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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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    Celiac Kids with Obstructive Sleep Apnea Improve on a Gluten-Free Diet


    Jefferson Adams


    • Children with obstructive sleep apnea (OSA) often have enlarged tonsils and adenoids, and lymphatic hyperplasia is common to both OSA and celiac disease. 


    Celiac.com 04/09/2018 - Children with obstructive sleep apnea (OSA) often have enlarged tonsils and adenoids. Additionally, lymphatic hyperplasia, an increase in the number of normal cells that are contained in lymph nodes, is common to both OSA and celiac disease. Lymphoid hyperplasia is usually due to an infection with bacteria, viruses, or other types of germs and is part of the body's reaction to the infection.  A team of researchers recently set out to investigate the effect of a gluten-free diet on OSA symptoms in children with celiac disease.

    The research team included A Yerushalmy-Feler, R Tauman, A Derowe, E Averbuch, A Ben-Tov, Y Weintraub, D Weiner, A Amir, H Moran-Lev, and S Cohen. They are variously affiliated with the Pediatric Gastroenterology Unit, the Pediatric ENT Unit, and the Pediatric Sleep Center at "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center in Tel Aviv, Israel; and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.


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    The team recruited children with celiac disease from ages 2-18 before the children began a gluten-free diet. As a control group, the team included children with negative celiac serology who underwent gastrointestinal endoscopies for other reasons.  All participants completed a validated OSA-related symptoms questionnaire and the pediatric sleep questionnaire (PSQ) at the start of the study, and again 6 months later. 

    The team recruited thirty-four children with celiac disease, along with twenty-four control subjects. Both groups were similar in terms of gender, body mass index or season at recruitment between the two groups.  The control group showed more OSA-related symptoms compared to the celiac group, both at recruitment and at the 6-month follow-up. Both groups showed significant improvement in PSQ scores at the 6-month follow-up, but improvement was significantly higher in the celiac group compared to the control group.

    Kids with celiac disease had fewer OSA-related symptoms than control subjects, but they had much higher levels of symptom improvement once they were on a gluten-free diet. 

    Overall, the data from this study suggests that a gluten-free diet provides strong improvement of OSA-related symptoms in children with celiac disease.

    Source:


    Image Caption: Image: CC--Rachel Tayse
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  • Related Articles

    Jefferson Adams
    Celiac.com 09/24/2010 - A team of researchers recently found that people with celiac disease, even those following a gluten-free diet, also commonly suffer from sleep disorders that are related to depression, anxiety and fatigue.
    Since anxiety and depression both occur at higher rates in people with celiac disease than in the general population, the researchers were curious to see how celiac disease might affect quality of sleep.
    The research team included F. Zingone, M. Siniscalchi, P. Capone, R. Tortora, P. Andreozzi, E. Capone, and C. Ciacci. They are affiliated with the Department of Clinical and Experimental Medicine at Federico II University of Naples in Italy.
    In addition to finding that sleep disorders commonly affect people with celiac disease, regardless of gluten-free status, they also found that sleep disorders are less common in celiacs who score higher on quality of life scales, while those with low quality of life scores suffer at higher rates.
    For their study, the team evaluated people celiac disease at diagnosis, celiacs on a gluten-free diet at follow-up, and a group of healthy control subjects. All patients completed the Pittsburgh Sleep Quality Index (PSQI), SF36, Zung and Fatigue scales and State-Trait Anxiety Inventory (STAI).
    Their results showed that people with celiac disease at diagnosis and those following a gluten-free diet showed higher PSQI scores than did healthy volunteers (P < 0.001). PSQI scores were no lower for those following a gluten-free diet than for the others with celiac disease (P = 0.245).
    People with celiacs disease at diagnosis and those on a gluten-free diet scored similarly on the other tests, but differed sharply from the healthy control subjects.
    Patients who had higher individual scores for overall physical and mental fitness (r = −0.327, P = 0.002, and r = −0.455, P < 0.001, respectively) had higher overall PSQI scores.
    Factors influencing sleep quality were depression (r = 0.633, P < 0.001), fatigue (r = 0.377, P < 0.001), state anxiety (r = 0.484, P < 0.001) and trait anxiety (r = 0.467, P < 0.001).
    So, if you or someone you love has celiac disease, be prepared to address sleep issues, and maybe consider doing everything possible to ensure a good night's rest.
    Source:

    Alimentary Pharmacology & Therapeutics. DOI: 10.1111/j.1365-2036.2010.04432.x

    Jefferson Adams
    Celiac.com 01/23/2013 - Can going gluten-free bring about a major improvement in mental health for some children?
    This question is addressed in recent article by Mary Lochner. In the article, Lochner talks about the challenges she faced in trying to raise her daughter who, for the first couple of years, seemed to become more and more emotionally volatile and unstable, even while her daughter's twin brother seemed just fine.
    Lochner details her trips to multiple pediatricians and behavioral therapists in an effort to get an answer for her daughter's behavior.
    Initially, the behavioral therapists pretty much dismissed her concerns and, when Lochner asked what she could do to calm her daughter down, told her to “Try distracting her…Give her a toy that makes noise. Or sit her down in front of the T.V. for a while.”
    Unimpressed with the advice, Lochner says she knew, as a mother often does, that something was, in fact, wrong with her child. In the mean time, her daughter's temper was becoming progressively more volatile. She began having behavioral episodes during the night, as well as during the day. The first time it happened, she woke up screaming hysterically at 2 a.m. Lochner found a new pediatrician for her daughter, one who took her concerns seriously.
    He ran Mary Jean through a test or screening for everything from iron deficiency to autism. At the same time, she continued to do her own research, and began to wonder if the problem might be Sensory Processing Disorder.
    It was during this time that Lochman stumbled onto the writings of nutritionist, Kelly Dorfman, who had co-authored an article in the Huffington Post which claimed that gluten intolerance sometimes manifests with “neurological symptoms.” The basic thrust of the article was that, for some people, gluten-sensitivity can cause neurological symptoms.
    While she was investigating that possibility, s came across an article from the March 2012 Huffington Post called “Is Sensory Processing Disorder the New Black?” The article described the case of a child whose extreme behavioral symptoms disappeared after her mother put her on a gluten-free diet after consulting a nutritionist.
    For Lochman, the article hit close to home, and led her to read Kelly Dorfman’s book concerning nutritional origins of childhood illnesses: What’s Eating Your Child? Initially, Lochman says she was skeptical of claims of major behavioral improvement in children who had gone gluten-free, and regarded much of what she'd heard about gluten-free diets with some doubt.
    However, she did bring up the book with her pediatrician, and, rather than dismissing her, the doctor confirmed that gluten can cause behavioral problems in some gluten-sensitive children. He suggested that her daughter go gluten-free for a month, then back on gluten for a month, then gluten-free a second month, and that she keep a journal of her daughter's behavior.
    By doing the gluten-free trial twice, she and the doctor would be able to confidently confirm that any improvement in my daughter’s behavior was due to the removal of gluten, and not to coincidence.
    During the first month on a gluten-free diet, her daughter’s episodes decreased sharply, but Lochman was still skeptical. However, when she went back to eating gluten during the second month, the emotional outbursts and episodes came back in less than a week. By the end of that second month, she found herself looking forward to returning her daughter to the gluten-free diet for month three of the trial. In the third month, her daughter’s episodes rapidly decreased during the first two weeks. By the end of the month, they were down to only two or three times a week.
    This is when Lochman really knew something was up. She says that she thought that her daughter was seeing a major shift, if not a miracle cure. She quick to tell people how she was wrong to think that. That's because, Lochmans says that taking gluten out of her daughter's life was, in fact, a miracle cure. She says that after just six weeks on the gluten-free diet, "her daughter's 'awful screaming and flailing episodes, the ones that would last for hours and come out of nowhere, were gone. Vanished. A thing of the past. It was like she was a completely new, and different, person."
    Lochman describes a daughter who now only gets upset with good reason, and who is highly responsive…a daughter who now looks her in the eyes again, who easily relaxes to snuggle, and who is ebullient, curious, affectionate, and "so thoroughly level-headed you would be hard pressed to connect her to her former self."
    For her part, Kelly Dorfman notes that non-celiac gluten-sensitivity has only recently been identified as a distinct medical condition, one that resists conventional tests for diagnosing celiac disease. She says that she commonly sees patients in her practice for whom behavior and mood issues are the only symptoms of gluten intolerance.
    Dorman's new book is due to be re-released in April under a new title, Cure Your Child With Food, and includes a new chapter with more on information on 'bizarre' gluten-related effects on behavior and more.
    Read Mary Lochner's full article in the Anchorage Press.

    Jefferson Adams
    06/04/2014 - A Swedish research team study of nearly four decades of population-based data shows that rates of celiac disease are rising in most age groups of children.
    The research team included Fredinah Namatovu, Olof Sandström, Cecilia Olsson, Marie Lindkvist, and Anneli Ivarsson. They are variously affiliated with the Department of Public Health and Clinical Medicine, Epidemiology and Global Health, the Department of Clinical Sciences, Paediatrics, and the Department of Food and Nutrition, all at Umeå University, in Umeå, Sweden.
    In order to assess variations by age, sex and birth cohort, and to determine the clinical impact of these changes, their research team recently looked at rates of biopsy-proven celiac disease in children in Sweden over a 36-year period. The team used the National Swedish Childhood Celiac Disease Register to identify 9,107 children under 15 years of age who were diagnosed with celiac disease from 1973 to 2009.
    From 1973 to 1990 the register covered 15% of the the Swedish population, increasing to 40% during 1991–1997, and then to 100% from 1998 onwards. The research team estimated annual celiac rates, cumulative incidence and clinical impact by age groups, calendar month and birth cohorts.
    Their results show that celiac disease rates are increasing in children aged 2–14.9 years. One encouraging piece of data revealed that celiac rates in children 1.9 years and under decreased sharply in the most recent years.
    Average age for celiac diagnosis rose from 1.0 year in the 1970s to 6.8 years by 2009. The average number of new cases rose from about 200 during 1973–1983 to about 600 during 2004–2009.
    In the birth cohorts of 2000–2002 the cumulative incidence even exceeded that of the epidemic cohorts at comparable ages. The highest overall rates were seen in those born between 1985–1995 and 2000–2002.
    Celiac disease risk varies between birth cohorts, which indicates environmental and/or lifestyle risk factors may be at play in triggering celiac disease. Finding new prevention strategies will require further research.
    Source:
    BMC Gastroenterology 2014, 14:59. doi:10.1186/1471-230X-14-59

    Jefferson Adams
    Celiac.com 01/11/2017 - Researchers know that canonical Wnt/β-catenin signaling controls the homeostasis of intestinal epithelium by regulating the balance between intestinal stem cell regeneration and differentiation, but they really don't know much at all about the non-genetic mechanics of the process.
    One research team recently set out to test a hypothesis that the epigenetic regulator, Polycomb Repressive Complex-2 (PRC2), plays a role in Wnt-mediated epithelial homeostasis on the crypt-villus axis, and that defects in the process are implicated both in celiac disease and intestinal cancers.
    The research team included Mikko Oittinen, Alina Popp, Kalle Kurppa, Katri Lindfors, Markku Mäki, Minna U. Kaikkonen, and Keijo Viiri. They are variously associated with the Tampere Centre for Child Health Research, University of Tampere, Department of Pediatrics and Tampere University Hospital, Tampere, Finland, with the Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland, and with the University of Medicine and Pharmacy “Carol Davila” at the Department of Pediatrics and Institute for Mother and Child Care in Bucharest, Romania.
    Their study showed that PRC2 establishes repressive crypt and villus specific trimethylation of histone H3 lysine 27 (H3K27me3) signature on genes responsible for nutrient transport and cell killing in crypts and, proliferation and differentiation in mature villi, suggesting that PRC2 facilitates the Wnt-governed intestinal homeostasis.
    When celiac patients regularly consume gluten, PRC2 goes out-of-bounds active, and its target genes in the intestinal epithelium are negatively impacted. Colorectal adenomas, and carcinomas, also differentially express a significant set of effective intestinal PRC2 targets. This indicates that PRC2 initiates and maintains polar crypt and villus specific H3K27me3 signatures.
    Because H3K27me3 is a mark enriched in developmentally important genes, identified intestinal PRC2 targets are possibe imperative drivers for enterocyte differentiation and intestinal stem cell maintenance downstream to Wnt-signaling. This research also clarifies the mechanics driving crypt hyperplasia in celiac disease, and suggests that PRC2-dependent fostering of epithelial stemness is a common aspect of intestinal diseases marked by epithelial hyperplasia or neoplasia.
    Lastly, the team's research shows that in the gut, PRC2 represses genes having both pro-stemness and pro-differentiation functions, a fact that should be weighed when designing non-genetic therapies including PRC2 as a drug target.
    Source:
    Stem Cells 2016

  • 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. 
    But, one of the main problems in protein engineering has to do with the way proteins fold into their various three-dimensional structures. Until recently, no one has been able to decipher the rules that will predict how proteins fold into those three-dimensional structures.  So even if researchers were somehow able to design a protein with the right shape for a given job, they wouldn’t know how to go about making it from protein’s building blocks, the amino acids.
    But now, scientists like William DeGrado, a chemist at the University of California, San Francisco, and David Baker, director for the Institute for Protein Design at the University of Washington, say that designing proteins will become at least as important as manipulating DNA has been in the past couple of decades.
    After making slow, but incremental progress over the years, scientists have improved their ability to decipher the complex language of protein shapes. Among other things, they’ve gained a better understanding of how then the laws of physics cause the proteins to snap into folded origami-like structures based on the ways amino acids are attracted or repelled by others many places down the chain.
    It is this new ability to decipher the complex language of protein shapes that has fueled their progress. UCSF’s DeGrado is using these new breakthroughs to search for new medicines that will be more stable, both on the shelf and in the body. He is also looking for new ways to treat Alzheimer’s disease and similar neurological conditions, which result when brain proteins fold incorrectly and create toxic deposits.
    Meanwhile, Baker’s is working on a single vaccine that would protect against all strains of the influenza virus, along with a method for breaking down the gluten proteins in wheat, which could help to generate new treatments for people with celiac disease. 
    With new computing power, look for progress on the understanding, design, and construction of brain proteins. As understanding, design and construction improve, look for brain proteins to play a major role in disease research and treatment. This is all great news for people looking to improve our understanding and treatment of celiac disease.
    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.
    But that commitment came to an ignoble end recently as Starbucks admitted that their gluten-free sandwich was plagued by  “low sales,” and was simply not sustainable from a company perspective. The sandwich may not have sold well, but it was much-loved by those who came to rely on it.
    With the end of that sandwich came the complaints. Customers on social media were anything but quiet, as seen in numerous posts, tweets and comments pointing out the callous and tone-deaf nature of the announcement which took place in the middle of national Celiac Disease Awareness Month. More than a few posts threatened to dump Starbucks altogether.
    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