In Ireland we have a high incidence of the gene that increases your risk for coeliac disease, rising to over 50% of the population in the west of Ireland.

When you should get investigated for Coeliac Disease

• chronic diarrhoea (or constipation)

• bloating, wind, distended stomach

• pain, cramping

• unexplained anaemia

• unexplained osteoporosis

• family history of gluten intolerance, thyroid conditions, type I diabetes

 

In addition, there may be a large number of people who are sensitive to gluten, now termed ‘Non-coeliac gluten sensitivity’ or NCGS. The article cited below discusses how we need more research into this condition and as of yet the mechanism, cause or incidence is largely unknown. Common symptoms can include (and some of these may occur in true Coeliac disease also)

• tiredness

• fatigue

• headache or migraine

• fibromyalgia-like joint or muscle pain

• leg or arm numbness

• ‘brain fog’

• dermatitis or skin rash

• depression

• anxiety

 

Excluding gluten from your diet can be a bit of a challenge. Without proper nutritional direction, it may leave you at risk for deficiencies. Iron and calcium absorption can be reduced or altered in coeliac or gluten sensitivity and therefore you may already be at risk without further restricting your diet. In addition, true Coeliacs are at increased risk for osteoporosis and bowel cancer. Excluding gluten before a true diagnosis of Coeliac disease may lead to reduced monitoring of other conditions that may arise.

If you have are considering excluding gluten talk to us first. You need to be eating a gluten-containing diet for approximately 6 weeks before you can accurately test for Coeliac disease. If you are excluding gluten, we can ensure that your diet is well balanced.

 

 

Non-coeliac gluten sensitivity: piecing the puzzle together

Full article available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406911/

United European Gastroenterol J. 2015 Apr; 3(2): 160–165.

Biesiekierski ^& Iven

Abstract

The avoidance of wheat- and gluten-containing products is a worldwide phenomenon. While coeliac disease is well-established, much remains unknown about whether gluten can be a trigger of gastrointestinal and/or extra-intestinal symptoms in patients without coeliac disease. In this article, we discuss the latest scientific evidence and our current understanding for the possible mechanisms of this largely ambiguous group, termed ‘non-coeliac gluten sensitive’ (NCGS). We can conclude that NCGS should be regarded as an independent disease outside of coeliac disease and wheat allergy, and that the number of patients affected is likely to be limited. Many questions remain unanswered and it needs to be verified whether the elimination of dietary gluten alone is sufficient for the control of symptoms, and to understand the overlap with other components of wheat.

 

Those of you getting out and about in the country or near a wood or stream may have noticed the recent appearance of beautiful, white flowers that look just like white bluebells, but have a distinct garlicy whiff about them. This is wild garlic – healthy, free and tasty. For pictures and more information have a look on the wild and slow website here http://wildandslow.com/wp-content/uploads/2011/03/THE-WILD-GARLIC.pdf

 

Jut pick the leaves and stems, including the flowers. Like all wild food, it’s important to just take what you need and leave the rest for others and for next year. A word or warning, don’t confuse wild garlic for lily of the valley, which looks a little similar, but is not edible.

To be sure of what you are picking, rub a leaf between your fingers and smell. You should be clearly able to smell garlic. If not, don’t pick it.

 

I like to blend the leaves and stems with some good Irish butter and black peppercorns to make wild garlic butter. This can be stored in the fridge for a week or so and in the freezer for a couple of months. It’s great dotted on fish before baking and also great for stirfrying some torn up kale and chickpeas for a speedy dinner.

 

The flowers make a beautiful and tasty addition to salads and taste a little like chive flowers.

 

One of my favourite ways to use wild garlic is to make pesto from the leaves and stems. This tastes great tossed through wholegrain pasta, cooked quinoa or ‘courgetti’ (courgette noodles). It’s also great as a spread on wholegrain pitta or used to top cod or other white fish. Best of all, it only takes a few minutes to make. Take 3 large handfuls of fresh wild garlic, wash VERY well, roughly chop and blend in a food processor with a cup of walnuts or cashew nuts and a cup of grated parmesan cheese. Blend for a minute, scrape down the processor, then add

1/2 – 1 cup extra virgin olive oil and continue to blend until a smooth paste is formed. Store in sterilised jars and cover the pesto with a layer of olive oil to keep fresh.

 

We would love to hear your ideas for using wild garlic too, so please share!

Magnesium is an essential element which takes part in hundreds of important biochemical reactions in the body. It is found in green leafy vegetables, legumes, nuts, seeds and whole grains. Due to food processing techniques, much magnesium is stripped from our foods, such as in the removal of the fibrous portion when refining white flour. There may be a significant number of people with magnesium deficiency, particularly those that eat a lot of processed or convenience foods.

Symptoms of magnesium deficiency include

• Fatigue, weakness
• Loss of appetite, nausea, vomiting
• Numbness, tingling, ‘pins and needles’
• Muscle spasms, cramps
• Restless legs
• Abnormal heart rhythms
• Personality changes

Magnesium deficiency is an important risk factor for type II diabetes, cardiovascular disease, stroke, osteoporosis, migraine including menstrual migraine and PMS. Magnesium is also essential for the developing foetus and deficiency can be linked to gestational diabetes, pre-eclampsia and negative effects in the child in later life.

Magnesium supplements can be used to increase magnesium levels in conjunction with dietary changes. However, not all supplements are easily absorbed by the body. Magnesium oxide, often found in cheaper multivitamins, is difficult to absorb with only 6% being usable by the body. Magnesium citrate on the other hand is much easier for your body to use, with up to 97% being utilised.

The most common measurement of magnesium carried out uses serum, which is a portion of your blood. This is a very inaccurate measurement. Magnesium is essential to maintain your heart rhythm. The ‘reservoir’ or store in your bone is released into your blood during times of deficiency to keep your heart beating correctly. Thus you may be losing magnesium from your bone and be unaware of this. A more accurate measurement is to look at the levels inside your red blood cells. This is a better indication of your magnesium levels over time.

Here at Glenville Nutrition we measure red blood cell magnesium and can advise you how to improve your magnesium levels using diet and supplements. Call us to find out more on 01-4020777. For further information on magnesium, read this fact sheet from the NIH: http://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/

 

Sperm carry very precious cargo: DNA. Their job is to deliver this DNA to the egg to meet the maternal DNA where two becomes one. A normal semen analysis will look at how good the sperm are at delivering this parcel i.e. how they can swim, how fast they can move. However if the quality of the goods within is compromised, successful conception may not occur.
The Sperm DNA fragmentation test therefore looks at the quality of the DNA within the sperm. Having high levels of DNA fragmentation can be a major cause of ‘unexplained infertility’, recurrent miscarriage and failed IUI or IVF cycles. It can easily be overlooked because high levels of DNA damage can be present even when sperm look normal i.e. you have a completely normal semen analysis.

 

High levels of DNA damage can occur under the following circumstances
– infection, either in or around the testicles (which may have little or no symptoms) or even a bad bout of flu or fever can temporarily cause DNA damage
– varicocele, like a varicose vein in the testicle
– with elevations of testicular heat such as with cycling, heated car seats, working with a laptop on your lap, possibly from carrying a mobile phone in your pocket, use of saunas or Jacuzzis.
– smoking
– increased age
– some medications
– exposure to some chemicals such as in paints, pesticides, or with occupational exposure
– obesity and overweight
– diabetes
– nutritional deficiencies
– genetic inability to use folic acid, such as occurs in up to 20% of the population to a high degree and to a minor degree in up to 40-50%

 

What can be done?
The DNA within sperm can be protected by antioxidants. Certain vitamins and minerals play an essential role here, especially zinc, selenium, vitamin C and vitamin E. Improving your diet by including plenty of fresh vegetables, fruit, nuts and seeds is a good place to start.

Supplements can also be very helpful but it is important to note that over-supplementation can be harmful. Antioxidants are also capable of dampening down some of the energy production that sperm need to swim fast toward an egg and successfully fertilise it. Therefore testing your levels of nutrients is important first and supplementing safely is the best approach.
Here at Glenville Nutrition we have special interest in this field and have published our own research on the topic (see below). We  can organise Sperm DNA fragmentation tests and relevant nutritional tests to personally tailor your treatment plan. DNA fragmentation can be improved in most cases using nutritional and lifestyle changes. Call us on 01-4020777 to find out more or make an appointment.

 

 

Reprod Biomed Online. 2014 Jun;28(6):684-703. doi: 10.1016/j.rbmo.2014.02.004. Epub 2014 Mar 4.

Sperm DNA damage caused by oxidative stress: modifiable clinical, lifestyle and nutritional factors in male infertility.

Wright C¹, Milne S², Leeson H³.

Abstract

DNA fragmentation is an important factor in the aetiology of male infertility. However, it is still underevaluated and its inclusion in routine semen analysis is debated. DNA fragmentation has been shown to be a robust indicator of fertility potential, more so than conventional semen parameters. Men with high DNA fragmentation levels have significantly lower odds of conceiving, naturally or through procedures such as intrauterine insemination and IVF. Couples may be counselled to proceed directly to intracytoplasmic sperm injection as it is more successful in this group, avoiding costly procedures, recurrent failures or pregnancy losses; however, this treatment is not without limitations or risks. Ideally DNA fragmentation should be minimized where possible. Oxidative stress is the major cause of DNA fragmentation in spermatozoa. Endogenous and exogenous factors that contribute to oxidative stress are discussed, and in many cases are shown to be easily modifiable. Antioxidants play a protective role, although a delicate balance of reduction and oxidation is required for essential functions, including fertilization. Reducing oxidative stress may improve a couple’s chances of conception either naturally or via assisted reproduction. Sources of oxidative stress therefore should be thoroughly examined in men with high levels of DNA fragmentation and modified where possible. DNA fragmentation is an important factor in the aetiology of male infertility. However it is still underevaluated and its inclusion in routine semen analysis is still debated. DNA fragmentation has been shown to be a robust indicator of fertility potential, more so than conventional semen parameters. Men with high levels of DNA fragmentation will have significantly lower odds of conceiving naturally or through procedures such as intrauterine insemination and IVF. Intracytoplasmic sperm injection (ICSI) may be much more successful in this group, and couples may be counselled to proceed directly to ICSI, avoiding costly procedures, recurrent failures or pregnancy losses. However, ICSI is not without its limitations or risks. Ideally, DNA fragmentation should be investigated and minimized where possible in men trying to conceive naturally or through assisted reproduction technology. Oxidative stress is the major cause of DNA fragmentation in spermatozoa. Endogenous and exogenous factors that contribute to oxidative stress are discussed and in many cases are easily modifiable. Antioxidants play a protective role, although a delicate balance of reduction and oxidation is required for essential sperm function, including fertilization. Reducing oxidative stress may improve a couple’s chances of conception either naturally or via assisted reproduction treatment. Sources of oxidative stress therefore should be thoroughly examined in men with high levels of DNA fragmentation and modified where possible.

Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

We are very pleased to say that Glenville Nutrition have teamed up with Pomegranate and are offering free nutritional consultations to some Pomegranate couples looking to optimise their fertility. Pomegranate is an Irish charity that supports those suffering from infertility, helping them take a step further towards becoming a parent.

Pomegranate was set up by Fiona McPhillips and Joanna Donnelly, both of whom have been lucky enough to have children thanks to fertility treatment. Fiona is also the author of Trying To Conceive: The Irish Couple’s Guide and the blog, Making Babies. Pomegranate is a symbol of fertility in many cultures and religions.

Fiona has written a guest blog piece for us this week, to share with us some of her story…

Let’s Talk About Infertility

Nobody expects to be in for the long haul when they start trying for a baby. It is supposed to be a time of great hope and anticipation, when you start planning your new lives together. It is true that having a baby changes your life, but not having one changes it so much more. Sadly, this is something that more than one in six couples will find out.
Before I became that statistic, I never thought too much about what it meant. Although infertility was a fear, it was not something that bore heavily on me – at least, only to the extent that I didn’t want to put off having children for too long, just in case. I didn’t know anyone who was infertile so I could only guess at how hard it might be.
I didn’t have a clue. My guess only extended to the long-term pain a couple might feel about not having a child in their lives. Thanks to television, many people assume there is a once-off diagnosis a couple has to deal with, and that they are then free to return to their lives and reshape their future without their much-wanted child. If only it was that easy.
It is very difficult to explain the cumulative effect of month after month, and year after year, of hope and disappointment. After a while, everything hurts – other people’s bumps and babies, anniversaries of failed cycles and lost babies, and every new birthday, Christmas and Mother’s Day you face with empty arms.
There is a huge lack of understanding of infertility in the outside world. It is just not viewed as one of the very bad things in life. A common reaction is, “Why can’t you be happy with what you’ve got? Focus on all the good things in your life”. When you can’t have a baby, nothing else matters. It’s not possible to forget about it, channel your energy elsewhere, take up a hobby. The desire for a child goes beyond the desire for the joy that a child brings – it is a primal, uncontainable urge that overpowers all reason.
Infertility is a very difficult and painful struggle. The research of Dr Alice Domar, professor at Harvard Medical School, suggests that the stress endured by infertility patients is comparable to that experienced by people undergoing treatment for cancer and Aids.
Sometimes this stress can be compounded by people with the best of intentions. “Don’t worry, it could be worse.” “It’s God’s will.” And the old chestnut: “Just relax and it will happen.” If there is one piece of advice I can give to those who know someone suffering from infertility, it is that it is better to say nothing at all than to say the wrong thing. If you feel awkward, just say sorry, and give the person a hug if you think it is appropriate. And one more thing, if I may: stress does not, I repeat, does not cause infertility, but infertility sure does cause stress.
Unfortunately, it’s not just emotional, physical and mental stress – there can also be a huge financial burden. At up to €6000 a go, and with less than a 25% success rate, IVF can become very costly. And for those who don’t have a spare few grand, a diagnosis is often the end of the line.
I know what some of you are thinking: the world is overpopulated already, so many unwanted children out there, why don’t you “just adopt”? Setting aside the huge amount of time and money needed to adopt, I always wonder why the burden of looking after the world’s orphans falls on the shoulders of the infertile. What about those who’ve already experienced the miracle of pregnancy and birth – why don’t they adopt instead of having, say, a second or third pregnancy?
Others may be concerned about the embryos that don’t make it through the IVF process. Even with a “natural” conception, only 20-40pc of embryos make it to implantation. Life may or may not begin at fertilisation but viable life does not begin until the fertilised egg has implanted in the uterus. There is nothing that can be done to protect an unimplanted embryo – you can give it a right to life in law but unfortunately science cannot give any such guarantees.
With one in six couples seeking help to conceive, everybody knows somebody suffering from infertility. It’s an issue that touches all of us either directly or indirectly. And yet it is a conversation many of us have never had.

– Fiona McPhillips, co-founder Pomegranate