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  • Kim Hopkins
    Kim Hopkins

    Gluten-Free Diet May Lead to Poor Gut Health

    Celiac.com 06/05/2009 - Recently, the British Journal of Nutritionreported that following a gluten-free diet may be detrimental to guthealth, which may also affect immune health, according to a new studyfrom the Spanish National Research Council. The Spanish researchersanalyzed the gut microflora of ten healthy subjects with an average ageof 30 assigned to consume a gluten-free diet for one month.   Analysisof the participants’ feces showed that populations of healthy gutbacteria decreased following the gluten-free diet, while populations ofunhealthy bacteria increased.

    It has been previously documented that gluten can cause leaky gut, evenwithout celiac disease.  Chronic gluten exposure has been shown toactivate zonulin resulting in increased intestinal permeability (orleaky gut) even in the absence of celiac disease. Intestinalpermeability with malabsorption has been described in celiac patientsand their relatives who don’t have atrophy of the intestine on biopsybut only increased inflammatory cells.  An imbalance of intestinalbacteria has been cited as one of the main causes of leaky gutsyndrome.  This study could be the beginning of discovering the missingcomponents of the known link between celiac disease (and foodsensitivities), leaky gut syndrome, inflammation, and immune health.

    If you have celiac disease and/or other food sensitivities, your riskfor a bacteria imbalance is high.  What can you do to protect yourhealth?

    • Know the signs of bacteria imbalance: abdominal pain, asthma, chronic joint pain, chronic muscle pain,confusion, fuzzy or foggy thinking, gas, indigestion, mood swings,nervousness, poor immunity, recurrent vaginal infections, skin rashes,diarrhea, bed-wetting, recurrent bladder infections, poor memory,shortness of breath, constipation, bloating, aggressive behavior,anxiety, fatigue, feeling toxic.
    • Consider dietary changes: Limit foods that feed bad bacteria – all forms of sugar, vinegars, andmoldy foods like mushrooms.  Eat foods that promote intestinal healing,including high fiber foods rich in antioxidants (cabbage, cauliflower,beets, and onions) and omega-3 fatty acids found in salmon andflaxseed.  Healthy bacteria found in yogurt (read the label to ensurethat it contains live cultures) has also been recommended.
    • Think about chemical exposure: Eliminating or reducing substances that promote intestinalpermeability, such as avoiding antibiotics, nonsteroidalanti-inflammatory drugs, pesticides, herbicides, and meat contaminatedwith hormones.
    • Talk to your doctor: More research needs to be done, but it seems as though probiotics maybe protective against leaky gut and bowel inflammation.  Clinicalresearch shows that oral supplementation of probiotics enhances theimmune system's ability to fight foreign organisms.  Digestive Enzymescan also help to restore intestinal permeability.  Herbs and botanicalswith anti-inflammatory properties, and those that reduce congestionand/or eliminate waste may also be helpful.
    Sources
    • autoimmunedisease.suite101.com
    • About.com   Leaky Gut Syndrome/Intestinal Permeability, Cathy Wong, July 23, 2007
    • www.Foodnavigator-usa.com
    • Crook, William; Dean, C.; Crook, E (2003).  The Yeast Connection and Women’s Health
    Author's Note:  I apologize for the confusion a poorly-worded sentence caused - it has since been removed.  Obviously, this study is very flawed - it can barely be called a study.  What prompted me to write about it was the very small glimmer of hope it gave me, and many of the people I work with...so many celiacs feel good on the diet for a long time, then don't feel good anymore.  Many are told that it's in their heads, or they must be consuming gluten.  Come to find out, it's a yeast overgrowth due to bacteria imbalance.  The relief that I, and many that I know, have felt from the suggested steps in the article has been incredible.  I'm just glad this connection is being looked at!  I'm hopeful more in-depth, meaningful research is to come!


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    Excellent article, but frustrating too. Just getting a handle on gluten free & now something else to worry about.

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    This report by Kim Hopkins is absolute nonesense. There is no such thing as a yeast which is also a bacteria. Candida is not a bacteria. Anything which follows from the logic that they are is not just suspect but dangerous. The content provided by Hopkins is extremely vague and not backed up with references (I would challenge Hopkins to provide ample evidence that consumption of meat derived from animals that have received hormone treatments results in humans with a leaky gut when compared to humans fed non-hormone treated animals).

    Anyone frustrated by their celiac disease who is further flummoxed by the additional load that Hopkins implies they should take on should simply ignore the article and make something good to eat.

     

    The study in Spain is damn near irrelevant to celiacs...10 healthy normal volunteers. Anybody here healthy and normal?

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    Informative...and my personal experience adds credibility to the ideas presented. I am Celiac and have Fibromyalgia. It has become obvious to me that my body needs supplementation at a higher level than normal for me to see improvement in symptoms. Particularly helpful are the probiotics, omegas, antioxidants, vitamins and enzymes. Of course, it goes without saying that all supplements must be gluten free!

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    I have celiac disease and am currently being treated for a systemic yeast infection. Good article! Need more info about a healthy intestinal tract.

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    Just getting started with corrective measure re: celiac disease. Thank you for writing an article my non-medical mind can wrap around.

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    Guest Phyllis Morrow

    Posted

    This is an alarmist article that could lead celiacs to think that a gluten-free diet is not good for us. Brian's comment about candida (yeast, not bacteria) is absolutely correct. Also, we do not know what the study subjects were eating, just that they were not eating gluten. And a month-long study gives no information on how digestive systems might adapt after more than a month on a balanced gluten-free diet. The article does not explain why gluten would be necessary for 'helpful bacteria' to grow in the gut - there needs to be some good hypothesis for me to consider the validity of the research. Finally, the list of 'symptoms' is so broad and typical of the kinds of things that celiacs may experience that it is not very helpful. Nothing wrong with eating yogurt and probiotics and a lot more veggies and fruits than most folks eat, but no reason to start worrying about the gluten-free diet without some more rigorous evidence here.

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    The experience of healthy subjects may have no bearing on people who go on the gluten-free diet after developing symptoms. Also without knowing what the subjects DID eat it is meaningless to know that their gut flora became more imbalanced. Many people eat more refined starches on a gluten-free diet and this alone can cause gut flora to become imbalanced, but this is not an intrinsic problem with a gluten-free diet. My family follows the Specific Carbohydrate Diet, which is gluten-free but also cuts out the starches that feed the bad gut flora. Our gut flora has improved significantly on this diet and our leaky gut is healing. The GAPS diet takes into account all of the info given here about enzymes, probiotics, malabsorption, and EFAs.

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    I think she brings up a good point...just because it's gluten free doesn't mean it's healthy. If we're changing our diet to be gluten-free, why not also cut out the other bad stuff...sugar, junk carbs and beef up on the better choices? After years of gluten abuse our immune systems probably need every boost they can get. Also, years of gluten damage can't be good for our flora balance, and many of us have had to take lots of antibiotics and/or steroids because we got sick more than most.

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    The listed signs of bacterial imbalance sound a lot like my pre-gluten, dairy, soy, corn starch, potato, green solanacea, and beet family free situation. (Yes, I can find food to eat but no more picnic baskets for me Boo-Boo! Lots of nuts & berries: Nuts!)

     

    After 8 months into gluten-free and shorter periods away from the rest, my blood pressure rises and I feel different if I have eaten something that is a known issue for me.

     

    Radical changes in diet are bound to cause some issues. Try eating a lot of plums, and see what happens. Many have reported issues early on when going gluten-free.

     

    Before going gluten-free, we ate more, fish, fruits, yogurt, and vegetables and prepared many more meals from scratch than our friends, though we are neither vegetarian nor vegan. (meat is something I can eat.) It is possible that was preconditioning and helpful to going gluten-free. I suspect the poor absorption of nutrients, made us crave nutrient-rich food.

     

    Avoidance of dairy, potato, and corn starch eliminates almost all gluten-free baked goods and desserts other than what little I make from scratch.

     

    If gluten is not very digestible and lines the gut, it is not unreasonable that as it clears, digestion changes and/or other intolerances make themselves known. It may be essential to avoid an excess of sugar and refined carbohydrates that might tax the system even though the sources are 'gluten-free', aside from any cross-contamination issues, until a new intestinal flora balance is developed.

     

    Before the casein and whey sensitivities were found, I consumed a lot of yogurt and Activia. the active cultures may also have helped more than the allergens they contained, hurt. I also noted that mushrooms in quantity did not make me feel well though they did not give an intolerance reaction and had been fine before going gluten-free.

     

    The study is WAY too small, of too short a duration, and with inadequate outlines of the diets used. It is a nice pilot study, though. At least someone is giving the issue some attention.

     

    Now they can repeat it with control, celiac going gluten-free, and non-celiac gluten-free groups of different periods of time for more publications! Publish or perish!

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    I think she brings up a good point...just because it's gluten free doesn't mean it's healthy. If we're changing our diet to be gluten-free, why not also cut out the other bad stuff...sugar, junk carbs and beef up on the better choices? After years of gluten abuse our immune systems probably need every boost they can get. Also, years of gluten damage can't be good for our flora balance, and many of us have had to take lots of antibiotics and/or steroids because we got sick more than most.

    Um, grass fed beef is by far one of the healthiest foods you can eat, and is a pretty important part of any gluten free diet.

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    There is much truth to this article! 6 years into a gluten free diet for our celiac---and my husband and I have been sicker than ever!!! I was finally starting to accept that there was simply gluten in everything. Until a friend told me about the GAPS diet. Wow! Gut dysbiosis is very real and very damaging. Because you start to 'react' to just about every single food you eat, thinking there is gluten, where in reality you have severe leaky gut. So you are 'reacting' to everything, with your immune system on high alert and attack mode. GAPS and SCD provide much needed relief for those of us who need MORE than just Standard American Gluten Free.

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    This report by Kim Hopkins is absolute nonesense. There is no such thing as a yeast which is also a bacteria. Candida is not a bacteria. Anything which follows from the logic that they are is not just suspect but dangerous. The content provided by Hopkins is extremely vague and not backed up with references (I would challenge Hopkins to provide ample evidence that consumption of meat derived from animals that have received hormone treatments results in humans with a leaky gut when compared to humans fed non-hormone treated animals).

    Anyone frustrated by their celiac disease who is further flummoxed by the additional load that Hopkins implies they should take on should simply ignore the article and make something good to eat.

     

    The study in Spain is damn near irrelevant to celiacs...10 healthy normal volunteers. Anybody here healthy and normal?

    I think you misunderstand. Gut bacteria help to regulate yeast in the intestines. Nobody said yeast is a bacteria.

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  • About Me

    Kim Hopkins is the founder of Food Sensitivity Resources. She is a licensed social worker and someone that "lives to eat" despite having multiple food challenges. Her mission is to combine her thorough, personal knowledge of food safety concerns with her lengthy counseling, training, & consulting experiences to help people live fully despite dietary restrictions. She offers personal coaching, an informative blog, the Safe Suppers Dining Club, as well as consultation for businesses & schools.

  • Related Articles

    Jefferson Adams
    Celiac.com 09/28/2009 - According to the results of a new Swedish study,  patients with mild intestinal inflammation and gluten sensitivity face an elevated risk of death, even in the absence of symptoms severe enough to merit a clinical diagnosis of celiac disease.
    A number of studies have shown that people with gluten sensitivity and intestinal inflammation, but just how great is the risk? However, of those previous studies that show an increased risk of death associated with the disease, many were not population-based, lacked children and outpatients, while others were hampered by small numbers of participants.
    A team of Swedish researchers led by Jonas F. Ludvigsson, MD, PhD, of Sweden's Örebro University Hospital, recently set out to conduct a large-scale, population-based study regarding mortality risk levels for people with celiac disease, and also for those with "gluten intolerance."
    Ludvigsson and colleagues examined histopathology data from tissue biopsies collected from 46,121 Swedish patients nationwide between July 1969 and February 2008. Of those patients, 29,096 had celiac disease, while 13,306 showed inflammation of the small intestine and 3,719 showed latent celiac disease, elevated blood antibodies used as markers for celiac disease, but no sign of gut inflammation or damage.
    The researchers compared the patient data to records of the Swedish Total Population Register to calculate mortality rates for the three groups of patients. They found that among the patients there were 3,049 deaths among those with celiac disease, 2,967 deaths for those with inflammation, and 183 deaths for patients with latent celiac disease.
    The overall risk was not great, mortality risk was 75% higher for patients with mild intestinal inflammation at a median follow-up of 7.2 years (95% CI 1.64 to 1.79), and 35% higher for patients with latent celiac disease, or gluten sensitivity, at median follow-up of 6.7 years (95% CI 1.14 to 1.58).
    The study also revealed that people diagnosed with celiac disease faced a 30% greater risk of death at a median follow-up of 8.8 years (95% CI 1.33 to 1.45). That means that over the 8.8 years following the study, 30% more people with celiac disease died compared to the control group.
    These findings confirm previous studies that show higher mortality rates in celiac patients. Major causes of death for people with celiac disease are cardiovascular disease and cancer.
    Still, overall mortality risk associated with celiac disease and intestinal inflammation for gluten intolerance was small, with just 2.9 additional deaths per 1,000 person-years for people with celiac disease, and 10.8 and 1.7 additional deaths per 1,000 person-years for people with inflammation and latent celiac disease, respectively.
    Of the population-based study, Jonas F. Ludvigsson, MD, PhD, of Örebro University Hospital in Sweden, and colleagues writes,
    "we examined risk of death in celiac disease according to small-intestinal histopathology...Excess mortality was observed independent of histopathology, but absolute excess mortality risk was small, especially in children."
    In an accompanying editorial, Peter H. R. Green, MD, of Columbia University Medical Center, writes that the study's findings on patients with latent celiac disease, those patients who, in the United States, would be labeled as having "gluten sensitivity," were the most intriguing.
    Dr. Green writes that until recently, "gluten sensitivity has received little attention in the traditional medical literature, although there is increasing evidence for its presence in patients with various neurological disorders and psychiatric problems."
    Furthermore, researchers currently know little about the long-term consequences of mild gut inflammation. In such cases, patients typically show no sign of villous atrophy,  the flattening of the innermost membrane of the intestinal wall common to people with clinical celiac disease.
    Overall, the "risk of death among patients with celiac disease, inflammation, or latent celiac disease is modestly increased," the researchers concluded.
    The researchers speculate that the increase in mortality might result from chronic inflammation that damages patients' small intestines (the duodenum, specifically) or from malnutrition that saps their vitamins and energy.
    The researchers did not, however, rule out the possibility that mortality may be due to other existing conditions. They also cautioned that some patients with inflammation may have been misclassified as having latent celiac disease or partial villous atrophy, skewing mortality rates upward for the latent celiac disease group.
    Green concludes that the "study by Ludvigsson and colleagues reinforces the importance of celiac disease as a diagnosis that should be sought by physicians. It also suggests that more attention should be given to the lesser degrees of intestinal inflammation and gluten sensitivity."
    Source:
    JAMA. 2009;302(11):1171-1178.


    Jefferson Adams
    Celiac.com 08/04/2011 - People who use direct-to-consumer genetic tests sold by deCODEme and 23andMe frequently receive misleading results, because these tests do not accurately predict risk factors. So say two geneticists, who conducted two studies that assessed the accuracy of test predictions relative to various known disease risks.
    Presenting their results from both studies at the annual conference of the European Society of Human Genetics, the scientists have gone so far as to call for a ban on the tests.
    The first study was conducted by Rachel Kalf, from the department of epidemiology at Erasmus University Medical Centre in Rotterdam. Using established genotype frequencies, Kalf simulated genotype data for 100,000 individuals. She then used the formulas and risk data provided by the test companies to predict risks for eight common multi-factorial diseases: age-related macular degeneration (AMD); atrial fibrillation; celiac disease; Crohn's disease; heart attack; prostate cancer; and Type 1 and Type 2 diabetes (T2D).
    Kalf noted that both companies assigned an increased risk to a substantial part of the test group. However, Kalf says the risk of disease in this group was often substantially lower than the risk in the rest of the study group.
    For example, for AMD, which has the highest predictive ability of all eight diseases, both companies assumed that the risk in the population was around 8 percent. However, among subject assigned an increased risk factor, 23andMe estimated risk at 16 percent, while deCODEme's estimated that 19 percent would develop AMD. This contrasts with a risk of about 4 percent for the rest of the study population.
    This means that people in the higher risk group may have a four-fold increased risk of disease, but "are still far more likely not to develop the disease at all," explains co-researcher Cecile Janssens.
    For T2D, using the risk levels of about 25 percent assigned by the companies, 32 percent of those in the higher risk group would actually develop T2D compared to just 22 percent in the rest of the study population. "This difference in disease risk is too small to be of relevance," says Janssens.

    Source:

    Science Blog

    Gryphon Myers
    There have been several studies of celiac disease sufferers and health-related quality of life (HRQoL), but few of these studies have focused on children. Since diseases that develop through childhood (as celiac disease often does) usually negatively impact physical, social and psychological development, it is important to determine the extent to which celiac children suffer as a result of the disease.
    In the present study, 160 celiac children (55 males and 105 females) were given questionnaires to assess mental health, social health and physical health over the four weeks prior to when the test was taken. Children were divided into three age groups: 8-11 years, 12-15 years and 16-18 years. Parents were given a proxy version of the questionnaire to assess their children. Questions came from the short version of the DISABKIDS questionnaire (a well-validated research method used for different chronic disease diagnostic groups). Age and severity of disease at onset were examined to determine if these factors influenced self-valuation later in life.
    Children rated their HRQoL surprisingly high, with a median score of 92/100 (85 points for mental health, 95 for social health and 100 for physical health). Sex and age did not show any significant correlation, though years since diagnosis showed slight correlation (children rated themselves higher the longer it had been since disease onset). Children who were younger at diagnosis also rated themselves higher, which is likely because young children have not grown accustomed to gluten-containing foods, and thus miss them less. It is also likely that children closer to adolescent age have a harder time accepting their 'otherness' due to their psychological development.
    Children with more severe symptoms at onset rated their HRQoL higher than children who had more mild symptoms, or were asymptomatic at onset. This is likely because more symptomatic children are able to perceive more of a dramatic change in their overall health after starting on gluten-free diet. They feel relatively better, so they rate themselves higher.
    Parents tended to rate their children's HRQoL lower than then the children themselves did. This underestimation is probably a result of parental worrying, guilt and/or sense of responsibility. Parents whose children were younger at onset of disease, or had lived with the disease longer tended to judge their children's HRQoL more accurately.
    This study suggests that children adapt well to celiac disease, and that parents tend to overestimate the negative impact the disease has on their children. At risk of overtreatment of the psychological, social and physical impacts of the disease, it is important that parents of celiac children let their children be heard about their perceived quality of life.
    Source:
    http://www.hindawi.com/journals/grp/2012/986475/

    Jefferson Adams
    Celiac.com 10/15/2012 - The drug ALV003, a potentially promising treatment celiac disease, made by Alvine Pharmaceuticals, Inc., has received Fast Track designation from the U.S. Food and Drug Administration (FDA).
    ALV003 is an orally administered mix of two recombinant gluten-specific proteases, a cysteine protease (EP-B2) and a prolyl endopeptidase (PEP).
    ALV003 works by targeting gluten and breaking it down into tiny fragments, which, in tests has been show to greatly reduce its ability to trigger immune responded in people with celiac disease. ALV003 is being developed as a potential treatment for celiac disease patients in conjunction with a gluten-free diet and is currently in phase 2 clinical development.
    The Fast Track status is important for ALV003, because there are currently no approved therapeutic treatment options available to patients and their physicians," said Abhay Joshi, Ph.D., Alvine's President and Chief Executive Officer.
    Fast Track is part of the FDA Modernization Act, passed in 1997. It is designed to streamline the development and review of drugs that treat serious or life-threatening conditions, and which address unmet medical needs.
    Source:
    Marketwatch

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    Corn would not make DH flare unless it was either CC'd in processing or was contaminated through your prep and cooking process. For example grilling the corn on a grill that had gluten prepared on it previously or washing it in a colander that had pasta drained previously.  IMHO Squirmy is spot on. Give yourself some time to heal on the gluten free diet and avoid HIGH iodine sources like iodized salt, seaweed and seafood. The bit of natural iodine in veggies and fruits shouldn't be an issue. If
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