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      Frequently Asked Questions About Celiac Disease   04/24/2018

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to Celiac.com's FREE weekly eNewsletter   What is Celiac Disease and the Gluten-Free Diet? What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease?  Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes
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    WHAT IS CELIAC DISEASE?
    Celiac disease is an autoimmune condition that affects around 1% of the population. People with celiac disease suffer an autoimmune reaction when they consume wheat, rye or barley. The immune reaction is triggered by certain proteins in the wheat, rye, or barley, and, left untreated, causes damage to the small, finger-like structures, called villi, that line the gut. The damage occurs as shortening and villous flattening in the lamina propria and crypt regions of the intestines. The damage to these villi then leads to numerous other issues that commonly plague people with untreated celiac disease, including poor nutritional uptake, fatigue, and myriad other problems.
    Celiac disease mostly affects people of Northern European descent, but recent studies show that it also affects large numbers of people in Italy, China, Iran, India, and numerous other places thought to have few or no cases.
    Celiac disease is most often uncovered because people experience symptoms that lead them to get tests for antibodies to gluten. If these tests are positive, then the people usually get biopsy confirmation of their celiac disease. Once they adopt a gluten-free diet, they usually see gut healing, and major improvements in their symptoms. 
    CLASSIC CELIAC DISEASE SYMPTOMS
    Symptoms of celiac disease can range from the classic features, such as diarrhea, upset stomach, bloating, gas, weight loss, and malnutrition, among others.
    LESS OBVIOUS SYMPTOMS
    Celiac disease can often less obvious symptoms, such fatigue, vitamin and nutrient deficiencies, anemia, to name a few. Often, these symptoms are regarded as less obvious because they are not gastrointestinal in nature. You got that right, it is not uncommon for people with celiac disease to have few or no gastrointestinal symptoms. That makes spotting and connecting these seemingly unrelated and unclear celiac symptoms so important.
    NO SYMPTOMS
    Currently, most people diagnosed with celiac disease do not show symptoms, but are diagnosed on the basis of referral for elevated risk factors. 

    CELIAC DISEASE VS. GLUTEN INTOLERANCE
    Gluten intolerance is a generic term for people who have some sort of sensitivity to gluten. These people may or may not have celiac disease. Researchers generally agree that there is a condition called non-celiac gluten sensitivity. That term has largely replaced the term gluten-intolerance. What’s the difference between celiac disease and non-celiac gluten-sensitivity? 
    CELIAC DISEASE VS. NON-CELIAC GLUTEN SENSITIVITY (NCGS)
    Gluten triggers symptoms and immune reactions in people with celiac disease. Gluten can also trigger symptoms in some people with NCGS, but the similarities largely end there.

    There are four main differences between celiac disease and non-celiac gluten sensitivity:
    No Hereditary Link in NCGS
    Researchers know for certain that genetic heredity plays a major role in celiac disease. If a first-degree relative has celiac disease, then you have a statistically higher risk of carrying genetic markers DQ2 and/or DQ8, and of developing celiac disease yourself. NCGS is not known to be hereditary. Some research has shown certain genetic associations, such as some NCGS patients, but there is no proof that NCGS is hereditary. No Connection with Celiac-related Disorders
    Unlike celiac disease, NCGS is so far not associated with malabsorption, nutritional deficiencies, or a higher risk of autoimmune disorders or intestinal malignancies. No Immunological or Serological Markers
    People with celiac disease nearly always test positive for antibodies to gluten proteins. Researchers have, as yet, identified no such antobodies or serologic markers for NCGS. That means that, unlike with celiac disease, there are no telltale screening tests that can point to NCGS. Absence of Celiac Disease or Wheat Allergy
    Doctors diagnose NCGS only by excluding both celiac disease, an IgE-mediated allergy to wheat, and by the noting ongoing adverse symptoms associated with gluten consumption. WHAT ABOUT IRRITABLE BOWEL SYNDROME (IBS) AND IRRITABLE BOWEL DISEASE (IBD)?
    IBS and IBD are usually diagnosed in part by ruling out celiac disease. Many patients with irritable bowel syndrome are sensitive to gluten. Many experience celiac disease-like symptoms in reaction to wheat. However, patients with IBS generally show no gut damage, and do not test positive for antibodies to gliadin and other proteins as do people with celiac disease. Some IBS patients also suffer from NCGS.

    To add more confusion, many cases of IBS are, in fact, celiac disease in disguise.

    That said, people with IBS generally react to more than just wheat. People with NCGS generally react to wheat and not to other things, but that’s not always the case. Doctors generally try to rule out celiac disease before making a diagnosis of IBS or NCGS. 
    Crohn’s Disease and celiac disease share many common symptoms, though causes are different.  In Crohn’s disease, the immune system can cause disruption anywhere along the gastrointestinal tract, and a diagnosis of Crohn’s disease typically requires more diagnostic testing than does a celiac diagnosis.  
    Crohn’s treatment consists of changes to diet and possible surgery.  Up to 10% of Crohn's patients can have both of conditions, which suggests a genetic connection, and researchers continue to examine that connection.
    Is There a Connection Between Celiac Disease, Non-Celiac Gluten Sensitivity and Irritable Bowel Syndrome? Large Number of Irritable Bowel Syndrome Patients Sensitive To Gluten Some IBD Patients also Suffer from Non-Celiac Gluten Sensitivity Many Cases of IBS and Fibromyalgia Actually Celiac Disease in Disguise CELIAC DISEASE DIAGNOSIS
    Diagnosis of celiac disease can be difficult. 

    Perhaps because celiac disease presents clinically in such a variety of ways, proper diagnosis often takes years. A positive serological test for antibodies against tissue transglutaminase is considered a very strong diagnostic indicator, and a duodenal biopsy revealing villous atrophy is still considered by many to be the diagnostic gold standard. 
    But this idea is being questioned; some think the biopsy is unnecessary in the face of clear serological tests and obvious symptoms. Also, researchers are developing accurate and reliable ways to test for celiac disease even when patients are already avoiding wheat. In the past, patients needed to be consuming wheat to get an accurate test result. 
    Celiac disease can have numerous vague, or confusing symptoms that can make diagnosis difficult.  Celiac disease is commonly misdiagnosed by doctors. Read a Personal Story About Celiac Disease Diagnosis from the Founder of Celiac.com Currently, testing and biopsy still form the cornerstone of celiac diagnosis.
    TESTING
    There are several serologic (blood) tests available that screen for celiac disease antibodies, but the most commonly used is called a tTG-IgA test. If blood test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.
    Testing is fairly simple and involves screening the patients blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis. Also, it is now possible to test people for celiac disease without making them concume wheat products.

    BIOPSY
    Until recently, biopsy confirmation of a positive gluten antibody test was the gold standard for celiac diagnosis. It still is, but things are changing fairly quickly. Children can now be accurately diagnosed for celiac disease without biopsy. Diagnosis based on level of TGA-IgA 10-fold or more the ULN, a positive result from the EMA tests in a second blood sample, and the presence of at least 1 symptom could avoid risks and costs of endoscopy for more than half the children with celiac disease worldwide.

    WHY A GLUTEN-FREE DIET?
    Currently the only effective, medically approved treatment for celiac disease is a strict gluten-free diet. Following a gluten-free diet relieves symptoms, promotes gut healing, and prevents nearly all celiac-related complications. 
    A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This is a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods. Still, with effort, most people with celiac disease manage to make the transition. The vast majority of celiac disease patients who follow a gluten-free diet see symptom relief and experience gut healing within two years.
    For these reasons, a gluten-free diet remains the only effective, medically proven treatment for celiac disease.
    WHAT ABOUT ENZYMES, VACCINES, ETC.?
    There is currently no enzyme or vaccine that can replace a gluten-free diet for people with celiac disease.
    There are enzyme supplements currently available, such as AN-PEP, Latiglutetenase, GluteGuard, and KumaMax, which may help to mitigate accidental gluten ingestion by celiacs. KumaMax, has been shown to survive the stomach, and to break down gluten in the small intestine. Latiglutenase, formerly known as ALV003, is an enzyme therapy designed to be taken with meals. GluteGuard has been shown to significantly protect celiac patients from the serious symptoms they would normally experience after gluten ingestion. There are other enzymes, including those based on papaya enzymes.

    Additionally, there are many celiac disease drugs, enzymes, and therapies in various stages of development by pharmaceutical companies, including at least one vaccine that has received financial backing. At some point in the not too distant future there will likely be new treatments available for those who seek an alternative to a lifelong gluten-free diet. 

    For now though, there are no products on the market that can take the place of a gluten-free diet. Any enzyme or other treatment for celiac disease is intended to be used in conjunction with a gluten-free diet, not as a replacement.

    ASSOCIATED DISEASES
    The most common disorders associated with celiac disease are thyroid disease and Type 1 Diabetes, however, celiac disease is associated with many other conditions, including but not limited to the following autoimmune conditions:
    Type 1 Diabetes Mellitus: 2.4-16.4% Multiple Sclerosis (MS): 11% Hashimoto’s thyroiditis: 4-6% Autoimmune hepatitis: 6-15% Addison disease: 6% Arthritis: 1.5-7.5% Sjögren’s syndrome: 2-15% Idiopathic dilated cardiomyopathy: 5.7% IgA Nephropathy (Berger’s Disease): 3.6% Other celiac co-morditities include:
    Crohn’s Disease; Inflammatory Bowel Disease Chronic Pancreatitis Down Syndrome Irritable Bowel Syndrome (IBS) Lupus Multiple Sclerosis Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Psoriasis Rheumatoid Arthritis Scleroderma Turner Syndrome Ulcerative Colitis; Inflammatory Bowel Disease Williams Syndrome Cancers:
    Non-Hodgkin lymphoma (intestinal and extra-intestinal, T- and B-cell types) Small intestinal adenocarcinoma Esophageal carcinoma Papillary thyroid cancer Melanoma CELIAC DISEASE REFERENCES:
    Celiac Disease Center, Columbia University
    Gluten Intolerance Group
    National Institutes of Health
    U.S. National Library of Medicine
    Mayo Clinic
    University of Chicago Celiac Disease Center
    Jefferson Adams
    Celiac.com 04/25/2018 - A team of Yale University researchers discovered that bacteria in the small intestine can travel to other organs and trigger an autoimmune response. In this case, they looked at Enterococcus gallinarum, which can travel beyond the gut to the spleen, lymph nodes, and liver. The research could be helpful for treating type 1 diabetes, lupus, and celiac disease.
    In autoimmune diseases, such as type 1 diabetes, lupus, and celiac disease, the body’s immune system mistakenly attacks healthy cells and tissues. Autoimmune disease affects nearly 24 million people in the United States. 
    In their study, a team of Yale University researchers discovered that bacteria in the small intestine can travel to other organs and trigger an autoimmune response. In this case, they looked at Enterococcus gallinarum, which can travel beyond the gut to the spleen, lymph nodes, and liver. They found that E. gallinarum triggered an autoimmune response in the mice when it traveled beyond the gut.
    They also found that the response can be countered by using antibiotics or vaccines to suppress the autoimmune reaction and prevent the bacterium from growing. The researchers were able to duplicate this mechanism using cultured human liver cells, and they also found the bacteria E. gallinarum in the livers of people with autoimmune disease.
    The team found that administering an antibiotic or vaccine to target E. gallinarum suppressed the autoimmune reaction in the mice and prevented the bacterium from growing. "When we blocked the pathway leading to inflammation," says senior study author Martin Kriegel, "we could reverse the effect of this bug on autoimmunity."
    Team research team plans to further investigate the biological mechanisms that are associated with E. gallinarum, along with the potential implications for systemic lupus and autoimmune liver disease.
    This study indicates that gut bacteria may be the key to treating chronic autoimmune conditions such as systemic lupus and autoimmune liver disease. Numerous autoimmune conditions have been linked to gut bacteria.
    Read the full study in Science.
    Tammy Rhodes
    Celiac.com 04/24/2018 - Did you know in 2017 alone, the United States had OVER TENS OF THOUSANDS of people evacuate their homes due to natural disasters such as fires, floods, hurricanes, tornadoes and tsunamis? Most evacuation sites are not equipped to feed your family the safe gluten free foods that are required to stay healthy.  Are you prepared in case of an emergency? Do you have your Gluten Free Emergency Food Bag ready to grab and go?  
    I have already lived through two natural disasters. Neither of which I ever want to experience again, but they taught me a very valuable lesson, which is why I created a Gluten Free Emergency Food Bag (see link below). Here’s my story. If you’ve ever lived in or visited the Los Angeles area, you’re probably familiar with the Santa Ana winds and how bitter sweet they are. Sweet for cleaning the air and leaving the skies a brilliant crystal blue, and bitter for the power outages and potential brush fires that might ensue.  It was one of those bitter nights where the Santa Ana winds were howling, and we had subsequently lost our power. We had to drive over an hour just to find a restaurant so we could eat dinner. I remember vividly seeing the glow of a brush fire on the upper hillside of the San Gabriel Mountains, a good distance from our neighborhood. I really didn’t think much of it, given that it seemed so far from where we lived, and I was hungry! After we ate, we headed back home to a very dark house and called it a night. 
    That’s where the story takes a dangerous turn….about 3:15am. I awoke to the TV blaring loudly, along with the lights shining brightly. Our power was back on! I proceeded to walk throughout the house turning everything off at exactly the same time our neighbor, who was told to evacuate our street, saw me through our window, assuming I knew that our hillside was ablaze with flames. Flames that were shooting 50 feet into the air. I went back to bed and fell fast asleep. The fire department was assured we had left because our house was dark and quiet again. Two hours had passed.  I suddenly awoke to screams coming from a family member yelling, “fire, fire, fire”! Flames were shooting straight up into the sky, just blocks from our house. We lived on a private drive with only one way in and one way out.  The entrance to our street was full of smoke and the fire fighters were doing their best to save our neighbors homes. We literally had enough time to grab our dogs, pile into the car, and speed to safety. As we were coming down our street, fire trucks passed us with sirens blaring, and I wondered if I would ever see my house and our possessions ever again. Where do we go? Who do we turn to? Are shelters a safe option? 
    When our daughter was almost three years old, we left the West Coast and relocated to Northern Illinois. A place where severe weather is a common occurrence. Since the age of two, I noticed that my daughter appeared gaunt, had an incredibly distended belly, along with gas, stomach pain, low weight, slow growth, unusual looking stool, and a dislike for pizza, hotdog buns, crackers, Toast, etc. The phone call from our doctor overwhelmed me.  She was diagnosed with Celiac Disease. I broke down into tears sobbing. What am I going to feed my child? Gluten is everywhere.
    After being scoped at Children's Hospital of Chicago, and my daughters Celiac Disease officially confirmed, I worried about her getting all the nutrients her under nourished body so desperately needed. I already knew she had a peanut allergy from blood tests, but just assumed she would be safe with other nuts. I was so horribly wrong. After feeding her a small bite of a pistachio, which she immediately spit out, nuts would become her enemy. Her anaphylactic reaction came within minutes of taking a bite of that pistachio. She was complaining of horrible stomach cramps when the vomiting set in. She then went limp and starting welting. We called 911.
    Now we never leave home without our Epipens and our gluten free food supplies. We analyze every food label. We are hyper vigilant about cross contamination. We are constantly looking for welts and praying for no stomach pain. We are always prepared and on guard. It's just what we do now. Anything to protect our child, our love...like so many other parents out there have to do every moment of ever day!  
    Then, my second brush with a natural disaster happened, without any notice, leaving us once again scrambling to find a safe place to shelter. It was a warm and muggy summer morning, and my husband was away on a business trip leaving my young daughter and me to enjoy our summer day. Our Severe Weather Alert Radio was going off, again, as I continued getting our daughter ready for gymnastics.  Having gotten used to the (what seemed to be daily) “Severe Thunderstorm warning,” I didn’t pay much attention to it. I continued downstairs with my daughter and our dog, when I caught a glimpse out the window of an incredibly black looking cloud. By the time I got downstairs, I saw the cover to our grill literally shoot straight up into the air. Because we didn’t have a fenced in yard, I quickly ran outside and chased the cover, when subsequently, I saw my neighbor’s lawn furniture blow pass me. I quickly realized I made a big mistake going outside. As I ran back inside, I heard debris hitting the front of our home.  Our dog was the first one to the basement door! As we sat huddled in the dark corner of our basement, I was once again thinking where are we going to go if our house is destroyed. I was not prepared, and I should have been. I should have learned my lesson the first time. Once the storm passed, we quickly realized we were without power and most of our trees were destroyed. We were lucky that our house had minimal damage, but that wasn’t true for most of the area surrounding us.  We were without power for five days. We lost most of our food - our gluten free food.
    That is when I knew we had to be prepared. No more winging it. We couldn’t take a chance like that ever again. We were “lucky” one too many times. We were very fortunate that we did not lose our home to the Los Angeles wildfire, and only had minimal damage from the severe storm which hit our home in Illinois.
      
    In 2017 alone, FEMA (Federal Emergency Management Agency) had 137 natural disasters declared within the United States. According to FEMA, around 50% of the United States population isn’t prepared for a natural disaster. These disasters can happen anywhere, anytime and some without notice. It’s hard enough being a parent, let alone being a parent of a gluten free family member. Now, add a natural disaster on top of that. Are you prepared?
    You can find my Gluten Free Emergency Food Bags and other useful products at www.allergynavigator.com.  
    Jefferson Adams
    Celiac.com 04/23/2018 - A team of researchers recently set out to learn whether celiac disease patients commonly suffer cognitive impairment at the time they are diagnosed, and to compare their cognitive performance with non-celiac subjects with similar chronic symptoms and to a group of healthy control subjects.
    The research team included G Longarini, P Richly, MP Temprano, AF Costa, H Vázquez, ML Moreno, S Niveloni, P López, E Smecuol, R Mazure, A González, E Mauriño, and JC Bai. They are variously associated with the Small Bowel Section, Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital; Neurocience Cognitive and Traslational Institute (INECO), Favaloro Fundation, CONICET, Buenos Aires; the Brain Health Center (CESAL), Quilmes, Argentina; the Research Council, MSAL, CABA; and with the Research Institute, School of Medicine, Universidad del Salvador.
    The team enrolled fifty adults with symptoms and indications of celiac disease in a prospective cohort without regard to the final diagnosis.  At baseline, all individuals underwent cognitive functional and psychological evaluation. The team then compared celiac disease patients with subjects without celiac disease, and with healthy controls matched by sex, age, and education.
    Celiac disease patients had similar cognitive performance and anxiety, but no significant differences in depression scores compared with disease controls.
    A total of thirty-three subjects were diagnosed with celiac disease. Compared with the 26 healthy control subjects, the 17 celiac disease subjects, and the 17 disease control subjects, who mostly had irritable bowel syndrome, showed impaired cognitive performance (P=0.02 and P=0.04, respectively), functional impairment (P<0.01), and higher depression (P<0.01). 
    From their data, the team noted that any abnormal cognitive functions they saw in adults with newly diagnosed celiac disease did not seem not to be a result of the disease itself. 
    Their results indicate that cognitive dysfunction in celiac patients could be related to long-term symptoms from chronic disease, in general.
    Source:
    J Clin Gastroenterol. 2018 Mar 1. doi: 10.1097/MCG.0000000000001018.
    Connie Sarros
    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
    Due to personal health reasons and restrictions, I find that I need to retire. My husband and I can no longer travel the country speaking at conferences and to support groups (which we dearly loved to do) nor can I commit to writing more books, articles, or menus. Consequently, I will no longer be contributing articles to the Journal of Gluten Sensitivity. 
    My following books will still be available at Amazon.com:
    Gluten-free Cooking for Dummies Student's Vegetarian Cookbook for Dummies Wheat-free Gluten-free Dessert Cookbook Wheat-free Gluten-free Reduced Calorie Cookbook Wheat-free Gluten-free Cookbook for Kids and Busy Adults (revised version) My first book was published in 1996. My journey since then has been incredible. I have met so many in the celiac community and I feel blessed to be able to call you friends. Many of you have told me that I helped to change your life – let me assure you that your kind words, your phone calls, your thoughtful notes, and your feedback throughout the years have had a vital impact on my life, too. Thank you for all of your support through these years.
    Jefferson Adams
    Celiac.com 04/20/2018 - A digital media company and a label data company are teaming up to help major manufacturers target, reach and convert their desired shoppers based on dietary needs, such as gluten-free diet. The deal could bring synergy in emerging markets such as the gluten-free and allergen-free markets, which represent major growth sectors in the global food industry. 
    Under the deal, personalized digital media company Catalina will be joining forces with Label Insight. Catalina uses consumer purchases data to target shoppers on a personal base, while Label Insight works with major companies like Kellogg, Betty Crocker, and Pepsi to provide insight on food label data to government, retailers, manufacturers and app developers.
    "Brands with very specific product benefits, gluten-free for example, require precise targeting to efficiently reach and convert their desired shoppers,” says Todd Morris, President of Catalina's Go-to-Market organization, adding that “Catalina offers the only purchase-based targeting solution with this capability.” 
    Label Insight’s clients include food and beverage giants such as Unilever, Ben & Jerry's, Lipton and Hellman’s. Label Insight technology has helped the Food and Drug Administration (FDA) build the sector’s very first scientifically accurate database of food ingredients, health attributes and claims.
    Morris says the joint partnership will allow Catalina to “enhance our dataset and further increase our ability to target shoppers who are currently buying - or have shown intent to buy - in these emerging categories,” including gluten-free, allergen-free, and other free-from foods.
    The deal will likely make for easier, more precise targeting of goods to consumers, and thus provide benefits for manufacturers and retailers looking to better serve their retail food customers, especially in specialty areas like gluten-free and allergen-free foods.
    Source:
    fdfworld.com
    Jefferson Adams
    Celiac.com 04/19/2018 - Previous genome and linkage studies indicate the existence of a new disease triggering mechanism that involves amino acid metabolism and nutrient sensing signaling pathways. In an effort to determine if amino acids might play a role in the development of celiac disease, a team of researchers recently set out to investigate if plasma amino acid levels differed among children with celiac disease compared with a control group.
     
    The research team included Åsa Torinsson Naluai, Ladan Saadat Vafa, Audur H. Gudjonsdottir, Henrik Arnell, Lars Browaldh, and Daniel Agardh. They are variously affiliated with the Institute of Biomedicine, Department of Microbiology & Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Division of Pediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden; the Department of Clinical Science and Education, Karolinska Institute, Sodersjukhuset, Stockholm, Sweden; the Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; the Diabetes & Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; and with the Nathan S Kline Institute in the U.S.A.
    First, the team used liquid chromatography-tandem mass spectrometry (LC/MS) to analyze amino acid levels in fasting plasma samples from 141 children with celiac disease and 129 non-celiac disease controls. They then crafted a general linear model using age and experimental effects as covariates to compare amino acid levels between children with celiac disease and non-celiac control subjects.
    Compared with the control group, seven out of twenty-three children with celiac disease showed elevated levels of the the following amino acids: tryptophan; taurine; glutamic acid; proline; ornithine; alanine; and methionine.
    The significance of the individual amino acids do not survive multiple correction, however, multivariate analyses of the amino acid profile showed significantly altered amino acid levels in children with celiac disease overall and after correction for age, sex and experimental effects.
    This study shows that amino acids can influence inflammation and may play a role in the development of celiac disease.
    Source:
    PLoS One. 2018; 13(3): e0193764. doi: & 10.1371/journal.pone.0193764
    Jefferson Adams
    Celiac.com 04/18/2018 - To the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service animals.
    If you’ve flown anywhere lately, you may have seen them. People flying with their designated “emotional support” animals. We’re not talking genuine service animals, like seeing eye dogs, or hearing ear dogs, or even the Belgian Malinois that alerts its owner when there is gluten in food that may trigger her celiac disease.
    Now, to be honest, some of those animals in question do perform a genuine service for those who need emotional support dogs, like veterans with PTSD.
    However, many of these animals are not service animals at all. Many of these animals perform no actual service to their owners, and are nothing more than thinly disguised pets. Many lack proper training, and some have caused serious problems for the airlines and for other passengers.
    Now the major airlines are taking note and introducing stringent requirements for service animals.
    Delta was the first to strike. As reported by the New York Times on January 19: “Effective March 1, Delta, the second largest US airline by passenger traffic, said it will require passengers seeking to fly with pets to present additional documents outlining the passenger’s need for the animal and proof of its training and vaccinations, 48 hours prior to the flight.… This comes in response to what the carrier said was a 150 percent increase in service and support animals — pets, often dogs, that accompany people with disabilities — carried onboard since 2015.… Delta said that it flies some 700 service animals a day. Among them, customers have attempted to fly with comfort turkeys, gliding possums, snakes, spiders, and other unusual pets.”
    Fresh from an unsavory incident with an “emotional support” peacock incident, United Airlines has followed Delta’s lead and set stricter rules for emotional support animals. United’s rules also took effect March 1, 2018.
    So, to the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service and emotional support animals.
    Source:
    cnbc.com
    Jefferson Adams
    Celiac.com 04/17/2018 - Could the holy grail of gluten-free food lie in special strains of wheat that lack “bad glutens” that trigger the celiac disease, but include the “good glutens” that make bread and other products chewy, spongey and delicious? Such products would include all of the good things about wheat, but none of the bad things that might trigger celiac disease.
    A team of researchers in Spain is creating strains of wheat that lack the “bad glutens” that trigger the autoimmune disorder celiac disease. The team, based at the Institute for Sustainable Agriculture in Cordoba, Spain, is making use of the new and highly effective CRISPR gene editing to eliminate the majority of the gliadins in wheat.
    Gliadins are the gluten proteins that trigger the majority of symptoms for people with celiac disease.
    As part of their efforts, the team has conducted a small study on 20 people with “gluten sensitivity.” That study showed that test subjects can tolerate bread made with this special wheat, says team member Francisco Barro. However, the team has yet to publish the results.
    Clearly, more comprehensive testing would be needed to determine if such a product is safely tolerated by people with celiac disease. Still, with these efforts, along with efforts to develop vaccines, enzymes, and other treatments making steady progress, we are living in exciting times for people with celiac disease.
    It is entirely conceivable that in the not-so-distant future we will see safe, viable treatments for celiac disease that do not require a strict gluten-free diet.
    Read more at Digitaltrends.com , and at Newscientist.com
    Jefferson Adams
    Celiac.com 04/16/2018 - A team of researchers recently set out to investigate whether alterations in the developing intestinal microbiota and immune markers precede celiac disease onset in infants with family risk for the disease.
    The research team included Marta Olivares, Alan W. Walker, Amalia Capilla, Alfonso Benítez-Páez, Francesc Palau, Julian Parkhill, Gemma Castillejo, and Yolanda Sanz. They are variously affiliated with the Microbial Ecology, Nutrition and Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), C/Catedrático Agustín Escardin, Paterna, Valencia, Spain; the Gut Health Group, The Rowett Institute, University of Aberdeen, Aberdeen, UK; the Genetics and Molecular Medicine Unit, Institute of Biomedicine of Valencia, National Research Council (IBV-CSIC), Valencia, Spain; the Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire UK; the Hospital Universitari de Sant Joan de Reus, IISPV, URV, Tarragona, Spain; the Center for regenerative medicine, Boston university school of medicine, Boston, USA; and the Institut de Recerca Sant Joan de Déu and CIBERER, Hospital Sant Joan de Déu, Barcelona, Spain
    The team conducted a nested case-control study out as part of a larger prospective cohort study, which included healthy full-term newborns (> 200) with at least one first relative with biopsy-verified celiac disease. The present study includes 10 cases of celiac disease, along with 10 best-matched controls who did not develop the disease after 5-year follow-up.
    The team profiled fecal microbiota, as assessed by high-throughput 16S rRNA gene amplicon sequencing, along with immune parameters, at 4 and 6 months of age and related to celiac disease onset. The microbiota of infants who remained healthy showed an increase in bacterial diversity over time, especially by increases in microbiota from the Firmicutes families, those who with no increase in bacterial diversity developed celiac disease.
    Infants who subsequently developed celiac disease showed a significant reduction in sIgA levels over time, while those who remained healthy showed increases in TNF-α correlated to Bifidobacterium spp.
    Healthy children in the control group showed a greater relative abundance of Bifidobacterium longum, while children who developed celiac disease showed increased levels of Bifidobacterium breve and Enterococcus spp.
    The data from this study suggest that early changes in gut microbiota in infants with celiac disease risk could influence immune development, and thus increase risk levels for celiac disease. The team is calling for larger studies to confirm their hypothesis.
    Source:
    Microbiome. 2018; 6: 36. Published online 2018 Feb 20. doi: 10.1186/s40168-018-0415-6
    Dr. Ron Hoggan, Ed.D.
    Celiac.com 04/14/2018 - There is a revolutionary new book about gluten sensitivity and celiac disease, written by Dr. Gordon Heinrichs, D.C. (whose article appears in this issue). His careers as a medical laboratory technologist, then a chiropractor, have uniquely located him to see gluten's impact on health in an entirely new way. His book critiques relevant scientific explorations and discoveries and the ensuing clinical practices. Titled "Celiac Disease & Gluten Sensitivity: A troubled past, but a promising future", this exciting book is a breath of fresh air in the field of gluten sensitivity and celiac disease. Dr. Heinrichs' thoughtful analysis of relevant data combined with the application of practical common sense explodes some of the common medical myths that claim to distinguish gluten sensitivity from celiac disease. He also explores conventional wisdom around dietary experimentation, and offers a rational approach to diagnosing gluten sensitivity. 
    The evidence Heinrichs provides raises questions about the view that we should continue to eat gluten until we can visit a gastroenterologist and get a biopsy taken. He also challenges the belief that HLA analysis is beneficial for those who are aware that gluten causes some or all of their health problems. 
    After a preview of the final draft, I can confidently predict that anyone who is interested in thoughtful, objective, and health promoting insights into gluten's impact on human health will be intrigued and motivated by the offerings of this inexpensive, powerful new ebook. I recommend it without reservation. It is very well researched and written and is now available on Amazon. I hope it will become the new best seller among books that explore the gluten syndrome.
    Betty Wedman-St Louis, PhD, RD
    Celiac.com 04/13/2018 - Is cannabis gluten-free? That is a frequent question I receive now that over 50%  of the United States has approved medical cannabis and some states have also included recreational cannabis. Let's begin be describing cannabis as an oral medicine that has been used since the Chinese treatise on pharmacology described Emperor Shen Nung in 2737 BCE using it. 
    In 1850 cannabis was listed in the U.S. Pharmacopoeia as a cure for many ailments. By the early 1900's Squibb Company, Eli Lilly and Park-Davis were manufacturing drugs produced from marijuana for use as antispasmodics, sedatives, and analgesics (pain medication).
    Today, hemp seed and hemp oil products are widely available. They provide CBD or cannabidiol - the non-psychoactive cannabinoid from various Cannabis sativa strains grown for high CBD levels. In order to be legal in the U.S. these products must contain less than 0.3% THC, the psychoactive cannabinoid in cannabis. CBD products can be consumed as capsules, tinctures, "gummy" chewables, lollipops, and numerous edibles like brownies, chocolates, and granola bars.
    The nutritive value of cannabis is presently described as that of hemp seed since no scientific analysis of Cannabis sativa has been done. Hemp is one of the world's most nutritious foods with high quality protein and essential fatty acids found in its seeds. Hemp contains all eight essential amino acids and can be sprouted for use in salads and shakes.
    Celiacs with protein allergies to eggs and soy need to be cautious when adding hemp and CBD products to their diet regimes. The major proteins in hemp are albumen and edestin. Hemp is a nut so those celiacs with nut sensitivities need to consider that. Others may be limiting their lectin intake and need to limit CBD products until processing evaluations can indicate levels resulting in the products.
    CBD oils contain linoleic and linolenic fatty acids which are important in reducing inflammation. They can be used in salad dressings, mashed potatoes and substituted for olive oil in recipes. Since these essential fatty acids must be obtained in the diet, using hemp or cannabis CBD products can enhance health.
    Cannabis products- particularly CBD- have been overlooked by individuals needing symptom relief from neurological (Parkinson's, ALS, Multiple Sclerosis, migraine), immune (cancer), and gastrointestinal disorders (Crohn's disease, IBS). When choosing cannabidiol-CBD products be sure to check that they have been tested for pesticides, heavy metals, and microbiological contaminants. 
    Today, more hemp is sold to pet owners as bird seed than used by humans. But as more individuals learn of the botanical benefits of cannabis, they should consider adding it to their diet and supplement regime. My book, Cannabis-A Clinician's Guide (CRC Press 2018) reviews the science and clinical uses of cannabis along with how to use it in recipes.  
    admin
    Celiac.com 03/30/2018 - As most people know already, “al dente” is an Italian term that describes how pasta should be prepared—not too hard, and not too soft. Konjac Angel Hair Zero Calorie Pasta by Konjac Foods comes ready-to-eat in 8.8 ounce packages that are filled with water, so the noodles are kept wet and ready-to-eat within the package, and despite this, the Konjac noodles are still perfectly al dente—firm but not soft. 
    Remarkably these noodles are marketed as “0 Calories,” and are free of sugar, fat, soy, and gluten. Their only ingredients are konjac glucomannan fiber, calcium hydroxide, and purified water. For those who don't know,  konjac glucomannan (KGM) is “a water-soluable dietary fiber derived from the root of the konjac plant.” It is known as “moyu” or “juruo” in China, and “konnyaku” or “shirataki noodles” in Japan.
    Besides being a great noodle choice for those on a gluten-free diet, Konjac noodles are also ideal for people on weight-loss or diabetic diets, as they are high in fiber and contain zero calories. Amazingly, the shelf life of these individual serving-sized packages is one full year at room temperature, so you can feel free to stock up on them.
    Konjac Foods also makes “Konjac Gucomannan Powder” in 500g packages. One teaspoon of the konjac powder can be added to 8 ounces of your favorite drink, including in smoothies. The dietary fiber in konjac flour is also water soluble, and according to the maker it has: “a greater potential to reduce postprandial blood glucose, insulin, and serum lipid levels than insoluble fiber.” 
    I tried both products, and found that the noodles were an excellent substitute for rice noodles in my homemade ramen. I also tried the noodles as a spaghetti replacement, and although they had a different texture than I'm used to, I really enjoyed it. The powder can be added as a fiber supplement to foods, drinks, and shakes, and I tried it in a smoothie. 
    Anyone who is dieting to lose weight, on a gluten-free or diabetic diet, or just looking for a more healthy noodle substitute (that won't spike your blood sugar) will appreciate these Konjac Foods products.  
    For more info visit their site.
    Jefferson Adams
    Celiac.com 04/12/2018 - Some parents are are apparently feeding their children a dangerous bleach-like concoction in an effort to ‘cure’ autism. The concoction, misleadingly called miracle mineral solution or master mineral solution or MMS, has been around for many years, with proponents claiming it can cure multiple illnesses and medical conditions. It cannot. There is currently no cure for autism, just as there is currently no cure for celiac disease. 
    While researchers have found no direct link between autism and celiac disease, studies have confirmed a strong association between autism and the presence of antibodies to gluten. There is also at least one case of celiac disease presenting as autism. In fact, the most commonly requested dietary intervention for Autism spectrum disorder (ASD) is a gluten-free and casein free diet. Among medical professionals however, the top treatment choice for autism still remains Applied Behavior Analysis. 

    Still, those medical realities don’t seem to stop people from making dangerously false claims about the alleged benefits of MMS, including the false claim that MMS can ‘cure’ autism.
    Those false claims have led to well-meaning, if misguided parents from using the concoction in the desperate belief that it will ‘cure’ their children of autism. Most recently, an Indiana mother recently gained media attention after allegedly using MMS on her autistic daughter in an effort to ‘cure’ her autism. According to the mother, she got the idea from a Facebook group.
    MMS is an unlicensed product that is basically a concoction of sodium chlorite and citric powder, known to make up chlorine bleach. It is potentially dangerous and offers no cure for autism, celiac disease, or any other medical condition. MMS is medically useless and dangerous.  High doses of the product could lead to nausea, diarrhea, vomiting, and dehydration. 
    In fact, in 2010, the FDA released a warning that describes the mixture as a potent bleach used for stripping textiles and industrial water treatment. In the warning, FDA recommends that consumers stop using the MMS immediately and throw it away. "There is no proper scientific evidence of any kind that any products 'cure' autism and these products are dangerous," says The National Autistic Society.
    If you or a loved one suffers from autism, or from celiac disease, please consult a medical professional. Do not use potentially dangerous home treatments, especially those you learn about online.
    Jefferson Adams
    Spring may have officially sprung, but there’s still snow on the ground in much of the country, so this delightful fish and potato stew may be just the thing to warm the tummies of the hungriest eaters. Based on similar dishes prepared by Italian fishermen after a long day on the water, this gluten-free stew is easy to make and certain to please.
    Ingredients:
    1½ pounds fresh or frozen cod fish (or other white fish), cut in 1 x 1½-inch pieces 2 celery stalks, diced 2 red potatoes, diced 1 large white potato, diced 1 28 ounce can of Italian chopped tomatoes, including juice 1 8 ounce bottle of clam juice 4 cups of chicken broth 1 tablespoon olive oil 1 large onion, diced 6 garlic cloves, minced 1 bay leaf ½ teaspoon dried thyme 1 teaspoon dried oregano ½ cup flat Italian parsley, chopped juice from 1 large lemon, deseeded salt and pepper, to taste Directions:
    In a large soup pot, heat oil and add onion, garlic, celery and potato. 
    Season with thyme, oregano, salt and pepper. 
    Sauté for about 10 minutes until slightly softened. 
    Add tomatoes, clam juice, lemon juice and broth. 
    Bring to a boil and then let simmer for about 20 minutes, until potatoes are firm, but tender. 
    Add fish pieces and stir gently. 
    Cook for another 15-20 minutes until fish is firm, but tender. 
    Add salt and pepper to taste.
    Serve with toasted gluten-free bread or crackers.
    Jefferson Adams
    Celiac.com 04/10/2018 - Celiac disease is a multi-system disorder with manifestations that may result in psychiatric disorders. Does that mean that celiac disease patients are more likely to take psychotropic drugs than other gastrointestinal patients? A team of researchers recently set out to assess the prevalence of medication use to treat psychiatric disorders in celiac disease patients compared to other gastrointestinal patients.
    The research team included Haley M. Zylberberg, Jonas F. Ludvigsson, Peter H. R. Green, and Benjamin Lebwohl. They are variously affiliated with the Division of Digestive and Liver Diseases, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, USA; the Department of Medical Epidemiology and Biostatistics, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden; the Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA; and with the Celiac Disease Center at Columbia University in New York, NY, USA.
    For their cross-sectional study, the team compiled data on patients undergoing esophago-gastroduodenoscopy over 9-years at a celiac disease referral center. They then compared rates of psychotropic medication use among 1,293 celiac disease patients to a control group of 1,401 patients with abdominal pain or reflux.
    Average patient age was 48.4 years, nearly 70% were female, and 22.7% used some sort of psychotropic medication. Overall, the team found no difference between rates of psychotropic medication use among celiac disease patients compared to control subjects.
    However, they did find that people with celiac disease were more likely to use antidepressants. This was confirmed using both univariate and multivariate analysis. Psychotropic medication use was not connected with either the duration or mode of presentation of celiac disease.
    So, even though the data show that celiac disease patients may use more antidepressants, they use psychotropic medications at similar rates as those with other gastrointestinal diseases. 
    From these data, the study team suggests that researchers should try to assess whether people with celiac disease suffer from mood disorders that are not treated with medications.
    Source:
    BMC Psychiatry. 2018; 18: 76. Published online 2018 Mar 27. doi: &nbsp;10.1186/s12888-018-1668-0
    Jefferson Adams
    Celiac.com 04/09/2018 - Children with obstructive sleep apnea (OSA) often have enlarged tonsils and adenoids. Additionally, lymphatic hyperplasia, an increase in the number of normal cells that are contained in lymph nodes, is common to both OSA and celiac disease. Lymphoid hyperplasia is usually due to an infection with bacteria, viruses, or other types of germs and is part of the body's reaction to the infection.  A team of researchers recently set out to investigate the effect of a gluten-free diet on OSA symptoms in children with celiac disease.

    The research team included A Yerushalmy-Feler, R Tauman, A Derowe, E Averbuch, A Ben-Tov, Y Weintraub, D Weiner, A Amir, H Moran-Lev, and S Cohen. They are variously affiliated with the Pediatric Gastroenterology Unit, the Pediatric ENT Unit, and the Pediatric Sleep Center at "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center in Tel Aviv, Israel; and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
    The team recruited children with celiac disease from ages 2-18 before the children began a gluten-free diet. As a control group, the team included children with negative celiac serology who underwent gastrointestinal endoscopies for other reasons.  All participants completed a validated OSA-related symptoms questionnaire and the pediatric sleep questionnaire (PSQ) at the start of the study, and again 6 months later. 
    The team recruited thirty-four children with celiac disease, along with twenty-four control subjects. Both groups were similar in terms of gender, body mass index or season at recruitment between the two groups.  The control group showed more OSA-related symptoms compared to the celiac group, both at recruitment and at the 6-month follow-up. Both groups showed significant improvement in PSQ scores at the 6-month follow-up, but improvement was significantly higher in the celiac group compared to the control group.
    Kids with celiac disease had fewer OSA-related symptoms than control subjects, but they had much higher levels of symptom improvement once they were on a gluten-free diet. 
    Overall, the data from this study suggests that a gluten-free diet provides strong improvement of OSA-related symptoms in children with celiac disease.
    Source:
    BMC Pediatr. 2018 Feb 7;18(1):35. doi: 10.1186/s12887-018-1039-5.
    Jefferson Adams
    Celiac.com 04/07/2018 - Looking for a sumptuous, easy-to-make gluten-free, egg-free dessert that will knock the socks off your guests? Try this variation on a fabulous dark chocolate mousse recipe courtesy of Maria Speck. Not only is this mousse quicker and easier to make than the fluffier traditional version, but dark chocolate lovers will really eat it up. 
    Ingredients:
    6 ounces high-quality dark chocolate with 70% cacao, finely chopped 1 cup whole milk Greek-style yogurt ½ cup whole milk 1 or 2 tablespoons Grand Marnier, or other orange liqueur, to taste 4 teaspoons orange marmalade  Directions:
    Place the chocolate into a medium heatproof bowl. 
    In a small heavy-bottomed saucepan, bring the milk just to a boil over medium heat. 
    Pour the hot milk over the chocolate, and let it sit for a couple of minutes. 
    Use a spatula or a wooden spoon to stir the mix until smooth. 
    In a small bowl, use a risk or fork to beat the Greek yogurt until smooth. 
    Fold the yogurt into the chocolate mixture using a spatula until thoroughly combined, then stir in the Grand Marnier. 
    Spoon the mousse into four small serving cups, cover with plastic wrap, and chill at least an hour, until firm. They can last up to a day in the refrigerator.
    Spoon a teaspoon of marmalade onto each cup and serve chilled.
    Sarah Curcio
    Celiac.com 04/06/2018 - For many individuals, the movie Peter Rabbit is a longtime, favorite children’s story. Unfortunately, the 2018 version that has been recently created by Sony Pictures has taken this story and changed it into something extremely controversial for the food allergy community. 
    As an overview, the movie pokes fun of individuals with food allergies, particularly anaphylactic shock, which is a life-threatening allergic reaction. Basically, the rabbits discover that the male human is highly allergic to blackberries and they plot to use it against him. In addition, the rabbits make it a point of saying, they hope they don’t receive any letters about the topic of food allergies and give a wink towards the screen. 
    Now if that was not bad enough, the movie provides children with false information. They show that once an EpiPen is administered the individual will be completely well, get right back up and resume normal activities with no problems at all. However, that is completely, 100 percent inaccurate information. You’ll still have to get to the hospital immediately for further treatment, so you can breathe, control severe hives, etc. 
    A lot of people feel that this is definitely, without a shadow of a doubt, food allergy bullying because of the insensitivity the film is presenting. Simply just turn on your computers, and browse through social media, specifically Twitter and YouTube. You will even find the trending hashtag #BoycottPeterRabbit all over the internet. 
    However, even with all this negative feedback from parents and food allergy charities, Sony Pictures did not pull this specific scene from their movie. They did decide to make an official public apology, but that was all. There was no donation made to any organization to help benefit food allergy awareness, advocacy, education or research. 
    Advertising Product-Review
    Celiac.com 04/06/2018 - There is a good reason why GlutenTox Home test kits have been around for so long—they work really well—and, like this Web site, have withstood the test of time. 
    In addition to the GlutenTox Home test kit, they also make a “GlutenTox Pro” kit which is designed for food manufacturers, restaurants, food retailers, etc., to be able to quickly test foods, ingredients, batches, surfaces, etc.
    I decided to test my daughter's hot breakfast cereal, which is a pre-packaged oatmeal mixture that is sold at Costco. She loves it, but my concern is the “manufactured in a facility that also processes wheat” disclaimer on the label, and the fact that the oats are not certified gluten-free.
    The testing process took only a few minutes to carry out, and I was fully expecting to be the bearer of bad news and have to tell my daughter that it contains gluten. I was, however, quite surprised to find that the cereal tested gluten-free down to 5 parts per million.
    The fact that GlutenTox test kits, both the “Home” and “Pro” versions, can test down to 5 parts per million is amazing—this is as accurate as modern professional labs! The kits are perfect for home or professional use, and it's clear that GlutenTox test kits will continue to be a great choice for those who demand a highly sensitive test for gluten.
    For more info visit their site.
    Jefferson Adams
    Looking for something easy, off-beat, nutritious and gluten-free? Well, look no further than these baked sweet potato chips. Just grab a couple sweet potatoes, slice, bake slightly and then toast to desired crispness. Add your ingredients of choice, and chow down.
    Ingredients:
    2-4 sweet potatoes Almond butter, peanut butter, or sunflower seed butter Blueberries Pomegranate seeds Directions:
    Heat your oven to 350°F.
    Use a knife, or vegetable slicer to slice your sweet potatoes to about ¼-inch thick.
    Place a wire baking rack on top of a large baking sheet and then place each slice on the wire rack.
    Bake for 20-25 minutes until they start to get soft, but tender enough to toast up later.
    Lightly toast each slice to desired crispness, then add almond, peanut or sunflower seed butter and top with blueberries or pomegranate seeds, as desired. 
    Dig in!
    Storage tip: Cool any extra slices, pop them into a glass container, and store them in the fridge for up to a few days.
    Jefferson Adams
    Celiac.com 04/04/2018 - Meal kits are a growing business segment, and an increasingly popular part of dinner for many busy working people. Meal kits typically include the ingredients necessary to make a complete meal, delivered to your door on a regular basis. For example, a company called  gFoodNow offers a variety of Gluten-Free Mealkits starting a only $6.99 per serving.  
    Another company called Green Chef has now included gluten-free meal options. Business Insider’s Connie Chen recently tried Green Chef’s meal offerings, and wrote about her experience for the magazine.
    In the interest of transparency, Business Insider openly declares that it has an affiliate partnerships with Green Chef, which provides them with revenue. As such, their review should be taken with a grain of salt.  That said, the idea of a reliable, good quality meal kit that is gluten-free, easy to prepare and tasty to eat will likely interest more than a few people with celiac disease.
    The meals Chen tried for one week included Orange Dijon Chicken, Hawaij-Rubbed Steak, and Red Lentil Tikka Masala. Each kit came with a recipe card that listed all meal ingredients, including known allergens, as well as the basic tools required to prepare each meal. 
    The meals can be prepared with simple kitchen tools, including a knife, pot, measuring cup, sauté pan, baking sheet, oil, salt, and pepper.
    In addition to offering gluten-free meal kits, Green Chef offers six more two-person meal kits at the following price points:
     
    Omnivore, $11.99/meal Carnivore, $13.49/meal Gluten-free, $13.49/meal Vegan, $11.99/meal Paleo, $14.99/meal Vegetarian, $10.49/meal Keto, $14.99/meal Chen did not try the gluten-free meal kits, but instead tried the omnivore kits. We have yet to try Green Chef, but look forward to reaching out to the company. If you have tried Green Chef’s gluten-free meals, we would love to hear about your experience.
    Meantime, you can browse all of Green Chef’s meal plans here.
    You can read Connie Chen's report for Business Insider here.
    Jefferson Adams
    Celiac.com 04/03/2018 - A gluten-free diet is crucial to avoiding problems associated with celiac disease. However, many gluten-free foods come with drawbacks that are important to understand.
    Also, not all gluten-free food is created equal, not all gluten-free foods are healthy, and simply going gluten-free may not resolve all of your issues. Here are some things to keep in mind about a gluten-free diet:
    Gluten-Free food is more expensive than food made with wheat flour. In fact, gluten-free substitutes are about twice as expensive as standard foods. They are more costly to make, and they sell in lower volume, which pushes up retail prices. Like many of their non-gluten-free counterparts, gluten-free foods can be highly processed. Processed foods can promote inflammation, which is one of the things that people with celiac disease are trying to avoid. Gluten-Free does not automatically mean nutritious. In fact, gluten-free food is generally less nutritious than similarly processed foods made with wheat flour. Foods that are naturally gluten-free will generally be healthier than gluten-free substitutes. That may seem obvious, but if you look at the gluten-free food aisle in your local store, you will see many highly processed foods that are not any better than their gluten-containing counterparts in terms of general nutrition. Gluten-free foods are often higher in carbohydrates and calories than their non-gluten-free counterparts. Gluten-Free food is higher in salt than its non-gluten-free counterparts. Recent products tests show that most gluten-free snacks tested are far saltier than their non-gluten-free alternatives. Of 106 products surveyed, researchers found that many gluten-free snacks have up to five times more salt than non-gluten-free counterparts.  Gluten-Free food is higher in fat than its non-gluten-free counterparts. Gluten-Free food is higher in sugar than its non-gluten-free counterparts. Gluten-Free ingredients don’t always mean gluten-free food. The news is riddled with stories about gluten contamination in restaurants, pizza joints, etc., that claim to use gluten-free ingredients. Examples of companies that rolled out gluten-free pizza only to be met with complaints by people with celiac disease include: California Pizza Kitchen, Domino’s pizza, and Papa John’s, among others. The longer you avoid gluten, the more sensitive you may become. For many people with celiac disease, the longer they avoid gluten, the more sensitive they become. This can mean stronger, more lengthy reactions to seemingly minor gluten ingestion, so be careful. A gluten-free diet will not reverse osteoporosis, or iron and calcium deficiency. If your celiac disease progressed for a long time before your diagnosis, then the odds are much more likely that you have suffered from osteoporosis, iron and calcium deficiency. A gluten-free diet alone will not reverse osteoporosis, or calcium deficiency. In such cases, you will need to consult your doctor for proper treatment. Osteoporosis is especially problematic in women with celiac disease.
    Jefferson Adams
    Celiac.com 04/02/2018 - Exactly how hard is it for people with celiac disease to faithfully follow a gluten-free diet? Anyone who’s ever tried to completely avoid gluten for any length of time likely has a story to tell about accidental gluten consumption, and the consequences that follow. It’s not at all uncommon for gluten-free celiacs to be exposed to low levels of gluten that can trigger symptoms and cause persistent intestinal histologic damage.
    To gain an understanding of gluten consumption across a wide population of celiac patients, a team of researchers recently set out to determine how much gluten people eat when they are trying to follow a gluten-free diet. 
    The team included Jack A Syage, Ciarán P Kelly, Matthew A Dickason, Angel Cebolla Ramirez, Francisco Leon, Remedios Dominguez, and Jennifer A Sealey-Voyksner. They are variously affiliated with ImmunogenX in Newport Beach, CA, the Beth Israel Deaconess Medical Center at Harvard Medical School in Boston MA, and with Biomedal in Seville, Spain.
    The team began by analyzing data from previous clinical studies. That meta-analysis focused on data from a clinical study of gluten in stool and urine in celiac patients, a second study on non-celiac populations; and an analysis of data from trials for the investigational therapeutic latiglutenase. 
    As part of the stool and urine studies the team included controlled gluten challenges. They then applied a calibration factor that allowed normal ingestion of gluten to be computed from the urine and stool measurements. They determined gluten consumption by estimating how much gluten was eliminated from patients’ diets due to a trial effect that resulted in improved histology, even in the placebo group.
    Using the stool test, the team estimated the average inadvertent exposure to gluten by celiac disease individuals on a GFD to be about 150–400 mg/d, while they estimated the median exposure to be about 100–150 mg/d. Using the urine test, those numbers showed an average exposure of about 300–400 mg/d, with a median of about 150 mg/d. 
    Meanwhile, data analyses showed that celiac patients with moderate to severe symptoms showed that patients ingested substantially more than 200 mg/d of gluten.
    The data indicate that many gluten-free celiacs regularly consume enough gluten to trigger symptoms and perpetuate gut damage.
    Source:
    The American Journal of Clinical Nutrition, Volume 107, Issue 2, 1 February 2018
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    We slowly grind our Whole Grains using a small natural pink granite stone mill that never overheats the flour. We transform it into living dough within hours of being ground.
    In today’s completely automated milling process, steel rollers crush the grain at remarkably high speeds heating it to elevated temperatures and destroying vitamins and antioxidants.
    Whole Grains are seeds coming from plants that, over millions of years, have developed the capacity to synthesize myriad phytochemicals that help them resist pathogens, parasites and predators, or attract beneficial organisms. We call these beneficial phytochemicals antioxidants. Our modern understanding on how they function in plants is helping us to discover the mechanisms by which Whole Grains benefit human health beyond basic nutrition. More than 8,000 phytochemicals have been identified, but a large number still remain unknown.
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    Jefferson Adams
    Celiac.com 04/25/2018 - A team of Yale University researchers discovered that bacteria in the small intestine can travel to other organs and trigger an autoimmune response. In this case, they looked at Enterococcus gallinarum, which can travel beyond the gut to the spleen, lymph nodes, and liver. The research could be helpful for treating type 1 diabetes, lupus, and celiac disease.
    In autoimmune diseases, such as type 1 diabetes, lupus, and celiac disease, the body’s immune system mistakenly attacks healthy cells and tissues. Autoimmune disease affects nearly 24 million people in the United States. 
    In their study, a team of Yale University researchers discovered that bacteria in the small intestine can travel to other organs and trigger an autoimmune response. In this case, they looked at Enterococcus gallinarum, which can travel beyond the gut to the spleen, lymph nodes, and liver. They found that E. gallinarum triggered an autoimmune response in the mice when it traveled beyond the gut.
    They also found that the response can be countered by using antibiotics or vaccines to suppress the autoimmune reaction and prevent the bacterium from growing. The researchers were able to duplicate this mechanism using cultured human liver cells, and they also found the bacteria E. gallinarum in the livers of people with autoimmune disease.
    The team found that administering an antibiotic or vaccine to target E. gallinarum suppressed the autoimmune reaction in the mice and prevented the bacterium from growing. "When we blocked the pathway leading to inflammation," says senior study author Martin Kriegel, "we could reverse the effect of this bug on autoimmunity."
    Team research team plans to further investigate the biological mechanisms that are associated with E. gallinarum, along with the potential implications for systemic lupus and autoimmune liver disease.
    This study indicates that gut bacteria may be the key to treating chronic autoimmune conditions such as systemic lupus and autoimmune liver disease. Numerous autoimmune conditions have been linked to gut bacteria.
    Read the full study in Science.
    Tammy Rhodes
    Celiac.com 04/24/2018 - Did you know in 2017 alone, the United States had OVER TENS OF THOUSANDS of people evacuate their homes due to natural disasters such as fires, floods, hurricanes, tornadoes and tsunamis? Most evacuation sites are not equipped to feed your family the safe gluten free foods that are required to stay healthy.  Are you prepared in case of an emergency? Do you have your Gluten Free Emergency Food Bag ready to grab and go?  
    I have already lived through two natural disasters. Neither of which I ever want to experience again, but they taught me a very valuable lesson, which is why I created a Gluten Free Emergency Food Bag (see link below). Here’s my story. If you’ve ever lived in or visited the Los Angeles area, you’re probably familiar with the Santa Ana winds and how bitter sweet they are. Sweet for cleaning the air and leaving the skies a brilliant crystal blue, and bitter for the power outages and potential brush fires that might ensue.  It was one of those bitter nights where the Santa Ana winds were howling, and we had subsequently lost our power. We had to drive over an hour just to find a restaurant so we could eat dinner. I remember vividly seeing the glow of a brush fire on the upper hillside of the San Gabriel Mountains, a good distance from our neighborhood. I really didn’t think much of it, given that it seemed so far from where we lived, and I was hungry! After we ate, we headed back home to a very dark house and called it a night. 
    That’s where the story takes a dangerous turn….about 3:15am. I awoke to the TV blaring loudly, along with the lights shining brightly. Our power was back on! I proceeded to walk throughout the house turning everything off at exactly the same time our neighbor, who was told to evacuate our street, saw me through our window, assuming I knew that our hillside was ablaze with flames. Flames that were shooting 50 feet into the air. I went back to bed and fell fast asleep. The fire department was assured we had left because our house was dark and quiet again. Two hours had passed.  I suddenly awoke to screams coming from a family member yelling, “fire, fire, fire”! Flames were shooting straight up into the sky, just blocks from our house. We lived on a private drive with only one way in and one way out.  The entrance to our street was full of smoke and the fire fighters were doing their best to save our neighbors homes. We literally had enough time to grab our dogs, pile into the car, and speed to safety. As we were coming down our street, fire trucks passed us with sirens blaring, and I wondered if I would ever see my house and our possessions ever again. Where do we go? Who do we turn to? Are shelters a safe option? 
    When our daughter was almost three years old, we left the West Coast and relocated to Northern Illinois. A place where severe weather is a common occurrence. Since the age of two, I noticed that my daughter appeared gaunt, had an incredibly distended belly, along with gas, stomach pain, low weight, slow growth, unusual looking stool, and a dislike for pizza, hotdog buns, crackers, Toast, etc. The phone call from our doctor overwhelmed me.  She was diagnosed with Celiac Disease. I broke down into tears sobbing. What am I going to feed my child? Gluten is everywhere.
    After being scoped at Children's Hospital of Chicago, and my daughters Celiac Disease officially confirmed, I worried about her getting all the nutrients her under nourished body so desperately needed. I already knew she had a peanut allergy from blood tests, but just assumed she would be safe with other nuts. I was so horribly wrong. After feeding her a small bite of a pistachio, which she immediately spit out, nuts would become her enemy. Her anaphylactic reaction came within minutes of taking a bite of that pistachio. She was complaining of horrible stomach cramps when the vomiting set in. She then went limp and starting welting. We called 911.
    Now we never leave home without our Epipens and our gluten free food supplies. We analyze every food label. We are hyper vigilant about cross contamination. We are constantly looking for welts and praying for no stomach pain. We are always prepared and on guard. It's just what we do now. Anything to protect our child, our love...like so many other parents out there have to do every moment of ever day!  
    Then, my second brush with a natural disaster happened, without any notice, leaving us once again scrambling to find a safe place to shelter. It was a warm and muggy summer morning, and my husband was away on a business trip leaving my young daughter and me to enjoy our summer day. Our Severe Weather Alert Radio was going off, again, as I continued getting our daughter ready for gymnastics.  Having gotten used to the (what seemed to be daily) “Severe Thunderstorm warning,” I didn’t pay much attention to it. I continued downstairs with my daughter and our dog, when I caught a glimpse out the window of an incredibly black looking cloud. By the time I got downstairs, I saw the cover to our grill literally shoot straight up into the air. Because we didn’t have a fenced in yard, I quickly ran outside and chased the cover, when subsequently, I saw my neighbor’s lawn furniture blow pass me. I quickly realized I made a big mistake going outside. As I ran back inside, I heard debris hitting the front of our home.  Our dog was the first one to the basement door! As we sat huddled in the dark corner of our basement, I was once again thinking where are we going to go if our house is destroyed. I was not prepared, and I should have been. I should have learned my lesson the first time. Once the storm passed, we quickly realized we were without power and most of our trees were destroyed. We were lucky that our house had minimal damage, but that wasn’t true for most of the area surrounding us.  We were without power for five days. We lost most of our food - our gluten free food.
    That is when I knew we had to be prepared. No more winging it. We couldn’t take a chance like that ever again. We were “lucky” one too many times. We were very fortunate that we did not lose our home to the Los Angeles wildfire, and only had minimal damage from the severe storm which hit our home in Illinois.
      
    In 2017 alone, FEMA (Federal Emergency Management Agency) had 137 natural disasters declared within the United States. According to FEMA, around 50% of the United States population isn’t prepared for a natural disaster. These disasters can happen anywhere, anytime and some without notice. It’s hard enough being a parent, let alone being a parent of a gluten free family member. Now, add a natural disaster on top of that. Are you prepared?
    You can find my Gluten Free Emergency Food Bags and other useful products at www.allergynavigator.com.  
    Jefferson Adams
    Celiac.com 04/23/2018 - A team of researchers recently set out to learn whether celiac disease patients commonly suffer cognitive impairment at the time they are diagnosed, and to compare their cognitive performance with non-celiac subjects with similar chronic symptoms and to a group of healthy control subjects.
    The research team included G Longarini, P Richly, MP Temprano, AF Costa, H Vázquez, ML Moreno, S Niveloni, P López, E Smecuol, R Mazure, A González, E Mauriño, and JC Bai. They are variously associated with the Small Bowel Section, Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital; Neurocience Cognitive and Traslational Institute (INECO), Favaloro Fundation, CONICET, Buenos Aires; the Brain Health Center (CESAL), Quilmes, Argentina; the Research Council, MSAL, CABA; and with the Research Institute, School of Medicine, Universidad del Salvador.
    The team enrolled fifty adults with symptoms and indications of celiac disease in a prospective cohort without regard to the final diagnosis.  At baseline, all individuals underwent cognitive functional and psychological evaluation. The team then compared celiac disease patients with subjects without celiac disease, and with healthy controls matched by sex, age, and education.
    Celiac disease patients had similar cognitive performance and anxiety, but no significant differences in depression scores compared with disease controls.
    A total of thirty-three subjects were diagnosed with celiac disease. Compared with the 26 healthy control subjects, the 17 celiac disease subjects, and the 17 disease control subjects, who mostly had irritable bowel syndrome, showed impaired cognitive performance (P=0.02 and P=0.04, respectively), functional impairment (P<0.01), and higher depression (P<0.01). 
    From their data, the team noted that any abnormal cognitive functions they saw in adults with newly diagnosed celiac disease did not seem not to be a result of the disease itself. 
    Their results indicate that cognitive dysfunction in celiac patients could be related to long-term symptoms from chronic disease, in general.
    Source:
    J Clin Gastroenterol. 2018 Mar 1. doi: 10.1097/MCG.0000000000001018.
    Connie Sarros
    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
    Due to personal health reasons and restrictions, I find that I need to retire. My husband and I can no longer travel the country speaking at conferences and to support groups (which we dearly loved to do) nor can I commit to writing more books, articles, or menus. Consequently, I will no longer be contributing articles to the Journal of Gluten Sensitivity. 
    My following books will still be available at Amazon.com:
    Gluten-free Cooking for Dummies Student's Vegetarian Cookbook for Dummies Wheat-free Gluten-free Dessert Cookbook Wheat-free Gluten-free Reduced Calorie Cookbook Wheat-free Gluten-free Cookbook for Kids and Busy Adults (revised version) My first book was published in 1996. My journey since then has been incredible. I have met so many in the celiac community and I feel blessed to be able to call you friends. Many of you have told me that I helped to change your life – let me assure you that your kind words, your phone calls, your thoughtful notes, and your feedback throughout the years have had a vital impact on my life, too. Thank you for all of your support through these years.
    Jefferson Adams
    Celiac.com 04/20/2018 - A digital media company and a label data company are teaming up to help major manufacturers target, reach and convert their desired shoppers based on dietary needs, such as gluten-free diet. The deal could bring synergy in emerging markets such as the gluten-free and allergen-free markets, which represent major growth sectors in the global food industry. 
    Under the deal, personalized digital media company Catalina will be joining forces with Label Insight. Catalina uses consumer purchases data to target shoppers on a personal base, while Label Insight works with major companies like Kellogg, Betty Crocker, and Pepsi to provide insight on food label data to government, retailers, manufacturers and app developers.
    "Brands with very specific product benefits, gluten-free for example, require precise targeting to efficiently reach and convert their desired shoppers,” says Todd Morris, President of Catalina's Go-to-Market organization, adding that “Catalina offers the only purchase-based targeting solution with this capability.” 
    Label Insight’s clients include food and beverage giants such as Unilever, Ben & Jerry's, Lipton and Hellman’s. Label Insight technology has helped the Food and Drug Administration (FDA) build the sector’s very first scientifically accurate database of food ingredients, health attributes and claims.
    Morris says the joint partnership will allow Catalina to “enhance our dataset and further increase our ability to target shoppers who are currently buying - or have shown intent to buy - in these emerging categories,” including gluten-free, allergen-free, and other free-from foods.
    The deal will likely make for easier, more precise targeting of goods to consumers, and thus provide benefits for manufacturers and retailers looking to better serve their retail food customers, especially in specialty areas like gluten-free and allergen-free foods.
    Source:
    fdfworld.com