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      Frequently Asked Questions About Celiac Disease   04/07/2018

      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 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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    ARE PEOPLE WITH CELIAC DISEASE AT RISK FOR DEMENTIA?


    Jefferson Adams

    Celiac.com 11/02/2015 - People with celiac disease frequently report cognitive symptoms when they are exposed to gluten, and clinicians have documented cognitive deficits in some patients with newly diagnosed celiac disease. A team of researchers recently set out to determine whether patients with celiac disease have an increased risk of dementia.


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    Photo: CC--Salford InstituteThe research team included Benjamin Lebwohl, José A. Luchsinger, Daniel E. Freedberg, Peter H.R. Green, and Jonas F. Ludvigsson. They are variously affiliated with the Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA; the Department of Medical Epidemiology and Biostatistics, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden; the Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA; the Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA; and the Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.

    For their study, the team used a population-based database of adults aged 50 years and older with histologically proven celiac disease; that is, patients showing duodenal/jejunal villous atrophy. The database included patients from all 28 pathology departments in Sweden.

    The team compared the incidence of a subsequent dementia diagnosis to those of age- and gender-matched controls.

    In all, the team reviewed data on 8,846 patients with celiac disease, and 43,474 control subjects, with a median age of 63 years; 56% were female. Over an average follow-up time of 8.4 years, 4.3% of celiac disease patients were diagnosed with dementia, compared with 4.4% of control subjects (HR 1.07; 95% CI 0.95–1.20).

    Even though the data showed an increased risk of dementia in the first year following celiac diagnosis (HR 1.73; 95% CI 1.15–2.61), the risk did not continue through entire the follow-up period. Moreover, the increased risk was restricted to celiac patients with vascular dementia (HR 1.28; 95% CI 1.00–1.64), and was not present for Alzheimer’s dementia (HR 1.12; 95% CI 0.91–1.37).

    Overall, people with celiac disease do not show any increased risk for dementia, though subgroup analysis suggests that they may have a higher risk for vascular dementia.

    Source:


    Image Caption: Photo: CC--Salford Institute
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    Guest Dayle

    Posted

    My mother passed away in my arms, she had Parkinson's dementia, her mother the same. Not quite sure I will sleep well tonight, now that I have a great chance of dementia. I refuse to live like that First symptom and I am checking out. I just turned 65 on 5/2.....God bless us all.

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    PEDIATRICS Vol. 108 No. 2 August 2001, p. e21
    Kieslich M, Errazuriz G, Posselt HG, Moeller-Hartmann W, Zanella F, Boehles H.
    Departments of Pediatrics, Johann Wolfgang Goethe University, Frankfurt/Main, Germany.
    Celiac.com 08/24/2001 - It is well known that celiac disease causes destruction of the villi in the small intestine that results in malabsorption of nutrients in affected individuals. There is solid evidence that additional neurological complications can result, such as epilepsy, possibly associated with occipital calcifications or folate deficiency and cerebellar ataxia. An increase in brain white-matter lesions has been reported in patients with Crohn disease and ulcerative colitis, but until now, not in patients with celiac disease. A recent study published in the August 2, 2001 issue of Pediatrics has now demonstrated a similar increase of these lesions in patients with celiac disease.
    The study was carried out by Dr. Kieslich and colleagues of the Departments of Pediatrics, Johann Wolfgang Goethe University, Frankfurt/Main, Germany, on 75 biopsy-proven celiac disease patients who were on a gluten-free diet. Most of the patients in the study were between 2.8 and 24.2 years old, and the mean age was 11.6 years. All of the patients underwent prospectively clinical neurological examinations, laboratory investigations, electroencephalography, computed tomography, and magnetic resonance imaging. According to the study the mean period of gluten exposure was 2.4 years, although it was likely longer as recent studies have shown that many celiacs are asymptomatic for many years before damage occurs that is severe enough to cause obvious symptoms.
    The researchers found that ten of the patients had neurological manifestations such as febrile seizures, single generalized seizures, mild ataxia, and muscular hypotonia with retarded motor development, although no folate deficiencies were found. Further, the hippocampal regions appeared normal, and no cerebral calcifications were found, however, the MRI results showed unilateral and bilateral T2-hyperintensive white-matter lesions in 15 patients (20%). According to the research, there does not appear to be a relationship between these lesions and dietary compliance or neurological or electroencephalographic abnormalities.
    The researchers conclude that focal white-matter lesions in the brain may represent an extra-intestinal manifestation of celiac disease. They theorize that the lesions may be the result of a decreased blood supply caused by the constriction or obstruction of blood vessels due to inflammation, or caused by the destruction of the nerve fiber due to inflammation. Further, children with white-matter lesions, even if they do not have intestinal symptoms, should be tested for celiac disease. Last, more research needs to be done on people celiac disease of all ages to develop a proper predictive value, and to discover the exact cause of the lesions.

    Jefferson Adams
    Celiac.com 09/17/2012 - Many aspects of celiac disease simply have not been well studied, so they remain poorly understood. For example, researchers have not done enough study on people with celiac disease to understand if they show any readily available serological markers of neurological disease.
    To better understand this issue, a research team recently assessed the amount of brain abnormality in patients with celiac disease, along with looking into MR imaging sequences as biomarkers for neurological dysfunction.
    The study team included S. Currie, M. Hadjivassiliou, M.J. Clark, D.S. Sanders, I.D. Wilkinson, P.D. Griffiths, and N. Hoggard, of the Academic Unit of Radiology at University of Sheffield, Royal Hallamshire Hospital, in Sheffield, UK.
    For their study, they conducted a retrospective examination of a consecutive group of 33 patients with biopsy proven celiac disease, who had been referred for neurological opinion. The group ranged in age from 19 to 64 years old, with an average of 44±13 years.
    Researchers divided the group into subgroups based on their main neurological complaints of balance disturbance, headache and sensory loss.
    They used 3T MR to evaluate variations in brain grey matter density, cerebellar volume, cerebellar neurochemistry and white matter abnormalities (WMAs) between celiac patients and control subjects.
    The results showed that the celiac patients had a significantly lower cerebellar volume than did control subjects. Celiac patients had 6.9±0.7% of total intracranial volume, compared with 7.4±0.9% for control subjects (p<0.05).
    Celiac patients also showed significantly less grey matter density in multiple brain regions, both above and below the tentorium cerebelli, compared with the control subjects (p<0.05).
    The data showed that 12 (36%) patients demonstrated WMAs unexpected for the patient's age, with the highest incidence occurring in the headache subgroup.
    This group of patients averaged nearly double the number of WMAs per MR imaging session than the subgroup with balance disturbance, and six times more than the subgroup with sensory loss.
    The MR images of celiac patients who have neurological symptoms show significant brain abnormality on MR imaging, which means that MR imaging may serve as valuable biomarkers of disease in celiac patients.
    Source:
    J Neurol Neurosurg Psychiatry. 2012 Aug 20.

    Jefferson Adams
    Celiac.com 03/20/2014 - No one wants a brain disease, and some recent books on the effects of gluten-free diets are suggesting that a gluten-free diet might actually protect you from brain diseases.
    One such book is Grain Brain: The Surprising Truth About Wheat, Carbs, and Sugar — Your Brain's Silent Killers, by David Perlmutter, M.D., a practicing neurologist.
    Symptoms of celiac disease are known to include intestinal difficulties associated with an adverse immunological response triggered by gluten. This response, which leads to inflammation in the gut, can happen elsewhere in the body too.
    According to Perlmutter, inflammation is at the root of many diseases and complications, including, brain decay.
    According to Perlmutter, gluten can lead to inflammation in the brain, which he believes leads to conditions like dementia and Alzheimer's.
    Perlmutter says that gluten, by triggering the immune system, causes inflammation in the brain, which promotes the brain's glycation by circulating blood sugar. Gram for gram, wheat raises blood sugar levels more than sugar itself.
    Perlmutter encourages strong dietary changes that have drawn some criticism. Specifically, he has recommended an intake of 60 or fewer grams of carbohydrate per day.
    Some point out potential negative health consequences of a high-fat, low-carb diet, both in healthy people and for those with specific conditions, like adrenal or thyroid issues.
    However, Perlmutter's take on brain glycation, in which gluten triggers an immune response in certain people, contributing to inflammation, and to inflammatory disease, such as diabetes and Alzheimer's, may have some foundation. 
    Perlmutter is a reputable neurologist, so his opinion and insight go beyond anecdotal evidence and speculation. It will be interesting to see how much of his perspective is borne out by science. Meantime, Perlmutter certainly makes for interesting, thought-provoking reading.
    What's your experience? Has going gluten-free made an impact on your brain function and awareness?
    Read more at: Celiac.com and at Medical Express.com.

    Jefferson Adams
    Celiac.com 12/08/2014 - Many people with celiac disease report suffering from impaired cognition or "brain fog," but no good study had been done until a research team took an in-depth look at the issue. Of particular interest was the degree to which improved mental clarity in gluten-free celiac patients correlates with histological and serological measures of disease severity.
    The research team included I. T. Lichtwark, E. D. Newnham, S. R. Robinson, S. J. Shepherd, P. Hosking, P. R. Gibson, and G. W. Yelland, who are variously affiliated with the School of Psychological Sciences, Monash University, Clayton, Australia, the Eastern Health Clinical School at Monash University, Box Hill Hospital, Melbourne, Australia, the School of Health Sciences at RMIT University in Bundoora, Australia, and the Central Clinical School at Monash University, Alfred Health, Melbourne, Australia.
    The team’s longitudinal pilot study investigated relationships between cognitive function and mucosal healing in people with newly diagnosed celiac disease beginning a gluten-free diet.
    The team evaluated eleven clinically diagnosed celiac patients (8 females, 3 males), ranging from 22–39 years of age. The test subjects submitted to a battery of cognitive tests at weeks 0, 12 and 52. The tests measured information processing efficacy, memory, visuospatial ability, motor function and attention.
    Subjects received small bowel biopsies via routine gastroscopy at weeks 12 and 52 and results were compared to baseline Marsh scores. The researchers then compared cognitive performance against serum concentrations of tissue transglutaminase antibodies, biopsy outcomes and other biological markers.
    All patients had excellent gluten-free dietary adherence. They also showed substantially improved Marsh scores (P = 0.001, Friedman's test), while tissue transglutaminase antibody concentrations dropped from an average of 58.4 at baseline to 16.8 U/mL at week 52 (P = 0.025).
    Results for four of the cognitive tests assessing verbal fluency, attention and motor function showed significant improvement over the 12 months, and these improvements strongly correlated with the Marsh scores and tissue transglutaminase antibody levels (r = 0.377–0.735; all P < 0.05).
    However, the data did not show any significant connections with nutritional or biochemical markers, or markers of intestinal permeability.
    Inpatients with newly diagnosed celiac disease, cognitive performance improves with a strict gluten-free diet in tandem with gut healing.
    People with untreated celiac disease may suffer suboptimal cognition that can impair the performance of everyday tasks.
    Source:
    Alimentary Pharmacology & Therapeutics, Volume 40, Issue 2, pages 160–170, July 2014 - DOI: 10.1111/apt.12809

  • Recent Articles

    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