Crohn's and Genetics

Last year, I took a class on human genetic variation. As the final project for the class, we had to write a 10-15 page paper on a topic regarding genetic variation in humans. I decided to focus my paper on Crohn's disease. Because Crohn's is an autoimmune disease, I figured there had to be some kind of genetic connection. If there is a mutation in a gene that codes for a cell receptor on digestive cells, then the body could identify it as foreign and thus attack the cells. 


So, I'd like to share with you my research. This paper is called a "review of the literature." I perused the research of others, compiling and synthesizing it to create a somewhat comprehensive view of the studies that have been done over the years. 


Enjoy this first installment!

It is estimated that 60 to 70 million people are affected by some sort of digestive disease in the United States alone. One to two million of these cases of digestive disease are inflammatory bowel disease, which can be separated into two categories: Crohn’s disease and colitis (Head and Jurenka 2004). Both are defined as a chronic inflammation of the digestive tract. Crohn’s disease can occur anywhere in the digestive system, but is typically found in the ileum or colon (Shoenstadt 2004).  Colitis is essentially the same thing, but is only found in the colon. This review will be focusing on Crohn’s disease, which is a complex interplay of environmental and genetic risk factors. While the evidence is inconclusive as to the exact cause of Crohn’s disease, Western style treatments focus on using drugs. However, the literature suggests that changes in diet can treat the disease much more effectively. Therefore, more research needs to be done on diets that are helpful to people with Crohn’s disease.


While Crohn’s disease is less prevalent than colitis (according to National Digestive Disease Information Clearinghouse (NDDIC 2010) statistics in 1998, Crohn’s affected only 359,000 people, whereas colitis affected 619,000) in 2004 it accounted for 1.1 million ambulatory care visits and 141,000 hospitalizations in the US. Furthermore, 1.8 million prescriptions were made in 2004 for the treatment of the disease (NDDIC 2010). Clearly, the disease has resounding effects. It is typically diagnosed between the ages of 15 and 35 and is the result of inflammatory T helper cells that cause lesions in the digestive tract (Cariappa et al. 1998, Forcione et al. 1996).

Many studies have been done on the demographics of people that Crohn’s affects. It is generally thought of as a primarily “white” disease, in that is rarely found in people not of Caucasian descent. Jeshion et al. (1998) found in a study of 337 children with Crohn’s that 92.9% of their subjects were white, 4.4% were black, 1.2% were Hispanic and 1.5% were other, unspecified races. In contrast, Shapira and Tamir (1994) note that in the United States, the United Kingdom and Sweden, Crohn’s has been predominant in Jewish patients. Shapira and Tamir’s study examined the prevalence of Crohn’s in the Euro-American, African-Asian and Israeli populations of the Kinnaret sub-district of north Israel. They found that the prevalence of the disease in the European-American born population was twice that of the other two populations. This suggests that susceptibility to the disease correlates more with country of origin rather than just their race. This conclusion supports Ghosh and Rona’s (2003) statement that a Western diet is one of the most prominent risk factors of Crohn’s disease.

          

Almond Torte

Evan and I are a match made in heaven. He loves to bake, and I love to eat the products of his baking. Last Christmas, my parents discovered a recipe for almond torte. Being the wonderful people they are, they made modifications to make this delectable dessert "Evan friendly." From that time on, we make this almond torte when we want a fancy dessert. The best thing about this dessert is that you can top it with almost anything and make it your very own. We like berries, and I like chocolate. Anyway, here is the recipe! I hope you like it.

Ingredients


3/4 cup whole almonds or almond meal
Butter (enough to coat bottom of a 2qt baking dish)
1 tbsp plus 1/2 cup honey
4 large eggs, separated
1 tsp almond extract
1/4 tsp salt

Directions


1) Bring a large pot of water to a boil. Add almonds and cook 2 minutes. Drain, rinse almonds with cold water, and slip off and discard skins. Pat dry with a kitchen towel and set aside (if using almond meal, you may skip this step).
2) Preheat oven to 375 degrees. Mix butter and 1 tbsp honey together and coat inside of a 2qt or 10 inch baking dish.
3) In a blender or a food processor, whirl almonds until finely ground (be careful not grind them into almond butter). If using almond meal you can skip this step.
4) In a large bowl, whisk egg yolks with remaining 1/2 cup honey for several minutes until pale yellow and thick. Gently stir in almond meal or ground almonds and almond extract. Set aside.
4) In a large clean bowl, beat together egg whites and salt until firm and peaks form. Stir 1/3 of the whites into yolk-almond mixture to combine thoroughly, then gently fold in remaining whites. Pour batter into prepared dish and bake until set and golden brown on top, about 30 minutes. Remove from oven and allow to cool for 15 minutes. Serve topped with your favorite toppings!

An Advantage of Your Non-Dominant Hand

As I was browsing my iGoogle page, I clicked on the news module and stumbled upon an article which discussed a study done by researchers of the University of Southern California. Apparently, one way to cut down on overeating is to eat with your non-dominant hand. 

The study put participants in a dark movie theatre to watch a series of movie trailers. The participants had easy access to both fresh and stale popcorn. When the researchers compared the amount of popcorn eaten with the non-dominant versus dominant hand, the amount of stale popcorn eaten was 30% lower when the participants used their non-dominant hand. The amount of fresh popcorn eaten didn't change significantly.

The study also looked at whether the environment affected the amount of food eaten. The participants were also placed in a darkened meeting room and watched a slideshow, again with popcorn close at hand. The researchers found that less popcorn of both stale and fresh varieties was eaten in the meeting room than in the theatre.

Now, this really doesn't have much to do with gluten free eating, I just thought it was an interesting idea. After all, even if you are being healthy by eating gluten free, it won't do much for you if you can't control how much gluten free food you put in your mouth.

Yogurt - Homemade is best

When you think about the things that you make from scratch, yogurt doesn't tend to be on the list. However, if you are on a specific carbohydrate diet (SCD) like Evan, then if you eat yogurt you only eat the homemade kind.

Before I met Evan, I had no idea that yogurt could be made at home. I figured that it was some complicated process that milk had to go through in order to become yogurt and that it was best left to the "professionals." And, I'll admit that I prefer store-bought yogurt. However, after reading up on the subject, I'll be working to change my tastes.

Now, obviously this thinking is quite flawed. Before the mechanization of the food system there was yogurt, and the people that made it got along just fine without any fancy equipment. And, according to one article, they were better off for it.

In spite of catchy advertising and sophisticated equipment for making yogurt, the big companies like Yoplait and Dannon are getting it all wrong. Some store-bought yogurt is fermented for only one hour! This isn't nearly enough time for all the lactose to be broken down and for the probiotic cultures to grow. Instead, yogurt should be fermented for a full 24 hours if you want to see the full benefits - but you won't find these benefits in a store.

One of the best wedding gifts we received was from Evan's parents. They gave us a wonderful Yogourmet yogurt maker, which is the same one they bought when Evan went on the SCD 10 years ago. They found out about the Yogourmet yogurt maker through a lady named Lucy. Lucy maintains a website called Lucy's Kitchen Shop, which contains products especially for the specific carb diet.

Now, making your own yogurt is actually incredibly easy. The yogurt maker comes with specific directions, so I won't detail them here. However, if you have a digestive disease, I highly recommend purchasing a yogurt maker in order to replenish the good bacteria in your digestive tract. It will do you a world of good.

Larabars

One of the things I have come to realize is that making a quick lunch on a gluten free diet is not easy. Most people can throw together a peanut butter and jelly sandwich and toss some crackers into their lunch bag and call it good. Obviously, gluten free eaters aren't free to do this. We have to be much more creative, or we have to be willing to spend a bit more money on decent gluten free bread.

One product that Evan and I love as a supplement to a sack lunch is Larabars. These fruit and nut bars are not only gluten free but also dairy free, soy free, vegan, kosher AND non-GMO. The best part is that the contain only things that are good for you - there are no preservatives; they are 100% fruit and nuts.

Evan and I first discovered Larabars at a small snack shop on our college campus. Evan read the ingredients and became very excited because they were something he could actually eat. He was also excited because each bar contains about 200 calories. Because of his diet, it is very difficult for him to gain weight, so high calorie snacks are always a bonus for him.

Now, for those of you who are on a gluten free diet and are worried about your snacks having calories, don't be. Because of the composition of these bars, they provide you with good fats, have no cholesterol and have at least 4 grams of protein. The benefits of eating these bars definitely outweigh the number of calories. Besides, in going gluten free you eliminate some of the most useless calories from your diet - cookies, cakes, doughnuts, bread, refined pasta...I could go on and on, but I won't.

If you are interested in trying Larabars, I'd recommend purchasing a single bar first. Their flavor takes some getting used to, and some flavors are better than others. Be warned - stores will charge up to $2 for a single bar. However, the most cost-effective way to purchase them is buy them at Costco. The box contains 15 bars in three different varieties and costs about $15, saving you up to $1 per bar.

Fusilli with Mahi Mahi and Broccoli

When I got home from class today, I was having a craving for Mexican food. However, since we didn't have any diced tomatoes with green chilies, I thought I should figure something else out (I love to mix refried beans with diced tomatoes and green chilies).

Well, since I couldn't get Mexican food out of my head, I decided to thumb through a cookbook that my aunt gave me a few years ago. I haven't cooked much out of it because many of the recipes require either a lot of ingredients or a lot of time, and I generally do not have either of those things.

Luckily, I stumbled across a pasta recipe that sounded simply delightful - Fusilli with Monkfish and Broccoli. I scanned the ingredients, and I realized that I had all the ingredients to make the recipe with a few modifications.

Upon completion of the recipe, Evan and I sat down to eat. With the steaming pasta sitting in front of me, I felt like life was complete. It has been a long time since I made pasta with homemade sauce other than spaghetti sauce, so I was very excited to try something new. We were amazed at how my experimentation yielded such a delightful dish.

So, I've decided to pass along the recipe with my modifications to you. It's a wonderful combination of gluten free whole grains, fish and vegetables. By the way, the picture is of the leftovers. I'm sorry that I don't have a more appetizing shot for you! I was more focused on eating it that photographing it when it was done!

Ingredients

4 oz broccoli, divided into florets

3 tbsp olive oil

12 oz mahi mahi fillet, skinned and chopped into bite sized pieces

2 garlic crushed, crushed

Salt and pepper

1/2 cup dry white wine

1 cup plain yogurt

1/2 cup corn starch

14 oz brown rice fusilli

Parmesean cheese

Directions

1. Divide broccoli into small sprigs. Boil broccoli for 2 minutes. Drain and refresh under cold running water, set aside.

2. Heat olive oil in a large skillet. Add mahi mahi, garlic and add salt and pepper to taste. Cook, stirring frequently for about 5 minutes or until fish is opaque. Pour in white wine, yogurt and corn starch. Cover and cook until sauce has thickened, stirring occasionally. Stir in broccoli.

3. While the sauce is cooking, cook brown rice fusilli according to package directions. Drain and place back into cooking pot. Add sauce and stir. Serve immediately.

Gluten Free Chocolate Chip Cookie Bars

One of my favorite things to do on a rainy day with my friends was always to bake. We'd make cakes and brownies from boxes of course, but our favorite was homemade chocolate chip cookies. Obviously, the recipe found in the Betty Crocker cookbook doesn't work very well if you're on a gluten free diet. Luckily, I have been given a recipe that, in my opinion, is much better than old Betty Crocker.

These cookie bars are soft and chewy, and because they contain honey rather than sugar as a sweetener, they taste even better than your average chocolate chip cookie.

I have just a couple of notes about this recipe. First, I refer to the cookie mixture as batter, not dough, because prior to baking it really has more of a batter consistency. Second, these cookies are VERY soft, and really don't hold together that well after baking. However, if you place them in the freezer for a few hours prior to serving, they hold together much better and have more of the consistency of a "normal" cookie. I don't typically do this because I like my cookies really soft, but it's simply a matter of preference.

Anyway, here is the recipe! Enjoy the gluten free cookie goodness!

Ingredients

3/4 cup butter

1 cup honey

3/4 tsp vanilla

2 eggs

2 1/2 cups rice flour

3/4 tsp baking soda

1 12 oz package gluten free chocolate chips

Directions

Preheat oven to 350 degrees

1. Cream the butter, honey, vanilla and eggs in a large mixing bowl.

2. Mix in the flour

3. Mix in the baking soda

4. Add about half of the chocolate chips and mix

5. Pour cookie batter into a 13x9 inch baking pan

6. Sprinkle as many chocolate chips as desired on top of the batter

7. Bake for about 10 minutes. Check at 5 minutes by sticking a toothpick or knife into the middle to see if it comes out clean. If it does, they are done!