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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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    GLUTEN-FREE DIETARY COMPLIANCE AND PSYCHOSOCIAL CHALLENGES IN INDIAN CHILDREN WITH CELIAC DISEASE


    Jefferson Adams

    Celiac.com 07/20/2010 - Anyone who's tried to maintain a gluten-free diet for celiac disease or other reasons can likely tell stories about the difficulties and challenges they face on a regular basis. Still, very little research has been done regarding the psychological and social challenges faced by people with celiac disease who are attempting to follow a gluten-free diet.


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    Scientists in India recently conducted just such a study. A research team set out to assess psychological and social challenges faced by Indian children with celiac disease who are attempting to follow a gluten-free diet. The research team included Srikanta Basu, J. C. Chauhan, A. K. Dutta, Praveen Kumar, and Arun Kumar from the Division of Gastroenterology, Department of Pediatrics at Lady Hardinge Medical College and Associated Kalawati Saran Children Hospital in New Delhi, India.

    Their goal was to assess dietary compliance to gluten-free diet, to identify barriers to compliance, and to study the impact of diet on the psychosocial behavior of children with celiac disease.

    For the study, the team looked at children with clinically proven celiac disease, who had been observed for at least 6 months. They then evaluated the children for gluten-free diet compliance.

    Researchers who were blinded to initial results then interviewed patients using a self-administered questionnaire. The team measured psychosocial parameters using the standard 35-item Pediatric Symptom Checklist (PSC).

    To determine what factors might affect dietary compliance, the team compared the results of children who were compliant with their gluten-free diets to those who were not-compliant. They then compared the psychosocial parameters of both groups to those of healthy control subjects.

    The team measured a total of 70 patients for dietary compliance. They found 53 children to be compliant with a gluten-free diet (75%). They found 13 were non-compliant with a gluten-free diet (18%), while 4 children were likely non-compliant.

    A total of 64 children completed the full assessment. Final analysis showed that 4 of those children were likely non-compliant. Data for 2 patients with incomplete assessments was dropped.

    Younger kids showed higher compliance with a gluten-free diet than did teens. 80% of younger kids showed compliance with a gluten-free diet, compared with just 44% of teens. Gluten-free diet compliance was also higher in children with higher maternal education, and in parents with better knowledge and understanding of celiac disease, and in nuclear families. Higher family income raised compliance levels.

    Children with 2 or fewer siblings did better, with compliance rates of 68.3% and just 23% non-compliance. 72% of kids who were compliant with a gluten-free diet had presented classic symptoms of celiac disease, while only 15% of this group was non-compliant.

    Adjustment-related challenges, such as difficulty in maintaining diet at school, restaurants, trips, etc. are among the most common problems faced by celiac children. Nearly half (45%) of the children complained that teachers did not adequately understand the challenges of their condition. Researchers established a PSC cutoff point of 4 for children in the dietary non-compliant group.

    Generally, kids with celiac disease did not show higher levels of symptoms, such as complaints of aches and pains; being irritable/angry; not listening to rules, blaming other for mistakes; teasing others; refusing to share.

    The study findings show that about 1 in 5 (18%) people with celiac disease fail to comply with their gluten free diet, and that kids who comply with a gluten-free diet have better psychosocial parameters, as measured by PSC score. Also, adolescents, kids in joint families, and kids in larger families tend to have greater non-compliance levels.

    Successful treatment of celiac disease requires full compliance with a gluten-free diet. Non-compliance increases risk factors for numerous celiac-associated conditions. Knowing which factors are most likely to present challenges for maintaining compliance can provide celiac suffers and clinicians with useful tools for reducing those challenges and increasing compliance.

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    admin

    Paul V, Henkerr J, Todt H, Eysold R.
    Z.Klin.Med., 1985; 40: 707-709.
    In this study 90 EEGs were performed on 58 celiac children. Researchers concluded that abnormal brain waves resulted from the ingestion of gluten by celiac children. They also concluded that a gluten challenge should not be given before a child reaches the age of 6 years old, and the challenge should not last longer than 5 months. The researchers main concern seems to be the risk of permanent brain damage that they believe could be caused in a celiac child who eats gluten for a prolonged period of time.

    Jefferson Adams
    Celiac.com 03/18/2010 - An international research team recently conducted an assessment of the nutritional status of children with newly diagnosed celiac disease, and compared the results to a group of matched control subjects.
    The team included B. Aurangzeb, S.T. Leach, D. A. Lemberg, and A. S. Day. They are associated variously with the Children's Hospital, Pakistan Institute of Medical Sciences in Islamabad, Pakistan, the Department of Paediatrics at the University of Otago in Christchurch, New Zealand, the School of Women's and Children's Health at the University of New South Wales, and the Department of Gastroenterology at Sydney Children's Hospital in Randwick, both in Sydney, Australia.
    In addition to gaining a better understanding of nutritional status in children with newly diagnosed celiac disease, the team sought to clarify the relationship between and nutrition and patterns of presentation in children with celiac disease.
    The team assessed nutritional status for newly diagnosed celiac disease patients using
    anthropometry, Bioelectrical Impedance and serum leptin levels, which they compared against age and gender matched control subjects.
    For the study, the team enrolled twenty-five children with clinically proven celiac disease, averaging 8.2 years old (± 4.5 years), along with 25 healthy control subjects averaging 8.1 years old (± 4.4 years).  A total of thirteen children with celiac disease experienced gastrointestinal symptoms, and fourteen had a family history of celiac disease. At presentation 8.7% showed physical wasting, 4.2% showed stunted growth, and 20.8% were overweight, though none were obese. There was no difference between the groups with regard to average height and weight for age, other nutritional parameters and serum leptin; which correlated with BMI in both groups.
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    The findings reiterate the importance of conducting nutritional assessments in the diagnosis and treatment of children with celiac disease.
    Source:

    Acta Pædiatrica; 19 Feb 2010

    Jefferson Adams
    Celiac.com 09/13/2010 - What's happening in with the immune system when a child is first diagnosed with celiac disease? What happens when they are treated with a gluten-free diet?
    Some recent studies have indicated that both the adaptive and the innate immune system play roles in celiac disease. However, until now, doctors haven't known much about the immune phenotype of children with celiac disease and how that phenotype might by affected by a gluten-free diet.
    To move toward a better understanding of these issues, a team of researchers recently studied immune phenotype in children with either newly diagnosed celiac disease, or celiac disease treated with a gluten-free diet.
    The research team included Áron Cseh, Barna Vásárhelyi, Balázs Szalay, Kriszta Molnár, Dorottya Nagy-Szakál, András Treszl, Ádám Vannay, András Arató, Tivadar Tulassay and Gábor Veres. The are affiliated with the First Department of Pediatrics in the Research Group for Pediatrics and Nephrology at Semmelweis University and Hungarian Academy of Sciences, in Budapest, Hungary.
    For their study, the team described the status of major players within the adaptive and innate immune system in peripheral blood of children with newly diagnosed celiac disease. They then looked to see how the phenotype might have changed
    once the symptoms improved following treatment with a gluten-free diet.
    The team drew peripheral blood samples from ten children with biopsy-proven celiac disease at the time of diagnosis and again after once clinical symptoms subsided with treatment by gluten-free diet. They also drew blood samples from a control group of 15 children who suffered from functional abdominal pain.
    They measured the prevalence of cells of adaptive and innate immunity by means of labeled antibodies against surface markers and intracellular FoxP3 using a flow cytometer.
    They found that patients with celiac disease had lower T helper, Th1 and natural killer (NK), NKT and invariant NKT cell prevalence and with higher prevalence of activated CD4+ cells, myeloid dendritic cells (DC) and Toll-like receptor (TLR) 2 and TLR-4 positive DCs and monocytes compared to controls.
    Most of these deviations returned to normal, once symptoms subsided with gluten-free diet treatment. However, prevalence of NK and NKT cell, DC and TLR-2 expressing DCs and monocytes remained abnormal.
    The immune phenotype in childhood celiac disease indicates that both adaptive and innate immune systems are playing a role in celiac disease.
    Treatment with a gluten-free diet reverses immune abnormalities, but the mechanics of the reversal likely varies among cell types.
    Source:

    Dig Dis Sci. 2010 Aug 5. DOI: 10.1007/s10620-010-1363-6

    Jefferson Adams
    Celiac.com 10/20/2011 - Very little study information exists concerning rates of celiac disease-predisposing, HLA-related genes in Arab populations.
    A research team recently investigated the distribution of HLA-DQ2 and -DQ8 genotypes in Libyan children with celiac disease, and in healthy control subjects.
    The study team included Kamla Alaridaa, Jumma Harownb, Maria Rosaria Di Pierroc, Sandro Dragoc, and Carlo Catassid.
    They are affiliated variously with the Department of Pediatrics, “Omar Al Mukhtar” University, and the El Thoura Hospital in Al Bayda, Libya, the Biodiagene S.r.L., Palermo, Italy, the  Department of Pediatrics of the Università Politecnica delle Marche in Ancona, Italy, and the Center For Celiac Research at the University of Maryland School of Medicine in Baltimore, Maryland.
    The team tested 31 Libyan children with celiac disease (22 females and 9 males, median age 9.2 years) and 156 Libyan control subjects (81 females and 75 males, median age 10.9).
    To determine HLA genes, the team used DQ-celiac disease Typing Plus kit by DiaGene of Palermo, Italy, on a drop of dried blood.
    Test results showed that the HLA-DQ pattern for the 3 children with celiac disease was: hetero DQ2 (n = 15), DQ2 with homo β2 (10), DQ8 and β2 positive (3), DQ8 (2), and hetero β2 (1).
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    The study team found that HLA-DQ2 and -DQ8 in was as common in Libyan children with celiac disease as in Italian children with the disease. However, there were more “high-risk” genotypes in Libyan children with the disease compared to their Italian counterparts.
    Lastly, the prevalence of HLA-DQ2 and -DQ8 genes was higher among the Libyan general population that among the Italian population, which suggests a strong genetic predisposition to celiac disease among the Libyan population.
    Source:

    Digestive and Liver Disease 42 (2010) 425–427

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    Jefferson Adams
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    Jefferson Adams
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    J Clin Gastroenterol. 2018 Mar 1. doi: 10.1097/MCG.0000000000001018.

    Connie Sarros
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    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. 
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    Source:
    fdfworld.com