(0:05 - 1:17) Hello and welcome to another episode. My name is Christof Plothe and I'll talk today about something that actually probably concerns all of us and most of us don't know about it. It is about how modern food processing gives rise to our growing gluten problem and maybe you've heard of somebody who has problems with bloating, indigestion or just fatigue after eating and probably you came across about the topic of gluten in this process.   But this is much more than just about gluten because it's about transaminases, it's transglutaminases, it's about molecular memory, it's about leaky gut and it's about the rise of autoimmunity. So I hope you find this interesting. I certainly did and the insights that I gained through researching this topic has wide-reaching consequences not only for my diet but the diet of my patients.   (1:18 - 2:58) So what are we talking about at the moment? It's not only about celiac disease which is the pathogenic form of not being able to digest gluten and thus if you miss this diagnosis you're in serious trouble for many, many problems in many of your bodily systems and we see a rise in celiac disease but to get data has proven to be very, very difficult and some countries talk about 1%, 2% but other studies talk about much, much higher incidences and with gluten intolerances it goes up as far as 6% but if you ask the general public how many people have problems after digesting gluten, the actual number might be much, much higher and of course everything is being as usually blamed on genetics. It does play a huge part in it, we'll talk about it, but it's also about diet and it's about other healthcare factors. And well, talking about genetic factors, there are two important markers, that's the HLA-DAQ2 and HLA-DQ8, so countries in which these two genes are active do have higher incidences and they play an important part in the process of not only celiac disease but also of gluten intolerance.   (2:58 - 6:37) And something that nobody seems to be talking about is the dietary influence because we've seen a huge rise since the introduction of heavily processed foods, of ultra-processed foods and this is not only about the gluten contained in them but stay tuned because it gets very, very interesting soon. And of course there's also the healthcare awareness in the last few decades we see much, much more focus not only in the press but there has been some interest in the scientific community about the topic of gluten and in some countries, we'll talk about that later, testing for gluten has already been made mandatory. And well, there are key countries and as with many of the current health crisis diseases, it's most likely to occur in the so-called industrial world.   So what are we doing wrong in comparison to other countries that don't have our dietary habits, that don't have our health care system, that don't have the ultra-processed food epidemic? So United States, Italy, UK, Australia are amongst the highest rates of gluten intolerance but we'll soon find out a little bit more about why that's the fact. So this is just a chart showing gluten intolerance and celiac disease since the 1970s and whilst you don't see real numbers here, if you just look at the amount of cases, it is rising and doesn't show any sign of dropping. So why avoidance? So many people that have gluten intolerance and of course if you have celiac disease, you have an instruction to avoid gluten altogether.   Why this is actually quite difficult, we'll see in a few moments because there is something that has been integrated in our food chain and those are transglutaminases and that's actually a hormone as we'll soon hear that is inherent in our own body but we have a different one that's being introduced through food processing and there's also something called molecular mimicry, that is that if something is quite similar in the amino acid sequences, the body might mistake it for something foreign that needs to be attacked and thus will find the door to autoimmune disease. So many people that have these digestive problems, feeling bloated, having constipation, diarrhea or just not feeling well, they've tried to eliminate gluten but it might have improved a bit but it didn't make the huge difference and there was a recent article in the New York Times talking about the fact that even moving in different countries on your holidays makes a huge difference when it comes to gluten sensitivity and we've had that in our practice as well. People go to France and they have no problems eating an entire baguette or a croissant when they come back here and they dig into their breads, they immediately develop symptoms.   (6:38 - 14:24) This article asks about all those reasons but actually it's quite difficult to give a real answer but something has to do definitely with the way we prepare a gluten as well because we've had our sourdough preparations and that always decreased all those anti-nutrients because gluten is actually an anti-nutrient and gets digested by these bacteria and thus has less effect on our system. But this also about spraying chemicals, it has to do about lots of things but let's dive into why in the so-called civilized countries we definitely have higher factors than in the so-called non-developed countries. So do you feel tired? Many people do nowadays and there are many reasons for this but with gluten sensitivities that might be a key symptom of where you stand.   Do you have that feeling of being bloated or not being able to really focus that clearly, some sort of brain fog after eating? Well then this might be another sign that you're dealing with something with your food. An old professor of mine always said well to check whether we really tolerate something or not has become very very difficult but the first sign you should look for is how do you feel after a meal. If you have any digestive problems or any mental problems afterwards, it's very likely you just digested something that wasn't good for you.   So many people then try to get into the gluten issue and it's much more listened to in many many countries than in my country here in Germany because you could get gluten-free alternatives almost everywhere whilst you can do here but not any Italian restaurant or any bakery. In fact hardly any bakery will offer you gluten-free alternatives. So why is it that some people do show signs of improvement but their symptoms still remain? Well it's not all in your head when you feel these symptoms, it's not all in your gut as we'll soon hear because it's the entire body.   So the symptoms can range from many many areas including the skin, including the brain, including our joints and we'll come to that in a moment. But let's see what we're really talking about when talking about gluten because well there are all these wheat varieties which are highly gluten rich which makes up most of what we eat of baked goods and pastas in our societies. And then there are ancient grains, there's kamut, there's einkorn, there's farro, croissant and others.   They used to be considered healthier but if you don't tolerate the gluten it might reduce this a little bit. But it is not the guarantee that you will be free of symptoms. And then there are hybrid grains, triticale, that's also containing gluten and that's often nowadays used in cereal products.   And there are other grains like barley and rye that do contain the gluten and that of course is also found in beer, something that some people don't think about. But where is beer coming from? So then many people dig into a gluten-free grain nutrition but it's not that straightforward. So there are certain things you should avoid of course, anything that contains wheat and all the others that we just mentioned, that's in bread and pasta, couscous and barley should also be excluded.   And then you're being offered all those gluten-free alternatives, if you go out of the grain field with fruits, vegetables, plain meats, eggs, nuts and seeds to provide essential nutrients without gluten. Well you don't see the gluten-free grains here because yet we're often being told that's rice, that's corn, that's quinoa, that's buckwheat that can be included safely. But we'll see there is something called molecular mimicry that might actually, if you're sensitive to it, might give you problems as well.   And this is called cross-reactivity. So if we look at the symptoms, we just said it's not just only your gut. You might have some gastrointestinal symptoms with many, many different varieties but it might be brain fog, persistence, headaches, skin rashes, joint pain, osteoporosis and debilitating fatigue.   It can even go as far as real neurological issues. Ataxia and neuropathy have been linked to gluten in many, many studies. And yeah, even your skin that can have problems such as dermatitis herpetiformis.   But it might even not only be this severe form with itchy blistering rashes that can be mistaken for other skin disorders because you might even have just some eczema on your body. And yeah, something that many people don't think about but rheumatological symptoms, so pains in your joints and the osteoporosis can be linked to gluten. And of course, psychological impacts.   And this is a wide range of symptoms that you can get. And if you read Dr. Plummer's excellent books about the brain, you know about the potential impact of eating grains for your brain. But this may lead to anxiety and depression and in children even to ADHD.   And something you don't really think about, you think about all those toxic supplements and talk about additives in your food chain. But no, it might be actually something that has been around for a few thousand years. Because in fact, about 10,000 years ago, we started to grow monocultures, which was in many, many respects one of the worst decisions we as humans did.   Because then we used it for animal production. We used it for grain production. And it had huge implications for our entire system.   So what is cross-reactivity? We just talked about it now. And this is something that many people don't think about when consuming something that actually doesn't say gluten on the label and is not even containing the real gluten that we usually talk about in the label. Because you might have a cross-reactivity.   (14:25 - 15:40) And casein, the protein in dairy, for example, has been linked to a so-called cross-reactivity. So the body thinks it is gluten, because it has some similarities in the protein makeup of it. But it isn't.   Nevertheless, it triggers an immune response to it. So this might include all kinds of dairy products. And in corn, you have zein.   That's a protein that's very, very like gluten. In fact, some authors even call it a gluten. So it's not completely gluten-free.   And if you go into oats, of course, you should always look for gluten-free oats. But avenin in it actually has the potential of cross-reactivity. So being mistaken by the body to be gluten.   And even in rice, oryzenin from rice is, by some authors, considered a gluten. And this can contribute to cross-reactivity. So if you haven't done this in the past and you have realized that you've got problems with gluten, did you ever try to eliminate all those grains? Well, you might try it.   (15:40 - 18:10) But now we come to something else. And that's transglutaminase 2, the key enzyme in gluten-related disorders. Who of you have heard of it? It is actually known by some because some of the gluten tests to test for sensitivity, and we'll come to that, actually do include a test against transglutaminase because it's an enzyme that's located in your gut.   And it plays an essential role in tissue maintenance and repair. But it somehow modifies gluten. And that's a long story how it does that.   But it transforms it because the gliadin in it can't be really absorbed by the body. But as soon as TG2 attaches to it, it forms a new protein that is actually recognized as foreign to the body. Usually, transglutaminase 2 is something very useful because it's involved in wound healing, and it stabilizes the extracellular matrix.   But it may become a main auto-antigen, it is called. And that's a huge role it plays when it comes to gluten. So each time you do digest gluten, you have the transglutaminase attaching to it.   It transforms and it forms a new molecule and it creates an immune reaction. But now we have another problem. The gut becomes leaky.   So the leaky gut syndrome comes and these molecules that enter the bloodstreams and then a whole cascade is triggered. Because as we just said, gliadin is actually not able to be absorbed the part of the gluten by our gut because it is rich in proline. That's an amino acid.   And so huge, large gluten fragments when attached to the enzyme, they go through intestinal linings. This becomes impaired and then it opens up the tight junctions in the gut and then it increases intestinal permeability. And then the trouble starts when it enters our bloodstream.   (18:11 - 19:02) And yeah, these processes you can diagnose now. We do that as a gut test to test for zonulin. But it's completely underestimated what it means because it basically means if you've got a leaky gut, by some authors it's considered nowadays as one of the leading causes for most chronic health problems.   It actually creates a cascade of immune reactions that contribute to many gluten related disorders. TG2 modifies gluten fragments. So we just talked about that it attaches to the gliadin aspects and then it transforms them and the immune system considers them as a threat.   (19:02 - 21:14) And that is crucial in the pathogenesis of autoimmune responses. And listen, autoimmune responses in general because you have a huge cross reactivity with gluten to many proteins in many of the autoimmune problems in general. So it might be worth because there are many, many publications and we do that with all our patients to avoid gluten and casein in case you've been diagnosed with any sort of autoimmune disease.   So the T cell activation now kicks in. That's the first part of the immune system. And that is especially prevalent in the two genetic factors we talked about, the HLA-DQ2 and the HLA-DQ8.   And that really leads to a robust T cell activation. So there you have it, an inflammation that's related to autoimmune diseases. So the B cell activation and autoantibody production is the next one.   That's lymphocytes now. B cells producing antibodies against the gluten peptide and TG2 itself. And that's one thing that most of the modern tests now do test for.   Has there been a reaction with this enzyme and the gliadin and thus the gluten? And that creates many problems in the cascade, not only in celiac disease. So this gliadin complex formation with the enzyme is a pivotal event in breaking immune tolerance that leads to chronic inflammation and damage to the intestinal lining. So a key concept to understand when it comes to something that's being introduced in our modern food.   And this is called the modern aggravator, microbial transglutaminase. Remember? The other one was called differently. This is MTJ, microbial transglutaminase.   (21:14 - 24:59) We'll see in a moment why this is such a potential problem. They are key enzymes that catalyze covalent bond formation between proteins. That's a good thing.   In general, when it is in your body, that's for general use of transglutaminases, but not for the microbial ones that we introduced. They play a significant role in various biological processes and have a wide ranging industrial applications. And we'll come to that in a moment.   And these enzymes impact food products by influencing texture, stability, and flavor. And understanding transglutaminase is essential for grasping protein interactions in biochemistry. So because it is an enzyme in our own bodies, listen to this, even if it's actually not the same and it's being used for different purposes, mainly to glue things in food together, they don't even bother labeling it.   So you won't find in your yogurt, in your meat, in the cookie you eat, in the cheese on your pizza, any mentioning of transglutaminases, whilst they actually should, as we'll hear in a moment. Because transglutaminase is referred to as the meat glue. And that's not just only in the meat production nowadays.   Because if you imagine that if you have this glue, makes your much more delicate, it glues pieces of meat together, as we'll see in a moment. So it's a very useful product indeed for the food industry. But if we have the antibodies in the test for gluten of the transglutaminase, just imagine if we get an introduction of this via our food chain, and I said it at the beginning, 80% of the food in the supermarket is now being loaded with transglutaminases.   It will, of course, trigger an immune reaction. And some people say, since the introduction in the late 90s in our food chain, this has been one of the factors why gluten sensitivity and potentially even celiac disease is on a rise. So just to give you an impression what this means, here is a little video that anybody can watch on YouTube.   Because this is the steak you've bought for your barbecue. Or is it? Entering meat glue. Because you see, it's quite expensive to get good portions of meat.   So the industry thought, well, why not using something that is out there in nature, and we're allowed to lose it, use it. And we just take fragments of the leftovers of meat from food processing. And now we get the enzyme to it.   And take a look. So these are just meat pieces that have been together, mixed with this enzyme. And lo and behold, if you wait a while until the enzyme has done its job, here's what you have.   (25:05 - 27:43) So this is a substantial part of your barbecue, or other things you can buy out there when getting your food in not only fast food restaurants, but even in your home. So that, I think, was quite impressive to see how well it works, and what a gift it has become for the meat industry. So summarizing, you do have molecular mimicry with many other grains that are so-called gluten-free.   You have cross-reactivity with many, many foods. And you have the key proteins involved, which are casein, zein, and avenin. You have potential human tissue mimicry, which means that you have parts in your body that do resemble the amino acid makeup of that.   And thus, when the immune system starts to attack these molecules, and starts to attack all the processes involved that we just talked about, it will attack all those body parts as well. So these are all immune responses triggered in gluten sensitivity. But we should actually be aware now that just to reduce gluten is really not enough to know whether you have a problem or not.   (27:44 - 30:07) And it also might lead us to considering whether the way we do food processing at the moment, this is just a small insight in all the processes that are being used, were they such a good idea? And should we at least require labeling so you can make an informed choice? I think anybody who has a gluten sensitivity deserves the right that you should have a labeling on your food. So what can you do? First of all, yeah, if you do realize, well, I might be having a gluten sensitivity, then yeah, reduce the antigenic load. So first of all, eat a diet that is not only low, but really eliminates all kinds of gluten from your diet and thus assists in healing your gut.   First step. And the next one, if you do realize, well, it helps me, but it's not really completely gone, then go to the next one and include organic meat, fish, eggs, vegetable, fruit, and nuts, which don't contain gluten and not in danger of being influenced by a transglutaminase processing and other cross reactivities with the other grains that we talked about. So that might be another thing, yeah? So you might just start with eating potatoes and then get the vegetables in and then some nuts and look at some eggs, keeping in mind that some people do react to these things as well.   But nevertheless, if it's to eliminate and to see whether you react to gluten, this might be a good idea. And if you then make a reintroduction of the products that you've left out, then try gluten-free grains like rice, quinoa, and gluten-free oats alongside other potential triggers. And yeah, anybody who knows my work knows that I like to have all those grains fermented as well to further reduce the load of gluten derivatives in the food, and we've developed cultures to do so.   (30:08 - 33:56) So the next one is vigilance, because that's vital when you consume all those foods, because as you could just see, there are hidden gluten traps that you didn't think about, and there are cross-contaminations that you should look for. So certified gluten-free is a must for the products that you will start to reintroduce. And this is something I usually don't do, but this is a new test that has just come out, and the advantage with this is you don't need a biopsy that's usually required for making the correct diagnosis for celiac disease because it looks at many, many parameters.   It looks at TTG, neoepitopes. It looks at microbial transglutaminase, neoepitopes. So we look at the reaction towards the transglutaminases introduced in our diet, and it looks at gliadin.   It uses IgA responses, and if you're interested in getting this test, it's not even on the market yet, you want it as a practitioner, or you want to inform your practitioner by showing in this video about this, you might give me, send me a mail, and I'll put you in contact with the company. I think if we look at countries like Italy, where a gluten testing has now been made mandatory for children, it just shows you there are some health agencies that do take it seriously, and I ask all of you to do so because many of the problems related to gluten, they take years to develop. So especially if you look at the ADHD crisis, the gut crisis, our mental crisis, so many other forms of chronic diseases that we have, I think we need to look at what we have changed in the last few decades to create this, because other countries that haven't undergone this transformation, especially when it comes to our food, they don't have this.   So again, I usually don't do this, don't recommend any products, but this is something I find very, very promising, and I've tried it out myself and on my staff, and it's quite amazing that if you look at all those criteria that are being tested, you can not only test for celiac disease, but also know we're very likely to have a real gluten sensitivity, something that has no criteria, by the way, in the current system at the moment. So thank you very much for your attention, and for those who are interested, they can just copy this page, and I included here some key references for everything that I've been saying. There is a lot more, but I thought these are very, very useful references if you want to know more about the subject.   So thank you very much for your attention, and all the best to you, and yeah, let's keep on pushing for more informed consent, all the things that should be labeled to enter our food chain. Thank you very much, and all the best. Bye-bye.