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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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    FIRST USE OF ECHOCARDIOGRAPHY TO ASSESS LEFT VENTRICULAR FUNCTION IN CELIAC PATIENTS


    Jefferson Adams

    Celiac.com 02/16/2015 - Celiac is predominantly a disease of the small intestine characterized by chronic malabsorption in genetically susceptible individuals who ingest grains containing. gluten, such as wheat, barley, and rye.


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    Image: Wikimedia Commons--EkkoUsing strain and strain rate echocardiography imaging, a research team set out to assess left ventricular function in patients with celiac disease.

    The research team included S. Cenk, D.B. Aylin, A. Fatma Ebru, A.B. Nihal, Ö.S. Sevil, B. Serdal, B. Emine, A. Hüseyin, K. Telat, D. Tahir, E. Osman, and B. Engin. For their study, the team included twenty celiac patients and twenty healthy control subjects. They assessed left ventricle systolic and diastolic functions using standard 2-dimension, M-mode, conventional Doppler echocardiography. They obtained strain and strain rate parameters for 8 segments of the left ventricle.

    They found no significant differences between patients and controls regarding left ventricle function as assessed by 2-dimensional, M-mode, conventional Doppler.

    Initially, differences between strain rate values did not reach statistical significance, but when strain and average strain values were considered together, statistically significant differences emerged between the groups. For the first time a research team has been able to determine the subclinical effect of celiac disease on left ventricular systolic function by using strain echocardiography imaging.

    Their success shows the potential value of assessing cardiac involvement in celiac patients using these echocardiographic techniques.

    Source:


    Image Caption: Image: Wikimedia Commons--Ekko
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    Celiac.com 12/11/2006 – A retrospective cohort study presented by Gunnar Midhagen with his Doctoral and Licentiate Theses at Linköping University, Sweden, found that those with diagnosed celiac disease actually have a 47% lower cancer risk than the normal population, presumably because a majority of them follow a gluten-free diet (although the study did not address this). The study also found that those with celiac disease have a 38% higher mortality rate than the normal population, which is due to a 48% higher rate of death due to ischemic heart disease. It would be interesting to determine what causes the higher heart disease risk, and I would speculate that it has to do with fat absorption—specifically the decreased ability of those with celiac disease to absorb omega-3 fatty acids. More on this topic can be found in this article:
    Heart Failure, Cardiomyopathy and Celiac Disease By Laura Yick Here is the abstract of the study:


    High Mortality in Ischemic Heart Disease in Patients with Celiac Disease
    Gunnar Midhagen
    Department of Internal Medicine, Skovde Hospital, Skovde, Sweden
    INTRODUCTION: "Previous reports about increased risks of malignancies and mortality in patients with celiac disease have been criticized as skewed by selection bias, because they emanate from referral centers. Recent register based studies indicate lower risks, but are contingent on complete registration."
    AIMS & METHODS: "Our aim was to perform a retrospective cohort study of all celiac disease patients residing in two Swedish counties and evaluate the risks of malignancies and excess mortality. All diagnosed celiac disease patients 15 years or older who were residents of the örebro and Linköping hospitals primary catchment areas on 31 Dec. 1986 were identified and followed up for at least 15 years. All celiac disease patients were checked against the Swedish hospital inpatient register. Standardized mortality ratios (SMR) and standard incidence ratios of cancer (SIR) were calculated."
    RESULTS: "There was a 47 percent lower risk of all malignancies in our total celiac population SIR=0.53 (95% C.I. 0.31-0.83) as compared with the general population. Total mortality was increased by 38% (SMR 1.38, 95% C.I. 1.08-1.75) as compared with the general population and was most pronounced in patients over 65 years (SMR 1.46).This was mainly explained by a 48% increased death rate in ischemic heart disease, significant in patients over 65 years (SMR 1.58, 95% C.I. 1.00-2.06). "
    CONCLUSION: "In a population based setting including all patients with celiac disease, there was no increased risk of malignancies. However, this study confirms an excess mortality risk, which appears to be attributable to ischemic heart disease mainly in patients over 65 years of age."

    Jefferson Adams
    Celiac.com 10/05/2011 - Researchers have established a number of inflammatory markers as risk factors for atrial fibrillation (AF), but they know very little about how autoimmune diseases affect AF.
    A team of researchers recently set out to examine the association between celiac disease and AF in a large cohort of patients with biopsy-verified celiac disease.
    The research team included Louise Emilsson, J. Gustav Smith, Joe West, Olle Melander, and Jonas F. Ludvigsson.
    They are affiliated variously with Arvika Hospital in Arvika, Sweden, the Department of Cardiology at Lund University in Lund, Sweden, the Broad Institute of Harvard and MIT in Cambridge, MA, USA, the Department of Clinical Sciences at Lund University in Malmö, Sweden, the Division of Epidemiology and Public Health at University of Nottingham, Nottingham City Hospital, the Nottingham Digestive Diseases Centre, NIHR Biomedical Research Unit in Nottingham, UK, the Department of Pediatrics, Örebro University Hospital in Örebro, Sweden, the Clinical Epidemiology Unit, Department of Medicine at Karolinska University Hospital and Karolinska Institutet in Stockholm, Sweden.
    For their study, the team used reports from biopsies performed between 1969 and 2008 at all 28 pathology departments in Sweden. They used reports of March 3 villous atrophy to identify 28,637 patients with celiac disease.
    The team then used the Swedish Total Population Register to compile a group of 141,731 individuals, who were matched for age and sex.
    The team gathered data on AF via the Swedish Hospital Discharge Register, the Hospital Outpatient Register, and the Cause of Death Register. They used Cox regression to estimated hazard ratios (HRs) for AF.
    Over an average follow-up period of nine-years, 941 individuals form the group with celiac disease developed AF, compared with 2918 from the control group.
    The adjusted HR for AF was 1.34 (95% CI = 1.24–1.44). The absolute risk of AF for the group with celiac disease was 321 for each 100,000 person-years, with an excess risk of 81 of 100,000.
    People with a prior AF diagnosis also faced a higher risk of subsequent celiac disease (odds ratio = 1.45, 95% CI = 1.31–1.62).
    The data show that atrial fibrillation is slightly more common both before and after celiac disease diagnosis in patients with celiac disease.
    Potential explanations for higher AF risk in people with celiac disease include chronic inflammation and shared risk factors, but sampling bias may also play a part.
    These results indicate that people with  biopsy-proven celiac disease face a slightly higher risk of atrial fibrillation.
    These findings are consistent with previous studies that increased levels of inflammatory markers means higher levels of atrial fibrillation.
    However, further study is required to isolate the direct link between atrial fibrillation and autoimmune diseases, such as celiac disease.
    Source:

    http://eurheartj.oxfordjournals.org/content/early/2011/06/07/eurheartj.ehr167.short?rss=1

    Jefferson Adams
    Celiac.com 05/05/2014 - People with celiac disease face double the risk of coronary artery disease compared with the general population, according to research to be presented at the American College of Cardiology's 63rd Annual Scientific Session.
    The data for the study were gathered by researchers using electronic health records of patients from 13 participating health care systems between January 1999 and September 2013. Out of a total of nearly 22.4 million patients, they found 24,530 with celiac disease. Patients without celiac disease served as controls.
    The researchers found was no difference in smoking status or diabetes rates between the two groups. Those with celiac disease had slightly higher cholesterol levels, but lower rates of high blood pressure.
    All patients were adults. For both groups, the team found comparable rates of traditional risk factors for coronary artery disease including sex, race, diabetes, high cholesterol, high blood pressure and smoking.
    Overall, the researchers found a significantly higher rates of coronary artery disease among patients with celiac disease compared to the control population. The rates were 9.5 percent for patients with celiac disease, compared to 5.6 percent, of the general population.
    Data showed a similar trend among younger patients, those under age 65, with with 4.5 percent of patients with celiac disease compared to 2.4 percent for those without celiac disease.
    People with celiac disease have some persistent low-grade inflammation in the gut that can spill immune mediators into the bloodstream, which can then accelerate the process of atherosclerosis and, in turn, coronary artery disease," said R.D. Gajulapalli, M.D., clinical associate at the Cleveland Clinic and co-investigator of the study.
    These findings “reinforce the idea that chronic inflammation, whether it's from an infection or a disease, can have an adverse role in coronary artery disease and general heart health, even in the absence of traditional cardiovascular risk factors," Gajulapalli said.
    The team was surprised by the “strength of the association, especially in younger people,” and, in addition to further study, they are calling for patients and doctors to be aware of this association.
    Source:
    Medical express.com

    Jefferson Adams
    Celiac.com 03/13/2015 - People who suffer from celiac disease with persistent villous atrophy do not face any higher risk of ischemic heart disease or atrial fibrillation, according to a recent study by a research team in Sweden.
    This is important, because patients with celiac disease do face an increased risk of death from cardiovascular causes, so it is mildly encouraging that persistent villous atrophy resulting from gluten exposure does not appear to affect overall or cardiovascular mortality.
    The research team, led by Dr. Jonas F. Ludvigsson from Karolinska University Hospital in Stockholm, studied 7,440 celiac disease patients, 43% with persistent villous atrophy, who had follow-up biopsies, along with up to five controls each, matched for age, gender, county, and calendar year.
    Overall risk of ischemic heart disease was not significantly higher in the patients with celiac disease. After adjusting for age at follow-up biopsy, gender, duration of celiac disease, and other factors, they found no significant difference in the risk of ischemic heart disease risk between patients with villous atrophy and those with mucosal healing.
    Similarly, patients with villous atrophy had no higher risk of atrial fibrillation than those with mucosal healing.
    Factors associated with ischemic heart disease risk included being male, older, and having lower educational levels. Factors associated with atrial fibrillation risk included being male and being older.
    Source:
    Medscape

  • 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