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Type 1 diabetes: Causes and prevention

More and more children are being diagnosed with type 1 diabetes, with the number of cases tripling in the last 30 years. Of particular concern is the disproportionate increase in children under the age of six.

Table of Contents

What is type 1 diabetes?

In type 1 diabetes, the immune system destroys the insulin-producing beta cells in the pancreas. As the amount of insulin decreases, the body can no longer use glucose, a vital source of energy. The cells starve, metabolism collapses, blood glucose levels rise, ketone bodies and sugar appear in the urine. The otherwise very narrow pH range of the blood shifts into the acidic range. This can be life-threatening.

What is molecular mimicry?

Molecular mimicry describes the observation in pathogens that their proteins and carbohydrates partially adapt their structures to those of their host during the immune invasion. These partially adapted molecules are therefore less recognised by the immune system because similar or identical substances are also present in the host. Since the host organism does not normally produce antibodies against its molecules, these components of the pathogen are not recognised as antigens.

What is the relationship between molecular mimicry, type 1 diabetes and autoimmune diseases?

Leaky gut syndrome is a major cause of autoimmune disease. When the body functions optimally, there is no leaky gut syndrome.

The intestinal wall is impermeable to large molecules with antigenic properties. The exception is during breastfeeding when breast milk proteins (lactoglobulin, lactalbumin and immunoglobulins) can pass through the intestinal wall. This process serves to build up maternal immunity in the offspring of mammals, including humans.

This immunological disorder is called autoimmunity. However, the name of the disease does not describe the actual process, because the body does not turn against itself without a trigger. Nearly 4% of the world’s population is affected by one of more than 80 different autoimmune diseases, the most common of which are type 1 diabetes, multiple sclerosis, rheumatoid arthritis, lupus, Crohn’s disease, psoriasis and scleroderma. The underlying cause of autoimmune diseases is a leaky gut.

What causes leaky gut syndrome?

The integrity of the human intestinal wall is essential for the body’s homeostasis, balance and optimal immunity. It enables the absorption of nutrients and protects the body from the invasion of infectious microorganisms and food allergens. This barrier, the protective wall, is not present at birth but develops from birth until the end of breastfeeding, around the age of two. This is why breastfeeding and the protective effects of breast milk are so important.

The integrity of the intestinal wall can be compromised throughout life. The tight junctions between the intestinal epithelial cells, which provide a tight seal, become damaged. The loosening makes the intestinal wall permeable to large molecules.

Causes that trigger the production of zonulin in the intestinal wall (zonulin loosens the tight junctions between intestinal epithelial cells):

  • Gliadin in unfermented gluten (sourdough bread vs. rye bread) (Elaine Leonard Puppa 2015).
  • Xenobiotics (foreign substances) ingested with food, especially residues of the herbicide glyphosate in food from genetically modified crops. The effects now affect almost everyone. Glyphosate at 0.1 mg/kg in food triggers the production of zonulin (Anthony Samsel and Stephanie Seneff 2013).
  • Glyphosate at levels as low as 0.1 mg/kg has negative effects on the gut flora. The gut microbiome changes. The amount of toxins from LPS (gram-negative) bacteria in the gut increases. Short-chain fatty acids (SCFA) are reduced (Drago, Sandro et al., 2006).
  • Stress is also an important factor in the development of a leaky gut. The loss of protective function can increase the permeability of the gut.

Glyphosate (N-phosphonomethyl glycine) and Typ-1-Diabetes

Myosin is the muscle protein in which the contraction of the 699 amino acids is controlled by glycine.

Glyphosate and its first breakdown product AMPA [aminomethylphosphonic acid] are essentially derivatives of glycine, an important amino acid needed in many parts of the body. Glycine and glyphosate, or glycine and AMPA, compete for binding sites, for example on cells, or for incorporation into certain proteins.

This mechanism can affect muscle function in all three types of muscle (heart, skeletal and smooth muscle). In a leaky gut, the tensile strength of the smooth muscle fibres that contract the tight junctions is reduced. This dysfunction of the myosin motor also plays a role in the development of leaky gut syndrome.

Other risk factors for type 1 diabetes

Other risk factors include various bowel diseases (Crohn’s disease, celiac disease, irritable bowel syndrome) and autoimmune and inflammatory diseases such as asthma, multiple sclerosis and chronic fatigue syndrome.

It may also play a role in depression, anxiety and schizophrenia along the gut-brain axis. Histamine produced in the gut may also contribute to its development.

In type 1 diabetes, what is mimicry?

Cow’s milk contains beta-lactoglobulin, a whey protein not found in human breast milk. There is increasing evidence that antigens in food (mainly molecular mimicry due to shared epitopes) are triggers of autoimmune diseases. The development of antibodies associated with type 1 diabetes can also be triggered by β-lactoglobulin and lactoalbumin (Vânia Vieira Borba et al. 2020).

Causes of type 1 diabetes

At the end of breastfeeding, the intestine closes. The ‘tight junctions’ that close the gaps between the intestinal epithelial cells (enterocytes) are contracted by smooth muscle fibres in the enterocytes. This completes the intestinal wall. This happens in children as young as two years old.

One of the most important molecular mimics is beta-lactoglobulin, which is found in the whey protein of cow’s milk but not in breast milk. Epidemiological studies have implicated the consumption of cow’s milk in the development of insulin-dependent diabetes mellitus (IDDM). The whey protein content of cow’s milk and the immune mechanism of antibodies to bovine serum albumin (BSA) lead to the destruction of the insulin-producing beta cells of the pancreas. Several infant feeding studies have shown a causal relationship between the timing of the introduction of infant formula containing cow’s milk protein and the risk of developing type 1 diabetes mellitus.

The classic trigger for autoimmune type 1 diabetes is fitness cereals (cereals soaked in milk sweetened with fructose). There is a close link between the simultaneous consumption of gluten and whey proteins, where the gliadin in gluten triggers the production of zonulin in the intestinal wall. The tight junction is opened and the intestinal wall becomes permeable.

The role of lipocalins

Beta-lactoglobulin is an important lipocalin protein found in cow’s milk. It is similar to the human glycodelin protein (PP14), which is a T cell modulator. Anti-β-lactoglobulin cross-reacts with glycodelin. The intestinal wall of newborns does not close completely, or in the case of a leaky gut, the intestine is penetrated by β-lactoglobulin from cow’s milk. The antibody formed against β-lactoglobulin damages the human protein glycodelin, which plays a role in T-cell regulation. This destroys the beta cells (Marcia F. Goldfarb 2008).

The role of flour bleaching and alloxan

Flour from freshly milled wheat has a pale yellow colour due to its carotenoid content. In unfermented processing, the carotenoids make fresh flour sticky, causing problems during processing and baking.

This is not a problem for bread and bakery products made with sourdough technology. During storage, these carotenoids are broken down by oxidative reactions during the natural ripening of the flour. The result is a white, soft and pliable flour that is more suitable for the production of modern, non-fermented baked goods with additives. To speed up these natural processes, the food industry uses chemical methods to improve both colour and leavening. Commonly used bleaching agents are benzoyl peroxide, chlorine gas, chlorine dioxide, nitrosyl chloride and nitrogen oxides (Chittrakorn et al., 2014).

Bakery products with chloride oxide

A more recent problem of food contamination is the use of chloride oxide to bleach flour in common bakery products.

In fast food restaurants, so-called self-bleached wheat flour is used to make hamburger buns. Chloride oxide bleaching produces alloxan as a by-product, which is toxic to the beta cells of the pancreas.

In the USA, chlorine and hypochlorite are considered safe compounds for food processing. Chlorine is on the Food and Drug Administration’s (FDA) list of food additives. These compounds break peptide bonds and degrade aromatic amino acids. These oxidation reactions can alter many flour components and lead to the formation of toxic products such as alloxan (Idaho Observer, 2005).

Alloxan causes insulin-dependent diabetes, also known as ‘alloxan diabetes’.

Alloxan is a well-known and widely used substance that causes insulin-dependent diabetes in laboratory animals due to its toxic effect on pancreatic beta cells (Isaac F. Federiuk et al., 2004).

Food science does not address this hidden link, but we can call it a double standard! Does alloxan cause insulin resistance in laboratory rats but not in children?

How to prevent type 1 autoimmune diabetes?

If you have type 1 diabetes, you should eliminate gluten and dairy from your diet.

Genetically modified foods that disrupt the gut flora should be removed from your diet. Meat and liver from pasture-raised animals, poultry and pork from non-industrial farms and wild-caught seafish (FAO: 21, 27, 34;) should be eaten.

The best way to feed the good gut bacteria that produce butyrate is to eat fresh, young leafy vegetables and fibre rich in pectin (rocket, all types of lettuce, parsley and celery leaves, Brussels sprouts, broccoli, asparagus, mushrooms).

Carbohydrate intake should be kept as low as possible, up to 20-30 grams per day is acceptable.

References

Anthony Samsel and Stephanie Seneff: Glyphosate, pathways to modern diseases II: Celiac sprue and gluten intolerance Interdiscip Toxicol. 2013 Dec; 6(4): 159–184. Published online 2013 Dec. doi: 10.2478/intox-2013-0026 PMCID: PMC3945755 PMID: 24678255

Drago, Sandro & Asmar, Ramzi & Pierro, Mariarosaria & Clemente, Maria & Tripathi, Amit & Sapone, Anna & Thakar, Manjusha & Iacono, Giuseppe & Carroccio, Antonio & D’Agate, Cinzia & Not, Tarcisio & Zampini, Lucia & Catassi, Carlo & Fasano, Alessio. (2006). Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines. Scandinavian journal of gastroenterology. 41. 408-19. 10.1080/0036552050023533

Elaine Leonard Puppa, Bruce Greenwald, Eric Goldberg, Anthony Guerrerio, Alessio Fasano: Effect of Gliadin on Permeability of Intestinal Biopsy Explants from Celiac Disease Patients and Patients with Non-Celiac Gluten Sensitivity. Nutrients 2015, 7(3), 1565-1576; https://doi.org/10.3390/nu7031565
Idaho Observer: Bleaching agent in flour linked to diabetes [WWW Document], 2005. URL.

Isaac F Federiuk, Heather M Casey, Matthew J Quinn, Michael D Wood, W Kenneth Ward: Induction of type-1 diabetes mellitus in laboratory rats by use of alloxan: route of administration, pitfalls, and insulin treatment National Library of Medicine Pub Med. 2004 Jun; 54 (3): 252-7.

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Marcia F. Goldfarb: Relation of Time of Introduction of Cow Milk Protein to an Infant and Risk of Type-1 Diabetes Mellitus Cite this: J, Proteome Res. 2008, 7, 5, 2165–2167. Publication Date:April 15, 2008. https://doi.org/10.1021/pr800041d

Sasivimon Chittrakorn, Dru Earls ,Finlay MacRitchie (2014): Ozonation as an alternative to chlorination for soft wheat flours Journal of Cereal Science, Volume 60, Issue 1, July 2014, Pages 217-221. Journal of Cereal Science

Shakila Banu.M, Sasikala.P (2012): Alloxan in refined flour: A Diabetic concern. Professor and Head, Department of Food Processing and Preservation, Technology Faculty of Engineering, Avinashilingam University For Women, Coimbatore.

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Vânia Vieira Borba, Aaron Lerner , Torsten Matthias, Yehuda Shoenfeld: Bovine Milk Proteins as a Trigger for Autoimmune Diseases: Myth or Reality?

International Journal of Celiac Disease. 2020, 8(1), 10-21. DOI: 10.12691/ijcd-8-1-3 Received January 11, 2020; Revised February 20, 2020; Accepted April 27, 2020

Vita Giaccone, Gaetano Cammilleri, Vita Di Stefano, Rosa Pitonzo, Antonio Vella, Andrea Pulvirenti, Gianluigi Maria Lo Dico, Vincenzo Ferrantelli, Andrea Macaluso (2017): First report on the presence of Alloxan in bleached flour by LC-MS/MS method Journal of Cereal Science, Volume 77, September 2017, Pages 120-125

Read the article in German: Typ-1-Diabetes: Ursachen und Präventionsmöglichkeiten

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