Malabsorption of iron, folate, calcium and fat soluble vitamins results in iron deficiency, folate deficiency and reduced bone density

Infants and young children present with diarrhoea, abdominal distension and FAILURE TO THRIVE

  Calcium malabsorption   Vitamin D malabsorption   Secondary hyperparathyroidism   Failure of peak bone density as child   Reduced gonadal function in men   Autoimmunity

  Delayed menarche   Premature menopause   Amenorrhoea   recurrent miscarriages   Infertility & low birthweight babies   Increased perinatal mortality

  Coeliac Disease   Diabetes Mellitus   Autoimmune Thyroid Disease / MS   Rheumatoid Arthritis / Psoriasis   Glomerulonephritis

Antibodies disappear on a gluten free diet

Anaemia Allergies Thyroid Disease Lactose Intolerance IBS, CFS

  IDDM   Thyroid disease   Sjogrens

D�isease   Renal Disease

  Addisons Disease

  Cardiomyopathy   Neurological

disorders   Autoimmune

liver disease

  Antibodies against gliadin (IgA-AGA, IgG-AGA)   Endomysial antibody (IgA-EMA)   Tissue transglutaminase antibody (IgA-tTG)   Total IgA

Malignant diseases are more frequent in coeliacs

  Small bowel CA   Oesophageal & oropharangeal CA   Non-Hogkins lymphoma

  Autistic children respond to gluten-free,casein-free diet

  Improved speech, social behaviour, sleeping habits

  Food peptides affect ADHD

  Depression & morphine-like exorphins

Oats are not toxic to patients with Coeliac Disease or Dermatitis Herpetiformis

  Genetic link (HLA-DQ2 and HLA-DQ8) in patients with coeliac disease

  Alpha-gliadin has immunoreactve peptides

  Hyphal wall protein (HWP 1) in C. albicans. Similar epitopes in gliadin

  Yeasts adhere to gut via transglutaminases

  Gliadin deamidated via transglutaminases

  Yeast & gluten provide T-cell epitopes (reactive peptides which trigger antibodies)   Autoreactive antibodies form against tissue

transglutaminases and endomysium peptides

  Increased candida overgrowth   Damage to gut   Increased exposure of transglutaminases   Increased binding of candida HWP 1   Tissue transaminases (autoantigen)

recognised by autoreactive antibodies

  Introduce gluten while breast feeding   Small quantities of gluten only   Keep breast feeding after gluten exposure   Breast feeding at exposure increases oral

tolerance   Breast feeding protects against Diabetes

type 1, IBS and Leukaemia

  Milk Allergy

  Milk Intolerance

Uncommon, Small amounts trigger IgE mediated Reactions sudden

Common Normal amounts trigger Not IgE mediated Skin tests Negative Reactions delayed (4-26 days)

  Masking- Remove dust, mould, dogs etc

  Glue ear- Are parents atopic?

  IBS- Milk & wheat increase rectal PGʼs

  Asthma- Look for milk addiction

  Eczema- >2 allergens (related to asthma)

Total Fat (% total energy) No IHD IHD Framington 38.8 40.0 Puerto Rico (urban) 36.6 37.7 Puerto Rico (rural) 32.2 32.0 Honolulu 33.3 35.2 London 40.5 40.0 Zutphen 41.7 41.8 Ireland/Boston 38.5 39.4 Caerphilly 40.1 40.9

  Glucose-Galactose (disaccharide)   12g per 250ml milk   Reduced in yogurt/fermented milk   Absent in hard cheese   Intolerance when lactase deficient

Examination of 23,207 sets of coronary arteries and aortas revealed severity of atherosclerosis was related to:

  Highest daily milk consumption  Those with highest lactase activity

Men 55-64 yrs had the same cholesterol and sat. fat intake (1950-1980) but IHD mortality was highest in Finland. Why?

(Wine and ethanol intake was the same)

The Finns drank 3.4 times more milk

During 1972-92 there was a dramatic decline in IHD in Finland as milk consumption declined .

Cheese intake increased 3 times during this period

  Japan,China, Greenland Eskimos (heavy smokers, low wine intake)

  Masai of East Africa (drink fermented milk low in lactose)

  South African Blacks, Afro-Carribeans, Prima Indians, Shri Lankans (low milk,low lactose)

North Indians, Pakistanis and British have elevated IHD, high milk intake and high lactase levels

Milk intake - 66% less than UK Fat intake - 33% more than UK Cheese intake 300% more than fresh milk

Lactase activity: Northern France - 50% less than Europe Southern France - 25% less than Europe

Galactose (and Fructose) preferentially glycate proteins especially LDL.

This makes LDL more susceptible to oxidation and thus atherosclerosis

Is high lactose consumption merely

a marker for β-casein intake?

“The rate of β-Casein A1 consumption (excluding cheese) is a more accurate predictor of heart disease…. Than that reported for traditional risk factors”

  CHOLESTEROL   BLOOD PRESSURE   SATURATED FATS   OBESITY Varied in relative contribution to illness

A survey of 39 centres in 26 countries

0100200300400500600

Relative Indidence of

Diabetes

Low MilkDiet

High MilkDiet

Ulcer withSippy

Ulcer with no Sippy

No Ulcer

05

10152025303540

% Relative

Incidence of Myocardial

Infarct

USA Britain

A1 CHD

A1

00.5

11.5

22.5

33.5

Relative Incidence of

Heart Disease

Toulouse Belfast

CHD

Rennet and subsequent enzymatic action as cheese ages causes alterations to

the cheese protein structure causing cross-linking of casein molecules.

Casomorphin-7 is absent in most cheeses

  Casein causes heart disease in animals   Casein accelerates hypercholesterolaemia and atherosclerosis in animals   Apo E deficient atherosclerosis prone mice

get more lesions   Longevity in animals decreased by casein (compared with soy and whey)   Pigs fed casein have elevated homocysteine