability to recover from illness will be compromised.
Besides breaking down food, enzymes (particularly the proteases) can help with gut healing, controlling pathogens, and immune support.
Your immune system begins in your gut— if you have enzyme and digestive issues, chances are your immune system isn’t functioning as well as it should be.
The Pearl: For autism, one does NOT out grow these disaccharidase enzyme deficiencies:
62 percent have lactase deficiency. Needed to digest milk sugars. One deficient would not be able to digest lactose containing dairy. Quoted from this study, “Most autistic children with lactose intolerance are not identified by clinical history.”
16 percent have sucrase deficiency. Needed to digest sucrose into glucose and fructose.
10 percent have maltase deficiency. Needed to digest malt formed from grains found in beverages, beer, cereal, pasta, potatoes and in many processed products which have been sweetened, as well as β-amylases found in plants, sweet potatoes, soybeans, barley and wheat.
Other relevant studies finding enzyme deficiency in autism are:
The number of Paneth’s cells in the duodenal crypts was significantly elevated in autistic children compared with non-autistic control subjects.
Low intestinal carbohydrate digestive enzyme activity was reported in 21 children (58.3%), although there was no abnormality found in pancreatic function.
Seventy-five percent of the autistic children (27/36) had an increased pancreatico-biliary fluid output after intravenous secretin administration.
Nineteen of the twenty-one patients with diarrhea had significantly higher fluid output than those without diarrhea.
Fourty-nine percent had at least one deficient enzyme activity, and
Twenty percent or more had deficiencies in two or more disaccharidase enzymes.
The most common deficiency was lactase and maltase deficiencies followed by low activity sucrase, palatinase, and glucoamylase.
All of the children having low enzyme activity had loose stools and/or gaseousness.
Note: If one lacks these enzymes, digestive enzymes are taken in addition to special diets that eliminate that food group (SCD, GAPS, PALEO…); digestive enzymes should not be used instead of special elimination diets.Digestive enzymes are taken as a precaution against unknown exposures. Enzymes can be naturally increased in the body. This post does not address such but a later post will.
The slide below (if the link fails, try here) demonstrates the success of eliminating certain food groups for autism. This is the list of the most effective treatments for children with autism after the Autism Research Institute (ARI) interviewed more than 27,000 parents (based on 2013 report):
“Autism – Part 4: Digestive Function”,Dr. Nicholas Anhorn, BSc, ND. http://www.ndaccess.com/MonctonNaturopathic/Page_Detail.asp?PageID=22&CommentID=20
When the biome is abnormal, micronutrient deficiencies occur since the biome bacteria produces vitamins (and many other compounds, see comment below). One such example is low biotin and Vitamin K levels:
“1st International Symposium on the Microbiome in Health and Disease with a Special Focus on Autism”, Little Rock, Arkansas, June 2014.
Lastly, I want to point out that heavy metals and pesticides, herbicides, and insecticide exposure also can contribute to enzyme deficiency.
Of significance: EWG specifically added three organophosphates (collards, kale, and red peppers (summer squash and zucchini were added in 2013) to their 2014 list so that it is now considered the “Dirty Fifteen” guide for buying organic vs non organic to eliminate significant pesticide, herbicide, and insecticide exposure.
Questioning Answers: … I’m talking today about the paper by Janie Shelton and colleagues [2] (open-access) and their results strengthening “the evidence linking neurodevelopmental disorders with gestational pesticide exposures, and particularly, organophosphates”. “Pesticides and autism: chapter II”, June 2014
If gut microbiome is found to be associated with dementia, reducing/eliminating the acid reducer factor which is contributing to skewed microbiome, with physician guidance, knocks down a big contributor to microbiome skew. Check out Dr. Mark Hyman’s post here to begin to self educate yourself on reducing heartburn drugs. 
