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    Jefferson Adams
    Brain Abnormalities in Patients with Celiac Disease and Neurological Issues
    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
    Can Going Gluten-free Protect You From Brain Disease?
    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 10/27/2014 - There have been a few reports tying cortical myoclonus with ataxia to celiac disease. Such reports also suggest that the former is unresponsive to a gluten-free diet.
    A team of researchers recently set out to determine if there is any significant connection between the two conditions. The research team included Ptolemaios G. Sarrigiannis, Nigel Hoggard, Daniel Aeschlimann, David S. Sanders, Richard A. Grünewald, Zoe C. Unwin, and Marios Hadjivassiliou.
    They are variously associated with the Departments of Gastroenterology, Neurology, Neurophysiology and Neuroradiology at Royal Hallamshire Hospital, in Sheffield, UK, and with the College of Biomedical and Life Sciences at Cardiff University in Cardiff, UK.
    The team presented detailed electro-clinical characteristics of a new syndrome of progressive cortical hyperexcitability with ataxia and refractory celiac disease. Regular follow ups of over 600 patients with neurological manifestations due to gluten sensitivity revealed 9 patients with this syndrome.
    They found that all nine patients, six men and three women, experienced asymmetrical irregular myoclonus involving one or more limbs and sometimes face. This was often stimulus sensitive and became more widespread over time. Three patients had a history of Jacksonian march, and five had at least one secondarily generalized seizure. Electrophysiology showed evidence of cortical myoclonus. Three showed a phenotype of epilepsia partialis continua at onset.
    All patients showed clinical, imaging and/or pathological evidence of cerebellar involvement. All patients followed a strict gluten-free diet, and most successfully eliminated gluten-related antibodies. However, all patients still showed evidence of enteropathy, suggests that refractory celiac disease is to blame.
    During the study, two patients died from enteropathy-associated lymphoma and one from status epilepticus. Five patients were treated with mycophenolate and one in addition with rituximab and IV immunoglobulins. These patients showed improvement of ataxia and enteropathy, but continued to suffer the effects of myoclonus.
    These results indicate that myoclonus ataxia might be the most common neurological manifestation of refractory celiac disease.
    The clinical involvement, apart from ataxia, covers the whole clinical spectrum of cortical myoclonus.
    Source:
    Cerebellum & Ataxias 2014, 1:11. doi:10.1186/2053-8871-1-11

    Jefferson Adams
    Israeli Researchers Propose Link Between Gluten and ALS
    Celiac.com 04/23/2015 - It's well-known that many people with celiac disease experience neuropathy and other nerve disorders. Now, a team of Israeli researchers are cautiously proposing a link between gluten reactions and ALS.
    The research team, from the Tel Aviv Medical Center, believes that the gluten sensitivity seen in people with celiac disease might have a connection with ALS, or amyotrophic lateral sclerosis. Their study linking tissue transglutaminase 6 antibodies to ALS is the first study to document a connection between ALS and antibodies to a particular enzyme. Also known as Lou Gehrig's disease, ALS is a progressive disease that attacks nerve cells and pathways in the brain and spinal cord, eventually causing paralysis.
    In the study, researcher Vivian Drory and her team found antibodies to an enzyme produced in the brain, called tissue transglutaminase 6 (TG6), in 23 out of 150 patients with ALS, but in only five of 115 healthy volunteer subjects. Furthermore, ALS patients showed higher concentrations of those antibodies.
    It's well documented that people with celiac disease produce antibodies to another transglutaminase, TG2, when they eat gluten, a protein in wheat, barley and rye. Interestingly, nearly half (45%) of patients with celiac disease also produce antibodies to TG6, even when they have no neurological symptoms.
    Droury's team set out to evaluate the prevalence of celiac disease-related antibodies and HLA antigen alleles, as well as TG6 antibodies, in patients with ALS and healthy individuals serving as controls to determine whether a neurologic presentation of a gluten-related disorder mimicking ALS might occur in some patients.
    They conducted a case-control study in an ALS tertiary center, where they measured serum levels of total IgA antibodies, IgA antibodies to transglutaminase 2 (TG2) and endomysium, along with IgA and IgG antibodies to deamidated gliadine peptide and TG6 and performed HLA antigen genotyping in 150 consecutive patients with ALS and 115 healthy volunteers of similar age and sex.
    Study subjects did not have any known autoimmune or gastroenterologic disorder, and none was receiving any immunomodulatory medications.
    The team found that ALS patients with antibodies to TG6 showed the classic picture of ALS and the typical rate of disease progression. The volunteers with antibodies to TG6 showed no signs of any disease.
    All patients and control group participants were seronegative to IgA antibodies to TG2, endomysium, and deamidated gliadine peptide. Twenty-three patients (15.3%) were seropositive to TG6 IgA antibodies as opposed to only 5 controls (4.3%) (P = .004). The patients seropositive for TG6 showed a classic picture of ALS, similar to that of seronegative patients.
    The team tested fifty patients and 20 controls for celiac disease-specific HLA antigen alleles; 13 of 22 TG6 IgA seropositive individuals (59.1%) tested seropositive for celiac disease-related alleles compared with 8 (28.6%) of the 28 seronegative individuals (P = .04).
    Average levels of IgA antibodies to TG6 were 29.3 (30.1) in patients and 21.0 (27.4) in controls (P = .02; normal, <26). Average levels of IgA antibodies to TG2 were 1.78 (0.73) in patients and 1.58 (0.68) in controls (normal, <10). In a subset of study participants, mean levels of deamidated gliadin peptide autoantibodies were 7.46 (6.92) in patients and 6.08 (3.90) in controls (normal, <16).
    None of the ALS patients or volunteers had the antibodies to TG2 that are commonly associated with celiac disease, but the ALS patients were more likely to show the genetic mutations that put them at risk for celiac disease.
    Drory said her team has begun to study TG6 antibody levels in patients newly diagnosed with ALS, and they will be testing the effects of a gluten-free diet in some of those that test positive. However, theirs is just one report, and Drory expects it will be at least a couple of years before the team has any solid results. Her team is also inviting further input from other centers, and study of their data.
    In the meantime, she warns ALS patients against adopting a gluten-free diet without "clear evidence of antibodies," because any imbalance of diet might prove harmful. It's also worth remembering that an association is not the same as a cause. At least one earlier study concluded that there was no association between TG6 antibodies and either neurological disease or gluten itself.
    The possibility of a link between celiac disease and a degenerative nerve disease like ALS is interesting, to say the least. The findings of this team will likely invite more examination of any connection between gluten reactions and nerve disorders, so stay tuned for any follow-up news.
    Source:
    JAMA Neurol. 2015 Apr 13. doi: 10.1001/jamaneurol.2015.48.

  • Recent Articles

    Jefferson Adams
    Did You Miss the Gluten-Free Fireworks This Past Fourth of July?
    Celiac.com 08/14/2018 - Occasionally, Celiac.com learns of an amusing gluten-free story after the fact. Such is the case of the “Gluten-Free Fireworks.” 
    We recently learned about a funny little event that happened leading up to Fourth of July celebrations in the town of Springdale in Northwest Arkansas. It seems that a sign advertising "Gluten Free Fireworks" popped up near a fireworks stand on interstate 49 in Springdale. 
    In case you missed the recent dose of Fourth of July humor, in an effort to attract customers and provide a bit of holiday levity, Pinnacle Fireworks put up a sign advertising "gluten-free fireworks.” 
    The small company is owned by Adam Keeley and his father. "A lot of the people that come in want to crack a joke right along with you," Keeley said. "Every now and then, you will get someone that comes in and says so fireworks are supposed to be gluten-free right? Have I been buying fireworks that have gluten? So then I say no, no they are gluten-free. It's just a little fun."
    Keeley said that their stand saw a steady flow of customers in the week leading up to the Fourth. In addition to selling “gluten-free” fireworks, each fireworks package sold by Pinnacle features a QR code. The code can be scanned with a smartphone. The link leads to a video showing what the fireworks look like.
    We at Celiac.com hope you and your family had a safe, enjoyable, and, yes, gluten-free Fourth of July. Stay tuned for more on gluten-free fireworks and other zany, tongue-in-cheek stories.
    Read more at kark.com
     

    Jefferson Adams
    Stress-Related Disorders Associated with Higher Risk for Autoimmune Disease
    Celiac.com 08/13/2018 - It’s not uncommon for people to have psychiatric reactions to stressful life events, and these reactions may trigger some immune dysfunction. Researchers don’t yet know whether such reactions increase overall risk of autoimmune disease.
    Are psychiatric reactions induced by trauma or other life stressors associated with subsequent risk of autoimmune disease? Are stress-related disorders significantly associated with risk of subsequent autoimmune disease?
    A team of researchers recently set out to determine whether there is an association between stress-related disorders and subsequent autoimmune disease. The research team included Huan Song, MD, PhD; Fang Fang, MD, PhD; Gunnar Tomasson, MD, PhD; Filip K. Arnberg, PhD; David Mataix-Cols, PhD; Lorena Fernández de la Cruz, PhD; Catarina Almqvist, MD, PhD; Katja Fall, MD, PhD; Unnur A. Valdimarsdóttir, PhD.
    They are variously affiliated with the Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; the Department of Epidemiology and Biostatistics, Faculty of Medicine, University of Iceland, Reykjavík, Iceland; the Department of Rheumatology, University Hospital, Reykjavík, Iceland; the Centre for Rheumatology Research, University Hospital, Reykjavík, Iceland; the National Centre for Disaster Psychiatry, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden; the Stress Research Institute, Stockholm University, Stockholm, Sweden; the Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; the Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden; the Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden; the Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; and the Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
    The team conducted a Swedish register-based retrospective cohort study that included 106, 464 patients with stress-related disorders, 1,064 ,640 matched unexposed individuals, and 126 ,652 full siblings to determine whether a clinical diagnosis of stress-related disorders was significantly associated with an increased risk of autoimmune disease.
    The team identified stress-related disorder and autoimmune diseases using the National Patient Register. They used Cox model to estimate hazard ratios (HRs) with 95% CIs of 41 autoimmune diseases beyond 1 year after the diagnosis of stress-related disorders, controlling for multiple risk factors.
    The data showed that being diagnosed with a stress-related disorder, such as post-traumatic stress disorder, acute stress reaction, adjustment disorder, and other stress reactions, was significantly associated with an increased risk of autoimmune disease, compared with matched unexposed individuals. The team is calling for further studies to better understand the associations and the underlying factors.
    Source:
    JAMA. 2018;319(23):2388-2400. doi:10.1001/jama.2018.7028  

    Jefferson Adams
    Gluten-Free Bacon-Wrapped Chicken Breasts
    Celiac.com 08/11/2018 - Need a quick, easy, reliable gluten-free dish that will satisfy everyone and leave the cook with plenty of time to relax? This recipe is sure to do the trick. Best of all, it's super easy. Just grab some chicken breasts, season them, hit them with a sprig of rosemary, wrap some bacon around them, and chuck them on the grill and call it dinner. Okay, you can add some rice and veggies.
    Ingredients:
    4 skinless, boneless chicken breast halves 4 thick slices bacon 4 teaspoons garlic powder 4 small sprigs fresh rosemary salt and pepper to taste Directions:
    Heat an outdoor grill to medium-high heat, and lightly oil the grate.
    Sprinkle 1 teaspoon garlic powder on a chicken breast and season with salt and pepper. 
    Place a rosemary sprig on each chicken breast. 
    Wrap the bacon around the chicken and the rosemary. 
    Hold bacon in place with a toothpick or extra rosemary stem.
    Cook the chicken breasts until no longer pink in the center and the juices run clear, about 8 minutes per side. 
    Keep an eye out for any grill flare ups from the bacon grease. 
    Remove the toothpicks and serve with steamed rice and your favorite vegetables for a winning meal.

    Connie Sarros
    Five-Minute Healthy Breakfasts
    Celiac.com 08/10/2018 - You’ve heard for years that it’s wise to start your day with a healthy breakfast.  Eating food first thing in the morning gets your metabolism revved so you have energy throughout the day.  There’s also the issue of incorporating healthy foods into your first meal of the day.  Ideally, every meal should include fiber and foods from a variety of food groups.  But the reality is that most people don’t have time in the morning to create an involved meal.  You’re busy getting ready for work, packing the kids’ lunches and trying to get everyone out of the door on time.  
    Don’t fret.  The task of preparing a healthy breakfast just got easier.  You can make 5-minute breakfasts and, with a little bit of planning, you can sneak fiber into those meals without spending a lot of extra time with preparation.  An ideal breakfast will include whole grains (from gluten-free cereals, breads, muffins, or uncontaminated oats), a low-fat dairy item (1% milk, low-fat yogurt, or low-fat cheese), and a source of protein (such as peanut butter or eggs).  Adding fruit is a plus.  
    If you can tolerate uncontaminated oats, make a bowl of oatmeal and add a little extra fiber by stirring in chopped walnuts and dried cranberries.  If you like scrambled eggs, toss some fresh spinach (sliced into thin strips), 1 chopped canned artichoke heart, two tablespoons crumbled feta cheese, and a dash of Italian seasoning to the egg as it cooks.  
    If you have time on weekends to make healthy gluten-free pancakes (which  means that you added perhaps flax seed meal or shredded apples or something that qualifies as fiber to the batter), then freeze the pancakes between sheets of wax paper, place them in a freezer bag, and freeze so they’ll be handy on busy weekday mornings.  If you don’t have time to make them prior to need, you can always use commercial frozen gluten-free pancakes.  In a bowl, mix together a few raisins, half of a chopped pear or apple, a few dashes of cinnamon and a couple of tablespoons of chopped walnuts.  Spoon this mixture down the centers of two toasted (or microwaved) pancakes, drizzle each with 1 teaspoon of pancake or maple syrup, then fold in the sides of the pancakes to make two breakfast sandwiches.
    Brown rice is brown because the bran layer is still on the rice, and the bran layer is the part that’s so high in fiber.  White rice is much lower in fiber and has less nutritional value.  Brown rice isn’t just for dinner anymore.  It offers a nice breakfast alternative from traditional hot cereals.  The next time you make brown rice for dinner, make a little extra and save some for breakfast the next morning.  In the A.M., mix the rice (about 1 cup) with a few chopped pecans, a few raisins, 1/2 cup milk, 3 tablespoons pancake syrup, a dash each of vanilla and cinnamon, then microwave the mixture for 1 minute, stirring once after 30 seconds.  Let it sit for 30 seconds to thicken before eating.  Or stir together 1 cup cooked brown rice, 1/4 teaspoon cinnamon, 1/2 navel orange diced, some chopped dates, dried cranberries, and shredded coconut; heat this in the microwave and then top it off with 1/2 cup low-fat vanilla yogurt.
    Just a note about using the microwave—it’s not an exact science.  Different ovens have different power levels so what cooks in 30 seconds in one person’s microwave may take 45 seconds in someone else’s unit.  Unless you want the food to splatter all over the sides of the oven, you’ll need to cover any liquids or soft foods with waxed paper.  
    There will be days when you don’t have time to sit down at the table and enjoy a leisurely breakfast.  On these days, make a “grab-and-go” breakfast that you can take with you.  Gluten-free wraps keep for several weeks in the refrigerator and they make great fill-and-go containers on busy mornings.  Spread a wrap with peanut butter, sprinkle some fortified gluten-free dry cereal on top, then drizzle with a teaspoon of pancake syrup; roll up the wrap and you have the perfect dashboard dining breakfast to eat on the way to work.  Or scramble an egg, spoon it down the center of the wrap, and then top it off with a little salsa and pepper-jack cheese before rolling it up. If you only have three minutes before you have to leave the house, spoon some low-fat cottage cheese into a cup, stir in a dash of cinnamon, top with a little low-fat gluten-free granola or fortified dry gluten-free cereal, sprinkle berries or chopped peaches over the top, grab a spoon, and you’re ready to go!
    Smoothies can be made in literally one minute.  Toss some frozen raspberries into a blender, add a 12-ounce container of low-fat lemon yogurt, a little milk, and two teaspoons of vanilla; blend, then pour the mixture into a large plastic cup.
    If you oversleep, don’t panic.  Have some back-up foods on hand that you can grab and eat en route to work, like a gluten-free protein bar and a banana, or a bag of nuts and dried fruit, or flax seed crackers with a handful of cheese cubes, or toss some gluten-free granola over a container of yogurt and grab a spoon to take along.
    All of the above suggestions can be made in five minutes or less.  Take the time to start your day off with a healthy breakfast—you deserve to do that for yourself and for your family.
    Apple English Muffins by Connie Sarros
    This recipe is from my newly-released book Student’s Vegetarian Cookbook for Dummies.  While this isn’t a gluten-free cookbook, most of the recipes are naturally gluten-free or can very easily be converted to gluten-free.  
    Preparation time:  4 minutes.  Cooking time:  30 seconds.  Yield:  1 serving
    Ingredients:
    1 tablespoon peanut butter  1 gluten-free English muffin, toasted  1/8 large apple, peeled, cored and sliced thin ½ teaspoon butter  ¾ teaspoon brown sugar 1/8 teaspoon cinnamon Directions:
    Spread peanut butter on one toasted English muffin half.  Lay the apple slices on top. In a small microwave safe bowl, heat the butter in the microwave on high for 15 seconds.  Stir in the brown sugar and cinnamon then nuke for another 15 seconds.  Stir until smooth.  (If necessary, pop it back into the microwave until the brown sugar melts).   Drizzle the cinnamon mixture over the apple slices then place the second half of the English muffin on top. Note:  If you’re out of apples, use a pear, ripe peach or nectarine, mango, or even a banana.

    Jefferson Adams
    Can a New Gluten-Free Cricket-Flour Cookbook Turn Americans on to Eating Bugs?
    Celiac.com 08/09/2018 - Whatever one might say about crawfish, shrimp and crustaceans in general, Americans don’t typically eat bugs. Can a former Ralph Lauren marketing executive turn the world on to flour made from crickets?
    Over the last few years, Americans have been presented with a buffet of alternative proteins and meals. Robyn Shapiro’s company, Seek, has created all-purpose, gluten-free, and Paleo blended flours, which can be used cup for cup in any recipe calling for flour. 
    The company, which makes pure cricket powder for smoothies, ice creams, and other liquid-based foods, is now selling cinnamon-almond crunch cricket protein and snack bites. To get the public interested in its cricket protein and cricket flour products, Shapiro has collaborated with famous chefs to create recipes for The Cricket Cookbook. 
    The book’s cast includes La Newyorkina chef Fany Gerson, a Mexico City native known for her cricket sundaes; noted Sioux chef and cookbook author Sean Sherman; and former Noma pastry chef Ghetto Gastro member, Malcolm Livingston, among others.
    Other companies have sought to promote the benefits of insect protein, including Chapul, which makes cricket protein bars and powders, and Exo, which makes dairy- and gluten-free cricket protein bars in flavors like cocoa nut and banana bread. These companies, along with others in the business tend to aim their products at Paleo dieters by promising more protein and no dairy.
    Seek’s chef-focused approach makes it unique. By pairing with noted chefs who already use bugs and bug protein in their cooking, Shapiro is looking to make the public more comfortable and confident in using bugs to cook and bake. So far, the response has been slow, but steady. Seek has already raised nearly $13,000 from 28 backers, well on its way toward its $25,000 goal. 
    Seek’s cricket flours and other products will initially only be available via Kickstarter. If that goes well, the products will be sold on Seek’s website. Early backers will get a discount and a chance for a signed copy of the book. Seek hopes to debut their products nationwide starting in the fall. 
    Could gluten-free cricket flour and the new cookbook be the next big gluten-free Christmas gift? Stay tuned for more on this and other gluten-free stories.
    Source:
    grubstreet.com