Hard to Digest

By Sudha Hamilton

 

Food allergies and intolerances in children have become the topic du jour in parenting circles and among health professionals. Whether the increase in interest is merely a raising of awareness or the true cause of the intolerances and allergies is the preservatives, chemicals and additives found in foods separates the experts. There has also been speculation that a generally more chemical rich environment can add to susceptibility to allergies in food, with so much pressure on our immune system, it is hardly surprising that allergies are affecting children's immature immune and digestive systems much more than in the past.
Eating organically can reduce the stress on children's immune system, by removing the stress of unnecessary chemicals, pesticides, phosphates in the fertilisers, not to mention the practice of picking the produce unripe, not allowing the important nutrients to fully develop, providing vital nutrition for growing immune and digestive systems.
Allergies and intolerances have a different physiological base and vary in severity and implication for the child's health. An intolerance is an unpleasant reaction to food, such as runny nose after a hot curry or a particularly antisocial aftermath to a bean casserole, some intolerances are more severe and symptoms may include bloating,
An allergy on the other hand is a function of the mast cells which are found underneath the lining of the skin, gut, lungs, nose and eyes. These cells are our protective force against worms and parasites. In allergic people, these cells react to the allergen when it presents itself. "Mast cells are like "land-mines", and contain "bags" filled with irritant chemicals including histamine. Mast cells are armed with proteins called IgE antibodies, which act as remote sensors in the local environment" www.allergycapital.com.au/Pages/food1.html
A person allergic to peanut, for example, will have IgE antibodies capable of recognizing the shape of peanut protein (the allergen), in much the same way that a lock "recognizes" the shape of a key. When this happens, mast cells are triggered to dump their contents (such as histamine) into the tissues, causing an allergic reaction.
Kristina Hoffman Philpott, M.D. on childhood food allergies
"The most common form of food intolerance is lactose intolerance, resulting from a lactase deficiency. Lactase is an enzyme made by the cells lining the stomach. It is responsible for breaking down lactose, the simple sugar found in dairy products. The symptoms of lactose intolerance are gas, bloating, abdominal pain and sometimes diarrhoea.
The most common food allergens for American children are milk, eggs, peanuts, soybeans, wheat and fish. In adults with food allergies, the most common culprits are shellfish (such as shrimp, escargot, squid, crab and clams), peanuts, tree nuts (such as walnuts, pine nuts and almonds), fish and eggs.
A true food allergy is an abnormal response to a food, triggered by the immune system. When the immune system overreacts to a food protein, an allergic reaction may result. Food intolerances differ from allergies in that they do not involve the immune system. It is important to identify true food allergies because these reactions can be severe and even life threatening". www.pamf.org
 Of course allergies and food intolerances grow up with their hosts and remain active in adult life and it is fascinating to speculate on their origins. If genetic predisposition is the first answer, where did it have its genesis in the generations before? Is it a mixed race issue? With lactose intolerance being far more common in non-Caucasian races for instance. Or perhaps the degradation of our environments and the continuing costs of mechanised mass production have changed our essential relationships with foods?

Eating food, ingesting nourishment - nutrition - the thing that we do everyday, mostly three times a day and often without thought. I wake up in the morning and break my fast with fresh juice, toast and coffee. I have lunch and later on dinner and hopefully leave it at that for the day, before sleeping and repeating the cycle once again, until one day I sicken and die and have no more need of food. What is the essential nature of this most banal of activities? What secrets lie at the heart of understanding - nutrition? When we do things unconsciously, or without considered thought, we are prone to repeat the mistakes of our forefathers - why am I eating toast for breakfast? Because my father did and his father before him. Is there intrinsic nutritional value in coming from a long line of toast eaters? Well if it is organic sour dough perhaps. So many of the basic and most important human activities like eating are handed down generationally, and like a taboo they come with many strings attached. If you eat differently from your parents in many cases they will be initially offended by your decision and will see your new nutritional path as a rejection of their values and upbringing of you. I am sure that many readers will have experienced this and that the differences can continue to grate in shared social settings, and as our parent's age and sicken one of the most frustrating things is trying to get them to eat better themselves. Traditions are like walls that keep people in and people out.
The Greek root of the word diet is diatia, which refers to a way of life toward wellness, and is more than just a regime of eating do's and don'ts. It understands the link between how you live your life and what and how you eat. Epicurus the Greek philosopher of BC 341-270 stressed the importance of eating with friends, and I personally know that when I eat with good friends that I eat with a greater degree of joy and don't eat as much as when I eat alone. Good conversation and the sharing of gratitude for a well prepared dish is the reason why, I think, that we first started eating out at friends places and restaurants in the first place. The level of noise in most restaurants in Australian cities has taken much of the joy of keen conversation away, above the 'night club' yell, "how's the steak?" Where we eat and how we eat impacts on our digestion and therefore ability to benefit from good food. Dishes in restaurants have to be designed to excite and rise above the clamor of the hustle and bustle of busy eating houses, they are therefore usually rich and high in sugar and fats. How do you get noticed in a crowded room? By being extra spicy or so sensual that I melt in your mouth. The ambience within restaurants is part of a cyclical fashion trend and I am confident that it will shift again, away from the current din.
So what actually happens on a physiological level when we eat? As I understand it once we have ingested the food and it has travelled down the gullet into our stomach, having been chewed into smaller bits and coated with saliva, the digestive process begins with acids and small particles that have been released from the stomach, liver and pancreas called enzymes. At this stage foodstuffs have been reduced down to a liquid by mastication by the muscles of the stomach wall, working in conjunction with acids and enzymes. Here the food's large molecules of carbohydrates, proteins and fats are broken down into even smaller particles that the body can absorb. Complex carbohydrates are reduced into simple sugars by the enzymes sucrase, amylase, maltase and lactase. Fats are separated into fatty acids and glycerol by the lipase enzymes. Protein becomes amino acids transformed by the enzymes pepsin, trypsin and chymotrypsin. Moving then to the small intestine, which on average receives around 6.5 litres of fluid from the stomach, salivary glands, pancreas and liver on a daily basis. This fluid is absorbed by the small intestine and then transfered by means of osmosis through the cell walls, this being totally dependent upon the level of sodium present within the cells (the vital importance of salt in our diet). The small intestine is responsible for virtually all the absorption of nutrients into our blood, which includes electrolytes such as sodium, chloride and potassium, and all the organic molecules, which include glucose, amino acids and fatty acids. The small intestine is lined with hairlike projections called villi that are close to many tiny blood vessels and nutrients are passed through the villi into these capillaries.
So the starchy foods we eat like bread, cereals, rice, pasta and potatoes are broken down from complex carbohydrates into simple sugars or monosaccharides, as are carbohydrates derived from lactose and sucrose. We are left with glucose, galactose and fructose from maltase, lactase and sucrase respectively and these make their way into our blood stream and give us energy. Proteins are almost always not absorbed directly but are digested into amino acids or dipeptides and tripeptides and these are likewise absorbed into our blood. One exception to this is for new born babies who are able to acquire passive immunity through the absorption of immunoglobulins in their mother' colostral milk. Fats are broken down by bile salts and the enzyme lipase through the process of emulsification and become fatty acids and monoglycerides. These are absorbed differently to the simple sugars and amino acids by diffusion across the plasma membrane. One well known lipid trygliceride is cholesterol which is vital to cell membranes, sex hormones and in digesting fats; it is however carried through the blood stream by lipoproteins and low density lipoproteins in particular. The build up of these in the blood can of course cause plaque deposits on artery walls and lead to heart attacks and strokes. Fatty acids are generally divided into three groups: saturated, monounsaturated and polyunsaturated - and these terms refer to the number of hydrogen atoms attached to the carbon atoms of the acid chains in the molecule of fat. The polyunsaturated fats are further defined by the number of carbon atoms in their acid chain and so named Omega-3, Omega-6 and Omega-9.
Enzymes are present in just about everything we eat and they are necessary for most of the chemical reactions within our bodies that make life possible. As proteins they are the catalysts for so many of the metabolic functions that give us our energy and the spark of life. With over 5000 now identified, they are involved in all the bodily processes that lead to movement, thinking, digestion and maintenance of the immune system. Cooking food at temperatures over 52C kills off the enzymes and so we derive most of our enzymes from raw plant life. New research is now positing that a diet poor in raw foods places a strain on the pancreas to keep producing enzymes for healthy digestion and metabolism. Studies have also shown that as we age we produce less of our own enzymes and diet becomes even more important for healthy functioning. Research has also shown that the body recycles enzymes by absorbing them through the large intestine and colon and then sending them back up through the bloodstream to the small intestine to be used again. Which may indicate their vital importance to the human body.

Lactose Intolerance
Lactose intolerance or lactase deficiency is an inability to break down the carbohydrate lactose, usually found in milk and dairy products. This can cause digestive problems resulting in abdominal pain and diarrhoea. The enzyme lactase is responsible for breaking down lactose into simple sugars so that we can derive the energy benefit from the carbohydrate. Without enough lactase in the mucus of the small intestine, the lactose finds its way into the large intestine and is partially broken down by the bacteria there. This can be experienced painfully as bloating and bowel problems.
If you think that you may be lactose intolerant, you can check by firstly eliminating foods that contain lactose - like dairy foods that are predominantly derived from cows and foods that contain milk solids, like milk chocolate; milk breads; processed foods that contain milk products and soups and sauces that are dairy based. If your physical reactions cease during this break and then re-appear when the foods are re-introduced then this is a very good case for lactose intolerance.
Some of the things that you can do to manage this condition, apart from a complete avoidance of these highly nutritious foods, are to eat fermented milk products like cheeses and yoghurts as these do not cause as much problem. . In particular goats or sheep milk products like fetta ( be warmed most fettas are not made from sheep's milk unless stated on the packaging); pecorino cheese made from ewe's milk and goats cheeses are delicious and do not contain the same level of lactose.
Avoid low fat milks as they move through your digestive system quickly causing a reaction, as the fats in full cream milk actually slow down the process and give the lactase more time to break down the lactose.
Soy food products are a good source of calcium and can be used in some cases as an alternative.
Acidophilus is a natural source of lactase.
There are some natural enzyme supplements that help the body's own lactase enzymes to digest the milk products and studies are proving these very effective.


Coeliac Disease and Gluten Intolerant
Although two different conditions they obviously share a problem with the digestion of the wheat protein gluten. In Coeliac Disease it is an apparent autoimmune reaction that causes  the destruction of the villi, which are hairlike projections of the mucosa into the small intestinal lumen and are actively involved in the digestion of sugars and proteins. It is posited that when the gliadin wheat protein is ingested by Coeliac Disease sufferers, the glutamine found within that binds to tissue transglutaminase and forms glutamic acid and the resultant gliadin epitopes are recognised as foreign by the host cells. This causes inflammation and mutation of the villi structures within the lumen. The consequences of this are varied and symptoms can range from many to none at all.
Symptoms can be:
Bloating and stomach cramping.
Nausea and vomiting.
Fatigue and lethargy.
Weight loss.
Anaemia.
Diarrhoea or Constipation.
Basically the absorption of the nutrients is not occuring and there is an inflammatory reaction that can manifest across a broad spectrum in different people. The only treatment for Coeliac Disease is a gluten free diet. Wheat is not the only grain to cause this reaction, as rye; barley and oats contain proteins called prolamines which have a similar effect.

The control of this amazing digestive system is achieved by electrical and hormonal messages in concert, coming from both the digestive functions own nervous and endocrine systems, and from the central nervous system and the adrenal gland. The body is a finely tuned instrument of incredible complexity that is continually interacting within itself and from without - meaning that the ability to digest and metabolise food into energy and life maintenance is effected by a myriad of things, thoughts and circumstances. In my opinion to simply focus on one particular aspect in exclusion of all others, for instance a particular food or chemical ingredient within a food, is often missing the whole picture. It is not only what we eat, but how we eat and under what conditions, both externally and internally we eat, that can seriously impact upon our health. Like an extremely delicate fulcrum we are all about balance and it may involve adjustments in not just what is ingested but in lifestyle and influences upon your life. Awareness of food allergies and intolerances may be just the beginning and they are quite likely pointers to a whole host of changes that may involve deeper introspection and attitudinal shifts from the current status quo. Our often defensive attachment to what has been scientifically proven and our quickness to ridicule any thing outside of the known scientific paradigm is in my opinion evidence of our resistance to the expansiveness of enlightenment, so many of us have an investment in keeping our world small. For what is scientifically known is forever changing and what we know now about nutrition is only beginning to unfold. My experience in all of this is that new nutritional answers are being revealed all the time like pieces of a jigsaw in a puzzle that nobody knows in its entirety.
Innovative, healthy organic recipes for precious little digestive systems, taken from Organic Baby & Toddler Cookbook by Lizzie Vann of Baby Organix produced in consultation with the OFA (Organic Federation of Australia Inc)

Spicy Bean Burgers

2 tbsp olive oil
1 onion, finely chopped
1 carrot, finely grated
1 green pepper, chopped
1 garlic clove, crushed
½ tsp ground coriander
½ tsp cumin seeds
1 tbsp tomato purée
1 egg, beaten
60g (2oz) dried breadcrumbs
60 g (2oz) mature cheddar cheese, grated
salt and freshly ground black pepper

2 x 400g (13oz) tin beans such as haricot, flageolet, kidney, or chickpeas, rinsed or drained.

Preheat the oven to 200 degrees C, 400 degrees F, Gas 6

Heat the oil in a frying pan over medium heat. Add the onion and fry gently until soft, about 5 minutes. Add the carrot, green pepper, garlic and spices and cook for a further 5 minutes. Remove from the heat.

In a large bowl, mash the beans and tomato purée together with a fork. Mix in the onion mixture, egg, breadcrumbs, cheese and seasoning. Divide the mixture into golf ball sized portions and shape into burgers with your hands.

Place the burgers on an oiled baking sheet and bake in the oven until crisp, about 25 minutes. Turn the burgers half-way through cooking to crisp both sides. Serve with jacket potato and peas - or burger style in a wholemeal bun.

Makes 8 burgers. Preparation 15 minutes + 20 minutes cooking time.

Dahl

1 tbsp good quality vegetable oil
1 small onion, finely chopped
½ tsp turmeric
½ tsp ground coriander or cumin seeds
125g (4oz) red lentils, washed and picked over
1 carrot, finely chopped
300 ml (1/2 pint) water
small handful shredded cabbage

Heat the oil in a pan over medium heat. Add the onion and fry gently until soft, about 5 minutes. Mix in the spices and cook for a further 2 minutes.

Add the lentils, carrot and water and bring to the boil. Reduce the heat and simmer for 20 minutes, until the lentils are soft and the Dahl has a smooth consistency. Add the cabbage and cook for a further 5 minutes, stirring from time to time.  Serve with boiled rice or a flatbread such as pita or naan.

Preparation 10 minutes + 25 minutes cooking time.

Mild Vegetable Korma with Couscous

1 tsp olive oil
1 small leek, well washed and sliced
½ tsp each ground cumin, gram masala and turmeric
1 carrot, diced
½ eggplant, chopped
1 small green pepper, diced
60g (2 oz) small broccoli or cauliflower florets
60g (2oz) sliced mushrooms
60g (2oz) fresh or frozen baby broad beans
200ml (7fl oz) water or stock
2tbsp tomato purée
60g (2oz) creamed coconut
125g (4oz) couscous or basmati rice

Heat the oil in a pan and fry the leek, cumin, garam masala and turmeric for 2 minutes. Add all the other ingredients, except the creamed coconut and couscous or rice and stir to mix.

Cover, bring to the boil, then reduce the heat and simmer, stirring occasionally, until the vegetables are tender, about 20 minutes.

Cook the couscous or rice according to the directions on the packet.

Stir the creamed coconut into the korma and heat for a further 2 minutes.
Arrange couscous or rice into a ring shape, then spoon the korma into the middle or it to serve.

Fresh and Fruity Shakes

300ml (1/2 pint) milk (cows, rice, soy, goats) or freshly squeezed juice of 2 oranges.
½ glass crushed ice (ice cubes crushed with a rolling pin)

For Banana Shake: add 1 sliced banana
For Pear Shake: add 1 cored and chopped pear
For Berry Shake: add 1 handful strawberries, raspberries, blackberries or blueberries, or a combination.
For Peach Shake: add 1 stoned and chopped ripe peach or nectarine.

Put the milk or OJ and crushed ice in a blender. Add the fruit of your choice. Blend the mixture at high speed until smooth, thick and bubbly. Pour into glass and serve immediately. Makes 1 serving, preparation time 5 minutes.

References

Organic Baby & Toddler Cookbook
Lizzie Vann, Penguin, Camberwell, 2005.

Fundamental Physiology and Anatomy of the Digestive System
http://arbl.cvmbs.colostate.edu/hbooks/pathphys/digestion/
The Coeliac Society of Australia
www.coeliac.org.au
Palo Alto Medical Foundation
www.pamf.org
Allergy Capital
www.allergycapital.com.au
©Sudha Hamilton
www.sudhahamilton.com

Appeared in WellBeing Magazine