Some problems with coeliac disease

Round & About

Round and About

Coeliac disease (CD) is not a minor ‘intolerance’ to gluten, it is an autoimmune condition in which the body’s immune system attacks the small intestine, reducing the ability of the body to absorb nutrients from food. If left undetected, CD has the potential to cause significant long-term health complications. CD is one of the most common lifelong disorders in north America and Europe and only one in eight coeliacs are ever diagnosed. These are disturbing facts.

Diagnosis of CD currently requires a positive blood test and then subsequently the detection of damage to the small intestine via an endoscopy. The first problem is that less than 50% of coeliacs are presenting with the classical symptoms of diarrhoea and abdominal cramping. The majority of coeliacs are ‘silent’ in their presentation – no overt digestive symptoms but signs and symptoms including anaemia, osteoporosis, arthritis, neurological degradation, depression, fertility issues, migraines and chronic kidney disease. This is likely to have a significant impact on whether testing for CD is even considered.

The next potential issue is with the blood testing itself. The standard NHS test for CD is good if you are presenting with significant damage to the small intestine and your immune system is functioning properly. We know, however, that damage to the small intestine is gradual and can take years or even decades to manifest; the immune system is often underperforming and the markers measured for are not broad enough. This can lead to very high rates of false negative results (up to 70%), which is dangerous if you are told it is fine to consume gluten when in fact it is not! Remember you have to be eating gluten and not taking any steroid or immune-supressing medication for any blood test to have half a chance of picking up an issue.

Finally, it is possible to have positive blood markers for CD and no small intestine damage – ‘latent’ CD (over and above the fact that the biopsies can often miss ‘damaged’ areas of the small intestine). Is it any wonder CD is such a poorly diagnosed and managed condition?

Call Mark BSc (Hons) BA (Hons) mBANT CNHC on 01183 219533 or visit www.entirewellbeing.com

Comfort & Joy

Liz Nicholls

Round and About

December is crazy-busy for one and all so Katie Kingsley created recipes that sparkle without imprisoning us in the kitchen, away from the well-deserved merriment!

Maple Roasted Brussels sprouts with honeyed chorizo

We are not a sprout family but this recipe has converted us. Leave out the sprouts if you must and just try the honeyed chorizo as a tapas with a drink… it will definitely be on our table this Christmas, jewels of deliciousness!

Heat oven to 200°C. Halve about 1kg of Brussels sprouts then toss in 3tbsp of rapeseed oil, 1 tbsp of maple syrup and season. Bake for 40 minutes in a pre-heated oven, turning halfway through cooking until crisp and golden. In the meantime, chop or break up (for tapas, double or triple the quantity) 100g of chorizo and toss with a drizzle of runny honey, 1tsp of paprika, 1tsp of fennel seeds and sauté for a few minutes until golden. Place 40g of pecans on an oven tray and bake for about five minutes (careful as they burn quickly) then roughly chop and add to the cooked Brussels with the chorizo.

Christmas “Pot Luck” pie

Named so because it is made up of leftover meat, potatoes and veg, so who knows what lurks beneath the puff… only the lunch guests from the day before! A penny-wise, practical pie and a hearty alternative to bubble and squeak after bountiful prosecco consumption.

Heat oven to 200°C. Take a casserole or large saucepan and add 475g of diced chicken thighs (try to keep pieces largish), 200g of halved new potatoes, 200g of cooked ham (again, large chunks are better), three finely diced celery stalks, one leek sliced into 1cm rounds, three cloves garlic (minced), 200ml of chicken stock and 5tbsp of single cream. Bring to a boil then simmer with lid on for about 30 minutes. Drain the mix over a sieve, keeping the liquid for the roux (you will need about 350ml) which you can make up with more cream or milk, if needed. Make a roux by melting 45g of butter in a small-medium sized saucepan, add 50g of plain flour, 1 tbsp at a time, stirring continuously so the flour cooks and forms a ‘glob’ then add your reserved liquor about a third at a time, stirring continuously so you end up with a thick, smooth consistency. Add a grating of fresh nutmeg, a handful of chopped parsley and season to taste then combine it with the pie filling. Leave to cool. Beat an egg yolk with 1tbsp of milk in a small bowl and wet around the rim of your pie dish (about 25cm diameter) and unroll a sheet of ready-rolled puff pastry. Cut a few strips off the shorter end and place around the lip of your pie dish then ladle in your cool pie filling and place the rest of the pastry on top, pinching the edges and cutting off any over-hanging pastry. Brush the top with your egg wash then create designs, if you desire before brushing over these and making a 2cm slit in the middle. Bake in the hot oven for about 25 minutes, when the top should be crisp and golden.

Dutch Christmas log

Pastry and almond with a hint of festive orange, this recipe is very simple to knock-up and great with coffee between breakfast and lunch. Use a pre-made marzipan if you want to speed it up a notch, almost makeable in an ad break! Some good uses for leftover almond paste are to add to mince pies, crumble or stollen.

Heat oven to 200°C. In a large bowl, combine 400g of ground almonds, 200g of icing sugar, two egg whites, 1tsp of almond extract and the zest of an orange. Wrap in cling-film and leave in the fridge for at least 15 minutes. Unroll a sheet of ready-rolled puff pastry and when ready take out your almond paste from the fridge, roll into a long sausage shape along the long end of the pastry sheet leaving a one-inch border on one end and both sides. Whisk an egg yolk with 1 tbsp of milk and brush around the border then fold the two shorter sides over the ends of the sausage and roll so that the seam joins at the bottom. Transfer to a baking tray lined with parchment. Brush with the egg wash and bake for about 25 minutes, or until browned. Gently heat 2 tbsp of apricot jam and brush over the log then sprinkle with chopped toasted almonds and finish with a dusting of icing sugar.

The Christmas rose

Cherry Butler

Round and About

Christmas rose is not a rose but in fact a hellebore and is in the buttercup family.

The Christmas Rose legend

According to legend a little shepherd girl from Bethlehem followed the other shepherds to the manger where Christ was born, but unlike them she had no gift to offer the baby Jesus. She searched but became upset because she couldn’t find anything suitable. Suddenly she was dazzled by a shaft of light which fell on a clump of pure white flowers. She picked some and laid them carefully at the manger. These were the very first ‘Christmas Roses’ to bloom on earth.

Use in the garden

Hellebores are naturally winter flowering or spring flowering depending on the type and are extremely hardy. They grow well in shade and the white flowered ones appear to glow and brighten up a dull winter border. Helleborus niger is often sold as a Christmas rose but is in fact one of the most temperamental. Helleborus orientalis is far more reliable in our climate and can also seed freely, cross breeding with it’s neighbours. There are a wide range of colours and flower types with several specialist nurseries selling them.

Black Death

Another interesting point is that Hellebores were used as a defence against the Plague! They suffer from a leaf spot which horticulturists call Hellebore black death… It is good practise to cut off the old leaves to allow the flowers and new leaves to develop.

Horticultural consultancy

I can spend half a day in your garden identifying your plants and teaching you how to look after them.

Cathie’s garden army

If you have lost control of your garden completely we are here to help! A qualified team of horticulturists can transform your garden in a day following a consultancy. Email [email protected], visit www.cathiesgardeningschool.co.uk and follow Cathie’s Gardening School on Facebook, Instagram and Twitter.

How to deal with uninvited gas

Round & About

Round and About

The digestive system is about 30ft in length from entrance to exit and consists of the following major sections in order from top down: the mouth, throat, stomach, small intestine (duodenum) and large intestine (colon).

As I have mentioned many times previously, the digestive tract is home to a complex community of bacteria  (approximately 100 trillion), which should not only be in balance for health and well being, but also should have the largest number of bacteria residing in the colon.

Sometimes, the small intestine gets overgrown with bacteria due to conditions such as low stomach acid, pancreatitis, diabetes, diverticulitis and coeliac disease. This is called Small Intestinal Bacterial Overgrowth or SIBO. These bacterial overgrowths produce either hydrogen and/or methane gas.

The small intestine has the surface area of a tennis court and is crucial to the efficient absorption of nutrients from the diet. SIBO disrupts the ability of the small intestine to efficiently absorb nutrients (the bacteria end up competing for the nutrients that the body is trying to absorb) often resulting in a broad range of micronutrient deficiencies (including iron, calcium, and vitamins B12, A, D, E and K) and symptoms including nausea, bloating, vomiting, diarrhoea, malnutrition, weight loss, joint pain, fatigue, acne, eczema, asthma, depression and rosacea.

SIBO is typically treated with antibiotics. Research suggests, however that certain herbal and lifestyle interventions are just as effective at treating SIBO.

In clinic, a multifactorial approach delivers the best results. This typically involves a combination of changing how much and how often you eat, what you are eating, adding in certain strains of probiotics, targeted supplementation, the use of herbs and essential oils and managing stress levels using techniques such as meditation, mindfulness, yoga, tai chi or deep breathing.

Call Mark BSc (Hons) BA (Hons) mBANT CNHC on 01183 219533 or visit www.entirewellbeing.com

Hydrangea heaven

Cherry Butler

Round and About

There are many types and some interesting facts about them. They can look good all year round but need a moist, well-drained soil. Pruning varies depending on type.

Hydrangea macrophylla

These are often referred to as indicator plants because their colour can determine soil pH. This refers to the mop head hydrangea macrophylla only; the bluer the flower the more acid your soil. In alkaline soil the flower will be pink but you can water on sequestered iron regularly or grow in a pot with ericaceous compost for more blue. They can be pruned to new shoots in late spring allowing the old flower heads to protect from frost during the winter.

Hydrangea paniculata

These are a lot larger and usually white and pale pink and my all-time favourite. The flowers are more pointed in shape and literally glow in a shady border. These are pruned to a woody framework in spring and will flower on the current growth. ‘Limelight’ and ‘Little Lime’ are lovely cultivars and ‘Vanilla Fraise’ is illustrated.

Hydrangea arborescens ‘Annabelle’

These huge white heads look amazing in a mixed border, under trees and anywhere you want a great summer show. Prune hard in spring support to tame heavy heads!

Hydrangea petiolaris

This climbing hydrangea will stick to a wall or fence, ideal for a northern aspect. Flowers are flatter and prolific. The only pruning needed is tidying and deadheading.

Horticultural consultancy

I can spend half a day in your garden identifying your plants and teaching you how to look after them. The four hydrangeas discussed all have very different pruning requirements and correct pruning of all plants is essential for healthy growth, fruit, flowers and foliage.

Cathie’s garden army

If you have lost control of your garden completely we are here to help! A qualified team of horticulturists can transform your garden in a day following a consultancy. Please ask for details. Find out more by emailing [email protected], visit www.cathiesgardeningschool.co.uk, call 07931 925 382 and follow Cathie’s Gardening School on Facebook, Instagram and Twitter.

Garden composting

Cherry Butler

Round and About

What is garden composting?

Recycling unwanted garden and kitchen waste into a free, nutrient-rich soil improver and mulch. There are some basic rules to follow that will unravel the mystery.

Choose your area and container

The wooden slatted, made-to-measure compost bins are my recommendation and they look nice too. Make up a group of three somewhere accessible and in a shady corner of the garden. Plastic bins can be obtained free from the council but are a little trickier to negotiate and don’t look so attractive. Many other systems are available.

The ‘recipe’

  1. Too many grass cuttings are the downfall of most compost systems. They become a squidgy, stinky mess.
  2. Layer grass cuttings with leaves, cardboard, non-perennial weeds, cut up perennials and green prunings, kitchen waste such as vegetable peelings, pet bedding etc.
  3. Try to avoid cooked foods such as meat, fish and bread products as these can attract vermin.
  4. Add a nitrogen compost activator such as chicken or horse manure or a compost activator available in all garden centres.
  5. Ensure it is not too wet or too dry as this will halt the process. Water in dry weather and add dry product like shredded paper or straw to absorb wetness.
  6. Air is needed so all the micro-organisms and worms can get to work, so layer grass clippings with dry material or move the heap from one bay to another.

The result

Compost that is suitable to use everywhere as a soil improver, mulch and even potting. I plant my full bins with courgettes so no square inch of garden is wasted!

Horticultural consultancy

I can spend half a day in your garden identifying your plants and teaching you how to look after them. I can even help you set up a composting area.

Cathie’s garden army

If you have lost control of your garden completely we are here to help! A qualified team of horticulturists can transform your garden in a day following a consultancy. Email [email protected], visit www.cathiesgardeningschool.co.uk and follow Cathie’s Gardening School on Facebook, Instagram and Twitter.

Leaky gut

Round & About

Round and About

We will consume between three and seven tonnes of food and drink in our lifetimes, which has to be broken down and then the nutrients absorbed across the gut barrier, before they can be utilised by the body. The size of a tennis court, the gut barrier of the small intestine is made up of a single layer of cells that not only regulate the flow of nutrients and water into the body, but also play a central role in how our immune system responds to the dietary proteins and microbes that are ingested on a daily basis.

Nothing put into the digestive system is, technically speaking, inside the body until it has been absorbed across the gut barrier. It is the gut barrier that decides what to both let in and keep out of systemic circulation.

Research shows that the integrity of the gut barrier is fundamental to health and wellbeing. If the gut barrier is compromised by ‘leaking’ between and/or through the cells (para and/or trans cellular hyperpermeability), unwanted substances might permeate through and provoke unwanted immune responses – fuelling chronic inflammation, which is the route cause of all chronic disease and is a recognised key factor in the development of autoimmunity. Some of the conditions directly associated with ‘leaky gut’ include: coeliac disease, type 1 diabetes, rheumatoid arthritis, psoriasis, spondylitis, Parkinson’s disease, endometriosis, eczema, Crohn’s disease, colitis, multiple sclerosis, chronic fatigue syndrome, depression, anxiety and schizophrenia.

Leakiness between the cells of the gut barrier is controlled dynamically by a protein called zonulin. The higher the levels of zonulin, the greater the leakiness between the cells. The zonulin pathway is initiated by either the presence of pathogenic bacteria and/or gluten in the gut. Dysbiosis (imbalances in the micro ecology of the gut) and leaky gut usually co exist.

The presence of either or both of these conditions will drive a state of chronic inflammation. Fortunately, you can repair ‘leaky gut’ and rebalance the micro ecology of the gut, regaining control of health and wellbeing.

Call Mark BSc (Hons) BA (Hons) mBANT CNHC on 01183 219533 or visit www.entirewellbeing.com

Hearty Heaven

Liz Nicholls

Round and About

Katie Kingsley serves up some wonderfully mellow autumn dishes –perfect for those cosy November evenings…

MulLigatawny

Hearty in every sense, generous to the stomach and the soul and just what we need this gusty time of year – a sturdy soup to keep us grounded. Very simple to prepare with ingredients to stave off the most stubborn of colds.

Add 2 tbsp of olive oil and a knob of butter to a casserole and heat then add two finely diced onions, cooking for about five minutes on a medium heat until softened. Add one finely diced carrot, one finely diced parsnip, two finely diced celery stalks and continue to sauté for another five minutes or so until softened. Add 2 tsp of grated ginger, two bay leaves and five minced garlic cloves and cook for a few minutes before adding six skinless, boneless chicken thighs, stirring to coat then 500ml of chicken stock, 250ml of boiling water, 150g of red split lentils and ½ a tsp of salt. Bring to a boil then cover and simmer for 35 minutes. In the meantime, add 100ml of hot milk to 50g of flaked almonds and let this stand for as long as possible before blitzing it up with a hand blender or food processor. Remove the chicken and shred using two forks, then return this to the soup with the almond milk, cooking for a further five minutes. Adjust seasoning and serve in bowls with chopped chives, mango chutney and lemon juice to taste.

Warm Salad of roast beetroot, blue cheese and pear with horseradish cream

This salad hits all the right notes as well as being easy on the eye. A sophisticated yet practical recipe, open to additions/exclusions depending on cupboard love. Serve with a nice loaf for happy and contented lunch guests.

Heat oven to 200°C. Remove the greens from about 10 small beetroots (a mixture of red and golden) then either peel or lightly scrub under a running tap. Halve or quarter them, depending on their size then drizzle over some olive oil, season generously and roast for about 25 minutes. Make a salad dressing by whisking together 3 tbsp of extra-virgin olive oil, 1 tsp of runny honey and lemon juice to taste then stir through 1 tbsp of finely chopped chives and toss through salad leaves to coat. Arrange the dressed salad leaves on the plates and add the roasted beetroot then dot with small chunks of blue cheese, fresh slices of sweet pear and a scattering of chopped walnuts, pistachios or toasted hazelnuts. Finish off by mixing fresh or jarred horseradish through crème fraiche (to taste) and dolloping over the salad.

« Tip: Add fresh thyme and honey to the beetroot before you roast it.
« Extra tip! Sauté the pear slices in butter then add brown sugar to caramelise.

Maple pecan pie

This is deep and delicious, gratifyingly simple to make and a worthwhile recipe to master. I’ve lost count of how many times I’ve made this. I always manage to find a reason if I fancy a slice and it keeps well if you have no guests! I like to serve this with a large scoop of vanilla ice cream.

Heat oven to 200°C. First prepare your pastry case: it needs to be 23cm wide and about 3.5cm deep. I make a sweet shortcrust or buy 500g pre-made pastry, roll it, line the tin, prick the base, blind bake then remove your baking beans and bake for longer to get a nice golden base. Make your filling by using an electric whisk to blend together 75g of softened butter with 100g of caster sugar. Add 175g of golden syrup, 175g of maple syrup, ½ tsp of vanilla extract, ¼ tsp of salt then blend again. Gradually add three beaten eggs while whisking then stir in 300g of pecan halves. Pour into your cooled pastry case and bake for 10 minutes then turn down your oven to 160°C and continue to bake for an extra 30-35 minutes. The pie should only wobble slightly in the centre, if the pastry is beginning to burn, lay a sheet of foil over the top while it cooks. Leave to cool in its tin then serve warm or at room temperature.

Warming Wizardry

Liz Nicholls

Round and About

As we don our slippers and step snugly into October, Katie Kingsley brings us the hearty root vegetables and warming suppers we crave.

Pasta e fagioli

This is a very basic and inexpensive pasta dish, translating to ‘pasta and beans’. A good one to try, to perfect and to keep up your sleeve for whipping up as if by magic, straight from the pantry. This does not essentially need the pancetta but it is a nice touch and a worthwhile addition, if you do step out of the pantry.

Heat 1 tbsp of olive oil in a pan then cook 100g of pancetta (cubed or sliced) until golden and crisp, remove with a slotted spoon and leave to one side to garnish. Make a sofrito by finely chopping one onion, two carrots and two celery stalks then sauté in the pan with more oil if necessary. When soft and starting to brown, add three minced garlic cloves, cooking for a few minutes before adding 500g of fresh roughly chopped tomatoes (or one can) with 2 tsp of runny honey and season. Cook, covered, for about 20 minutes until the tomatoes have broken down then stir through 500ml of vegetable stock. Bring to a boil then add 200g of pastini (little pasta shapes), cover and simmer for 10-20 minutes or until the pasta is cooked and the sauce has thickened. Stir in a can of chickpeas for the last few minutes of cooking and serve with lots of grated parmesan and the crispy pancetta.

« Tip – Add dried herbs or sundried tomato paste for extra flavour.

Celeriac remoulade

I absolutely love making mayonnaise in this way, it is culinary wizardry. Despite this recipe never failing, it still feels like such a delicious accomplishment every time. This is great with smoked salmon or trout on a good rye bread or scallion pancakes as a refreshing starter or snack.

Measure and combine 75ml each of groundnut and olive oil. Place an egg yolk into a large bowl with 1 tbsp of Dijon mustard and a sprinkle of salt and pepper. Take an electric whisk or use a food processor to add the oils in a very slow, steady stream until it is all incorporated and you have a thick mayonnaise. Add 1 tbsp of white wine vinegar and adjust seasoning to taste. Peel one celeriac and cut into matchsticks, dropping them into a bowl of water as you go with a good squeeze of lemon juice.
Take 2 small tart red apples and slice thinly, adding to the acidulated water with the celeriac then drain well, pat dry and combine with the mayonnaise. Add 1 tbsp of finely chopped dill, freshly grated or about 1 tbsp of hot horseradish from a jar and about 1 tsp of caster sugar, tasting as you go. Serve with smoked fish and lemon wedges.

Apple and Blackberry frangipane crumble

Everyone loves crumble and everyone has eaten good crumble but this is taking it to another level, good enough for any dinner party in my opinion.

Heat your oven to 180°C. Beat together 100g of softened butter with 150g of caster sugar then add 150g of ground almonds, two egg yolks and two or three tbsp of plain flour with a pinch of salt. Add ½ tsp of almond essence and beat until you have a smooth, stiff mixture. Spread into the base of a buttered 1 litre ovenproof dish and bake for 30 minutes or until set and golden. Cover it with foil for the last part of the baking if the mixture begins to get too dark. Peel, core and slice three cooking apples and toss together with 300g of fresh or frozen blackberries and the juice of half a lemon then bake in a dish for 30 minutes. In the meantime, make the crumble topping by combining together 100g of plain flour, 50g of ground almonds, 125g of chilled cubed butter and either rub together using your fingertips or pulse briefly in a food processor until you get course breadcrumbs, with some larger pieces. Stir through 35g of demerara sugar and 35g of caster sugar, sprinkle with water and roughly rake with a fork then refrigerate until you need it. When the fruit is cooked, turn up the oven to 200°C then use a slotted spoon to transfer it on top of the frangipane, with some of the juice then add your crumble topping and bake in the oven for 20 minutes or until golden.

« Tip – Add chopped hazelnuts, flaked almonds and porridge oats to your crumble topping for extra crunch.

Chronic fatigue, fibromyalgia and energy production

Round & About

Round and About

I regularly see clients with chronic fatigue syndrome (CFS) – fatigue so debilitating that they are virtually unable to function. Often CFS presents as fibromyalgia, which is chronic fatigue with the added burden of widespread pain and stiffness all over the body.

It is believed the pain associated with fibromyalgia is caused when the mitochondria (the energy production plants in our cells), desperate to supply energy to the body, switch from efficient aerobic (using oxygen) to inefficient anaerobic (no oxygen) metabolism. Anaerobic energy production creates large amounts of lactic acid.

Lactic acid, as anyone who pushes themselves when exercising knows, causes muscle pain, which dissipates after a short rest. This pain, however, does not dissipate with fibromyalgia, as the body is unable to break lactic acid down, due to mitochondrial dysfunction. The excess acid can also cause damage to muscle tissue, presenting as very sensitive areas. This process can feed on itself as the damage releases lots of free radicals (destructive molecules), which can cause additional damage if antioxidant status (the ability to neutralise free radical damage) is low. So mitochondrial dysfunction is one of the key areas when it comes to helping move the body back into balance with CFS and fibromyalgia. Healthy mitochondria require a raft of key nutrients for optimal performance, including but not limited to magnesium, B vitamins, essential fats, CoQ10, carnitine and alpha lipoic acid and must not be bathed in toxins. There are often multiple systemic imbalances going on, including but not limited to digestive dysfunction, poor antioxidant status, immune system dysregulation, chronic inflammation, viral infections, food and/or environmental sensitivities/allergies, thyroid and adrenal dysfunction and micronutrient deficiencies. Nothing exists in isolation. Once again looking at the body from a functional and holistic perspective is key.

Call Mark BSc (Hons) BA (Hons) mBANT CNHC on 01183 219533 or visit www.entirewellbeing.com