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This blog is about gut flora, good bacteria, scientific research, and anti-inflammatory food. It’s a prescription for anyone who wishes to eat their way to a healthier life. It’s impossible to overdose on this course of treatment.

Ann Fernholm

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Children Who Consume a Lot of Wheat Flour Have a Higher Risk of Gluten Intolerance

Eating lots of pasta, bread, pancakes, buns and pizza during the first years of life increases the risk of developing gluten intolerance if the child has a genetic risk for the disease. These are the showings in a new international study conducted across four countries.

For many years, parents like myself have been advised to give our children wheat at the barely ripe age of 4-6 months old. It was said to protect against gluten intolerance and celiac disease, among other things, this was supported by a multitude of national food agencies.

Researchers have compared the effect of giving children gluten at six months compared to waiting until they turn one year old. The study shows that half as many have celiac disease at the age of two if the gluten was introduced later. At the age of five, however, there is no difference between the children.

The more flour, the higher the risk of celiac disease

Now, an international study conducted in Sweden, Finland, Germany and the United States shows that the amount of gluten that children eat seems to play a role in the development of celiac disease. The study included 6605 babies with genetic risk of celiac disease. On several occasions, parents have had to fill out dietary questionnaires and on the basis of these researchers have analyzed how much gluten the children consumed during the first years of life.

More than one slice of white bread increases the risk

The results show that the children who ate the most flour were most at risk of developing celiac disease. In an interview with one of the researchers behind the study, Daniel Agardh from Lund University, said:

– It is difficult to say how much gluten is harmful and at what level, but it seems that if you exceed two grams per day, which is quite little, the risk increases, compared to those who do not eat two grams per day, says Daniel Agardh.

Two grams of gluten is about the amount contained in a slice of white bread.

Low Gluten Cooking for Babies

The study is a so-called observational study, and researchers cannot establish any causation correlation. The study should be followed with a so-called randomized and controlled trial. In anticipation of such studies, parents can try to vary children’s diets and try out some “low gluten cooking”. Now a days there are recipes galore for pancakes, bread and pizza, which contain alternative types of flour such as buckwheat, sorghum, teff and almond flour. The great thing about them is that the food also becomes more nutritious, a great side bonus. Reducing wheat flour is easier than many people think, especially if you give your child such food right from the start.

Ann Fernholm is the author of several books in Sweden pertaining to health, food and children. She has also founded the Kostfonden, a non-profit research fund with the goal of ensuring that food is used as medicine in healthcare. Every now and then she writes here at Food Pharmacy. The views in the chronicle are the writer’s own.

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Karolinska Institutet

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Vaginal Delivery Induces “Good” Stress

A little more than a year ago, my son was born. And, just as the birth of my daughter had been, the delivery became an emergency caesarean section. Neither my first nor my second went all the way, despite hours even days of pain and contractions.

Why am I telling you this? Yes, believe it or not, but the stress induced by giving birth vaginally actually equivalates to a positive impact. At least for the child anyways.

Five years ago, my colleagues did an attention-grabbing study in which they looked epigenetically at how children are affected by vaginal birth compared to being born via caesarean section. This in light of previous studies that have shown that children born via a planned cesarean section have a higher risk of developing asthma, type 1 diabetes, obesity and gluten intolerance later in life. The reason for the connection is not fully established, but as planned caesarean deliveries have increased in many parts of the world, it is of increasing importance to look into this more closely.

In my study, my colleagues investigated epigenetic changes in stem cells from cell-sorted umbilical cord blood. Global epigenetic analysis was performed on 43 newborn infants, 18 of whom were delivered with planned caesarean section. Furthermore, DNA from twelve newborns (six planned cesarean sections) was analyzed for gene-specific epigenetic change throughout the genome.

The results show specific epigenetic differences between the groups at nearly 350 sites in the genome. The genes with different methylation patterns were involved, among other things, in processes that control the metabolism and the immune system.

The study provides support for the theory that the act of giving birth itself leaves imprints in the genome of the newborn baby’s stem cells. The discovery may be important to understand why people born with caesarean section are statistically at increased risk for immunological diseases. However, it is still unclear whether the so-called epigenetic change is temporary or persists for a long time. The biological mechanisms that predispose a fetus or newborn to diseases later in life are complex and depend on both inheritance as well as environment during the fetal stage and throughout adolescence (which I wrote about earlier).

But what could this “good” stress* be positive for?

One possible explanation is that during a vaginal delivery, the fetus is subjected to a progressively increasing and very strong stress onset, which here is positive for the child and prepares it for life outside the uterus. This stress is believed to activate the child’s defense system for adaptation to life after birth, which is absent in planned Caesarean sections where the work of labor never starts. However, it is important to remember that many immunological diseases, including those mentioned above, are a result of both inheritance and the environment, and that our epigenome is not static but is affected by our internal and external environment throughout our lives.

Finally, I sometimes can’t help but think that no matter how much advanced technology and knowledge we get, we often cannot circumvent biology. Maybe something to comfort yourself with the next time you think back on your (or your partner’s) labor. Or when you’re breathing through the pain of your upcoming labor. And to those who have had emergency C-sections: those hours of pain pre-cesarean were actually useful. So don’t despair!

(This post does not try to blame or act as a pointing stick. My view is that every woman decides over her own body and knows what it can and does best. For many, planned caesarean sections are a medical necessity. As I see it, knowledge is power to be able to make sensible decisions and change the world in a positive direction.)

* However, it should be clarified that the type of stress we are talking about here is not the same as chronic, long-term, stress. Which has on the contrary been shown to have negative health effects (which I do not go into here).

Louise Sjöholm has an education in molecular biology and a doctorate in depression genetics from Karolinska Institutet. She has been working as an epigeneticist for seven years and is researching the role of the gastrointestinal tract in autoimmune diseases, i.e., diseases in which the body’s immune system attacks its own tissue. She is also interested in understanding the epigenetics of bacteria and its connection to health and disease. The views in the chronicle are the writer’s own.

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Erik Hemmingsson

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Onward and Upward with the Diet Debate Now, Please?

As a researcher, it is not uncommon to receive comments when a new study is published in the likes of: “But didn’t we already know this?”. An example, this happened last autumn when a survey I was involved in was published, which showed that Swedes fitness has worsened over the last 20 or so years.

We have most certainly had a lot to say on the matter of our increasingly sophisticated lifestyle which creates a challenge to stay in form, but we have not had any good scientific documentation on the matter. And because we live in an evidence and information society, we are quite dependent on proof of what we believe we know.

Evidence requirements are, of course, both good and bad. As far as the work on improving human health is concerned, research is absolutely necessary, that part is obvious. But research also takes a very long time to perform, it is rarely as perfect as we would like, and it often has difficulty reaching out to the public.

In addition, the lack of solid evidence easily becomes an excuse for not doing anything, for example when it comes to food. It is easy to see how authorities and other decision-making bodies have postponed measures to help people improve their food intake with regard to a lack of research situation. We have also had dietary debates that have not always been constructive, such as with carbohydrates and fats and what causes obesity and type-2 diabetes.

At the same time, we have seen an enormous influx of processed and ultra-processed junk food, such as soft drinks, sweets and chips. These are products that are extremely nutrient-poor, but are packed with refined carbohydrates, fats, salt, additives, and other things that our body absolutely does not need. At the same time, we miss opportunities to consume nutritious food, which our body is absolutely dependent on.

It goes without saying that if we eat junk food, we can expect health consequences later. But I still like to argue that an important piece of the puzzle was recently added with the publication of a study that convincingly showed that the ultra-processed junk food leads to excessive calorie intake and obesity (Hall et al., Cell Metabolism, May 16). Earlier this year, research also showed that individuals who eat a lot of junk food have shorter lives. At the same time, we are more or less surrounded by the lure of junk food. This is obviously not how it should be.

What if we moved the discussions towards being more all encompassing and talked more about what’s happening in terms of the quality of what we eat, instead of getting stuck in old discussions about fat and carbohydrates, and how the processed junk food affects our health? Not only does this matter for out immediate, it’s equally important that we are building a healthy future, and a sustainable society. I think we owe it to our children, and to all future generations.

For those of you who want to read more in depth on the matter:

Hall KD, Ayuketah A, Brychta R, et al. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab. 2019 May 16.

Kim H, Hu EA, Rebholz CM. Ultra-processed food intake and mortality in the

USA: results from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994). Public Health Nutr. 2019 Feb 21:1-9.

Rico-Campà A, Martínez-González MA, Alvarez-Alvarez I, Mendonça RD, de la Fuente-Arrillaga C, Gómez-Donoso C, Bes-Rastrollo M. Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study. BMJ. 2019 May 29;365:l1949.

Erik Hemmingsson is an obesity researcher at GIH in Stockholm. The views in the chronicle are the writer’s own.

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Mix Things Up This Summer with Alcohol-Free From Time to Time

Just because we are a few days into August doesn’t mean that the summer is over. On the contrary! Sure, the days are getting shorter, but in August the water is usually warmer and it doesn’t require as much self-talk to get into the water beyond your knees.

During the vacay season one glass of rosé frequently turns into two. Even I am guilty of this pleasure. Fortunately, drinks with a lower alcohol content (or none at all) are quite popular right now and it’s about time. Mocktails served now a days are as good as the originals. You shouldn’t have to feel like you’re giving something up when making the choice though like, replacing a glass of champagne with a splash of lukewarm juice or a kool-aid like alcohol-free red wine.

Body and health are good reasons to make the choice but another could be for the sake of children. Too many children grow up with someone near them who drinks too much. The Central Association for Alcohol and Drug Information, CAN, estimates that about 100,000 children in Sweden live with an adult who meets the criteria for alcohol abuse. According to the National Institute of Public Health’s calculations from 2008, it can be as many as 380,000 children.

Why do we drink? Well, when CAN did a survey on alcohol consumption in Sweden, it turns out that we usually drink alcohol because we like the feeling of “having a glass”. Another common motive among the respondents is that parties and other events become more fun with alcohol. Less than one in twenty drinks to forget about problems or not to feel left out.

Perhaps it’s time to question why we bare that perception of that the  party is more fun with a lot of alcohol. And, is it really? If you think about how many children are suffering from adult alcohol consumption, perhaps the fun doesn’t go all the way around the table.

Give it a try, why not give yourself and children a happier summer. Test a few alcohol-free alternatives, or skip the alcohol completely. Mix up a glass of Plato’s bubble or one of the Soki Choi’s kombucha drinks. No one will be disappointed!

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