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    Jefferson Adams is a freelance writer living in San Francisco. He has covered Health News for Examiner.com, and provided health and medical content for Sharecare.com. His work has appeared in Antioch Review, Blue Mesa Review, CALIBAN, Hayden's Ferry Review, Huffington Post, the Mississippi Review, and Slate, among others.

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    Scott Adams
    Rasmusson CG, Eriksson MA.
    Department of Pedodontics, Uddevalla Hospital, Uddevalla, Sweden.
    Int J Paediatr Dent 2001 May;11(3):179-83
    Celiac.com 05/08/2003 - In a study from Finland in 1986 it was shown that celiac disease was often associated with tooth enamel defects of permanent teeth. This study also showed a strong association between the time of gluten challenge in the diagnostic procedure and enamel defects. In the current study, dental examinations were carried out for a group of 40 children and adolescents suffering from celiac disease diagnosed according to the criteria of The European Society of Pediatric Gastroenterology and Nutrition (ESPGAN) at the Department of Pediatrics, Hospital of Uddevalla, Sweden. A control group made of 40 healthy children of the same age, sex and living area was examined in the same way. The results failed to show disturbances of the same type, degree of severity or frequency as was reported in Finland and no statistically significant differences concerning enamel defects were found between the patients with celiac disease and the controls.
    PMID: 11484467

    Claire Atkin
    Celiac.com 06/02/2009 - Celiac disease is an autoimmune disorder thatis triggered by gluten, and it is being diagnosed more often than inthe past. Previously considered quite rare, it is now estimated tooccur in 1 in 100-150 people in all societies (with the possibleexception of Japan). Physical activity counters some of the lastingsymptoms of celiac disease, but some of the symptoms actually mayinhibit physical activity. Older adults (+55) with celiac disease mayhave positive or negative attitudes toward physical activity. As itstands, we’re not sure whether celiac disease helps or hinders theirwill to exercise.

    There are many symptoms associated with celiac disease. They mayinclude neurological symptoms, physical symptoms and overall feelingsof fatigue or depression. This makes celiac disease difficult toidentify, but also forces individuals with celiac disease to find theirown individualized balanced lifestyles. Balanced lifestyles areespecially important for older adults with celiac disease because, asanyone diagnosed with a disease knows, they must maintain theirphysical wellbeing in order to heal. Older adults with celiac diseaseare also at risk of gaining weight after starting a gluten free dietbecause their bodies absorb nutrients so much more efficiently thanbefore, and because many gluten-free breads and desert substitutes maybe higher in calories than their gluten-containing counterparts.

    Because each person with celiac disease exhibits different symptoms,each older adult with celiac disease must find their own way of livingwith the disease. Their will to excercise depends on how celiac diseasehas affected their appetite, energy level, mental health, nervoussystem and overall body functions.

    Research about the attitudes of older adults with celiac disease toward physical activity will help to understand:

    The general attitudes of older adults with celiac disease toward physical activity; The symptoms of celiac disease that directly or indirectly affect older adults’ attitudes toward physical activity; How physicians, recreation centres, celiac associations and theCanadian Government can work with people with celiac disease tomaintain or increase their levels of physical activity, and; Provide literature on nutrient deficiency and physical activityto patients in need of information or reassurance about their attitudestoward physical activity.
    Celiac disease may negatively affect the attitudes of people withceliac disease toward physical exercise and activity in two differentways. First, celiac disease symptoms inhibit exercise. Chronic andacute pain, fatigue, bruising and other symptoms associated withnutrient deficiency and celiac disease recovery could easily affect themotivation that people with celiac disease have to exercise. Second,the exercise may exacerbate symptoms of celiac disease. 

    Certain studies have shown that allergies can exacerbate or inducefood-dependent allergy symptoms (Sampson, 2003). If someone with celiacdisease were to experience symptoms as if they were having an allergicreaction to gluten when they conducted certain exercises, they wouldeither try to push through, stop, or change their exercise program orschedule. They could exercise only in the morning, before breakfast andafter a long period of not eating, or they could choose activities withless physical impact, such as walking/hiking, or biking.

    Symptoms of celiac disease may also encourage exercise. If an olderadult with celiac disease finds out that they have low bone density,they may choose to increase their weight bearing activity to encouragebone growth.

    There is a long list of symptoms that are associated with celiacdisease. Some of the symptoms of celiac disease that are documented inliterature about include:
     No obvious physical symptoms (just fatigue, overall not feeling well) Gastrointestinal symptoms Fatigue Weight loss Pallor (unhealthy pale appearance) Flatulence Borborygmi (stomach rumbling) Nausea Vomiting Anorexia Voracious appetite Iron deficiency anemia Failure to thrive Lymphocytic gastritis Vitamin B12 deficiency Vitamin D deficiency Hypocalcaemia/ hypomagnesaemia Vitamin K deficiency Coetaneous bleeding Epitasis (nose bleeding) Hematuria (red urine) Gastrointestinal hemorrhage
    Celiac Disease affects the nutrient absorption level of the smallintestine, and people diagnosed with celiac disease should therefore betested for vitamin deficiencies. Side effects of nutrient deficiencyvary from person to person, but the level of nutrient deficiency mayaffect the amount that someone with celiac disease will exercise. Forexample, a person's calcium absorption rate may affect their bonedensity, and a person's iron absorption rate may affect their energylevels. In general, weight-bearing exercise is associated with strongerbone density. Anemia (lack of iron), though, decreases a person’senergy levels. Depending on the person, the two opposing influences offatigue and bone density loss may sway the person’s attitude towardexercise in different ways.

    This is the subject of a human geography honours project at theUniversity of Victoria. If you have any comments on the subject, pleasecontact me by using the comment form below this article.

    Related Articles:
    Sampson, H.A. (2003). Food Allergy. Journal of Allergy Clinical Immunology. 111:2, S540-S547. Sategna-Guidetti, C. et al. (2000). The effects of 1-year glutenwithdrawal on bone mass, bone metabolism and nutritional status innewly diagnosed adult coeliac disease patients. Alimentary Pharmacology& Therapeutics. 14, 35-43. Palosuo, K. (2003). Transglutaminase-mediated cross-linking of apeptic fraction of w-5 gliadin enhances lgE reactivity inwheat-dependent, exercise-induced anaphylaxis. Journal of Allergy andClinical Immunocology: 111:6, 1386-1392.


    Jefferson Adams
    Celiac.com 11/07/2011 - Fat-soluble vitamin malabsorption, inflammation and/or under-nutrition put children with celiac disease at risk for decreased bone mineral density.
    A research team recently set out to determine how vitamin D and K might influence bone mineral density and bone growth in children and adolescents with celiac disease. The study team included D. R. Mager, J. Qiao, and J. Turner.
    The team's goal was to examine the interrelationships between vitamin K/D levels and lifestyle factors on bone mass density in children and adolescents with celiac disease at diagnosis and after 1 year on the gluten-free diet.
    The team studied children and adolescents aged 3–17 years with biopsy proven celiac disease at diagnosis and after 1 year on the gluten-free diet.
    To measure bone mineral density the researchers used dual-energy X-ray absorptiometry, factoring in relevant variables including anthropometrics, vitamin D/K status, diet, physical activity and sun exposure.
    The children saw their lowest BMD-z scores for whole-body and lumbar-spine (−1) at diagnosis (10–20%) and after 1 year (30–32%), independent of symptoms.
    Older children (>10 years) showed substantially lower BMD-z scores for whole-body (−0.55±0.7 versus 0.72±1.5) and serum levels of 25(OH) vitamin D (90.3±24.8 versus 70.5±19.8 nmol/l) 
    as compared with younger children (10 years) (P<0.001).
    Overall, forty-three percent showed suboptimal vitamin D status (25(OH)-vitamin D <75 nmol/l) at diagnosis. Nearly half of these vitamin D deficiencies corrected after 1 year on the gluten-free diet.
    Also, twenty-five percent of the children showed suboptimal vitamin K status at diagnosis. All vitamin K deficiencies resolved after 1 year.
    Both children and adolescents with celiac disease face a substantial risk for suboptimal bone health at time of diagnosis and up to 1 year after adopting a gluten-free diet. This higher risk is likely due in part to suboptimal vitamin D/K levels.
    Children and teens with celiac disease may benefit from treatment regimens that promote optimal vitamin K/D intake.
    Source:

    European Journal of Clinical Nutrition, (5 October 2011) | doi:10.1038/ejcn.2011.176

    Jefferson Adams
    Celiac.com 07/12/2012 - A research team affiliated with the Department of Endocrinology and Nutrition at Complejo Hospitalario Mancha Centro in Alcázar de San Juan, Spain, recently set out to study how bone mineral density correlates with duodenal Marsh stage in newly diagnosed adult celiac patients. The team made up of A. García-Manzanares, J.M. Tenias, and A.J. Lucendo.
    For their study, the researchers wanted to estimate the rates of low bone mineral density (BMD) in adult celiac patients and to better understand nutritional and metabolic factors associated with osteoporosis and osteopenia.
    To do so, they recruited patients a consecutive group of 40 adults (36 females/4 males), between the ages of 18 and 68, who were newly diagnosed with celiac disease. Average patient age was 44.25 years.
    For each patient, the researchers conducted bone density scans on the left hip and lumbar spine using dual-energy X-ray absorptiometry. They also assessed nutritional parameters and conducted a hormone study to exclude secondary low BMD.
    Overall, at diagnosis 45% of patients showed low BMD at both hip and lumbar spine. Risk of hip fracture was generally low, but climbed into the mild range for patients with villous atrophy (p = 0.011).
    The team also found that major fracture risk varied according to Marsh stage (p = 0.015). They found significant differences in nutritional status between patients with and without duodenal villous atrophy. Marsh III stage patients showed substantially reduced body mass index and blood levels of pre-albumin, iron, vitamin D and folic acid.
    The team found no differences found in blood hormone levels between Marsh stages or BMDs.
    They found that the amount of bone mass loss in the lumbar spine was directly tied to Marsh stage. They found a parallel association between BMD and Marsh stage in the hip, but this was not statistically significant.
    Overall, results showed that duodenal villous atrophy, through malabsorption, was the main factor for low BMD in patients with adult-onset celiac disease.
    Source:
    Scand J Gastroenterol. 2012 May 16.

  • Recent Articles

    Christina Kantzavelos
    Celiac.com 07/20/2018 - During my Vipassana retreat, I wasn’t left with much to eat during breakfast, at least in terms of gluten free options. Even with gluten free bread, the toasters weren’t separated to prevent cross contamination. All of my other options were full of sugar (cereals, fruits), which I try to avoid, especially for breakfast. I had to come up with something that did not have sugar, was tasty, salty, and gave me some form of protein. After about four days of mixing and matching, I was finally able to come up with the strangest concoction, that may not look the prettiest, but sure tastes delicious. Actually, if you squint your eyes just enough, it tastes like buttery popcorn. I now can’t stop eating it as a snack at home, and would like to share it with others who are looking for a yummy nutritious snack. 
    Ingredients:
    4 Rice cakes ⅓ cup of Olive oil  Mineral salt ½ cup Nutritional Yeast ⅓ cup of Sunflower Seeds  Intriguing list, right?...
    Directions (1.5 Servings):
    Crunch up the rice into small bite size pieces.  Throw a liberal amount of nutritional yeast onto the pieces, until you see more yellow than white.  Add salt to taste. For my POTS brothers and sisters, throw it on (we need an excess amount of salt to maintain a healthy BP).  Add olive oil  Liberally sprinkle sunflower seeds. This is what adds the protein and crunch, so the more, the tastier.  Buen Provecho, y Buen Camino! 

    Jefferson Adams
    Celiac.com 07/19/2018 - Maintaining a gluten-free diet can be an on-going challenge, especially when you factor in all the hidden or obscure gluten that can trip you up. In many cases, foods that are naturally gluten-free end up contain added gluten. Sometimes this can slip by us, and that when the suffering begins. To avoid suffering needlessly, be sure to keep a sharp eye on labels, and beware of added or hidden gluten, even in food labeled gluten-free.  Use Celiac.com's SAFE Gluten-Free Food List and UNSAFE Gluten-free Food List as a guide.
    Also, beware of these common mistakes that can ruin your gluten-free diet. Watch out for:
    Watch out for naturally gluten-free foods like rice and soy, that use gluten-based ingredients in processing. For example, many rice and soy beverages are made using barley enzymes, which can cause immune reactions in people with celiac disease. Be careful of bad advice from food store employees, who may be misinformed themselves. For example, many folks mistakenly believe that wheat-based grains like spelt or kamut are safe for celiacs. Be careful when taking advice. Beware of cross-contamination between food store bins selling raw flours and grains, often via the food scoops. Be careful to avoid wheat-bread crumbs in butter, jams, toaster, counter surface, etc. Watch out for hidden gluten in prescription drugs. Ask your pharmacist for help about anything you’re not sure about, or suspect might contain unwanted gluten. Watch out for hidden gluten in lotions, conditioners, shampoos, deodorants, creams and cosmetics, (primarily for those with dermatitis herpetaformis). Be mindful of stamps, envelopes or other gummed labels, as these can often contain wheat paste. Use a sponge to moisten such surfaces. Be careful about hidden gluten in toothpaste and mouthwash. Be careful about common cereal ingredients, such as malt flavoring, or other non-gluten-free ingredient. Be extra careful when considering packaged mixes and sauces, including soy sauce, fish sauce, catsup, mustard, mayonnaise, etc., as many of these can contain wheat or wheat by-product in their manufacture. Be especially careful about gravy mixes, packets & canned soups. Even some brands of rice paper can contain gluten, so be careful. Lastly, watch out for foods like ice cream and yogurt, which are often gluten-free, but can also often contain added ingredients that can make them unsuitable for anyone on a gluten-free diet. Eating Out? If you eat out, consider that many restaurants use a shared grill or shared cooking oil for regular and gluten-free foods, so be careful. Also, watch for flour in otherwise gluten-free spices, as per above. Ask questions, and stay vigilant.

    Jefferson Adams
    Celiac.com 07/18/2018 - Despite many studies on immune development in children, there still isn’t much good data on how a mother’s diet during pregnancy and infancy influences a child’s immune development.  A team of researchers recently set out to assess whether changes in maternal or infant diet might influence the risk of allergies or autoimmune disease.
    The team included Vanessa Garcia-Larsen, Despo Ierodiakonou, Katharine Jarrold, Sergio Cunha,  Jennifer Chivinge, Zoe Robinson, Natalie Geoghegan, Alisha Ruparelia, Pooja Devani, Marialena Trivella, Jo Leonardi-Bee, and Robert J. Boyle.
    They are variously associated with the Department of Undiagnosed Celiac Disease More Common in Women and Girls International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America; the Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom; the Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom; the Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; the Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom; the Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, United Kingdom; and Stanford University in the USA.
    Team members searched MEDLINE, Excerpta Medica dataBASE (EMBASE), Web of Science, Central Register of Controlled Trials (CENTRAL), and Literatura Latino Americana em Ciências da Saúde (LILACS) for observational studies conducted between January 1946 and July 2013, and interventional studies conducted through December 2017, that evaluated the relationship between diet during pregnancy, lactation, or the first year of life, and future risk of allergic or autoimmune disease. 
    They then selected studies, extracted data, and assessed bias risk. They evaluated data using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). They found 260 original studies, covering 964,143 participants, of milk feeding, including 1 intervention trial of breastfeeding promotion, and 173 original studies, covering 542,672 participants, of other maternal or infant dietary exposures, including 80 trials of 26 maternal, 32 infant, or 22 combined interventions. 
    They found a high bias risk in nearly half of the more than 250 milk feeding studies and in about one-quarter of studies of other dietary exposures. Evidence from 19 intervention trials suggests that oral supplementation with probiotics during late pregnancy and lactation may reduce risk of eczema. 44 cases per 1,000; 95% CI 20–64), and 6 trials, suggest that fish oil supplementation during pregnancy and lactation may reduce risk of allergic sensitization to egg. GRADE certainty of these findings was moderate. 
    The team found less evidence, and low GRADE certainty, for claims that breastfeeding reduces eczema risk during infancy, that longer exclusive breastfeeding is associated with reduced type 1 diabetes mellitus, and that probiotics reduce risk of infants developing allergies to cow’s milk. 
    They found no evidence that dietary exposure to other factors, including prebiotic supplements, maternal allergenic food avoidance, and vitamin, mineral, fruit, and vegetable intake, influence risk of allergic or autoimmune disease. 
    Overall, the team’s findings support a connection between the mother’s diet and risk of immune-mediated diseases in the child. Maternal probiotic and fish oil supplementation may reduce risk of eczema and allergic sensitization to food, respectively.
    Stay tuned for more on diet during pregnancy and its role in celiac disease.
    Source:
    PLoS Med. 2018 Feb; 15(2): e1002507. doi:  10.1371/journal.pmed.1002507

    Jefferson Adams
    Celiac.com 07/17/2018 - What can fat soluble vitamin levels in newly diagnosed children tell us about celiac disease? A team of researchers recently assessed fat soluble vitamin levels in children diagnosed with newly celiac disease to determine whether vitamin levels needed to be assessed routinely in these patients during diagnosis.
    The researchers evaluated the symptoms of celiac patients in a newly diagnosed pediatric group and evaluated their fat soluble vitamin levels and intestinal biopsies, and then compared their vitamin levels with those of a healthy control group.
    The research team included Yavuz Tokgöz, Semiha Terlemez and Aslıhan Karul. They are variously affiliated with the Department of Pediatric Gastroenterology, Hepatology and Nutrition, the Department of Pediatrics, and the Department of Biochemistry at Adnan Menderes University Medical Faculty in Aydın, Turkey.
    The team evaluated 27 female, 25 male celiac patients, and an evenly divided group of 50 healthy control subjects. Patients averaged 9 years, and weighed 16.2 kg. The most common symptom in celiac patients was growth retardation, which was seen in 61.5%, with  abdominal pain next at 51.9%, and diarrhea, seen in 11.5%. Histological examination showed nearly half of the patients at grade Marsh 3B. 
    Vitamin A and vitamin D levels for celiac patients were significantly lower than the control group. Vitamin A and vitamin D deficiencies were significantly more common compared to healthy subjects. Nearly all of the celiac patients showed vitamin D insufficiency, while nearly 62% showed vitamin D deficiency. Nearly 33% of celiac patients showed vitamin A deficiency. 
    The team saw no deficiencies in vitamin E or vitamin K1 among celiac patients. In the healthy control group, vitamin D deficiency was seen in 2 (4%) patients, vitamin D insufficiency was determined in 9 (18%) patients. The team found normal levels of all other vitamins in the healthy group.
    Children with newly diagnosed celiac disease showed significantly reduced levels of vitamin D and A. The team recommends screening of vitamin A and D levels during diagnosis of these patients.
    Source:
    BMC Pediatrics

    Jefferson Adams
    Celiac.com 07/16/2018 - Did weak public oversight leave Arizonans ripe for Theranos’ faulty blood tests scam? Scandal-plagued blood-testing company Theranos deceived Arizona officials and patients by selling unproven, unreliable products that produced faulty medical results, according to a new book by Wall Street Journal reporter, whose in-depth, comprehensive investigation of the company uncovered deceit, abuse, and potential fraud.
    Moreover, Arizona government officials facilitated the deception by providing weak regulatory oversight that essentially left patients as guinea pigs, said the book’s author, investigative reporter John Carreyrou. 
    In the newly released "Bad Blood: Secrets and Lies in a Silicon Valley Startup," Carreyrou documents how Theranos and its upstart founder, Elizabeth Holmes, used overblown marketing claims and questionable sales tactics to push faulty products that resulted in consistently faulty blood tests results. Flawed results included tests for celiac disease and numerous other serious, and potentially life-threatening, conditions.
    According to Carreyrou, Theranos’ lies and deceit made Arizonans into guinea pigs in what amounted to a "big, unauthorized medical experiment.” Even though founder Elizabeth Holmes and Theranos duped numerous people, including seemingly savvy investors, Carreyrou points out that there were public facts available to elected officials back then, like a complete lack of clinical data on the company's testing and no approvals from the Food and Drug Administration for any of its tests.
    SEC recently charged the now disgraced Holmes with what it called a 'years-long fraud.’ The company’s value has plummeted, and it is now nearly worthless, and facing dozens, and possibly hundreds of lawsuits from angry investors. Meantime, Theranos will pay Arizona consumers $4.65 million under a consumer-fraud settlement Arizona Attorney General Mark Brnovich negotiated with the embattled blood-testing company.
    Both investors and Arizona officials, “could have picked up on those things or asked more questions or kicked the tires more," Carreyrou said. Unlike other states, such as New York, Arizona lacks robust laboratory oversight that would likely have prevented Theranos from operating in those places, he added.
    Stay tuned for more new on how the Theranos fraud story plays out.
    Read more at azcentral.com.