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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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    COULD FRUCTAN BE THE CULPRIT IN NON-CELIAC GLUTEN SENSITIVITY?


    Jefferson Adams


    • A team of researchers recently set out to investigate the effect of gluten and fructans separately in individuals with self-reported gluten sensitivity


    Celiac.com 11/20/2017 - People who do not have celiac disease, but who have celiac-like symptoms that improve on a gluten-free diet are prime candidates for a condition called non-celiac gluten sensitivity (NCGS).


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    Researchers don't know much about the condition. There are no biomarkers, so they can't just do a blood test. People with this condition often experience celiac-like symptoms. Many of people with non-celiac gluten sensitivity see their symptoms improve on a gluten-free diet. However, these people may also have puzzling sensitivities to other foods that just don't seem to add up. Interestingly, foods with gluten often contain fructans, a type of fermentable oligo-, di-, monosaccharides and polyols (FODMAPs). Fructan is one such compound. Could fructan be the culprit?

    A team of researchers recently set out to investigate the effect of gluten and fructans separately in individuals with self-reported gluten sensitivity.

    The research team includes Gry I. Skodje, Vikas K. Sarna, Ingunn H. Minelle, Kjersti L. Rolfsen, Jane G. Muir, Peter R. Gibson, Marit B. Veierød, Christine Henriksen, Knut E.A. Lundin. They are variously affiliated with the Division of Cancer Medicine, Oslo University Hospital, Rikshospitalet, 0424 Oslo, Norway; the K. G. Jebsen Celiac Disease Research Centre, University of Oslo, Norway; the Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway; the Department of Gastroenterology, Monash University and Alfred Hospital, Melbourne, Victoria, Australia; the Department of Immunology and Transfusion Medicine, Oslo University Hospital, 0424 Oslo, Norway; and the Centre for Immune Regulation, University of Oslo, 0424 Oslo, Norway.

    For their double-blind crossover challenge, the team enrolled 59 individuals without celiac disease, but who followed a self-driven gluten-free diet. The team conducted the study at Oslo University Hospital in Norway from October 2014 through May 2016. The team randomly assigned study subjects to groups. For 7 days, each group ate muesli bars containing either 5.7 grams of gluten, 2.1 grams fructans, or a placebo.

    Subjects then underwent a washout period that lasted until the symptoms caused by the previous challenge were resolved. Washout period was a minimum of 7 days. After the washout period, participants crossed over into a different group, until they completed all 3 challenges.

    To measure symptoms, the team used the gastrointestinal symptom rating scale irritable bowel syndrome (GSRS-IBS) version. They used a linear mixed model for analysis.

    In this study of individuals with self-reported non-celiac gluten sensitivity, researchers found that fructans induced symptoms of irritable bowel syndrome, as measured by the gastrointestinal symptom rating scale.

    Clinicaltrials.gov no: NCT02464150

    See the article below for more information, including study results.

    Source:


    Image Caption: Image: CC--Miguel B
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  • Related Articles

    Jefferson Adams
    Celiac.com 11/30/2015 - A new study by researchers in Italy shows that only a minority of patients who meet clinical criteria for non-celiac gluten sensitivity actually show symptoms when exposed to gluten in a controlled gluten challenge. Why is that?
    Researchers haven't had much good information on whether symptoms in people who meet clinical diagnostic criteria for non-celiac gluten sensitivity (NCGS) are specifically triggered by gluten. To provide better information, a team of researchers recently set out to assess gluten sensitivity in patients diagnosed with NCGS.
    The research team includes B. Zanini; R. Basché; A. Ferraresi; C. Ricci; F. Lanzarotto; M. Marullo; V. Villanacci; A. Hidalgo; and A. Lanzini. They are variously affiliated with Department of Gastroenterology, and the Department of Pathology at the University and Spedali Civili of Brescia, Brescia, Italy, and the Department of Food, Environmental and Nutritional Sciences at the University of Milan, Milan, Italy.
    For their in a double-blind challenge study, their team looked at 31 females and 4 males without celiac disease, who were following a gluten-free diet (GFD). Participants were randomly broken into groups that received either gluten-containing flour or gluten-free flour for 10 days, followed by a 2-week washout period, followed by a switch in gluten-free/non-gluten-free diets.
    The main outcome measure was the test subjects' ability to identify which flour contained gluten. Secondary outcome measures were based upon Gastrointestinal Symptoms Rating Scale (GSRS) scores.
    Only 12 participants (34%) classified as having NCGS correctly pointed out the gluten-containing flour. These participants showed much higher average GSRS dimension scores following gluten challenge compared to baseline.
    The team measured scores for: pain, 1.7 ± 0.8 vs. 2.6 ± 1.0; reflux, 1.6 ± 0.5 vs. 2.2 ± 0.9; indigestion, 1.9 ± 0.7 vs. 3.2 ± 1.1; diarrhea, 1.6 ± 0.7 vs. 2.9 ± 1.5 and constipation, 1.9 ± 0.9 vs. 2.9 ± 1.3.
    Seventeen participants, nearly half, erroneously considered the gluten-free flour to contain gluten. Their average GSRS dimension scores were significantly higher following gluten-free flour challenge compared to baseline.
    The scores were: pain, 1.6 ± 0.9 vs. 3.0 ± 0.9; reflux, 1.4 ± 0.5 vs. 2.3 ± 1.1; indigestion, 2.0 ± 1.1 vs. 3.7 ± 1.1; diarrhea, 1.6 ± 0.7 vs. 3.0 ± 1.2 and constipation, 1.6 ± 0.9 vs. 2.6 ± 1.3.
    The other six participants (17%) were unable to distinguish between the flours.
    Based on this study, only about one in three patients with clinical non-celiac gluten sensitivity showed an adverse reaction to gluten.
    Clearly, more needs to be done to determine the exact nature of non-celiac gluten-sensitivity, and to determine what, if anything, may be driving these adverse reactions that can be triggered by non-gluten containing foods.
    Source:
    Aliment Pharmacol Ther. 2015;42(8):968-976.

    Jefferson Adams
    Celiac.com 08/09/2016 - Some researchers have suggested that gluten may not be the actual trigger of symptoms in non-celiac gluten sensitivity. Others feel that gluten is definitely the trigger, especially in certain cases.
    A team of researchers recently set out to evaluate patients with clinical non-celiac gluten sensitivity (NCGS), who presented with lymphocytic enteritis, positive celiac genetics and negative celiac blood tests. The team felt that the results would confirm that gluten is, in fact, the trigger of symptoms in this subgroup of patients.
    The research team included M Rosinach, F Fernández-Bañares, A Carrasco, M Ibarra, R Temiño, A Salas, and M Esteve. They are variously affiliated with the Department of Gastroenterology, Hospital Universitari Mutua Terrassa, Terrassa, Barcelona, Spain, the Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain, and with the Department of Pathology, Hospital Universitari Mutua Terrassa, Terrassa in Barcelona, Spain.
    The team conducted a double-blind randomized clinical trial of gluten vs placebo re-challenge on 18 patients over 18 years of age, HLA-DQ2/8+, negative celiac serology and gluten-dependent lymphocytic enteritis, and GI symptoms, with clinical and histological remission at inclusion.
    Eleven of the patients received 20 grams per day of gluten, while the seven others received a non-gluten placebo. The team measured clinical symptoms, quality of life (GIQLI), and presence of gamma/delta+ cells and transglutaminase deposits.
    The results showed that 91% of patients had clinical relapse during gluten challenge compared with just 28.5% after placebo (p = 0.01). Clinical scores and GIQLI worsened after gluten, but not after placebo (p<0.01).
    This study shows that gluten is definitely the trigger for symptoms in a subgroup of patients with clinical NCGS. After a gluten-free diet patients experienced positive celiac genetics, lymphocytic enteritis, and clinical and histological remission.
    Source:
    PLoS One. 2016 Jul 8;11(7):e0157879. doi: 10.1371/journal.pone.0157879. eCollection 2016.

    Jefferson Adams
    Celiac.com 01/02/2017 - New research shows that a group of proteins in wheat, called ATIs, may be responsible for activating inflammation in such disorders as celiac disease, multiple sclerosis, asthma, and rheumatoid arthritis.
    Scientists also believe that the proteins may promote the development of non-celiac gluten sensitivity. The findings were presented at UEG Week 2016 in Vienna in Vienna, Austria, a meeting organized by United European Gastroenterology for specialists to communicate the latest research in digestive and liver diseases.
    One group of proteins found in wheat - amylase-trypsin inhibitors (ATIs) - has been shown to trigger an immune response in the gut that can spread to other tissues in the body. ATIs are plant-derived proteins that inhibit enzymes of common parasites - such as mealworms and mealybugs - in wheat.
    Interestingly, ATIs also have an important role in metabolic processes that occur during seed development.
    The finding that ATIs may promote inflammation in the and beyond the gut, is a major step forward in understanding the mechanics of celiac disease and/or gluten-intolerance.
    Stay tuned for more news on this and other breaking stories in celiac disease research.
    Read more at MedicalNewsToday.com.

    Jefferson Adams
    Celiac.com 05/15/2017 - For all the talk of studies touting evidence for non-celiac gluten sensitivity, the actual data don't stack up very well, according to an recent assessment by two researchers, whose results appear in Clinical Gastroenterology and Hepatology.
    In an effort to determine the accuracy of using a double-blind, placebo-controlled study to confirm diagnosis of non-celiac gluten sensitivity in patients who respond to a gluten-free diet, researchers Javier Molina-Infante, and Antonio Carroccio recently set out to assess data on a series of such studies. Both researchers are affiliated with the Department of Gastroenterology, Hospital Universitario San Pedro de Alcantara in Caceres, Spain.
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    Most of the studies did find gluten challenge to significantly increase symptom scores compared with placebo. However, out of 231 NCGS patients, only 38 patients (16%) showed gluten-specific symptoms. Moreover, nearly half (40%) of these patients showed similar or increased symptoms in response to placebo; something researchers term a 'nocebo' effect. That leaves just 6 or 7 patients out of 231 showing gluten-specific symptoms.
    The researchers also point to heterogeneity and to potential methodology flaws in gluten challenge studies. They also present powerful questions about gluten as the trigger for symptoms in most patients with presumptive NCGS. Lastly, they highlight the importance of the nocebo effect in these types of studies.
    These results certainly invite more careful, rigorous studies on the matter, and challenge researchers to provide solid data from well-crafted double-blind placebo controlled studies.
    Basically, what little evidence we thought we had to support the existence of non-celiac gluten sensitivity has been shown to be thin at best. Until solid evidence arrives, the status of non-celiac gluten sensitivity will remain open to question and doubt by both researchers and potential sufferers.
    Source:
    Clin Gastroenterol Hepatol. 2017;15(3):339-348.

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    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?  
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    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.
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    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.” 
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    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.
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    Source:
    fdfworld.com

    Jefferson Adams
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    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.
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    Source:
    PLoS One. 2018; 13(3): e0193764. doi: & 10.1371/journal.pone.0193764