Almond Flour Flatbreads

Flatbreads are not a major part of my lunchtime repertoire. Normally I’m a bit sniffy about substitutes for everyday foods. Vegetarian sausages which look and taste like their meat based equivalent are to my mind a bit of a no no. We should (to my mind) be celebrating vegetarian food, not pretending that it is meat.

By that logic, if we are not eating bread then bread alikes should also be out, however sometimes, just sometimes, it is nice to be able to put together a sandwich.

Answers to this need include the lettucewich where the filling is placed between two slices of lettuce or the meatwich which could end up just being three slices of meat. Something that I find hits the mark is this almond flour flat bread. The recipe originally came from Low Carb Living for Families by Monique le Roux Forslund. The book is excellent and I only ended up tweaking the recipe because she uses a lot of dairy produce. The whole book relies heavily on butter, cream and cheese some of which can be substituted without going too far from the original.

My Version

First up you put about 100g or 4oz, depending on how you think, almond flour (ground almonds) into a bowl.  I use half  a 200g packet measuring by eye.

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Then add an egg

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Follow with a glob of olive oil. This helps it mix evenly. Add a pinch of salt at this stage too.

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Mix it up.

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Then form into two flat breads on a large plate and microwave on high for 2 minutes. The plate will be surprisingly hot when you take it out which is probably something to do with the way the egg cooks.

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The flatbreads will come off the plate very easily so I prise them off with a knife and let them cool a bit before filling them up. They are quite dense and the original recipe calls for lashings of extra butter at this stage. I use mayonnaise on both flatbreads instead.

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The sandwich travels reasonably well so can be used as a packed lunch. It is very filling though so you will not need to pack much more to see you through to dinner. I have also found that solid fillings work better than more runny ones like tuna mayo.

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A1 and A2 Milk

A1 and A2 milk

When I discovered that milk was off the menu for me I was encouraged to discover that some milk may be acceptable to people who were intolerant of standard cow’s milk.  Goats, sheep and even some cows produce milk which has a different structure and providing lactose intolerance isn’t the problem, can be happily drunk.  Welcome to the world of A1 and A2 milk.
Milk carton

The alternative milk is identified as A2.  Originally all milk was A2 in structure – more details later – but somewhere between 5,000 and 10,000 years ago a genetic mutation occurred in cows that caused A1 milk. Thus, older breeds of cow produce A2 milk and newer breeds A1. Channel Island milk produced from Jersey and Guernsey cows can be A2 (I initially got the idea that all Channel Island milk is A2 but that is WRONG).

The first thing I did when I left work at the start of the summer holiday was buy a pint of gold top Channel Island milk and a big box of paper hankies. The milk tasted delicious but it was a good job I had the hankies because over the course of three days the nosebleeds started and got heavier.

Time for a bit more research!

A bit more research

Channel Island milk is not exclusively A2. Guernsey milk is nearly all A2 but Jersey milk has a lower percentage. A2 cows’ milk has to be selected for and it is available in the UK. (Link)

Milk is made up of two categories of protein: casein proteins which in cows is about 82% of total protein and whey protein (the other 18%). The A1 and A2 tags refer to a difference in one of the casein proteins.

Casein proteins come in alpha, beta and kappa forms and the crucial difference we are interested in lies on the beta form.

To understand this, I needed to understand some of the science behind proteins, their composition and digestion; so here goes…

Proteins are made up of amino acids, all of which have an amine group at one end and an acid group at the other. Between the amine and acid there is a carbon based chain which generally includes carbons, hydrogens, oxygens and nitrogens in varying amounts. There are 22 different amino acids that can be combined to make proteins, 21 of which are used by humans. See them here. 9 of the amino acids cannot be made by humans, have to be obtained from the diet and are termed essential.

More than two amino acids joined together is called a peptide unless more than 50 of them are joined when they are termed proteins. Protein chains are long enough to form linkages and to fold themselves up. The beta casein protein contains 209 amino acids joined together and the A1 version differs from the A2 in that the 67th protein is histidine not proline.

Histidine and proline

Digestion breaks the protein chain down into peptides which are called beta casomorphines or BCMs for short. BCMs are given a number to indicate how many amino acids are in the chain so BCM-3 refers to a peptide, beta casomorphine with 3 amino acids. The name “morphine” gives a clue about how they affect us when they bind to opioid receptors in our brain, spinal chord, gastrointestinal tract and other organs. Ideally the BCMs should stay within the gastrointestinal tract and only fully digested nutrients be allowed through into the bloodstream but leaky guts allow the particle to pass through and be transported around the body. According to drugabuse.gov the result is drowsiness, mental confusion, nausea, constipation and depressed respiration. A good thing that beta casein is only a tiny percentage of milk. Total protein in milk is slight over 3% with the remainder being water, fat, sugar and trace elements (here).  82% of that is casein and 30-35% of that is beta casein. The problem with beta casein is BCM-7 which is formed during the digestion of A1 milk and contains the histamine at position 67 on the chain.

Once the casomorphines have bound to opioid receptors in the body they are broken down into inactive dipeptides by an enzyme dipeptidyl dipeptidase-4. In the case of BCM-7 this releases histamine into the blood stream. The histamine is formed because histidine is only weakly bonded to the rest of the BCM-7 peptide.

Histamine causes inflammation in the body, runny nose, stuffiness, dilated blood vessels, gastric issues, lowered blood pressure and breathing difficulties.

BCM-7 has been called “the devil in the milk” and this is the title of a book of the same name by Keith Woodford,a New Zealand Dr, who noticed that patients with chronic illness were often intolerant of cow’s milk.

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Taking Stock

There comes a point in everyone’s life where in order to keep moving forward you have to take stock of where you have come from. To turn around and to admire the view. To reflect on the journey so far.

Having done very little on this blog recently I think it is time to take stock and unstick myself ready to move along.

Picture of a rocky path

Taking Stock of the Journey

There are several embryonic posts: started but not quite completed, unpublished and lurking in the background on this website. Lots of ideas have flitted through my head but not made it through the interface between me and the keyboard. Yup, I’m stuck and this is time for a stock take.

In my day job I work from 8am to 6pm with an extra hour and a half for traveling. Since Christmas this has been even more stressful than it was before and my psoriasis flared up with a vengeance. I had been waiting for an appointment with a dietician but twelve weeks ago, in desperation, I started an elimination diet. This has successfully stopped ALL nosebleeds and identified foodstuffs that cause my gums to bleed BUT the psoriasis just carried on flaring and getting worse.  There is an excellent online community www.inspire.com which has a forum devoted to psoriasis and psoriatic arthritis.  Many people using the forum are trying to relieve their condition through diet and the concensus seems to be that things do get worse for a few months before they get better.  A paleo autoimmune diet is popular which is fairly close to the elimination diet I have been following.  Nightshade foods – the ones I love: tomatoes, peppers, aubergines, potatoes etc are strongly implicated in triggering inflammatory disorders in the body.

My Favourite Fruit

My Favourite Fruit

Last week I gave up waiting for diet alone to fix the problems and asked my doctor to prescribe steroids to relieve the pain of the psoriasis which had moved in scale from mild to moderate in its coverage and in many places was cracked and bleeding as well as flaking large scales of skin. He reminded me that steroids were not a cure and that using them can make things worse. He also had a look up my nose and expressed surprise that I had managed to go for so long with out a nosebleed because there are so many blood vessels close together and close to the surface. What this really means I don’t know but at least the leaky pipe has stopped leaking.

Other things which have stopped since starting my journey are fatigue, depression and brain fog (a.k.a. cotton wool head). Last time I tested for zinc deficiency that had gone too.

I still have quite heavy growth of dark hair on my face so suspect that the PCOS has not been affected by the restricted diet – maybe it never will go. I have lost a fair bit of weight – weight gain being associated with PCOS.

Stock taking over; it has been an interesting journey so far, if rocky underfoot.

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The Gut-Brain Connection

The gut-brain connection is more powerful than we may realise. Maybe for you too, sometimes gut instincts just make more sense than anything else. Ever had butterflies in your stomach? Well, it turns out that the gut is a lot more influential on our behaviour that even gut instincts and butterflies credit.

Digestion alone is pretty amazing as foods get broken down into their constituent fats,amino acids and monosaccharides in order to be transported through the gut wall into the bloodstream for transportation to cells. Once in the cells these basic building blocks are reassembled into larger molecules which can be used by the body.

So that complicated process is amazing enough and presumably takes a lot of organising from somewhere deep in our subconscious. It turns out though that the gut is a nervous system all on its own which relays messages and instructions to the brain rather than passively receiving directions from the brain.

The gut is part of the Enteric Nervous System (ENS) and has sometimes been referred to as the second brain because it can function on its own without input from the brain. The ENS is made up of the entire gastrointestinal tract from the esophagus down to the exit and includes the stomach, small and large intestines, pancreas, gall bladder and a large amount of nerve fibres.(see this link for more detail.)

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The system has two layers of neurons which regulate the processes of digestion and movement of nutrients into the body while also sending messages to the brain about the state of the digestive system (hunger, pain, discomfort, stop eating – full up etc.). Other neurons receive messages from the brain.

The ENS also communicates with the immune system, signalling the need for tight junctions in the intestine to open up allowing water to flow into the gut and flush out foreign invaders (see leaky gut).

So it is not really any great surprise then to discover that what is going on in your gut can have a direct effect on your mental health.

Non Coeliac Gluten Sensitivity has been implicated in a wide range of autoimmune illnesses and also mental conditions such as depression, bipolar disorder and schizophrenia.

People who manage to eliminate all foods which they have become sensitive to from their diet often report a greater feeling of calm. Their mental stability seems to increase and they can deal with stress more easily. Eliminating these foods is not easy and an elimination diet may be the quickest way to identify them, however the benefits are worth it. Calming the gut will calm the brain.

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Psoriasis and Non Coeliac Gluten Sensitivity

What is psoriasis?

Psoriasis is a skin condition similar to eczema where there are reddened, inflamed patches of skin, capped with white dead skin which is in the process of sloughing off.

The skin cells are in the process of dividing far more quickly than normal skin does which is why you can often tell where someone with psoriasis has been. They leave a tell-tale scattering of dead skin (like really bad dandruff) on the floor which is particularly noticeable in bedrooms.

Psoriasis is often found close to the bones.  In this case on the scalp.

Psoriasis is often found close to the bones. In this case on the scalp.

The photo above shows a patch of psoriasis with a cap of skin cells on the right hand side. It is lumpy in appearance. The very red area over on the left hand side shows the inflammation visible once the cap has fallen off.

A number of people with psoriasis also suffer from psoriatic arthritis where the inflammation is internal around the joints.

What causes psoriasis?

Until recently no one really knew why some people developed psoriasis and others didn’t although there are plenty of theories. There does seem to be a genetic component to it though, which there isn’t with eczema. Eczema seems to be a response to environmental triggers, psoriasis is not. Psoriasis is exacerbated by stress and it does seem to respond to diet. It is also definitely linked to NCGS and may be caused by leaky gut in the same way as other inflammatory responses in the body. One other thing is clear and that is that once you have developed psoriasis, you will always have it to one degree or another however there is now growing evidence that it responds to removal of gluten from the diet.

An antipsoriatic diet

There are four main food groups implicated in aggravating this skin condition: gluten containing, dairy, legumes and FODMAPs.

Gluten and wheat contribute to the formation of leaky gut (explained here) which triggers an inflammatory response in the body. The inflammation can manifest in many ways with skin conditions being just one.

Because wheat contains over 23,000 proteins, once you become sensitive to it you also run the risk of developing sensitivities to other food stuffs which contain identical or very similar proteins. It is very common for someone who is sensitive to wheat to also be sensitive to dairy; slightly less common for legumes to pose a problem but not unusual.

FODMAPs are carbohydrates rather than proteins so they seem to be an strange addition to the ‘please avoid’ list. FODMAP is shorthand for ‘Fermentable, Oglio-, Di-, Monosaccharides And Polyol’ all of which are short chain carbohydrates, poorly absorbed in the gut.

Again, the diet recommended for psoriasis is very similar to that recommended for NCGS where the above triggers are identified and eliminated.

So if your brain fog has lifted, your mood and energy lifted but psoriasis is still a problem, it may just be that there is something more you are reacting to.

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