Forgot to marinate the steaks and hit a homerun

MMMMM.... Dinner, or as Mr. put it "you really hit a home run with that one." Seriously, a complement on a meal that didn't contain any starches or grains? I. am. floored. I do have to take some credit where credit is deserved. Initially dinner was going to be some eye of round steaks but I forgot to marinate them, so they will have to wait. Instead I made this...

Meatballs with a vegetable medley over spinach and spaghetti squash.

First the meatballs,

 Preheat oven to 325

Mix
2lbs Grass fed beef
1tsp oregano
1tsp sweet basil leaf
1tsp salt

Mold into 1 1/2 diameter balls ( about 1 oz a piece)

I have a very hard time not eating this raw, so good.


Veggie Medley

Time to clean out the veggie drawer!!!

I used...

1 zuchinni
1/2 onion
4 oz of mushroom
1/2 red pepper
2 cloves of garlic
Broccoli
4 tbsp coconut oil
salt and sweet basil to taste

Saute onions first then set aside and do the rest of the veggies ('cept broccoli and garlic).  Set that with the onions and do the broccoli. When ready to serve throw it all together and add garlic. Make sure not to over do the garlic.

Don't forget the spaghetti squash and raw spinach. If you put the raw spinach on the bottom and layer the rest on top it will cook the spinach just a bit making it the perfect texture.


Not to make you crave pasta or anything but this is what the kids had...

Gluten free ravioli

My 15 year old and I have been gluten free for about 10 years and this is the first time she has been able to have ravioli. She was beyond excited and managed to eat 90% of the package herself. @nd daughter got the other 10%. They also had a blueberry treat. The company is called Maninis and their ingredients are impressive. No nasty oils like canola, only ancient grains. We don't eat a bunch of grains in our house but if we did I wouldn't feel bad about serving this stuff. Check out their website and see for yourself, good stuff.

Enjoy!!!

Today was filled with those pesky Saturday chores. You know the ones that just don't or can't be done during the week. That's one difficult part of owning your own business, you don't every really get time off. Weekends are just extra time to get work done. Still worth it.

So today, among other things, we went shopping.

Whole paycheck was quite busy which the Mr. hates but I made him come anyway. He keeps saying he doesn't know what to eat so I wanted to show him. Basically, it's nothing from the isles and all from the perimeter. We don't have to worry much about meat because I bought 1/4 of a cow from Olsen Farms in Seattle. There is nothing like buying your beef directly from the owner.

Here was our Whole Foods haul.

The Mr. tried his first kombucha today and will be trying baba ganoush later. I will let you know how that goes. FYI, I think kombucha is whole 30 if there is no sugar and only sweetened with a bit of juice. The sugar in the juice is consumed by the beneficial bacteria, therefore it is almost negligible. But don't get all litigious on my ass. There is no black and white here peeps.

So here is dinner...

Here is what you need...

A big fracking chuck roast (grass fed, grass finished)- I think mine was 1.5 lbs but I wish I would have done a bigger one for more leftovers
4-5 large organic diced carrots
1 large diced onion
3-4 diced celery stalks
3-4 large Portabella mushrooms, whole caps, diced stems
2-4 tablespoon of tomato paste
2 bay leaves
1 rosemary sprig
2 diced garlic cloves
Enough beef bone broth or chicken broth to almost cover the meat, keeping the top exposed.
Grass fed ghee

Preheat oven to 325
First brown the meat, using ghee, in a dutch oven, cast iron skillet or pan. I prefer the dutch oven for the one pot meal effect. Less clean up=happier mama.  Then place the meat aside and in the same pot saute the carrots, onions and celery. When the onions begin to brown add the tomato paste making a mirepoix. Turn off heat. Now you can add the mushroom stems, garlic, meat, stock and bay leaves. Adding the garlic now avoids over cooking the delicate flavor of the garlic. Then place the mushroom caps on top of the meat and the rosemary on top of everything. The rosemary flavor will infuse into the whole dish without being overwhelming.

Bake covered for 2-4 hours depending on the amount of meat. I suggest you check after 2 hours. If it is done the meat will fall apart  when you twist a fork in it. As little kids we used to call this "string meat."

The butternut squash pictured above was tosses in,

4 tbsp coconut oil
2 tsp thyme
sea salt and white pepper

Roast on convection at 375 until browned slightly. If you don't have convention, bake at 350. This can be done after the meat is finished. Usually takes about 20-25 min but keep an eye on it becuase it can go faster depending on the size of the cubes.
You can also use acorn squash or pretty much any squash you like. 'cept spaghetti squash...probably not a good idea.

Enjoy!

Whole 30 day 6

Feeling pretty good today. Breakfast was awesome. I didn't mention this before but I am on the leptin reset. It works really well with the Whole 30 so I just incorporated the two. I probably should have been this strict on the leptin reset starting from the begining, I would probably be onto phase II already. Oh well, whats done is done so moving on...

Breakfast. Favorite meal of the day. Today was leftover chuck roast from dinner, a piece of bacon and 2 eggs. AND tumeric, I love tumeric.

Mr. has been sick since the beginning of the month so he is a bit bummed that he doesn't feel any better even though his diet has been flawless. I feel like my head is clearer and I have a bit more energy than usual. I still have the remnants of New Years around my waist (baily's, if it's in the house I have to have it and boy did I).

I am making chuck roast again tonight so I will post the recipe later with a pick. Spoiler alert....

My, not so, secret ingredient is portabella mushrooms.

Whole 30ying

So on January 2nd, I started the whole 30. Why not January 1st you ask? I have a hard time being a "joiner". It just rubs me the wrong way. Also, I had no intention of doing this until the Mr. gluten free NP decided he need to make some changes. He has been an avid carb eater/beer drinker forever so I had to grab this opportunity for change.

So what I am going to do is post both the glorious and not so glorious from the whole 30 extravaganza.


Here is the first breakfast, taken on the 2nd.

Okay, just kidding but I did make a lot of bacon.

Now, bacon is supposed to be eaten in moderation on the whole 30. I can respect that. In fact, I agree with it. That being said, I eat 1-2 slices of bacon a day. Clearly not moderate when you take in that it's 14 pieces a week or maybe it is moderate. I dunno, it's all semantics. The truth is that I don't over fry it and I buy quality bacon. Sometimes from the farmers market, sometimes from whole foods and soon from U.S. Wellness meats.

That's what I have to say about bacon and my new venture in the Whole 30. Stay tuned for further updates.

It's business time

Okay, so not that kind of business ;) but it's still kind of fun. I am gearing up to roll out my business. Gotta find an office and set up. Working on paperwork and insurance paneling ( asking insurance companies to accept me as a provider). 

Now I realize this blog is mainly for me to talk to myself. I know this because, sadly, I have no comments. It okay, I like myself enough that I may someday comment on my own blog...wow that sound really pathetic! HA! 

Moving on...if anyone has any ideas on names I would be oh so grateful. Here is a description of the practice. 

I am a psychiatric nurse practitioner who will be working collaboratively with patients to achieve optimal wellness through diet and lifestyle changes. I am paleo/primal based and will have a register dietitian and a possibly a naturopath in the office (the naturopath will be added when I have enough patients to warrant it)

I am an avid researcher and love to educate clients. I believe that wellness is achieved when people have the information and the desire.

My practice will focus on eating disorder (including exercise addiction), ADHD, anxiety, depression, adolescent issues, family conflict and optimal happiness :)

Also, if there are any suggestions for other things I should add or services I could have that would be helpful too!

Thanks,

Christina

Celiac and psychiatric disorders

I actually wrote this for my professional organizations newsletter. I didn't get a whole lot of space so I kept it quite concise. The chart was not included in the letter but I think it is important.

Psychiatric manifestations of gluten sensitivity/celiac disease and why it is important to psychiatric providers

The spectrum of gluten sensitivity to celiac disease is caused by a molecule contained in wheat, rye, barley and through cross-contamination on oats. These disorders are commonly associated with the gut but current research suggests they may be more likely to manifest as psychiatric conditions. These include but are not limited to schizophrenia, depression, attention deficit, and autism spectrum. Celiac disease is up to 25% more prevalent in people with psychiatric disorders [i]. People suffering from these conditions often initially present to psychiatric providers. Therefore, psychiatric nurse practitioners should have a basic understanding of celiac/gluten sensitivity to assist with early detection and diagnosis.

Gliadin, the offending protein in gluten, causes a breakdown of the protective cells of the gut. This occurs in all people, regardless of celiac status, and can lead to increased gut permeability [ii]. Essential this process allows dangerous macromolecules into the gut and eventually into the blood stream[iii]. This stimulates an inflammatory reaction that has been found to have an effect on neuronal Purkinje cells, cortical neurons and the brain stem[iv] [v]. There is evidence to suggest a gluten free diet causes a regression of the inflamatory assult as well as a lessening of psychiatric symptoms in celiac patients.

What does this mean to psychiatric practitioners? Undrstanding that there is a connection between psychiatric disorders and celiac is essential in managing our client’s overall health. A history of familial food sensitivities and GI disorders is often common in psychiatiric, gluten sensitive patients. If this connection exists testing can be helpful in making a diagnosis. If caught early the prognosis is good and the client can be managed with a combination of a gluten free diet and psychotropic medication. A full recovery from psychiatric symptoms has been noted in several studies but the diet complexity and lifstyle changes warrent a referal to a nutritionist.  

For more information or complete list of references please contact pikec@uw.edu

---

[i] Hadjivassiliou, M., R. A. (2006a) Neuropathy associated with gluten sensitivity. J Neurol Neurosurg Psychiatry, 77, 1262-6.

[ii] Drago, S., R. et al. (2006) Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines. Scand J Gastroenterol, 41, 408-19.

[iii] Lammers, K. M. et al. (2008) Gliadin induces an increase in intestinal permeability and zonulin release by binding to the chemokine receptor CXCR3. Gastroenterology, 135, 194-204.e3.

[iv] Hadjivassiliou, M., S. et al.(2002) The humoral response in the pathogenesis of gluten ataxia. Neurology, 58, 1221-6.

[v] Boscolo, S. et al. (2007) Gluten ataxia: passive transfer in a mouse model. Ann N Y          Acad Sci, 1107, 319-28.

Tests	CD/GS	Sensitivity	Specificity	Notes
tTG-IgA (TG2)	CD	95%	90%	If positive it is villous atrophy highly likely but a negative does not rule out CD or GS
IgA-AGA	GS	53-100%	65-100%	Can positive with extra-intestinal symptoms, a negative does not rule out CD/GS
IgG-AGA	GS	57-100%	42-100%	Can positive with extra-intestinal symptoms, a negative does not rule out CD/GS False positive in Crone’s, wheat protein allergy, and with recent diarrhea
Anti-deaminated gliadin-IgA/IgG	CD	90&92% Respectively	98&75% Respectively	Shows CD before intestinal damage occurs
Total IgA	CD/GS	No Data	No Data	IgA deficiency can cause all AGA tests to show false negative
TG6	GS	No Data	No Data	Associated with neurological symptoms Not readily available yet
Genetic	CD/GS	% in CD	% in GS	Notes
HLA-DQ8	CD/GS	95%	50%	30% of the general population will have this halotype, Helps with inconclusive serology
HLA-DQ2	CD/GS	5%	9%	Helps with inconclusive serology
HLA-DQ1	GS	0	1%	Helps with inconclusive serology
Biopsy results	Increased intraepithelial lymphocytes	Crypt Hyperplasia	Villous Atrophy	Notes
Marsh Grade I	Present	Not  present	Not Present	Found in pre-celiac and GS
Marsh II	Present	Present	Not Present / Partial	Pre-Celiac/CD
Marsh Grade III	Present	Present	Total	Celiac Disease

Baby bok choy courtesy of full circle farms!!!

Really great box of organic produce arrive at my door this week. Here is one of the meals I made.


Ingredients
Bok choy
Red and greeen pepper
Onion
crimini mushrooms
Organic grass fed sirloin tip
ginger
Tamari
Chili oil
lime
coconut oil
coconut butter




In a small bowl add ginger, tamari, lime and chili oil. Set aside.
Saute onions and bok choy stems (they cook faster than the leaves) in tons of CO. remove and place aside


Separately in a cast iron fry steak to char outside, again in CO. Remove and rest ( the steak not you).
Saute the peppers and mushrooms then add in the sauteed bok choy stems and onions and beef ontop. Then pour the sauce from in the small bowl. Give a little stir then put the bok choy leaves in and stir. Once the bok choy is glossy you are ready to serve!


side note- I like to throw a bit of coconut butter in each dish. mmmmm.

Why gluten is the equivalent of evil.

In my almost 10 years of being gluten free I have made countlessly attempts to attest to the actual east of a GF lifestyle. Although, I believe it is fairly simple, most people tend not to get past the no bread for their sandwiches part. Their blank expression screams "you lost me at no bread." The other expression I get is as if they are giving me the 5 year olds response in the heads "LALALALALA I'm not listening!" Fortunately adults have learned that the act of actually covering their ears whilst someone speaks is inappropriate. Nevertheless, I can see the desire to resort to this when I explain how gluten affects the system.


You can cover your eyes if this starts to have the previously explained effect on you.




Here it is...


Gluten is a molecule contained in wheat, rye, barley and through cross-contamination on oats. The offending protein in gluten is called gliadin. This gliadin is further dissected into several areas that all have very separate effect on the gastrointestinal tract depending on genetic expression. 


What does that mean for you? This stupid little molecule can exacerbate any inflammatory condition in the body. This is a non-discriminatory statement. Meaning you do not have to have celiac or gluten sensitivity to be affected by gluten. Gliadin, the offending protein in gluten, causes an initial insult at the intracellular tight junctions located on the luminal side of the intestine. These tight junctions are responsible for maintaining the integrity of the intestinal wall and keeping out macromolecules. Gliadin binds with CXCR3, a chemokine receptor responsible for leukocyte recruitment and eventually involvement of T-helper cells. Lammers and colleagues (2008) reported a higher concentration of CXCR3 in the gut epithelium of those with celiac disease as compared to those without.


CXCR3 recruits myD88, an adaptor protein, allowing the release of zonulin to the apical side of the epithelium (Lammers et al. 2008, Clemente et al. 2003). Zonulin, in celiac, is responsible for the changes in cellular structure and arrangement of the cytoskeleton which allows for increased gut permeability. Interestingly, in non-celiac intestinal epithelium, zonulin strengthens the tight junctions (Drago et al. 2006).  While both celiac and non-celiac tissue reacted to gliadin, only the celiac epithelial membrane up-regulated the production of the mRNA for CXCR3 gene expression at a 9.6 fold increase. When gliadin was removed, the expression of the CXCR3 in the tissues of celiac patients decreased to what was seen in those without celiac disease (Lammers et al. 2008). It is important to note that CXCR3 is expressed in several other cells including natural killer cells, and CD3⁺/CD8⁺ T cells which could account for the instigation of the innate immune response associated with celiac disease. In addition, toll like receptors, which are also responsible for innate immune response, have been reported to be increased in the duodenum of children with celiac as compared to healthy controls (Szebeni et al. 2007). 


Tight junctions in the epithelial wall are critical for maintaining the integrity of the gut. The increased permeability seen in celiac disease appears to be associated with the onset of other autoimmune disorders (Drago et al. 2006, Sapone et al. 2006, and Watts et al. 2005). Although, I would not be surprised if it was a bit more chicken and egg-ish.


Bottom line
If you are suffering from any autoimmune disorder gluten is probably one of the most detrimental pieces of the puzzle. Stop eating gluten and you can begin to heal depending on the amount of damage done. 


If you do not have an autoimmune disorder gluten is your russian roulette for one.  


Gluten causes intestinal permeability changes in celiacs and non-celiacs alike.