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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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    BONE SCREENING RECOMMENDED FOR NEWLY DIAGNOSED CELIAC KIDS


    Jefferson Adams

    Celiac.com 02/20/2009 - Doctors are recommending screening for bone density in children with newly diagnosed celiac disease.


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    A team of researchers recently set out to evaluate children with celiac disease for bone deficits in spine (SP) and whole body (WB) bone mineral content (BMC) at time of diagnosis, and to evaluate whether such deficits are associated with deviations in growth and body composition. Additionally, the team sought to assess the effect of histological grade on BMC.

    The research team was made up of doctors Muralidhar Jatla, Zemel, S. Babette, Patricia Bierly, and Ritu Verma associated with the Department of Pediatrics, Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia

    Their study was supported by the Nutrition Center at the Children's Hospital of Philadelphia and the Clinical and Translational Research Center from Clinical and Translational Science Award UL1-RR0241340. Their findings were reported in a recent issue of Gastroenterology.

    The team conducted a retrospective study that compared the results of children who had undergone a dual energy x-ray absorptiometry scan at the time of their celiac disease diagnosis against a healthy reference sample matched for age, race and geographic region in the United States. All celiac disease diagnosis occurred between October 1, 2003, and June 15, 2006.

    To evaluate differences between the celiac disease and the control group, the research team expressed SP and WB BMC as sex-specific z scores relative to age and relative to height. They performed Pearson correlation, t tests, and analysis of variance to assess predictors of BMC.

    They evaluated a total of forty-four children with celiac disease and compared them with 338 healthy controls. The celiac children averaged 10.6 ± 3.4 years of age, were 77% female, and 96% white. The children with celiac disease were shorter than their healthy counterparts of similar age, sex and region.

    The children with celiac disease also showed significantly lower SP and WB BMC for age z scores compared with controls. The children with celiac showed significant deficits in WB BMC, even once the figures were adjusted for height. Low SP and WB BMC were associated with advanced histological grade in celiac disease. Low body mass index was associated with low WB BMC in celiac disease.

    The research team concluded that screening for low bone mineral content may benefit children who are newly diagnosed with celiac disease, as those with low body mass index and those with advanced histological damage (Marsh grade IIIc) face an elevated risk of osteopenia.

    Journal of Pediatric Gastroenterology and Nutrition:Volume 48(2)February 2009p 175-180


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  • Related Articles

    admin

    Arch Intern Med. 2005;165:370-372, 393-399
    Celiac.com 03/09/2005 - According to a new study by researchers at Washington University School of Medicine in St. Louis, Missouri, everyone with osteoporosis should also be screened for celiac disease. The study looked at 840 people—266 with osteoporosis and 574 without—who were screened for celiac disease using serum anti-tissue transglutaminase (tTG) and anti-endomysial (EMA) antibodies—those who tested positive for either were given a follow-up biopsy. The serological screening results indicated that 12 (4.5%) of the 266 osteoporotic patients were positive for celiac disease, while only six (1.0%) of the 574 non-osteoporotic patients tested positive. Out of the osteoporotic patients who were positive, 3.4% were confirmed by a biopsy, while only 0.2% of the non-osteoporotic patients were confirmed via biopsy (2 of the serological positive group refused a follow-up biopsy). In the group with both celiac disease and osteoporosis, the researchers found a direct correlation between the severity of both diseases, and the treatment of these patients via a gluten-free diet dramatically improved the symptoms of both diseases.
    According to the researchers: The prevalence of celiac disease among osteoporotic patients was much higher than among the non-osteoporotic population and high enough to justify a recommendation that all individuals with osteoporosis undergo serologic screening for celiac disease.

    Jefferson Adams

    Celiac.com 04/10/2007 - According to a recent Swedish research report, the adverse immune response to gluten may be tied to a specific set of dendrite cells in the small intestine. A team led by Dr. J.F. Ludvigsson of Orebro University Hospital set out to compare rates of bone fracture in patients with celiac disease versus those from normal individuals. The goal of the study was to assess the connection between celiac disease and fractures.
    The study used Cox regression to examine over 13,000 patients with celiac disease, along with 65,000 people among the general population who were sex and age-matched. The Study tallied 1365 first hip fractures 4867 non-hip fractures.
    The results showed celiac disease to be a contributing factor in fractures at a rate of 4 fractures per 100,000 people per year, compared to a rate of 2 fractures per 100,000 people per year for non-celiacs.
    The study calculated the following hazard ratios for celiac-associated hip fracture:
    Adults: ¼ 2.1; 95% CI ¼ 1.8–2.4 Children: ¼ 2.6; 95% CI ¼ 1.1–6.2 For celiac-associated non-hip fractures, the hazard ratios were:
    Adults: ¼ 1.4; 95% CI ¼ 1.3–1.5 Children: ¼ 1.1; 95% CI ¼ 1.0–1.2 The study concludes that both adults and children with celiac disease run a significant risk of increased hip fractures and fractures of any type. These increased risks continue for at least 20 years following diagnosis. The study did not measure risk for undiagnosed celiacs, but common sense would indicate that the risks would be the same, or perhaps even greater. Clearly, more research is needed to determine the reasons for these increased fracture risks among celiac patients, and also to determine the associated risks for non-celiacs.
    Aliment Pharmacol Ther 25, 273–285
    health writer who lives in San Francisco and is a frequent author of articles for Celiac.com.

    Jefferson Adams
    Celiac.com 09/08/2010 - Children with celiac disease face high risks for bone disease without supplemental vitamins, according to a recent study by scientists at the Canada's University of Alberta. The study shows that without certain crucial vitamins, children with celiac disease face a greater risk for weak bones and osteoporosis.
    For the study, the research team evaluated 43 children and teens from three to 18 years of age with clinically proven celiac disease. They found that the children commonly showed low bone density, most likely from poor intake and absorption of vitamins and minerals.
    According to the results, the children with celiac disease got less than half of their recommended daily intake of Vitamin K. They also showed low Vitamin D levels, which can be normalized by eating fortified dairy products by regular sun exposure.
    That means kids with celiac disease need more of bone-promoting vitamins such as K and D as part of their regular nutrition, says Diana Mager who is professor of agricultural, food and nutritional science, and co-leader the research team together with Justine Turner, pediatric gastroenterologist in the Department of Pediatrics at the U of A.
    "Children with celiac disease are at risk for poor bone health, but by adding vitamins K and D to their diets, it can help reduce the risk of fractures and osteoporosis," Mager said. 
    Mager also recommends that children with celiac disease get outside as part of their regular play activity to build bone strength and boost Vitamin D levels.
    "Enjoying activities such as walking and running outdoors when there is more sunshine is a great way to contribute to healthy bones," Mager said.
    Source:

    University of Alberta

    Jefferson Adams
    Celiac.com 09/02/2013 - Most people with celiac disease are now diagnosed as adults, and many suffer from impaired bone mineralization.
    Researchers A.J Lucendo and A. García-Manzanares recently conducted a review of bone mineral density in patients with adult celiac disease.
    Their goal was to provide an updated discussion on the relationship between low bone mineral density (BMD), osteopenia and osteoporosis, and celiac disease.
    They conducted a search of relevant articles published in PubMed over the last 15 years. They also reviewed all sources cited in the article results to identify potential sources of information.
    They found that up to 75% of celiac patients can suffer from low BMD, which can occur at any age, independently of positive serological markers and presence of digestive symptoms.
    Patients with osteoporotic issues have significantly higher rates of celiac disease.
    The team proffers two theories which may explain the origins of low BMD in celiac patients. The first says that low BMD may result from malabsorption of micronutrients (including calcium and vitamin D) determined by villous atrophy, which has has been related to secondary hyperparathyroidism and incapacity to achieve the potential bone mass peak;
    The second theory says that low BMD may result from chronic inflammation, which was also related with RANKL secretion, osteoclasts activation and increased bone resorption.
    Whatever the cause of the low BMD, people with celiac disease have more than 40% higher rates of bone fractures compared to matched non-celiac individuals.
    Treatment of low BMD in celiac disease includes gluten-free diet, supplementation of calcium and vitamin D, and the use of biphosphonates, the effects of which on celiac disease have not been specifically studied.
    Up to 75% of people with celiac disease, and 40% of those diagnosed in adulthood show low BMD, along with increased risk of bone fractures.
    This information shows the potential importance of bone density scans for adults with celiac disease.
    Source:
     Rev Esp Enferm Dig. 2013 May;105(3):154-162.

  • Recent Articles

    Tammy Rhodes
    Celiac.com 04/24/2018 - Did you know in 2017 alone, the United States had OVER TENS OF THOUSANDS of people evacuate their homes due to natural disasters such as fires, floods, hurricanes, tornadoes and tsunamis? Most evacuation sites are not equipped to feed your family the safe gluten free foods that are required to stay healthy.  Are you prepared in case of an emergency? Do you have your Gluten Free Emergency Food Bag ready to grab and go?  
    I have already lived through two natural disasters. Neither of which I ever want to experience again, but they taught me a very valuable lesson, which is why I created a Gluten Free Emergency Food Bag (see link below). Here’s my story. If you’ve ever lived in or visited the Los Angeles area, you’re probably familiar with the Santa Ana winds and how bitter sweet they are. Sweet for cleaning the air and leaving the skies a brilliant crystal blue, and bitter for the power outages and potential brush fires that might ensue.  It was one of those bitter nights where the Santa Ana winds were howling, and we had subsequently lost our power. We had to drive over an hour just to find a restaurant so we could eat dinner. I remember vividly seeing the glow of a brush fire on the upper hillside of the San Gabriel Mountains, a good distance from our neighborhood. I really didn’t think much of it, given that it seemed so far from where we lived, and I was hungry! After we ate, we headed back home to a very dark house and called it a night. 
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    When our daughter was almost three years old, we left the West Coast and relocated to Northern Illinois. A place where severe weather is a common occurrence. Since the age of two, I noticed that my daughter appeared gaunt, had an incredibly distended belly, along with gas, stomach pain, low weight, slow growth, unusual looking stool, and a dislike for pizza, hotdog buns, crackers, Toast, etc. The phone call from our doctor overwhelmed me.  She was diagnosed with Celiac Disease. I broke down into tears sobbing. What am I going to feed my child? Gluten is everywhere.
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    Then, my second brush with a natural disaster happened, without any notice, leaving us once again scrambling to find a safe place to shelter. It was a warm and muggy summer morning, and my husband was away on a business trip leaving my young daughter and me to enjoy our summer day. Our Severe Weather Alert Radio was going off, again, as I continued getting our daughter ready for gymnastics.  Having gotten used to the (what seemed to be daily) “Severe Thunderstorm warning,” I didn’t pay much attention to it. I continued downstairs with my daughter and our dog, when I caught a glimpse out the window of an incredibly black looking cloud. By the time I got downstairs, I saw the cover to our grill literally shoot straight up into the air. Because we didn’t have a fenced in yard, I quickly ran outside and chased the cover, when subsequently, I saw my neighbor’s lawn furniture blow pass me. I quickly realized I made a big mistake going outside. As I ran back inside, I heard debris hitting the front of our home.  Our dog was the first one to the basement door! As we sat huddled in the dark corner of our basement, I was once again thinking where are we going to go if our house is destroyed. I was not prepared, and I should have been. I should have learned my lesson the first time. Once the storm passed, we quickly realized we were without power and most of our trees were destroyed. We were lucky that our house had minimal damage, but that wasn’t true for most of the area surrounding us.  We were without power for five days. We lost most of our food - our gluten free food.
    That is when I knew we had to be prepared. No more winging it. We couldn’t take a chance like that ever again. We were “lucky” one too many times. We were very fortunate that we did not lose our home to the Los Angeles wildfire, and only had minimal damage from the severe storm which hit our home in Illinois.
      
    In 2017 alone, FEMA (Federal Emergency Management Agency) had 137 natural disasters declared within the United States. According to FEMA, around 50% of the United States population isn’t prepared for a natural disaster. These disasters can happen anywhere, anytime and some without notice. It’s hard enough being a parent, let alone being a parent of a gluten free family member. Now, add a natural disaster on top of that. Are you prepared?
    You can find my Gluten Free Emergency Food Bags and other useful products at www.allergynavigator.com.  

    Jefferson Adams
    Celiac.com 04/23/2018 - A team of researchers recently set out to learn whether celiac disease patients commonly suffer cognitive impairment at the time they are diagnosed, and to compare their cognitive performance with non-celiac subjects with similar chronic symptoms and to a group of healthy control subjects.
    The research team included G Longarini, P Richly, MP Temprano, AF Costa, H Vázquez, ML Moreno, S Niveloni, P López, E Smecuol, R Mazure, A González, E Mauriño, and JC Bai. They are variously associated with the Small Bowel Section, Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital; Neurocience Cognitive and Traslational Institute (INECO), Favaloro Fundation, CONICET, Buenos Aires; the Brain Health Center (CESAL), Quilmes, Argentina; the Research Council, MSAL, CABA; and with the Research Institute, School of Medicine, Universidad del Salvador.
    The team enrolled fifty adults with symptoms and indications of celiac disease in a prospective cohort without regard to the final diagnosis.  At baseline, all individuals underwent cognitive functional and psychological evaluation. The team then compared celiac disease patients with subjects without celiac disease, and with healthy controls matched by sex, age, and education.
    Celiac disease patients had similar cognitive performance and anxiety, but no significant differences in depression scores compared with disease controls.
    A total of thirty-three subjects were diagnosed with celiac disease. Compared with the 26 healthy control subjects, the 17 celiac disease subjects, and the 17 disease control subjects, who mostly had irritable bowel syndrome, showed impaired cognitive performance (P=0.02 and P=0.04, respectively), functional impairment (P<0.01), and higher depression (P<0.01). 
    From their data, the team noted that any abnormal cognitive functions they saw in adults with newly diagnosed celiac disease did not seem not to be a result of the disease itself. 
    Their results indicate that cognitive dysfunction in celiac patients could be related to long-term symptoms from chronic disease, in general.
    Source:
    J Clin Gastroenterol. 2018 Mar 1. doi: 10.1097/MCG.0000000000001018.

    Connie Sarros
    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
    Due to personal health reasons and restrictions, I find that I need to retire. My husband and I can no longer travel the country speaking at conferences and to support groups (which we dearly loved to do) nor can I commit to writing more books, articles, or menus. Consequently, I will no longer be contributing articles to the Journal of Gluten Sensitivity. 
    My following books will still be available at Amazon.com:
    Gluten-free Cooking for Dummies Student's Vegetarian Cookbook for Dummies Wheat-free Gluten-free Dessert Cookbook Wheat-free Gluten-free Reduced Calorie Cookbook Wheat-free Gluten-free Cookbook for Kids and Busy Adults (revised version) My first book was published in 1996. My journey since then has been incredible. I have met so many in the celiac community and I feel blessed to be able to call you friends. Many of you have told me that I helped to change your life – let me assure you that your kind words, your phone calls, your thoughtful notes, and your feedback throughout the years have had a vital impact on my life, too. Thank you for all of your support through these years.

    Jefferson Adams
    Celiac.com 04/20/2018 - A digital media company and a label data company are teaming up to help major manufacturers target, reach and convert their desired shoppers based on dietary needs, such as gluten-free diet. The deal could bring synergy in emerging markets such as the gluten-free and allergen-free markets, which represent major growth sectors in the global food industry. 
    Under the deal, personalized digital media company Catalina will be joining forces with Label Insight. Catalina uses consumer purchases data to target shoppers on a personal base, while Label Insight works with major companies like Kellogg, Betty Crocker, and Pepsi to provide insight on food label data to government, retailers, manufacturers and app developers.
    "Brands with very specific product benefits, gluten-free for example, require precise targeting to efficiently reach and convert their desired shoppers,” says Todd Morris, President of Catalina's Go-to-Market organization, adding that “Catalina offers the only purchase-based targeting solution with this capability.” 
    Label Insight’s clients include food and beverage giants such as Unilever, Ben & Jerry's, Lipton and Hellman’s. Label Insight technology has helped the Food and Drug Administration (FDA) build the sector’s very first scientifically accurate database of food ingredients, health attributes and claims.
    Morris says the joint partnership will allow Catalina to “enhance our dataset and further increase our ability to target shoppers who are currently buying - or have shown intent to buy - in these emerging categories,” including gluten-free, allergen-free, and other free-from foods.
    The deal will likely make for easier, more precise targeting of goods to consumers, and thus provide benefits for manufacturers and retailers looking to better serve their retail food customers, especially in specialty areas like gluten-free and allergen-free foods.
    Source:
    fdfworld.com

    Jefferson Adams
    Celiac.com 04/19/2018 - Previous genome and linkage studies indicate the existence of a new disease triggering mechanism that involves amino acid metabolism and nutrient sensing signaling pathways. In an effort to determine if amino acids might play a role in the development of celiac disease, a team of researchers recently set out to investigate if plasma amino acid levels differed among children with celiac disease compared with a control group.
     
    The research team included Åsa Torinsson Naluai, Ladan Saadat Vafa, Audur H. Gudjonsdottir, Henrik Arnell, Lars Browaldh, and Daniel Agardh. They are variously affiliated with the Institute of Biomedicine, Department of Microbiology & Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Division of Pediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden; the Department of Clinical Science and Education, Karolinska Institute, Sodersjukhuset, Stockholm, Sweden; the Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; the Diabetes & Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; and with the Nathan S Kline Institute in the U.S.A.
    First, the team used liquid chromatography-tandem mass spectrometry (LC/MS) to analyze amino acid levels in fasting plasma samples from 141 children with celiac disease and 129 non-celiac disease controls. They then crafted a general linear model using age and experimental effects as covariates to compare amino acid levels between children with celiac disease and non-celiac control subjects.
    Compared with the control group, seven out of twenty-three children with celiac disease showed elevated levels of the the following amino acids: tryptophan; taurine; glutamic acid; proline; ornithine; alanine; and methionine.
    The significance of the individual amino acids do not survive multiple correction, however, multivariate analyses of the amino acid profile showed significantly altered amino acid levels in children with celiac disease overall and after correction for age, sex and experimental effects.
    This study shows that amino acids can influence inflammation and may play a role in the development of celiac disease.
    Source:
    PLoS One. 2018; 13(3): e0193764. doi: & 10.1371/journal.pone.0193764