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Can a pill simulate "gluten-free"?

The problem with gluten (if there is one, after all we are not all suffering from coeliac disease) is that its proline-peptides cannot be digested by any of the enzymes in the human intestinal tract. Therefore, the long proline-rich gluten peptides reach the small intestine intact after ingestion where they are the driving motors of coeliac disease in 1% of the population, in whom the specific amino acid sequences of such poorly digested proline-rich gluten peptides triggers an abnormal immune response.

More recently, though, studies have shown that less pronounced adverse reactions to gluten consumption can occur even in subjects who don't suffer from coeliac disease. As Salden et al. point out, "[p]resently non-coeliac gluten sensitivity has been clinically recognised as a separate condition in which neither allergic nor autoimmune mechanisms are involved" (Salden. 2015). Accordingly, the results of the latest study from the Maastricht University Medical Center are relevant for much more than just 1% of the population (West. 2003; Mäki. 2003; Fasano. 2003; Bingley. 2004).
Now I got you curious, right? Ok, here's what the Dutch scientists did: In their randomized, double-blind, placebo-controlled, cross-over study 12 healthy volunteers attended to four test days with at least one week washout in-between. On day 2-3, a liquid low or high calorie meal (4 g gluten) with Aspergillus niger prolyl endoprotease (AN-PEP | 6.1 mL of AN-PEP corresponding with 1.600.000 Protease in a total of 100 mL water) or placebo was administered into the stomach.

Table 1: Recipe and nutritional composition of the low and high calorie test meal per 300 g portion (Salden. 2015).

Table 1 shows the composition of the meals. All test meals contained 5.2 g of gluten powder, of which 4.0 g was gluten protein (Syral, Aalst, Belgium). Encapsulated refined olive oil powder (VanaGrasa 80B; FrieslandCampina, Kievit B.V., Meppel, The Netherlands) was used as fat source for the meals and together with maltodextrin as additional energy source for the high calorie meal, and sodium caseinate (DMV, Veghel, The Netherlands) was used to match both meals for protein content. The dry meal powders were dissolved in a total volume of 300 mL tap water of 40 °C by stirring with a spoon and subsequently mixing with a Turrax (Ultra Turrax T25; IKA, Staufen, Germany). Low and high caloric meals were not blinded to the investigator.

The gastric emptying was tracked with acetaminophen and a triple-lumen catheter was used to get the gastric and duodenal samples that were used to calculate the 240-min area under the curve (AUC0–240 min) of α-gliadin concentrations.

Figure 1: Total alpha-gliadin in the duodenum (µg x min | left) and western blot showing degradation of water-insoluble gliadin over time in the stomach and duodenum in low and high calorie meals with and without AN-PEP (Salden. 2015).

As you can see in Figure 1, the addition of the Aspergillus niger prolyl endoprotease worked it's magic on the indigestible gluten peptides and reduced the amount of potentially pro-inflammatory alpha-gliadin that made it into the duodenum by 91% and 81% depending on the size of the meal. That's huge and as the scientists point out the first time that someone observed in vivo that the AN-PEP enzyme efficiently degrades gluten from a meal in the stomach of human subjects.
References:

• Bingley, Polly J., et al. "Undiagnosed coeliac disease at age seven: population based prospective birth cohort study." Bmj 328.7435 (2004): 322-323.
• Fasano, Alessio, et al. "Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study." Archives of internal medicine 163.3 (2003): 286-292.
• Mäki, Markku, et al. "Prevalence of celiac disease among children in Finland." New England Journal of Medicine 348.25 (2003): 2517-2524.
• Piper, Justin L., Gary M. Gray, and Chaitan Khosla. "Effect of prolyl endopeptidase on digestive-resistant gliadin peptides in vivo." Journal of Pharmacology and Experimental Therapeutics 311.1 (2004): 213-219.
• Salden et al. "Randomised clinical study: Aspergillus niger-derived enzyme digests gluten in the stomach of healthy volunteers." Alimentary Pharmacology and Therapeutics (2015): Accepted manuscript.
• West, J., et al. "Seroprevalence, correlates, and characteristics of undetected coeliac disease in England." Gut 52.7 (2003): 960-965.

Yes, blueberry smoothies are heart healthier than those without blueberries, but can't replace blood pressure meds.

In today's installment of the waredownloadsoft short news we will take a look at a bunch of recent studies that have been published in the open-source journal Nutrients in the last months. Some of them deal with foods, others with behavioral aspects that are related to one's diet and its effects on body weight and health.

I will try to adapt the length of the summary to the appeal of the article, but if you feel that a specific topic has not been covered "in-depth enough" for your liking, you can always type the title of the study from the references into google and take a closer look, yourself.

• We don't see the dietary mistakes we make (Sproesser. 2015) - In contrast to our perception of physical weaknesses like love-handles and co our perception of our eating habits is often not critical enough. According to a recent study from the University of Konstanz in Germany, people considered what they ate always healthier than what others ate, even if an objective assessment said that there were no significant differences.
  

  Figure 1: Annotated photo of the foods subjects chose from when they put together the meals for themselves and their peers (Sproesser. 2015).

  What is particularly interesting is that this became a self-fulfilling prophecy, when the participants were asked to compose a meal for their peers and chose (a) more energy for a peer than for themselves (M = 4983 kJ or 1191 kcal on average for the peers’ meals vs. M = 3929 kJ or 939 kcal on average for the own meals) and (b) more high-caloric food items for a typical meal - a behavior that is highly indicative of a so-called "self-other bias", which would confirm that at least many of us really think they were eating healthy even if that's in stark contrast to epidemiological data indicating overall unhealthy eating habits.
• Egg yolk protein delays, egg ovalbumin (the white stuff) boosts the recovery of your iron levels (Kobayashi. 2015) - In spite of the fact that the study at hand was conducted in female rats, it's safe to assume that the yolk and white protein will have different effects on iron absorption and thus the the induction of iron deficiencies in man and women on low iron diets, too.
  

  Figure 2: Body weight gain, food intake, hematocrit, hemaglobin and red blood cell count in response to different iron deficient diets compared to control = iron sufficient diet (Kobayashi. 2015).

  In other words, if you are eating 20 full yolks per day and your iron-levels are suppressed, you may reconsider this practice. If it's just the occasional egg yolk, let alone egg protein powder (which is usually ovalbumin, only), don't worry. 
• Blueberries are good for the heart, but they are no replacement for your blood pressure meds (Stull. 2015) - ed. In a recent double-blind and placebo-controlled study was conducted in 44 adults (blueberry, n = 23; and placebo, n = 21). The subjects were randomized to receive a blueberry or placebo smoothie twice daily for six weeks.
  

  Table 1:  Nutritional composition and ingredients in the smoothies (Stull. 2015).

  A snack that didn't have any effects on either the blood pressure or the insulin sensitivity of the >20 year-old subjects suffering from metabolic syndrome. That the blueberry smoothie still had beneficial effects on the endothelial function of the subjects can be seen by the improvements in reactive hyperemia index (RHI - an index that is among other things used for the noninvasive identification of patients with early coronary atherosclerosis" | Bonetti. 2004), which remained statistically significant even after adjusting for confounding factors, i.e., the percent body fat and gender.
  
  Accordingly, the study does support the notion that eating blueberries - even in form of a smoothie - can have beneficial effects on your heart health. In view of the fact that in this particular study a comparison of no-blueberry vs. blue-berry smoothies was conducted, you could also argue that the inclusion of blueberries in a smoothie may smooth out the negative effects of another (unnecessary) snack on your health and suggest: If you want to eat blueberries don't add them as a snack, but use them as a replacement for other foods.