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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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    Gluten-free Diet and Body Mass in Normal-weight and Overweight Children with Celiac Disease


    Jefferson Adams

    Celiac.com 12/19/2011 - Very little data has been collected about how body mass relates to celiac disease in children in the United States. Recently, a team of researchers sought to document the way celiac disease presents in children with normal and with elevated body mass index (BMI) for age, and to study BMI changes in those kids following a gluten-free diet.


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    Photo: CC--dboyThe research team included Norelle Rizkalla Reilly, Kathleen Aguilar, Benjamin G. Hassid, Jianfeng Cheng, Amy R. DeFelice, Philip Kazlow, Govind Bhagat, and Peter H. Green. They are variously affiliate with Columbia University School of Medicine.

    The team reviewed data from patients treated at their specialty clinic from 2000 to 2008, for whom follow-up growth data available. In all, they evaluated 142 children from 13 months to 19 years in age, all with biopsy-proven celiac disease.

    To compare the results, they assessed patient height, weight, and BMI by age (z score), and grouped results by BMI as underweight, normal, or overweight.

    To be certain which of the patients were following a gluten-free diet, the team used results of serological assays, and data of noncompliant patients, which they assessed separately.

    Their analysis included only data gathered during the observation period, which they then expressed as change in height, weight, and BMI z score per month of dietary treatment.

    They found that almost 1 in 5 (19%) of patients showed an elevated BMI at diagnosis (12.6% were overweight, while 6% obese). Nearly 3 out of 4 patients (74.5%) showed normal BMI.

    The team followed each patient for an average of 35.6 months. Three out of four patients (75%) with an elevated BMI at diagnosis showed a substantial decrease in BMI z scores after following a gluten-free diet. Nearly half (44%) of those patients showed a normalized BMI after following a gluten-free diet.

    North American children with celiac disease frequently present as either normal weight or overweight. Patients with normal BMI at diagnosis showed sharply higher weight z scores after following a gluten-free diet, and 13% became overweight. This means that normal weight individuals will likely gain weight on a gluten-free diet, and that just over one in ten will become overweight.

    However, for overweight and obese children with celiac disease, the results indicate that a gluten-free diet may be helpful in lowering BMI.

    Source:

    • JPGN 2011;53: 528–531

    Image Caption: Photo: CC--dboy
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    After reading the post with good tips, I thought it would be good to mention that a person should also gauge the amount of calories they eat by the amount of calories their body burns. There actually is available an online calculator that will tell you how many calories your body is burning and how many calories you should eat per day to gain or lose weight.

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    It might be helpful to know if whether gluten free substitutes were regularly eaten by those whose BMI increased.

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  • Related Articles

    Jefferson Adams
    Celiac.com 03/19/2012 - A clinical gastroenterology research team recently weighed in on the practice of using weight as a factor to screen for celiac disease. They are calling for doctors to ignore body-mass when assessing patients for possible celiac disease screening.
    The team was made up of Fabio Meneghin, Dario Dilillo, Cecilia Mantegazza, Francesca Penagini, Erica Galli, Giulia Ramponi, and Gian Vincenzo Zuccotti. They are affiliated with the Department of Pediatrics of the Università di Milano Luigi Sacco Hospital in Milan, Italy.
    The team argues that, more and more, people with clinical celiac disease are presenting widely varied symptoms, while classic gastrointestinal symptoms like diarrhea or failure to thrive are becoming less frequent at diagnosis.
    In fact, data shows that symptoms once considered to be atypical are now appearing at least as often as classical symptoms related to nutritional malabsorption.
    Recent studies and case reports show that the expected clinical-condition of malnutrition, typical in a disease where there is a disorder of absorption, is less frequent than in the past. Meanwhile, overweight and even obesity are increasingly common in people with as yet undiagnosed celiac disease.
    The team points out that obesity has become the most prevalent nutritional disorder among children and adolescent of United States, and also in many European countries. They note that a rates of overweight and obesity have doubled in a single generation.
    They use these facts to encourage doctors to screen for celiac disease without regard for the patient’s body weight, and thus speeding diagnosis and avoiding possible clinical consequences for patients.
    For now, their call has been rejected by the editors of Gastroenterology Research and Practice. However, look for this kind of call to be echoed in the future, as data are compiled, and the realities of celiac disease are better understood.
    Source:

    Gastroenterology Research and Practice

    Jefferson Adams
    Celiac.com 05/25/2012 - A team of researchers recently set out to examine body mass and obesity risk in a large population of people with celiac disease who are following a gluten-free diet.
    The research team included T. A. Kabbani, A. Goldberg, C. P. Kelly, K. Pallav, S. Tariq, A. Peer, J. Hansen, M. Dennis & D. A. Leffler. They are affiliated with the Department of Medicine and Division of Gastroenterology at Beth Israel Deaconess Medical Center in Boston, Massachusetts.
    Diagnosis for celiac disease is on the rise, and many people who are diagnosed experience weight changes once they adopt a gluten-free diet. There's a pretty good amount of study data on weight change on a gluten-free diet, but a very limited amount of data regarding changes in body mass.
    The researchers wanted to look at a large population of people with celiac disease, who followed a gluten-free diet to better understand changes in body mass index (BMI) following celiac diagnosis.
    To do this, they looked at a total of 1018 patients with biopsy confirmed celiac disease. The patients had all previously visited the Beth Israel gastroenterology clinic in Boston.
    The team recorded data for initial and follow-up BMIs, and used an expert dietitian to assess patient compliance with a gluten-free diet. They found a total of 679 patients with at least two recorded BMIs and GFD adherence data, and used data from those patients in their study. The average amount of time from first BMI measurement to follow-up measurement was 39.5 months.
    When they compared the results against data for the general population, they found that celiac disease patients on a gluten-free diet were significantly less likely to be overweight or obese (32% vs. 59%, P < 0.0001).
    They also found that average body mass increased significantly after patients adopted a gluten-free diet (24.0 to 24.6; P < 0.001). Overall, 21.8% of patients with normal or high BMI at study entry increased their BMI by more than two points.
    The results of this study show that celiac disease patients on a gluten-free diet have lower BMI than the regional population at diagnosis, but that BMI increases with a gluten-free diet, especially in those who follow the diet closely.
    Still, even though overall risk of obesity is lower than the regular population, once celiac patients adopt a gluten-free diet, 15.8% of patients move from a normal or low BMI class into an overweight BMI class, and 22% of patients overweight at diagnosis gain weight.
    As a result, the study team feels that weight maintenance counseling should be an integral part of celiac dietary education.
    Source:
    Alimentary Pharmacology & Therapeutics. 2012;35(6):

    Jefferson Adams
    Celiac.com 08/27/2012 - Because so many patients are now overweight upon diagnosis for celiac disease, and so fee present as classically underweight, doctors are revising the clinical presentation guidelines for celiac disease diagnosis.
    That being said, some researchers have voiced concern that some patients might gain further weight while on a gluten-free diet.
    Recently, a team of researchers conducted a study to assess the impact of a gluten-free diet on body mass index (BMI) in a nationwide group of celiac patients and to isolate any variables that might help to predict favorable or unfavorable BMI changes.
    The research team included Anniina Ukkola, Markku Mäki, Kalle Kurppa, Pekka Collin, Heini Huhtala, Leila Kekkonen, and Katri Kaukinen. They are affiliated variously with the School of Medicine, University of Tampere, and the Department of Gastroenterology and Alimentary Tract Surgery at Tampere University Hospital, both in Tampere, Finland.
    To assess weight and disease-related issues, the researchers looked at 698 newly detected adults who were diagnosed with celiac disease by classical or extra-intestinal symptoms or by screening.
    The researchers measured BMI upon celiac diagnosis and after one year on a gluten-free diet. They then compared the results against data for the general population.
    Study data showed that 4% of patients were underweight at celiac diagnosis, 57% were normal weight, 28% were overweight and 11% were obese.
    On a gluten-free diet, 69% of underweight patients gained weight, while 18% of overweight and 42% of obese patients lost weight. BMI remained stable for the other patients.
    Both symptom- and screen-detected celiac patients showed similar results. The patients with celiac disease showed a more favorable BMI pattern than the general population.
    The most favorable BMI changes were seen in patients with self-rated gluten-free diet expertise, along with those who were younger upon diagnosis. Dietary counseling did not seem to impact .
    The initial method of detection does not seem to matter for people with celiac disease who are following a gluten-free diet. Both screen-detected and symptom-detected celiac disease patients who followed a gluten-free diet showed similar improvements in body mass index (BMI).
    Source:
    European Journal of Internal Medicine Volume 23, Issue 4, Pages 384-388, June 2012

    Jefferson Adams
    Celiac.com 04/06/2015 - Several studies have shown that many patients with celiac disease experience changes in body weight after starting a gluten-free diet, but researchers still don't have much data on rates of metabolic syndrome in this population.
    A team of researchers recently set out to assess rates of metabolic syndrome in patients with celiac at diagnosis, and at one year after starting gluten-free diet. The research team included R. Tortora, P. Capone, G. De Stefano, N. Imperatore, N. Gerbino, S. Donetto, V. Monaco, N. Caporaso, and A. Rispo. They are affiliated with the Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy, or with the Department of Education and Professional Studies, King's College London, London, UK.
    For their study, the team enrolled all consecutive patients with newly diagnosed celiac disease who were referred to their third-level celiac disease unit. For all patients the team collected data on waist circumference, BMI, blood pressure, HDL cholesterol, triglycerides, and blood sugar levels.
    The team diagnosed metabolic syndrome according to the International Diabetes Federation (IDF) criteria for European countries. They reassessed rates of metabolic syndrome in patients after 12 months of gluten-free diet.
    The team assessed ninety-eight patients with celiac disease, two (2%) who fulfilled the diagnostic criteria for metabolic syndrome at diagnosis, and 29 patients (29.5%) after 12 months of gluten-free diet (P < 0.01; OR: 20).
    After 1 year on a gluten-free diet, the team compared the patient data to baseline, with respect to metabolic syndrome sub-categories. They found 72 vs. 48 patients exceeded waist circumference cut-off (P < 0.01; OR: 2.8); 18 vs. 4 patients had high blood pressure (P < 0.01; OR: 5.2); 25 vs. 7 patients exceeded glycemic threshold (P = 0.01; OR: 4.4); 34 vs. 32 patients with celiac disease had reduced levels of HDL cholesterol (P = 0.7); and 16 vs. 7 patients had high levels of triglycerides (P = 0.05).
    The results of this study show that celiac disease patients have a high risk of developing metabolic syndrome 1 year after starting a gluten-free diet.
    To address this, the research team recommends an in-depth nutritional assessment for all patients with celiac disease.
    Source: 
    Aliment Pharmacol Ther. 2015;41(4):352-359.

  • Recent Articles

    Jefferson Adams
    Celiac.com 05/22/2018 - Proteins are the building blocks of life. If scientists can figure out how to create and grow new proteins, they can create new treatments and cures to a multitude of medical, biological and even environmental conditions.
    For a couple of decades now, scientists have been searching for a biological Rosetta stone that would allow them to engineer proteins with precision, but the problem has remained dauntingly complex.  Researchers had a pretty good understanding of the very simple way that the linear chemical code carried by strands of DNA translates into strings of amino acids in proteins. 
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    Source:
    Bloomberg.com

    Jefferson Adams
    Celiac.com 05/21/2018 - Just a year ago, Starbucks debuted their Canadian bacon, egg and cheddar cheese gluten-free sandwich. During that year, the company basked in praise from customers with celiac disease and gluten-sensitivity for their commitment to delivering a safe gluten-free alternative to it’s standard breakfast offerings.
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    A few of the choice tweets include the following:  
    “If I’m going to get coffee and can’t eat anything might as well be DD. #celiac so your eggbites won’t work for me,” tweeted @NotPerryMason. “They’re discontinuing my @Starbucks gluten-free sandwich which is super sad, but will save me money because I won’t have a reason to go to Starbucks and drop $50 a week,” tweeted @nwillard229. Starbucks is not giving up on gluten-free entirely, though. The company will still offer several items for customers who prefer gluten-free foods, including Sous Vide Egg Bites, a Marshmallow Dream Bar and Siggi’s yogurt.
    Stay tuned to learn more about Starbucks gluten-free foods going forward.

    Jefferson Adams
    Celiac.com 05/19/2018 - Looking for a nutritious, delicious meal that is both satisfying and gluten-free? This tasty quinoa salad is just the thing for you. Easy to make and easy to transport to work. This salad of quinoa and vegetables gets a rich depth from chicken broth, and a delicious tang from red wine vinegar. Just pop it in a container, seal and take it to work or school. Make the quinoa a day or two ahead as needed. Add or subtract veggies as you like.
    Ingredients:
    1 cup red quinoa, rinsed well ½ cup water ½ cup chicken broth 2 radishes, thinly sliced 1 small bunch fresh pea sprouts 1 small Persian cucumber, diced 1 small avocado, ripe, sliced into chunks Cherry or grape tomatoes Fresh sunflower seeds 2 tablespoons red wine vinegar  Kosher salt, freshly ground pepper Directions:
    Simmer quinoa in water and chicken broth until tender.
    Dish into bowls.
    Top with veggies, salt and pepper, and sunflower seeds. 
    Splash with red wine vinegar and enjoy!

    Jefferson Adams
    Celiac.com 05/18/2018 - Across the country, colleges and universities are rethinking the way they provide food services for students with food allergies and food intolerance. In some cases, that means major renovations. In other cases, it means creating completely new dining and food halls. To document both their commitment and execution of gluten-free and allergen-free dining, these new food halls are frequently turning to auditing and accreditation firms, such as Kitchens with Confidence.
    The latest major player to make the leap to allergen-free dining is Syracuse University. The university’s Food Services recently earned an official gluten-free certification from Kitchens with Confidence for four of the University’s dining centers, with the fifth soon to follow.
    To earn the gluten-free certification from Kitchens with Confidence, food services must pass a 41 point audit process that includes 200 control check points. The food service must also agree to get any new food item approved in advance, and to submit to monthly testing of prep surfaces, to furnish quarterly reports, and to provide information on any staffing changes, recalls or incident reports. Kitchens with Confidence representatives also conduct annual inspections of each dining center.
    Syracuse students and guests eating at Ernie Davis, Shaw, Graham and Sadler dining centers can now choose safe, reliable gluten-free food from a certified gluten-free food center. The fifth dining center, Brockway, is currently undergoing renovations scheduled for completion by fall, when Brockway will also receive its certification.
    Syracuse Food Services has offered a gluten-free foods in its dining centers for years. According to Jamie Cyr, director of Auxiliary Services, the university believes that the independent Gluten-Free Certification from Kitchens with Confidence will help ease the anxiety for parents and students.”
    Syracuse is understandably proud of their accomplishment. According to Mark Tewksbury, director of residence dining operations, “campus dining centers serve 11,000 meals per day and our food is made fresh daily. Making sure that it is nutritious, delicious and safe for all students is a top priority.”
    Look for more colleges and universities to follow in the footsteps of Syracuse and others that have made safe, reliable food available for their students with food allergies or sensitivities.
    Read more.

    Zyana Morris
    Celiac.com 05/17/2018 - Celiac disease is not one of the most deadly diseases out there, but it can put you through a lot of misery. Also known as coeliac, celiac disease is an inherited immune disorder. What happens is that your body’s immune system overreacts to gluten and damages the small intestine. People who suffer from the disease cannot digest gluten, a protein found in grain such as rye, barley, and wheat. 
    While it may not sound like a severe complication at first, coeliac can be unpleasant to deal with. What’s worse is it would lower your body’s capacity to absorb minerals and vitamins. Naturally, the condition would cause nutritional deficiencies. The key problem that diagnosing celiac is difficult and takes take longer than usual. Surprisingly, the condition has over 200 identified symptoms.
    More than three million people suffer from the coeliac disease in the United States alone. Even though diagnosis is complicated, there are symptoms that can help you identify the condition during the early stages to minimize the damage. 
    Here is how you can recognize the main symptoms of celiac disease:
    Diarrhea
    In various studies conducted over years, the most prominent symptom of celiac disease is chronic diarrhea.
    People suffering from the condition would experience loose watery stools that can last for up to four weeks after they stop taking gluten. Diarrhea can also be a symptom of food poisoning and other conditions, which is why it makes it difficult to diagnose coeliac. In certain cases, celiac disease can take up to four years to establish a sound diagnosis.
    Vomiting
    Another prominent symptom is vomiting.  
    When accompanied by diarrhea, vomiting can be a painful experience that would leave you exhausted. It also results in malnutrition and the patient experiences weight loss (not in a good way though). If you experience uncontrolled vomiting, report the matter to a physician to manage the condition.
    Bloating
    Since coeliac disease damages the small intestine, bloating is another common system. This is due to inflammation of the digestive tract. In a study with more than a 1,000 participants, almost 73% of the people reported bloating after ingesting gluten. 
    Bloating can be managed by eliminating gluten from the diet which is why a gluten-free diet is necessary for people suffering from celiac disease.
    Fatigue
    Constant feeling of tiredness and low energy levels is another common symptom associated with celiac disease. If you experience a lack of energy after in taking gluten, then you need to consult a physician to diagnose the condition. Now fatigue can also result from inefficient thyroid function, infections, and depression (a symptom of the coeliac disease). However, almost 51% of celiac patients suffer from fatigue in a study.
    Itchy Rash
    Now the chances of getting a rash after eating gluten are slim, but the symptom has been associated with celiac disease in the past. The condition can cause dermatitis herpetiformis, which causes a blistering skin rash that occurs around the buttocks, knees, and elbows. 
    A study found out that almost 17% of patients suffering from celiac disease might develop dermatitis herpetiformis due to lack of right treatment. Make sure you schedule an online appointment with your dermatologist or visit the nearest healthcare facility to prevent worsening of symptoms.
    Even with such common symptoms, diagnosing the condition is imperative for a quick recovery and to mitigate the long-term risks associated with celiac disease. 
    Sources:
    ncbi.nlm.nih.gov  Celiac.com ncbi.nlm.nih.gov  mendfamily.com