Is there a connection?

I was diagnosed with Dupuytren’s contracture ten years ago. I have it in both my hands and my feet. I also have Celiac disease and have always wondered if the two were related. There’s no sound research indicating comorbidity, but since both are immune mediated, I’m thinking they might be kindred spirits. Comorbidity is the simultaneous presence of two chronic diseases in the same person.

Would you, my bright and nerdy readers, help me do an (un)scientific and peer reviewed (that would be you) study? Having a blog allows for some creative crowd-sourcing, so if you’ll play along, we might be able to pull off an interesting randomized (literally) study on the possible connection between the two autoimmune diseases. But, let’s do this right. Humor me while I switch from gluten-free nutrition blogger to medical researcher.

Celiac disease and Dupuytren’s contracture: are they related?
Jory MM, et al. (et al. refers to all of you)
Research study in progress

ABSTRACT

Objective: To determine if Celiac disease and Dupuytren’s contracture share common pathophysiological origins and/or genetic associations.
Method: To elicit a response in the comment section from blog readers who have both Celiac disease and Dupuytren’s contracture. People who have Celiac disease and/or Type 1 diabetes should also respond in the comment section. Any combination of the three diseases mentioned, or the suspicion of a combination should be noted.
Conclusion: Pending
Key words: Celiac disease, Dupruytren’s contracture, Type 1 diabetes, autoimmunity, gluten, genetics.

INTRODUCTION

Celiac disease is a genetically predisposed digestive disease in which gluten, a protein found in wheat, barley, and rye, causes an immune reaction that damages to the lining of the small intestine. The resulting inability to properly digest (breakdown) and absorb food leads to nutrient deficiencies and a multitude of health issues. The comorbidity between Celiac disease and other autoimmune disorders has been studied extensively and clearly established. According to several research studies, Celiac disease and Type 1 diabetes share common genetic origins and immune mediated tissue damage. Dietary intolerances are found in both diseases. The prevalence of Celiac disease in people who have Type 1 diabetes is about seven times greater than in the general population.

Dupruytren’s contracture is a disease that typically affects the connective tissue in the palm of the hand, although it can also impact the feet. Scarring develops in the fascia covering the tendons that facilitate movement. The fascia becomes thick and shortened, causing the fingers to contract and pull inward. In advances cases, the muscles and tendons involved in gripping become “frozen” and unable to extend. The disease progresses until the fourth (ring) and fifth fingers remain in a permanent flexed position and a loss of mobility occurs. In more extreme cases, all fingers can be implicated. The frequency of Dupuytren’s contracture is ten times greater in people with type 1 diabetes than in the general population.

The main objective of this (un)scientific, blog-sourced study is to determine a relationship between Celiac disease and Dupuytren’s contracture. If there is a genetic and food-related link between Celiac disease and Type 1 diabetes and a genetic link between Type 1 diabetes and Dupuytren’s, could gluten and specific gene markers play a role in all three conditions? Is there a comorbidity between Celiac disease and Dupuytren’s contracture? Should people diagnosed with Dupuytren’s contracture be screened for Celiac disease? Should people with Dupuytren’s contracture go on an anti-inflammatory, gluten-free diet?

Do you have Celiac disease? Do you have Dupuytren’s contracture? Do you have Type 1 diabetes? Do you have any combination of the above? Please leave your answer in the comment section of this blog post. If you don’t want your name associated with your answer, please comment anonymously. Thank you!

Let’s see what we can come up with. Scientifically speaking, although loosely so.

Peace, love and science blogging.
Melissa
P.S. I chose the above photo because it implied a warm connection between people (all of us) and the image of contracted ring and pinky fingers is exactly what Dupuytren’s contracture looks like.

*Warning: this post took on a life of its own. If you’re looking for a quick recipe, bail out now. If you’re remotely interested in my take on the wonderful world of food, genetics, evolution and Celiac disease, brace yourself and read on.

Was this Paleo guy after the mastodon or the armadillo?

Or, maybe he was out doing some wild cereal hunting. That field of Triticum would be a lot easier to tackle than the mastodon. I’m pretty sure I evolved from a less aggressive, nomadic, grass-eating tribe. My ancestors hunted with pruning shears, not six foot long daggers with jagged tips. We ate grasses, berries, nuts, seeds, dates, olives, leafy green things and even rich, savory mushrooms once we figured out which ones didn’t kill us. We also ate a lot of fish depending on our travels.

Unfortunately, that’s where things went awry. When we stopped wandering and built condos on the Mediterranean Sea. I had HLA DQ2 ancestors and around 8500 B.C. they decided cultivating Triticum dicoccum (emmer wheat) was less dangerous than chasing 6 ton mastodons with sharp pointy tusks.

And so, the Celiac story begins – with the domestication of wheat and the interaction of HLA (human leukocyte antigen) genes and deamidated gluten peptides. To make it even more fun, let’s throw in sexual selection, mating preferences and pathogen resistance. We actually have some biological factors (those HLA genes again) influencing who we’re attracted to and mate with.

HLA genes are involved in immune function. They guard against nasty invaders and do a good job keeping us healthy. They also magically prompt us to compliment our disease fighting ability with genetic dissimilarities. We subconsciously strive for varied biological attributes in our offspring. Bottom line? These genes play a role in who we get the hots for.

Seriously. I’m not making this up. Check here for details.

It’s called olfactory curb appeal. Okay, I made that up.

Without even knowing it, you might be attracted to someone because of smell? You don’t know why they smell good, it’s not perfume or cologne or anything. It’s just them. That’s deep, dark and delicious biology working to keep the species healthy. Subconsciously we’re seeking to keep our DNA loaded with a genetic mixture of diverse immunity, so we sniff out complimentary HLA genes. Unfortunately, the introduction of wheat, barley and rye played havoc on our genetic blueprint. These normally brilliant little HLA DQ2 genes also code for autoimmunity (check here for details), as is the case with Celiac Disease and Type 1 Diabetes.

Oops.

Okay, that was a rather convoluted introduction to why I don’t favor the Paleo diet, but I had to set the biogeographical stage. You see, my ancestors go back 10,000 years ago to the Fertile Crescent. They were sunbathing on the Syrian coast and eating a Mediterranean diet way back when. Before it was cool and trendy to eat like that. I’m pretty sure they weren’t loading up on pounds of mastadon meat. Maybe on rare occasions like someone’s wedding or the toppling of a rival empire, but not often.

I’m also thinking my female ancestors frequently had to settle for HLA DQ2 suitors rather than shaking things up with an anti-Celiac DQ4 guy. Life was different then. It’s not like you could jet off to the Andes in hopes of diluting the DQ2 gene pool. You got stuck with whoever was in your merry band of hunters and gatherers and that probably meant similarly encoded DQ antigen regions.

I’m just curious about all this because I think it’s in my genetic makeup to favor plants. I’m not much of a meat eater. Paleo eating is popular right now and supporters suggest we evolved to eat a high animal protein diet, but that doesn’t work for me. At all. Ethics aside, I’m not fond of animal products and I don’t digest meat or dairy well. I’m much better off eating a big bowl of leafy greens, some brown rice and a mix of roasted veggies than I am a slab of prime rib or a chunk of cheese. I’m sure I’d do better if my meat sources were from wild, organic, healthy animals and my dairy sources were raw and from 100% grass fed, happy goats, but in general, and for a lot of reasons, I’m more suited to a plant-based diet. Considering the toxic chemicals in our food supply, the overuse of antibiotics and hormones in CAFO (confined animal feeding operations) and the increase in antibiotic resistant bacteria, I don’t think a diet heavy with animal protein is healthy. And that’s not factoring in the impact on the environment.

By the way, this post isn’t an endorsement of any specific eating plan. I’m just thinking out loud. So, don’t hit me over the head with a club if you’re a Paleo fan. For the record, I’m not vegetarian or vegan, but if I do eat animal products, I’m grateful that I can be picky about the sources.

Okay? Are we all friends? Omnivores and herbivores? Vegans and meat eaters? Berry pickers and spear throwers? What works for one person doesn’t always work for another. We’re biochemically unique. I’m also convinced that genetic influences (as wildly explained above), environmental determinants, ethical leanings, lifestyle factors and nutrient feng shui make a difference.

I made up that nutrient feng shui thing. That’s my phrase for food combining, which I’m not into either. Life is hard enough, lets make eating easier, not more difficult. A nutrient-dense, whole foods, plant-based diet is easy and healthy. At least for my DNA.

Points to Ponder

• Recent research suggests that red meat consumption increases the risk of type 2 diabetes. American Journal of Clinical Nutrition, 2011

• Study reveals direct evidence for a variety of plant foods in the Neanderthal diet, including legumes, date palms and grass seeds (Triticeae). PNAS – Proceedings of the National Academy of Sciences of the United States of America, 2010

• Don’t assume we were all heavy meat eaters. Molar macrowear in Neanderthals and early Homo Sapiens suggests high dietary variability. My ancestors were Paleo Plant People from Mediterranean habitats. Check here for the research details. I made up Paleo Plant People, but who knows, that might emerge as a classification system. I’ll contact the Paleolithic genome project and suggest it.

• Maintaining a healthy pH balance is important to health. Beef, pork, poultry, milk, butter, cheese, cream are acid-forming foods. Plants are alkalizing. An acidic internal environment is disease-promoting. Low acid diets may protect against several diseases, including osteoporosis (yes, osteoporosis). Check here for details.

• According to my weight and age, I’m supposed to consume about 45 to 50 grams of protein per day. The average American adult consumes at least twice that much per day (100 to 120 grams per day). When that much protein (along with the often higher percentage of fat in animal products) is consumed, other important nutrients are often excluded from the diet. Fiber percentages and beneficial plant nutrients are often lacking in high protein (animal source) diets. I prefer less protein than the USDA’s RDA and more fiber than they recommend. That can easily be accomplished on a high-grade, plant-based diet. Even if you’re exercising a lot. Even if you’re a serious athlete.

• Strong and consistent correlations are reported between death rates from cancer and per capita consumption of animal products. Check here for epidemiological correlations between diet and cancer frequency.

• It’s my opinion that a whole foods, predominantly plant-based diet filled with lots of fiber and organic, nutrient-dense vegetables is the best way to heal and thrive if you have Celiac disease or gluten sensitivity. I have DQ2 genes and Celiac disease. People like me often have difficulty digesting animal products (meat and dairy). Maybe we didn’t evolve to do so. Maybe our genes are telling us something. Maybe Paleo isn’t for us. Maybe we’re Paleo Plant People.

Peace, love and green veggies.
Melissa