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      Frequently Asked Questions About Celiac Disease   04/07/2018

      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 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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    THE GLUTEN-FREE DIET 101 - A BEGINNER'S GUIDE TO GOING GLUTEN-FREE


    admin

    Celiac.com 04/09/2010 - Receiving a celiac disease diagnosis or being told you need to be on a gluten-free diet can be an overwhelming experience, and it is certainly not for the faint of heart. Most people get frustrated with the transition, and many don't know where to begin. While eating gluten-free can improve your health, I must emphasize that it is not recommended to attempt a gluten-free diet without a doctors supervision, as there are many potential health risks involved with making drastic changes to your diet, which can be avoided with assistance of a qualified doctor and/or nutritionist. If you suspect gluten-intolerance to be the culprit for your health problems, get examined by a doctor and get tested for celiac disease before initiating a gluten-free diet. It is very important to continually consume gluten while you are undergoing testing for celiac disease because many of the tests require you to be consuming gluten to get accurate results.

    Prescription: A Gluten-Free Diet


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    Now that you have your diagnosis and need to eliminate gluten, you can make the transition to a gluten-free diet with confidence. The following information is a guideline of what you will need to know to get started. I must emphasize that this is only a guideline, and you will need to do your own research and consult with your doctor for more detailed information on a gluten-free diet. It is also a great idea to get involved in local support groups. Support groups will have members that understand what you are going through and they can help direct you to beneficial resources:

    Create New Habits
    To begin, if you are accustomed to doing things your own way, you will have to throw out many of your old habits. To avoid gluten poisoning you must keep all gluten away from your mouth. You will need to evaluate everything you ingest very carefully. Gluten can come in a variety of unexpected ways, including a kiss from a loved one, and any gluten that comes into contact with your mouth is a potential source of contamination. Cross-contamination can occur when a meal is prepared on cooking equipment shared with gluten-containing foods. It can also come from touching anything that has come into contact with gluten. It is therefore important to gluten-proof your house and to keep everything you eat separate from gluten and gluten residue. If you eat at restaurants, it is important to only eat at places that you know are safe. To help you avoid accidental gluten ingestion, please follow your instincts and use the following guidelines and avoid potential health hazards. Please remember that these are only guidelines--if you still have questions, please consult with a medical professional.

    What does "Gluten-Free" Actually Mean?

    Since gluten is found in wheat, rye and barley, it is obvious that you will need to avoid these grains. Less obvious however, are the myriad of products that contain gluten as a hidden ingredient. The Food and Drug Administration (FDA) recently regulated the use of "gluten-free" on a food label, and there was already an FDA regulation that requires manufacturers to declare wheat if it is used as an ingredient in a product. Products that don't use "gluten-free" on their label unfortunately don't have to disclose ingredients that are made from barley or rye, which requires you to learn to read and understand ingredient labels. Many additives, natural or artificial, can contain gluten. Sometimes companies label products as "gluten-free" or the ingredients are naturally gluten-free, but the product may have be contaminated if it was manufactured on shared equipment. You will have to decide if you want to include such products in your diet. It is also important to remember, for reasons just mentioned, that “wheat-free” does not mean “gluten-free.”

    Batch Testing:
    According to current FDA proposals, products testing at less than 20 parts per million (PPM)  for gluten will likely be allowed to be labeled "gluten-free," and, according to them, are considered safe for people with gluten-intolerance or celiac disease. There are several organizations that offer gluten-free certification for companies who follow their guidelines and batch test their products. Check out the link below for more information on gluten-free certification and labeling.

    Gluten-Free Shopping

    Shopping will likely take much longer for you than it used to. Don't rush. It is important to read all ingredients carefully. If you are in a hurry, you run the risk of overlooking a key ingredient that might contain gluten. I find it helpful to plan my meals in advance. There is nothing worse than coming home from work hungry and realizing that you have nothing to eat (and it isn't like you can go to the first drive-thru you find). So planning my meals on the weekend and doing my shopping in advance, cuts my stress level down considerably and keeps me from going hungry. Check your products against your gluten-free guidebooks, and contact the manufacturer if you are unsure about something. The following links will help you take the guess work out of shopping for gluten-free products:

    As mentioned, there are also many products that are naturally gluten-free that are not labeled "gluten-free," and there are some very helpful books that can help you find these foods when you are shopping.

    A Gluten-Free Kitchen

    A gluten-free kitchen is very important. If you can have an entirely gluten-free kitchen, that is ideal, but it may not be an option for many households. Therefore it is especially important to keep your house clean and free of gluten contaminates.  It is also important to dedicate special kitchen supplies for gluten-free cooking. I bought a new cutting board that is dedicated only to gluten-free cooking. You may also want to have separate kitchen utensils such as sponges, toasters (a dedicated gluten-free toaster is highly recommended), sifters, bread machines, etc. This is especially important if you use utensils that are made of wood, plastic, or other porous materials that could harbor gluten and possibly contaminate your gluten-free food. If possible use an electric dishwasher to clean your dishes.

    If everyone in your household is going gluten-free it is important to clean out and empty all of the gluten products from your kitchen. If you share a kitchen with gluten eating family members, it is a good idea to store their food products separately from your gluten-free products, and to clean off all surfaces before you prepare your gluten-free food. Dedicating gluten-free cupboards and refrigerator shelves is a great way to start.

    Here are some important links that will help you cook gluten-free meals with ease:


    Kitchen Checklist - Possible Sources of Contamination:

    • Bread-machine
    • Toaster
    • Sponges & cleaning pads
    • All kitchen supplies & utensils
    • Colanders
    • Cutting boards
    • Door handles
    • Soaps

    For more information on maintaining a safe kitchen environment, click the link below:

    Dining Out Gluten-Free

    Dining out presents a challenge for most people on a gluten-free diet. Depending on your level of sensitivities, you may have difficulty eating out at all. Even if the restaurant offers a gluten-free menu, it is always important to find out what safety precautions the restaurant uses to avoid cross-contamination, and to make sure all the ingredients in your food are gluten-free. This may require you to modify your order, and also may mean talking with the chef about their kitchen practices. You may also benefit from utilizing a guide to safe restaurants.

    Here is an additional article that may be helpful to your situation:

    A Gluten-Free Bathroom

    Believe it or not, your bathroom is another place where you might be getting sick from gluten contamination, and not even know it. There are many products in your bathroom to watch out for as many body products contain wheat and/or hidden gluten ingredients. Most celiacs can use body products without a negative reaction, though some people experience rashes and other unsavory reactions from gluten body products. However, if you are using face or body products that contain gluten, it is very important not to ingest them. I find it difficult to avoid getting shampoo or makeup near my mouth, so I don't take any chances. I use gluten-free soap, shampoo, conditioner, face-cleaner, toner, make-up, toothpaste; basically nothing goes onto my body that contains gluten. Using gluten-free body products allows me the freedom to worry less about accidental contamination, and gives me more time to enjoy my life. Many gluten-free body products are not labeled gluten-free, so it is important to read ingredient labels carefully and check with the manufacturer if necessary.

    Bathroom Checklist:

    • Toothpaste
    • Shampoo/conditioner
    • Make-up
    • Lip-stick, lip-liner, lip-gloss, cosmetics, etc.
    • Lotion
    • Sunscreen

     

    Gluten-Free Medications (Prescriptions and Supplements)

    Most people with celiac disease or gluten-intolerance also suffer from malabsorption and sometimes malnutrition. Your doctor may prescribe pain, anti-inflammatory, digestive or other medications or supplements to help assist with your recovery. It is very important to note that some medications and supplements can contain gluten. Do not assume that just because your doctor knows you have celiac disease or gluten intolerance that the medications or supplements they may prescribe for you are gluten-free.  Be your own advocate and read the ingredients and contact your pharmacist and/or the manufacturer and find out if your prescriptions, vitamins and supplements are gluten-free.

    Additional Concerns

    Children with Celiac Disease
    Raising children with celiac disease or gluten-intolerance is no easy feat. Your kids will have to deal with immense  peer pressure and there will be a great deal of temptation for them to eat gluten-containing foods. Talk to the staff at their school and help them to understand your child's special needs. The more support you have, the better off your child will be. There are many support groups that advocate for children with celiac disease, and it is important to get involved and learn everything you can to help support your child.

    Pets
    Your pets present another source of potential contamination, especially if you have pets like mine that love to smother you with unexpected kisses, sometimes on the mouth. What your pet eats can affect you too. Handling your pet's food, cleaning your pet's dishes and having young celiac children in a house where they may eat dog or cat food are all legitimate concerns. I decided to switch my pets to gluten-free pet food. Most pet food is not labeled gluten-free, so it is important to read ingredients carefully. I found grain-free, all natural pet food to be a great alternative to gluten-containing pet foods, that way I don't have to worry about accidental contamination or getting kisses from my pets--and it's healthier for them too!  It is also important to check all other pet products that you come into contact with for hidden gluten ingredients, like shampoos and soaps. It is of course always important to talk to your veterinarian before making any dietary changes for your pet.

    Other Food Sensitivities
    Most people who begin a gluten-free diet experience almost immediate relief from their symptoms. However, many people experience gluten-like reactions to other foods, and often suspect that their food was contaminated by gluten. As it turns out, many people who experience such reactions may in fact have additional food sensitivities. Some of the most common food sensitivities include, dairy/casein, soy, corn, sugar, nuts, shell-fish and processed or fatty foods. While many people report that they are able to add these foods back into their diet after they have established a gluten-free diet for many months, and after their intestines have had time to heal, it is up to you and your doctor or nutritionist to determine which foods may be causing you trouble. The 'elimination diet' is often recommended for determining what additional food sensitivities you may have. Ask your doctor if the elimination diet is right for you.

    Food Diary
    It is important to keep a food diary, especially when first initiating a gluten-free diet. Making notes of the foods you eat and the reactions you have to the foods you eat, and how you feel that day, can give you more insight as to which foods are hurting you and which foods your body can easily digest.

    Final Thoughts

    Be Picky
    Having a gluten intolerance means taking pride in your body, but not being too proud to say, "no, thank you." Don't worry about appearing too picky to others, you simply can't take care of yourself and worry what others think of you at the same time. You have the right to eat what you want; if something doesn't look, smell or taste right to you, or if you just don't feel right about eating something, don't eat it! It is better to come across as too finicky, than to spend the night in the bathroom or worse yet, the emergency room. Everyone has a different level of gluten sensitivity and you will have to find out through trial and error what works best for you.

    Be Prepared
    As a former Boy-Scout, my high-school teacher used to always say, "Be prepared".  I cannot emphasize enough the importance of this statement. It is important to be prepared and think ahead. Keep gluten-free snacks on hand at all times, because you never know when you are going to get hungry somewhere that doesn't offer gluten-free food. Keep shelf-stable snacks in your car, office, purse, and anywhere you spend time. It is better to have gluten-free snacks on hand, then to get hungry and make a bad decision to eat something you might later regret.


    Gluten-Free Quick-Check:

    • Read all labels carefully
    • Call the manufacturer whenever necessary
    • Avoid cross-contamination at all times
    • Keep your hands clean
    • Check personal-care products for hidden gluten
    • Check all vitamins, supplements and RX prescriptions for hidden gluten
    • Make sure your pets are gluten-free
    • Maintain a food diary
    • Get involved-join a support group
    • Rule of thumb-if you think it's possibly contaminated, don't take any chances. It's better to go hungry than to suffer later.
    • Above all, trust your body

    Additional Resources:



    Image Caption: Photo: CC--Michael Coghlan
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    Recommended Comments

    Guest jaime hunt

    Posted

    My Daughter and Son (ages 3 and 1) have just been diagnosed with celiac disease. It has been a daunting task to rid our house of gluten. I have found this article very helpful. Thank-you.

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    Guest Sheila

    Posted

    I think this message will greatly help me in trying to understand what gluten -free really is all about.

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    This article scared me to death since I'm getting tested next week. I don't know how I am going to avoid the cross contamination which may I add looks impossible especially if you live with others who are not celiacs.

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    This article has been incredibly helpful in understanding gluten free and celiac disease. I have a student with it and wanted to understand what the implications are.

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    This article scared me to death since I'm getting tested next week. I don't know how I am going to avoid the cross contamination which may I add looks impossible especially if you live with others who are not celiacs.

    The only thing that makes something impossible is attitude. A gluten-free diet is a blessing, a solution, a "cure" of sorts, not a curse. It will lead you to eat healthier foods than you would have either, like more vegetables and unprocessed meat and fewer processed foods and processed grains. As a member of the health field that sees so much misinformation out there on nutrition, a gluten-free diet seems like a good idea regardless of who you are. One way or another, just being careful and having a good attitude is 90% of the solution.

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    Guest Jessica

    Posted

    I live in a house with 7 other people, none of whom have had the constant problems that I have... I had a blood test done to check for celiac and it came back negative, but I've had constant gastrointestinal issues since I was a child. I don't see how I'm going to manage trying a gluten free diet (especially with all of the avoiding cross contamination and the constant worrying) with so many other people in my house. I'm extremely underweight as is, and looking at all of the things that I cannot eat... I fear I may wind up even worse than if I just kept eating what I do already!

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    Guest Celiac Diet

    Posted

    I appreciate the thoroughness of this article. Leaves no stone unturned, as it were. As mentioned earlier, I think gluten-free is a good way to go even if you don't have celiac disease. I've been reading up on "Paleo" diets...which seems to be essentially a gluten-free diet...back to our roots! Thanks for putting this article together!

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    Guest Amber Emery

    Posted

    Thanks for the article - I have been going to the doctor for years trying to find out why I feel the way I do and finally they diagnosed me with something that makes sense! This article has given me a really good insight into what I'm going to be dealing with from this point on with my celiac disease. Thanks a lot!

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    Guest Michigan '11

    Posted

    I actually had these symptoms since 13 years of age. I did several colonoscopies, testing for what they could. A minor thing that came about was ulcerative colitis about 4 years ago. I went to the doctor again this past month August 2011 and my celiac panel came back POSITIVE! After all these years, so it's constantly changing, or may have been the start of something. I was heartbroken but same time relieved because I was just getting really sick in eating the foods that I love just became not worth it anymore to me. This is actually my first week trying and starting my new gluten free diet lifestyle. It could be worse, I always think of Diabetics now that is a huge lifestyle change. I at least went to Mexican place and ordered relatively clean gluten free diet. Still need to do major research but it was a start and didn't feel nearly as sick has I have been. Thank you to Celiac.com found a lot that was very helpful.

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    Guest Jennifer

    Posted

    I've been having a lot of symptoms for years that seem related to having a gluten intolerance. My doctor told me to go gluten free for a month to see how it goes. I have done lots of tests but I tend not to ask enough of questions at the doctors. My blood work indicated celiacs but the biopsy came back negative, so I don't really know where that leaves me. I heard you can have a gluten intolerance without celiacs. This website has been a huge help in figuring out how to start my diet!

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    Guest Lindsay

    Posted

    I live in a house with 7 other people, none of whom have had the constant problems that I have... I had a blood test done to check for celiac and it came back negative, but I've had constant gastrointestinal issues since I was a child. I don't see how I'm going to manage trying a gluten free diet (especially with all of the avoiding cross contamination and the constant worrying) with so many other people in my house. I'm extremely underweight as is, and looking at all of the things that I cannot eat... I fear I may wind up even worse than if I just kept eating what I do already!

    I know how you feel Jessica, I am in a similar situation. I am underweight and am worried that going gluten free might cause me to lose additional weight, something I can not really afford. Cross contamination is always an issue when you live in a house with many other people who are likely ignorant to this condition. The best thing to do is have your own little box of utensils, pans and a toaster but don't be afraid to educate your housemates, this is your daily health and that is VERY important. Gluten intolerance causes malabsorption in the small intestine, what you are eating now could be the reason you are underweight. Time on a gluten free diet could cause a turnaround, it's worth a try...isn't it?

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    Very good article, very surprising all the labels you have to check including toiletries and make up. It is life changing but hopefully with help it will be manageable.

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    Guest Peter Edwards

    Posted

    It is surprising the amount of people that, try to diagnose themselves with an illness, or have a negative outlook stating things like it won't work or it is not that.

     

    The first part of anything health-related is coming to terms with what you have been told, if you have the forethought of going to a good doctor, that wants to rule lots of illnesses out, to find out what is going on.

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    Guest Kayleigh

    Posted

    I know how you feel Jessica, I am in a similar situation. I am underweight and am worried that going gluten free might cause me to lose additional weight, something I can not really afford. Cross contamination is always an issue when you live in a house with many other people who are likely ignorant to this condition. The best thing to do is have your own little box of utensils, pans and a toaster but don't be afraid to educate your housemates, this is your daily health and that is VERY important. Gluten intolerance causes malabsorption in the small intestine, what you are eating now could be the reason you are underweight. Time on a gluten free diet could cause a turnaround, it's worth a try...isn't it?

    Being underweight is likely from being a celiac. Since your body does not absorb the nutrients, you become malnourished and you end up not being able to gain weight.

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    Why are MD's reluctant to investigate?

    Because there's no pharmaceutical cure and ergo they don't get any kickbacks to treat it.

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    Guest Popcoen

    Posted

    My wife was just diagnosed with celiac disease and I found this site and article to be a extremely helpful. I do not have a problem with the gluten protein but we are all going to a gluten-free lifestyle. It will make it easier for my wife to transition. I thank you so much for the information. Now it is time to get the kids tested as well.

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    Wonderful overview, and even though change is unpleasant this leaves me feeling positive. Even being in France and Spain this month where baguettes and croissants are the basics, I've managed to stay on track.

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    Guest Lindsey

    Posted

    Don't forget things like antacids, Maltodextrin (which is in everything) is NOT gluten free. It makes it hard to take a fast acting antacid, of course if I didn't slip and eat gluten I wouldn't need it... Catch-22.

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    Guest mum2aceliac

    Posted

    This article scared me to death since I'm getting tested next week. I don't know how I am going to avoid the cross contamination which may I add looks impossible especially if you live with others who are not celiacs.

    We have a gluten house with a sole celiac. We double wash any shared dishes and taught her to be diligent about hand washing. She has had 4 straight tears of negative tests so what we're doing is working. It's about education and attitude and sometimes a bit of extra work.

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    Glutamic Acid
    Glutamine (amino acid)
    Glutinous Rice
    Glutinous Rice Flour
    Glycerides
    Glycerin
    Glycerol Monooleate
    Glycol Monosterate
    Glycol
    Glycolic acid
    Gram flour (chick peas)
    Grape Skin Extract
    Grits, Corn
    Guar Gum
    Gum Acacia
    Gum Arabic
    Gum Base
    Gum Tragacanth
    Hemp
    Hemp Seeds
    Herbs
    Herb Vinegar
    Hexanedioic Acid
    High Fructose Corn Syrup
    Hominy
    Honey
    Hops
    Horseradish (Pure)
    HPP
    HVP
    Hyacinth Bean
    Hydrogen Peroxide
    Hydrolyzed Caseinate
    Hydrolyzed Meat Protein
    Hydrolyzed Plant Protein
    Hydrolyzed Protein
    Hydrolyzed Soy Protein
    Hydrolyzed Vegetable Protein
    Hydroxypropyl Cellulose
    Hydroxypropyl Methylcellulose
    Hypromellose
    Illepe
    Iodine
    Inulin
    Invert Sugar
    Iron Ammonium Citrate
    Isinglass
    Isolated Soy Protein
    Isomalt
    Job's Tears
    Jowar (Sorghum)
    Karaya Gum
    Kasha (roasted buckwheat)
    Keratin
    K-Carmine Color
    K-Gelatin
    Koshihikari (rice)
    Kudzu
    Kudzu Root Starch
    Lactalbumin Phosphate
    Lactase
    Lactic Acid
    Lactitol
    Lactose
    Lactulose
    Lanolin
    Lard
    L-cysteine
    Lecithin
    Lemon Grass
    Lentils
    Licorice
    Licorice Extract
    Lipase
    L-leucine
    L-lysine
    L-methionine
    Locust Bean Gum
    L-tryptophan
    Magnesium Carbonate
    Magnesium Hydroxide
    Magnesium Oxide
    Maize
    Maize Waxy
    Malic Acid
    Maltitol
    Maltodextrin (except in pharmaceuticals)
    Maltol
    Maltose
    Manganese Sulfate
    Manioc
    Masa
    Masa Flour
    Masa Harina
    Meat (fresh)
    Medium Chain Triglycerides
    Menhaden Oil
    Methyl Cellulose2
    Microcrystalline Cellulose
    Micro-particulated Egg White Protein
    Milk
    Milk Protein Isolate
    Millet
    Milo (Sorghum)
    Mineral Oil
    Mineral Salts
    Mixed Tocopherols
    Modified Food Starch
    Modified Starch
    Modified food Starch
    Molybdenum Amino Acid Chelate
    Monocalcium Phosphate
    Monoglycerides
    Mono and Diglycerides
    Monopotassium Phosphate
    Monosaccharides
    Monosodium Glutamate (MSG)
    Monostearates
    MSG
    Mung Bean
    Musk
    Mustard Flour
    Myristic Acid
    Natural Flavoring
    Natural Flavors
    Natural Smoke Flavor
    Niacin-Niacinamide
    Neotame
    Niacin
    Niacinamide
    Nitrates
    Nitrous Oxide
    Non-fat Milk
    Nuts (except wheat, rye & barley)
    Nut, Acron
    Nut, Almond
    Oats3
    Oils and Fats
    Oleic Acid
    Oleoresin
    Olestra
    Oleyl Alcohol/Oil
    Orange B
    Oryzanol
    Palmitic Acid
    Pantothenic Acid
    Papain
    Paprika
    Paraffin
    Patially Hydrogenated Cottonseed Oil
    Patially Hydrogenated Soybean Oil
    Peas
    Pea - Chick
    Pea - Cow
    Pea Flour
    Pea Starch
    Peanuts
    Peanut Flour
    Pectin
    Pectinase
    Peppermint Oil
    Peppers
    Pepsin
    Peru Balsam
    Petrolatum
    PGPR (Polyglycerol Polyricinoleate)
    Phenylalanine
    Phosphoric Acid
    Phosphoric Glycol
    Pigeon Peas
    Polenta
    Polydextrose
    Polyethylene Glycol
    Polyglycerol
    Polyglycerol Polyricinoleate (PGPR)
    Polysorbates
    Polysorbate 60
    Polysorbate 80
    Potassium Benzoate
    Potassium Caseinate
    Potassium Citrate
    Potassium Iodide
    Potassium Lactate
    Potassium Matabisulphite
    Potassium Sorbate
    Potatoes
    Potato Flour
    Potato Starch
    Povidone
    Prinus
    Pristane
    Propolis
    Propylene Glycol
    Propylene Glycol Monosterate
    Propyl Gallate
    Protease
    Psyllium
    Pyridoxine Hydrochloride
    Quinoa
    Ragi
    Raisin Vinegar
    Rape
    Recaldent
    Reduced Iron
    Rennet
    Rennet Casein
    Resinous Glaze
    Reticulin
    Riboflavin
    Rice
    Rice (Enriched)
    Rice Flour
    Rice Starch
    Rice Syrup
    Rice Vinegar
    Ricinoleic Acid
    Romano Bean (chickpea)
    Rosematta
    Rosin
    Royal Jelly
    Saccharin
    Saffron
    Sago
    Sago Palm
    Sago Flour
    Sago Starch
    Saifun (bean threads)
    Salt
    Seaweed
    Seeds (except wheat, rye & barley)
    Seed - Sesame
    Seed - Sunflower
    Shea
    Sherry Vinegar
    Silicon Dioxide
    Smoke Flavoring
    Soba (be sure its 100% buckwheat)
    Sodium Acid Pyrophosphate
    Sodium Acetate
    Sodium Alginate
    Sodium Ascorbate
    Sodium Benzoate
    Sodium Caseinate
    Sodium Citrate
    Sodium Erythrobate
    Sodium Hexametaphosphate
    Sodium Lactate
    Sodium Lauryl Sulfate
    Sodium Metabisulphite
    Sodium Nitrate
    Sodium Phosphate
    Sodium Polyphosphate
    Sodium Silaco Aluminate
    Sodium Stearoyl Lactylate
    Sodium Sulphite
    Sodium Stannate
    Sodium Tripolyphosphate
    Sorbic Acid
    Sorbitan Monostearate
    Sorbitol-Mannitol (can cause IBS symptoms)
    Sorghum
    Sorghum Flour
    Soy
    Soybean
    Soy Lecithin
    Soy Protein
    Soy Protein Isolate
    Spices (pure)
    Spirits (Specific Types)
    Spirit Vinegar
    Starch (the single word ingredient is, by law, cornstarch)
    Stearates
    Stearamide
    Stearamine
    Stearic Acid
    Stearyl Lactate
    Stevia
    Subflower Seed
    Succotash (corn and beans)
    Sucralose
    Sucrose
    Sulfosuccinate
    Sulfites
    Sulfur Dioxide
    Sweet Chestnut Flour
    Tagatose
    Tallow
    Tapioca
    Tapioca Flour
    Tapioca Starch
    Tara Gum
    Taro
    Tarro
    Tarrow Root
    Tartaric Acid
    Tartrazine
    TBHQ is Tetra or Tributylhydroquinone
    Tea
    Tea-Tree Oil
    Teff
    Teff Flour
    Tepary Bean
    Textured Vegetable Protein
    Thiamin Hydrochloride
    Thiamine Mononitrate
    Thiamine Hydrochloride
    Titanium Dioxide
    Tofu (Soy Curd)
    Tolu Balsam
    Torula Yeast
    Tragacanth
    Tragacanth Gum
    Triacetin
    Tricalcium Phosphate
    Tri-Calcium Phosphate
    Trypsin
    Turmeric (Kurkuma)
    TVP
    Tyrosine
    Urad/Urid Beans
    Urad/Urid Dal (peas) Vegetables
    Urad/Urid flour
    Urd
    Vinegar (All except Malt)
    Vanilla Extract
    Vanilla Flavoring
    Vanillin
    Vinegars (Specific Types - Except Malt Vinegar)
    Vitamin A (retinol)
    Vitamin A Palmitate
    Vitamin B1
    Vitamin B-12
    Vitamin B2
    Vitamin B6
    Vitamin D
    Vitamin E Acetate
    Waxy Maize
    Whey
    Whey Protein Concentrate
    Whey Protein Isolate
    White Vinegar
    Wines
    Wine Vinegars (& Balsamic)
    Wild Rice
    Xanthan Gum
    Xylitol
    Yam Flour
    Yeast (except brewer's yeast)
    Yogurt (plain, unflavored)
    Zinc Oxide
    Zinc Sulfate
    1) Cellulose is a carbohydrate polymer of D-glucose. It is the structural material of plants, such as wood in trees. It contains no gluten protein. 2) Methyl cellulose is a chemically modified form of cellulose that makes a good substitute for gluten in rice-based breads, etc. 3) Recent research indicates that oats may be safe for people on gluten-free diets, although many people may also have an additional, unrelated intolerance to them. Cross contamination with wheat is also a factor that you need to consider before choosing to include oats in your diet.

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    Abyssinian Hard (Wheat triticum durum)
    Alcohol (Spirits - Specific Types)
    Atta Flour
    Barley Grass (can contain seeds)
    Barley Hordeum vulgare
    Barley Malt
    Beer (most contain barley or wheat)
    Bleached Flour
    Bran
    Bread Flour
    Brewer's Yeast
    Brown Flour
    Bulgur (Bulgar Wheat/Nuts)
    Bulgur Wheat
    Cereal Binding
    Chilton
    Club Wheat (Triticum aestivum subspecies compactum)
    Common Wheat (Triticum aestivum)
    Cookie Crumbs
    Cookie Dough
    Cookie Dough Pieces
    Couscous
    Criped Rice
    Dinkle (Spelt)
    Disodium Wheatgermamido Peg-2 Sulfosuccinate
    Durum wheat (Triticum durum)
    Edible Coatings
    Edible Films
    Edible Starch
    Einkorn (Triticum monococcum)
    Emmer (Triticum dicoccon)
    Enriched Bleached Flour
    Enriched Bleached Wheat Flour
    Enriched Flour
    Farik
    Farina
    Farina Graham
    Farro
    Filler
    Flour (normally this is wheat)
    Freekeh
    Frikeh
    Fu (dried wheat gluten)
    Germ
    Graham Flour
    Granary Flour
    Groats (barley, wheat)
    Hard Wheat
    Heeng
    Hing
    Hordeum Vulgare Extract
    Hydroxypropyltrimonium Hydrolyzed Wheat Protein
    Kamut (Pasta wheat)
    Kecap Manis (Soy Sauce)
    Ketjap Manis (Soy Sauce)
    Kluski Pasta
    Maida (Indian wheat flour)
    Malt
    Malted Barley Flour
    Malted Milk
    Malt Extract
    Malt Syrup
    Malt Flavoring
    Malt Vinegar
    Macha Wheat (Triticum aestivum)
    Matza
    Matzah
    Matzo
    Matzo Semolina
    Meripro 711
    Mir
    Nishasta
    Oriental Wheat (Triticum turanicum)
    Orzo Pasta
    Pasta
    Pearl Barley
    Persian Wheat (Triticum carthlicum)
    Perungayam
    Poulard Wheat (Triticum turgidum)
    Polish Wheat (Triticum polonicum)
    Rice Malt (if barley or Koji are used)
    Roux
    Rusk
    Rye
    Seitan
    Semolina
    Semolina Triticum
    Shot Wheat (Triticum aestivum)
    Small Spelt
    Spirits (Specific Types)
    Spelt (Triticum spelta)
    Sprouted Wheat or Barley
    Stearyldimoniumhydroxypropyl Hydrolyzed Wheat Protein
    Strong Flour
    Suet in Packets
    Tabbouleh
    Tabouli
    Teriyaki Sauce
    Timopheevi Wheat (Triticum timopheevii)
    Triticale X triticosecale
    Triticum Vulgare (Wheat) Flour Lipids
    Triticum Vulgare (Wheat) Germ Extract
    Triticum Vulgare (Wheat) Germ Oil
    Udon (wheat noodles)
    Unbleached Flour
    Vavilovi Wheat (Triticum aestivum)
    Vital Wheat Gluten
    Wheat, Abyssinian Hard triticum durum
    Wheat Amino Acids
    Wheat Bran Extract
    Wheat, Bulgur
    Wheat Durum Triticum
    Wheat Germ Extract
    Wheat Germ Glycerides
    Wheat Germ Oil
    Wheat Germamidopropyldimonium Hydroxypropyl Hydrolyzed Wheat Protein
    Wheat Grass (can contain seeds)
    Wheat Nuts
    Wheat Protein
    Wheat Triticum aestivum
    Wheat Triticum Monococcum
    Wheat (Triticum Vulgare) Bran Extract
    Whole-Meal Flour
    Wild Einkorn (Triticum boeotictim)
    Wild Emmer (Triticum dicoccoides)
    The following items may or may not contain gluten depending on where and how they are made, and it is sometimes necessary to check with the manufacturer to find out:
    Amp-Isostearoyl Hydrolyzed Wheat Protein4
    Artificial Color4
    Baking Powder4
    Clarifying Agents4
    Coloring4
    Dry Roasted Nuts4
    Emulsifiers4
    Enzymes4
    Fat Replacer4
    Gravy Cubes4
    Ground Spices4
    Hydrolyzed Wheat Gluten4
    Hydrolyzed Wheat Protein4
    Hydrolyzed Wheat Protein Pg-Propyl Silanetriol4
    Hydrolyzed Wheat Starch4
    Hydrogenated Starch Hydrolysate4
    Hydroxypropylated Starch4
    Miso4
    Natural Juices4
    Non-dairy Creamer4
    Pregelatinized Starch4
    Protein Hydrolysates4
    Seafood Analogs4
    Seasonings4
    Sirimi4
    Soba Noodles4
    Soy Sauce4
    Soy Sauce Solids4
    Sphingolipids4
    Stabilizers4
    Starch1, 4
    Stock Cubes4
    Suet4
    Tocopherols4
    Vegetable Broth4
    Vegetable Gum4
    Vegetable Protein4
    Vegetable Starch4
    Vitamins4
    Wheat Starch5
    1) If this ingredient is made in North America it is likely to be gluten-free. 4) Can utilize a gluten-containing grain or by-product in the manufacturing process, or as an ingredient. 5) Most celiac organizations in the USA and Canada do not believe that wheat starch is safe for celiacs. In Europe, however, Codex Alimentarius Quality wheat starch is considered acceptable in the celiac diet by most doctors and celiac organizations. This is a higher quality of wheat starch than is generally available in the USA or Canada.

    Dr. Ron Hoggan, Ed.D.

    This article appeared in the Spring 2005 edition of Celiac.coms Scott-Free Newsletter.
    Celiac.com 04/10/2005 - Celiac disease is, by definition, a condition in which the intestinal wall is damaged as a result of eating gluten. It is a chronic illness in which the symptoms wax and wane1 for reasons that are not yet understood. Celiac disease is the result of genetic and environmental factors. We now know two HLA markers (DQ2 and DQ8) for the predisposition for celiac disease2. One environmental factor is, of course, the consumption of gluten, but there may be other environmental contributors. Recent research reveals that about 1% of the population suffers from this condition3 although most remain undiagnosed.
    On the other hand, gluten sensitivity is characterized by antigliadin antibodies. This condition afflicts at least 12% of the general population4 and is found in patients with a wide variety of autoimmune diseases. In some studies of neurological diseases of unknown origin, a majority of patients show signs of gluten sensitivity4. These patients are mounting an immune response to the most common food in the western diet, yet many practitioners consider gluten sensitivity to be a non-specific finding, frequently counseling patients to ignore these test results. This is particularly unfortunate since a strict gluten-free diet has repeatedly proven helpful to patients who are fortunate enough to consult a practitioner who is versed in gluten sensitivity and its connection with autoimmunity.
    Untreated celiac disease carries an added risk for a wide variety of additional autoimmune diseases. The most likely cause of this predisposition to additional autoimmune disease is a condition sometimes referred to as leaky gut syndrome. We know that gluten causes intestinal damage. We also know that this damage allows large undigested and partly digested proteins to leak into the bloodstream through the damaged intestinal wall. This leakage results in immune system production of antibodies to attack these foreign proteins as if they were invading microbes. The result is the production of a huge variety of selective antibodies, and each type recognizes a particular short chain of amino acids located somewhere in the proteins structure. Unfortunately, our own tissues can contain very similar or identical sequences of amino acids. Hence, by a process called molecular mimicry, we are producing antibodies that attack both the foreign food proteins that are leaked into our blood through the damaged intestinal wall, and similar amino acid sequences in our own tissues, often resulting in an autoimmune disease5.
    The supposedly non-specific antigliadin antibodies in gluten sensitivity provide two important pieces of information: 1) That the intestinal wall has been damaged and is permitting leakage of food proteins into the bloodstream, and; 2) That the dynamic contributing to increased autoimmunity in celiac disease may well be an important contributing factor in gluten sensitivity5. The currently common view that celiac disease is a serious illness, while disregarding gluten sensitivity, is dangerous to gluten sensitive patients.
    This bias is also a divisive element in the gluten-sensitive/celiac community. Whether a person has "biopsy proven" damage to the intestinal wall, if this person gets sick from eating gluten, or mounts an immune response to gluten, we are all in the same leaky boat (please pardon the pun). We need to work together to get a better understanding of gluten sensitivity in all its forms (including celiac disease). As a community, we need to discourage any kind of dismissal of illnesses that are partly or wholly mediated by gluten.
    If we can stand together in our quest for widespread recognition of the damaging impact of gluten consumption, we can all enjoy a healthier life. Our descendants will also inherit a more gluten-savvy world.
    Ron Hoggan is an author, teacher and diagnosed celiac who lives in Canada. His book "Dangerous Grains" can be ordered at Celiac.com. Rons Web page is: www.DangerousGrains.com
    Sources:
    Cooke W, Holmes G. Coeliac Disease. Churchill Livingstone, New York, N.Y. 1984. Fasano A. Celiac disease--how to handle a clinical chameleon.
    N Engl J Med. 2003 Jun 19;348(25):2568-70. Fasano A, Berti I, Gerarduzzi T, Not T, Colletti RB, Drago S, Elitsur Y, Green PH, Guandalini S, Hill ID, Pietzak M, Ventura A, Thorpe M, Kryszak D, Fornaroli F, Wasserman SS, Murray JA, Horvath K. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med. 2003 Feb 10;163(3):286-92. Hadjivassiliou M, Grunewald RA, Davies-Jones GA. Gluten sensitivity as a neurological illness. J Neurol Neurosurg Psychiatry. 2002 May;72(5):560-3. Braly J, Hoggan R.. Dangerous Grains, Penguin-Putnam-Avery, New York, N.Y., 2002.

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    Celiac.com 04/09/2010 - Receiving a celiac disease diagnosis or being told you need to be on a gluten-free diet can be an overwhelming experience, and it is certainly not for the faint of heart. Most people get frustrated with the transition, and many don't know where to begin. While eating gluten-free can improve your health, I must emphasize that it is not recommended to attempt a gluten-free diet without a doctors supervision, as there are many potential health risks involved with making drastic changes to your diet, which can be avoided with assistance of a qualified doctor and/or nutritionist. If you suspect gluten-intolerance to be the culprit for your health problems, get examined by a doctor and get tested for celiac disease before initiating a gluten-free diet. It is very important to continually consume gluten while you are undergoing testing for celiac disease because many of the tests require you to be consuming gluten to get accurate results.
    Prescription: A Gluten-Free Diet
    Now that you have your diagnosis and need to eliminate gluten, you can make the transition to a gluten-free diet with confidence. The following information is a guideline of what you will need to know to get started. I must emphasize that this is only a guideline, and you will need to do your own research and consult with your doctor for more detailed information on a gluten-free diet. It is also a great idea to get involved in local support groups. Support groups will have members that understand what you are going through and they can help direct you to beneficial resources:
    Celiac Disease Support Groups, Organizations & Contacts Create New Habits
    To begin, if you are accustomed to doing things your own way, you will have to throw out many of your old habits. To avoid gluten poisoning you must keep all gluten away from your mouth. You will need to evaluate everything you ingest very carefully. Gluten can come in a variety of unexpected ways, including a kiss from a loved one, and any gluten that comes into contact with your mouth is a potential source of contamination. Cross-contamination can occur when a meal is prepared on cooking equipment shared with gluten-containing foods. It can also come from touching anything that has come into contact with gluten. It is therefore important to gluten-proof your house and to keep everything you eat separate from gluten and gluten residue. If you eat at restaurants, it is important to only eat at places that you know are safe. To help you avoid accidental gluten ingestion, please follow your instincts and use the following guidelines and avoid potential health hazards. Please remember that these are only guidelines--if you still have questions, please consult with a medical professional.
    What does "Gluten-Free" Actually Mean?
    Since gluten is found in wheat, rye and barley, it is obvious that you will need to avoid these grains. Less obvious however, are the myriad of products that contain gluten as a hidden ingredient. The Food and Drug Administration (FDA) recently regulated the use of "gluten-free" on a food label, and there was already an FDA regulation that requires manufacturers to declare wheat if it is used as an ingredient in a product. Products that don't use "gluten-free" on their label unfortunately don't have to disclose ingredients that are made from barley or rye, which requires you to learn to read and understand ingredient labels. Many additives, natural or artificial, can contain gluten. Sometimes companies label products as "gluten-free" or the ingredients are naturally gluten-free, but the product may have be contaminated if it was manufactured on shared equipment. You will have to decide if you want to include such products in your diet. It is also important to remember, for reasons just mentioned, that “wheat-free” does not mean “gluten-free.”
    Batch Testing:
    According to current FDA proposals, products testing at less than 20 parts per million (PPM)  for gluten will likely be allowed to be labeled "gluten-free," and, according to them, are considered safe for people with gluten-intolerance or celiac disease. There are several organizations that offer gluten-free certification for companies who follow their guidelines and batch test their products. Check out the link below for more information on gluten-free certification and labeling.
    Gluten-Free Food Certification Program by the Gluten Intolerance Group Gluten-Free Shopping
    Shopping will likely take much longer for you than it used to. Don't rush. It is important to read all ingredients carefully. If you are in a hurry, you run the risk of overlooking a key ingredient that might contain gluten. I find it helpful to plan my meals in advance. There is nothing worse than coming home from work hungry and realizing that you have nothing to eat (and it isn't like you can go to the first drive-thru you find). So planning my meals on the weekend and doing my shopping in advance, cuts my stress level down considerably and keeps me from going hungry. Check your products against your gluten-free guidebooks, and contact the manufacturer if you are unsure about something. The following links will help you take the guess work out of shopping for gluten-free products:
    Safe Gluten-Free Food List (Safe Ingredients) Unsafe Gluten-Free Food List (Unsafe Ingredients) As mentioned, there are also many products that are naturally gluten-free that are not labeled "gluten-free," and there are some very helpful books that can help you find these foods when you are shopping.
    A Gluten-Free Kitchen
    A gluten-free kitchen is very important. If you can have an entirely gluten-free kitchen, that is ideal, but it may not be an option for many households. Therefore it is especially important to keep your house clean and free of gluten contaminates.  It is also important to dedicate special kitchen supplies for gluten-free cooking. I bought a new cutting board that is dedicated only to gluten-free cooking. You may also want to have separate kitchen utensils such as sponges, toasters (a dedicated gluten-free toaster is highly recommended), sifters, bread machines, etc. This is especially important if you use utensils that are made of wood, plastic, or other porous materials that could harbor gluten and possibly contaminate your gluten-free food. If possible use an electric dishwasher to clean your dishes.
    If everyone in your household is going gluten-free it is important to clean out and empty all of the gluten products from your kitchen. If you share a kitchen with gluten eating family members, it is a good idea to store their food products separately from your gluten-free products, and to clean off all surfaces before you prepare your gluten-free food. Dedicating gluten-free cupboards and refrigerator shelves is a great way to start.
    Here are some important links that will help you cook gluten-free meals with ease:
    Gluten-Free Cooking Gluten-Free Recipes
    Kitchen Checklist - Possible Sources of Contamination:
    Bread-machine Toaster Sponges & cleaning pads All kitchen supplies & utensils Colanders Cutting boards Door handles Soaps For more information on maintaining a safe kitchen environment, click the link below:
    What You Need If You Can't Have A Gluten-Free Kitchen Dining Out Gluten-Free
    Dining out presents a challenge for most people on a gluten-free diet. Depending on your level of sensitivities, you may have difficulty eating out at all. Even if the restaurant offers a gluten-free menu, it is always important to find out what safety precautions the restaurant uses to avoid cross-contamination, and to make sure all the ingredients in your food are gluten-free. This may require you to modify your order, and also may mean talking with the chef about their kitchen practices. You may also benefit from utilizing a guide to safe restaurants.
    Here is an additional article that may be helpful to your situation:
    Take Charge of Your Meal When Eating Out A Gluten-Free Bathroom
    Believe it or not, your bathroom is another place where you might be getting sick from gluten contamination, and not even know it. There are many products in your bathroom to watch out for as many body products contain wheat and/or hidden gluten ingredients. Most celiacs can use body products without a negative reaction, though some people experience rashes and other unsavory reactions from gluten body products. However, if you are using face or body products that contain gluten, it is very important not to ingest them. I find it difficult to avoid getting shampoo or makeup near my mouth, so I don't take any chances. I use gluten-free soap, shampoo, conditioner, face-cleaner, toner, make-up, toothpaste; basically nothing goes onto my body that contains gluten. Using gluten-free body products allows me the freedom to worry less about accidental contamination, and gives me more time to enjoy my life. Many gluten-free body products are not labeled gluten-free, so it is important to read ingredient labels carefully and check with the manufacturer if necessary.
    Bathroom Checklist:
    Toothpaste Shampoo/conditioner Make-up Lip-stick, lip-liner, lip-gloss, cosmetics, etc. Lotion Sunscreen  
    Gluten-Free Medications (Prescriptions and Supplements)
    Most people with celiac disease or gluten-intolerance also suffer from malabsorption and sometimes malnutrition. Your doctor may prescribe pain, anti-inflammatory, digestive or other medications or supplements to help assist with your recovery. It is very important to note that some medications and supplements can contain gluten. Do not assume that just because your doctor knows you have celiac disease or gluten intolerance that the medications or supplements they may prescribe for you are gluten-free.  Be your own advocate and read the ingredients and contact your pharmacist and/or the manufacturer and find out if your prescriptions, vitamins and supplements are gluten-free.
    Gluten-Free Medications List Additional Concerns
    Children with Celiac Disease
    Raising children with celiac disease or gluten-intolerance is no easy feat. Your kids will have to deal with immense  peer pressure and there will be a great deal of temptation for them to eat gluten-containing foods. Talk to the staff at their school and help them to understand your child's special needs. The more support you have, the better off your child will be. There are many support groups that advocate for children with celiac disease, and it is important to get involved and learn everything you can to help support your child.
    Raising our Celiac Kids (R.O.C.K) Support Group Pets
    Your pets present another source of potential contamination, especially if you have pets like mine that love to smother you with unexpected kisses, sometimes on the mouth. What your pet eats can affect you too. Handling your pet's food, cleaning your pet's dishes and having young celiac children in a house where they may eat dog or cat food are all legitimate concerns. I decided to switch my pets to gluten-free pet food. Most pet food is not labeled gluten-free, so it is important to read ingredients carefully. I found grain-free, all natural pet food to be a great alternative to gluten-containing pet foods, that way I don't have to worry about accidental contamination or getting kisses from my pets--and it's healthier for them too!  It is also important to check all other pet products that you come into contact with for hidden gluten ingredients, like shampoos and soaps. It is of course always important to talk to your veterinarian before making any dietary changes for your pet.
    Other Food Sensitivities
    Most people who begin a gluten-free diet experience almost immediate relief from their symptoms. However, many people experience gluten-like reactions to other foods, and often suspect that their food was contaminated by gluten. As it turns out, many people who experience such reactions may in fact have additional food sensitivities. Some of the most common food sensitivities include, dairy/casein, soy, corn, sugar, nuts, shell-fish and processed or fatty foods. While many people report that they are able to add these foods back into their diet after they have established a gluten-free diet for many months, and after their intestines have had time to heal, it is up to you and your doctor or nutritionist to determine which foods may be causing you trouble. The 'elimination diet' is often recommended for determining what additional food sensitivities you may have. Ask your doctor if the elimination diet is right for you.
    Food Diary
    It is important to keep a food diary, especially when first initiating a gluten-free diet. Making notes of the foods you eat and the reactions you have to the foods you eat, and how you feel that day, can give you more insight as to which foods are hurting you and which foods your body can easily digest.
    Final Thoughts
    Be Picky
    Having a gluten intolerance means taking pride in your body, but not being too proud to say, "no, thank you." Don't worry about appearing too picky to others, you simply can't take care of yourself and worry what others think of you at the same time. You have the right to eat what you want; if something doesn't look, smell or taste right to you, or if you just don't feel right about eating something, don't eat it! It is better to come across as too finicky, than to spend the night in the bathroom or worse yet, the emergency room. Everyone has a different level of gluten sensitivity and you will have to find out through trial and error what works best for you.
    Be Prepared
    As a former Boy-Scout, my high-school teacher used to always say, "Be prepared".  I cannot emphasize enough the importance of this statement. It is important to be prepared and think ahead. Keep gluten-free snacks on hand at all times, because you never know when you are going to get hungry somewhere that doesn't offer gluten-free food. Keep shelf-stable snacks in your car, office, purse, and anywhere you spend time. It is better to have gluten-free snacks on hand, then to get hungry and make a bad decision to eat something you might later regret.

    Gluten-Free Quick-Check:
    Read all labels carefully Call the manufacturer whenever necessary Avoid cross-contamination at all times Keep your hands clean Check personal-care products for hidden gluten Check all vitamins, supplements and RX prescriptions for hidden gluten Make sure your pets are gluten-free Maintain a food diary Get involved-join a support group Rule of thumb-if you think it's possibly contaminated, don't take any chances. It's better to go hungry than to suffer later. Above all, trust your body Additional Resources:
    Gluten-Free Forum Celiac Disease Support Groups Gluten-Free Newsletters & Magazines

  • Recent Articles

    Jefferson Adams
    Celiac.com 04/19/2018 - Previous genome and linkage studies indicate the existence of a new disease triggering mechanism that involves amino acid metabolism and nutrient sensing signaling pathways. In an effort to determine if amino acids might play a role in the development of celiac disease, a team of researchers recently set out to investigate if plasma amino acid levels differed among children with celiac disease compared with a control group.
     
    The research team included Åsa Torinsson Naluai, Ladan Saadat Vafa, Audur H. Gudjonsdottir, Henrik Arnell, Lars Browaldh, and Daniel Agardh. They are variously affiliated with the Institute of Biomedicine, Department of Microbiology & Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Division of Pediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden; the Department of Clinical Science and Education, Karolinska Institute, Sodersjukhuset, Stockholm, Sweden; the Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; the Diabetes & Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; and with the Nathan S Kline Institute in the U.S.A.
    First, the team used liquid chromatography-tandem mass spectrometry (LC/MS) to analyze amino acid levels in fasting plasma samples from 141 children with celiac disease and 129 non-celiac disease controls. They then crafted a general linear model using age and experimental effects as covariates to compare amino acid levels between children with celiac disease and non-celiac control subjects.
    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.
    The significance of the individual amino acids do not survive multiple correction, however, multivariate analyses of the amino acid profile showed significantly altered amino acid levels in children with celiac disease overall and after correction for age, sex and experimental effects.
    This study shows that amino acids can influence inflammation and may play a role in the development of celiac disease.
    Source:
    PLoS One. 2018; 13(3): e0193764. doi: & 10.1371/journal.pone.0193764

    Jefferson Adams
    Celiac.com 04/18/2018 - To the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service animals.
    If you’ve flown anywhere lately, you may have seen them. People flying with their designated “emotional support” animals. We’re not talking genuine service animals, like seeing eye dogs, or hearing ear dogs, or even the Belgian Malinois that alerts its owner when there is gluten in food that may trigger her celiac disease.
    Now, to be honest, some of those animals in question do perform a genuine service for those who need emotional support dogs, like veterans with PTSD.
    However, many of these animals are not service animals at all. Many of these animals perform no actual service to their owners, and are nothing more than thinly disguised pets. Many lack proper training, and some have caused serious problems for the airlines and for other passengers.
    Now the major airlines are taking note and introducing stringent requirements for service animals.
    Delta was the first to strike. As reported by the New York Times on January 19: “Effective March 1, Delta, the second largest US airline by passenger traffic, said it will require passengers seeking to fly with pets to present additional documents outlining the passenger’s need for the animal and proof of its training and vaccinations, 48 hours prior to the flight.… This comes in response to what the carrier said was a 150 percent increase in service and support animals — pets, often dogs, that accompany people with disabilities — carried onboard since 2015.… Delta said that it flies some 700 service animals a day. Among them, customers have attempted to fly with comfort turkeys, gliding possums, snakes, spiders, and other unusual pets.”
    Fresh from an unsavory incident with an “emotional support” peacock incident, United Airlines has followed Delta’s lead and set stricter rules for emotional support animals. United’s rules also took effect March 1, 2018.
    So, to the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service and emotional support animals.
    Source:
    cnbc.com

    admin
    WHAT IS CELIAC DISEASE?
    Celiac disease is an autoimmune condition that affects around 1% of the population. People with celiac disease suffer an autoimmune reaction when they consume wheat, rye or barley. The immune reaction is triggered by certain proteins in the wheat, rye, or barley, and, left untreated, causes damage to the small, finger-like structures, called villi, that line the gut. The damage occurs as shortening and villous flattening in the lamina propria and crypt regions of the intestines. The damage to these villi then leads to numerous other issues that commonly plague people with untreated celiac disease, including poor nutritional uptake, fatigue, and myriad other problems.
    Celiac disease mostly affects people of Northern European descent, but recent studies show that it also affects large numbers of people in Italy, China, Iran, India, and numerous other places thought to have few or no cases.
    Celiac disease is most often uncovered because people experience symptoms that lead them to get tests for antibodies to gluten. If these tests are positive, then the people usually get biopsy confirmation of their celiac disease. Once they adopt a gluten-free diet, they usually see gut healing, and major improvements in their symptoms. 
    CLASSIC CELIAC DISEASE SYMPTOMS
    Symptoms of celiac disease can range from the classic features, such as diarrhea, upset stomach, bloating, gas, weight loss, and malnutrition, among others.
    LESS OBVIOUS SYMPTOMS
    Celiac disease can often less obvious symptoms, such fatigue, vitamin and nutrient deficiencies, anemia, to name a few. Often, these symptoms are regarded as less obvious because they are not gastrointestinal in nature. You got that right, it is not uncommon for people with celiac disease to have few or no gastrointestinal symptoms. That makes spotting and connecting these seemingly unrelated and unclear celiac symptoms so important.
    NO SYMPTOMS
    Currently, most people diagnosed with celiac disease do not show symptoms, but are diagnosed on the basis of referral for elevated risk factors. 

    CELIAC DISEASE VS. GLUTEN INTOLERANCE
    Gluten intolerance is a generic term for people who have some sort of sensitivity to gluten. These people may or may not have celiac disease. Researchers generally agree that there is a condition called non-celiac gluten sensitivity. That term has largely replaced the term gluten-intolerance. What’s the difference between celiac disease and non-celiac gluten-sensitivity? 
    CELIAC DISEASE VS. NON-CELIAC GLUTEN SENSITIVITY (NCGS)
    Gluten triggers symptoms and immune reactions in people with celiac disease. Gluten can also trigger symptoms in some people with NCGS, but the similarities largely end there.

    There are four main differences between celiac disease and non-celiac gluten sensitivity:
    No Hereditary Link in NCGS
    Researchers know for certain that genetic heredity plays a major role in celiac disease. If a first-degree relative has celiac disease, then you have a statistically higher risk of carrying genetic markers DQ2 and/or DQ8, and of developing celiac disease yourself. NCGS is not known to be hereditary. Some research has shown certain genetic associations, such as some NCGS patients, but there is no proof that NCGS is hereditary. No Connection with Celiac-related Disorders
    Unlike celiac disease, NCGS is so far not associated with malabsorption, nutritional deficiencies, or a higher risk of autoimmune disorders or intestinal malignancies. No Immunological or Serological Markers
    People with celiac disease nearly always test positive for antibodies to gluten proteins. Researchers have, as yet, identified no such antobodies or serologic markers for NCGS. That means that, unlike with celiac disease, there are no telltale screening tests that can point to NCGS. Absence of Celiac Disease or Wheat Allergy
    Doctors diagnose NCGS only by excluding both celiac disease, an IgE-mediated allergy to wheat, and by the noting ongoing adverse symptoms associated with gluten consumption. WHAT ABOUT IRRITABLE BOWEL SYNDROME (IBS) AND IRRITABLE BOWEL DISEASE (IBD)?
    IBS and IBD are usually diagnosed in part by ruling out celiac disease. Many patients with irritable bowel syndrome are sensitive to gluten. Many experience celiac disease-like symptoms in reaction to wheat. However, patients with IBS generally show no gut damage, and do not test positive for antibodies to gliadin and other proteins as do people with celiac disease. Some IBS patients also suffer from NCGS.

    To add more confusion, many cases of IBS are, in fact, celiac disease in disguise.

    That said, people with IBS generally react to more than just wheat. People with NCGS generally react to wheat and not to other things, but that’s not always the case. Doctors generally try to rule out celiac disease before making a diagnosis of IBS or NCGS. 
    Crohn’s Disease and celiac disease share many common symptoms, though causes are different.  In Crohn’s disease, the immune system can cause disruption anywhere along the gastrointestinal tract, and a diagnosis of Crohn’s disease typically requires more diagnostic testing than does a celiac diagnosis.  
    Crohn’s treatment consists of changes to diet and possible surgery.  Up to 10% of Crohn's patients can have both of conditions, which suggests a genetic connection, and researchers continue to examine that connection.
    Is There a Connection Between Celiac Disease, Non-Celiac Gluten Sensitivity and Irritable Bowel Syndrome? Large Number of Irritable Bowel Syndrome Patients Sensitive To Gluten Some IBD Patients also Suffer from Non-Celiac Gluten Sensitivity Many Cases of IBS and Fibromyalgia Actually Celiac Disease in Disguise CELIAC DISEASE DIAGNOSIS
    Diagnosis of celiac disease can be difficult. 

    Perhaps because celiac disease presents clinically in such a variety of ways, proper diagnosis often takes years. A positive serological test for antibodies against tissue transglutaminase is considered a very strong diagnostic indicator, and a duodenal biopsy revealing villous atrophy is still considered by many to be the diagnostic gold standard. 
    But this idea is being questioned; some think the biopsy is unnecessary in the face of clear serological tests and obvious symptoms. Also, researchers are developing accurate and reliable ways to test for celiac disease even when patients are already avoiding wheat. In the past, patients needed to be consuming wheat to get an accurate test result. 
    Celiac disease can have numerous vague, or confusing symptoms that can make diagnosis difficult.  Celiac disease is commonly misdiagnosed by doctors. Read a Personal Story About Celiac Disease Diagnosis from the Founder of Celiac.com Currently, testing and biopsy still form the cornerstone of celiac diagnosis.
    TESTING
    There are several serologic (blood) tests available that screen for celiac disease antibodies, but the most commonly used is called a tTG-IgA test. If blood test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.
    Testing is fairly simple and involves screening the patients blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis. Also, it is now possible to test people for celiac disease without making them concume wheat products.

    BIOPSY
    Until recently, biopsy confirmation of a positive gluten antibody test was the gold standard for celiac diagnosis. It still is, but things are changing fairly quickly. Children can now be accurately diagnosed for celiac disease without biopsy. Diagnosis based on level of TGA-IgA 10-fold or more the ULN, a positive result from the EMA tests in a second blood sample, and the presence of at least 1 symptom could avoid risks and costs of endoscopy for more than half the children with celiac disease worldwide.

    WHY A GLUTEN-FREE DIET?
    Currently the only effective, medically approved treatment for celiac disease is a strict gluten-free diet. Following a gluten-free diet relieves symptoms, promotes gut healing, and prevents nearly all celiac-related complications. 
    A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This is a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods. Still, with effort, most people with celiac disease manage to make the transition. The vast majority of celiac disease patients who follow a gluten-free diet see symptom relief and experience gut healing within two years.
    For these reasons, a gluten-free diet remains the only effective, medically proven treatment for celiac disease.
    WHAT ABOUT ENZYMES, VACCINES, ETC.?
    There is currently no enzyme or vaccine that can replace a gluten-free diet for people with celiac disease.
    There are enzyme supplements currently available, such as AN-PEP, Latiglutetenase, GluteGuard, and KumaMax, which may help to mitigate accidental gluten ingestion by celiacs. KumaMax, has been shown to survive the stomach, and to break down gluten in the small intestine. Latiglutenase, formerly known as ALV003, is an enzyme therapy designed to be taken with meals. GluteGuard has been shown to significantly protect celiac patients from the serious symptoms they would normally experience after gluten ingestion. There are other enzymes, including those based on papaya enzymes.

    Additionally, there are many celiac disease drugs, enzymes, and therapies in various stages of development by pharmaceutical companies, including at least one vaccine that has received financial backing. At some point in the not too distant future there will likely be new treatments available for those who seek an alternative to a lifelong gluten-free diet. 

    For now though, there are no products on the market that can take the place of a gluten-free diet. Any enzyme or other treatment for celiac disease is intended to be used in conjunction with a gluten-free diet, not as a replacement.

    ASSOCIATED DISEASES
    The most common disorders associated with celiac disease are thyroid disease and Type 1 Diabetes, however, celiac disease is associated with many other conditions, including but not limited to the following autoimmune conditions:
    Type 1 Diabetes Mellitus: 2.4-16.4% Multiple Sclerosis (MS): 11% Hashimoto’s thyroiditis: 4-6% Autoimmune hepatitis: 6-15% Addison disease: 6% Arthritis: 1.5-7.5% Sjögren’s syndrome: 2-15% Idiopathic dilated cardiomyopathy: 5.7% IgA Nephropathy (Berger’s Disease): 3.6% Other celiac co-morditities include:
    Crohn’s Disease; Inflammatory Bowel Disease Chronic Pancreatitis Down Syndrome Irritable Bowel Syndrome (IBS) Lupus Multiple Sclerosis Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Psoriasis Rheumatoid Arthritis Scleroderma Turner Syndrome Ulcerative Colitis; Inflammatory Bowel Disease Williams Syndrome Cancers:
    Non-Hodgkin lymphoma (intestinal and extra-intestinal, T- and B-cell types) Small intestinal adenocarcinoma Esophageal carcinoma Papillary thyroid cancer Melanoma CELIAC DISEASE REFERENCES:
    Celiac Disease Center, Columbia University
    Gluten Intolerance Group
    National Institutes of Health
    U.S. National Library of Medicine
    Mayo Clinic
    University of Chicago Celiac Disease Center

    Jefferson Adams
    Celiac.com 04/17/2018 - Could the holy grail of gluten-free food lie in special strains of wheat that lack “bad glutens” that trigger the celiac disease, but include the “good glutens” that make bread and other products chewy, spongey and delicious? Such products would include all of the good things about wheat, but none of the bad things that might trigger celiac disease.
    A team of researchers in Spain is creating strains of wheat that lack the “bad glutens” that trigger the autoimmune disorder celiac disease. The team, based at the Institute for Sustainable Agriculture in Cordoba, Spain, is making use of the new and highly effective CRISPR gene editing to eliminate the majority of the gliadins in wheat.
    Gliadins are the gluten proteins that trigger the majority of symptoms for people with celiac disease.
    As part of their efforts, the team has conducted a small study on 20 people with “gluten sensitivity.” That study showed that test subjects can tolerate bread made with this special wheat, says team member Francisco Barro. However, the team has yet to publish the results.
    Clearly, more comprehensive testing would be needed to determine if such a product is safely tolerated by people with celiac disease. Still, with these efforts, along with efforts to develop vaccines, enzymes, and other treatments making steady progress, we are living in exciting times for people with celiac disease.
    It is entirely conceivable that in the not-so-distant future we will see safe, viable treatments for celiac disease that do not require a strict gluten-free diet.
    Read more at Digitaltrends.com , and at Newscientist.com

    Jefferson Adams
    Celiac.com 04/16/2018 - A team of researchers recently set out to investigate whether alterations in the developing intestinal microbiota and immune markers precede celiac disease onset in infants with family risk for the disease.
    The research team included Marta Olivares, Alan W. Walker, Amalia Capilla, Alfonso Benítez-Páez, Francesc Palau, Julian Parkhill, Gemma Castillejo, and Yolanda Sanz. They are variously affiliated with the Microbial Ecology, Nutrition and Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), C/Catedrático Agustín Escardin, Paterna, Valencia, Spain; the Gut Health Group, The Rowett Institute, University of Aberdeen, Aberdeen, UK; the Genetics and Molecular Medicine Unit, Institute of Biomedicine of Valencia, National Research Council (IBV-CSIC), Valencia, Spain; the Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire UK; the Hospital Universitari de Sant Joan de Reus, IISPV, URV, Tarragona, Spain; the Center for regenerative medicine, Boston university school of medicine, Boston, USA; and the Institut de Recerca Sant Joan de Déu and CIBERER, Hospital Sant Joan de Déu, Barcelona, Spain
    The team conducted a nested case-control study out as part of a larger prospective cohort study, which included healthy full-term newborns (> 200) with at least one first relative with biopsy-verified celiac disease. The present study includes 10 cases of celiac disease, along with 10 best-matched controls who did not develop the disease after 5-year follow-up.
    The team profiled fecal microbiota, as assessed by high-throughput 16S rRNA gene amplicon sequencing, along with immune parameters, at 4 and 6 months of age and related to celiac disease onset. The microbiota of infants who remained healthy showed an increase in bacterial diversity over time, especially by increases in microbiota from the Firmicutes families, those who with no increase in bacterial diversity developed celiac disease.
    Infants who subsequently developed celiac disease showed a significant reduction in sIgA levels over time, while those who remained healthy showed increases in TNF-α correlated to Bifidobacterium spp.
    Healthy children in the control group showed a greater relative abundance of Bifidobacterium longum, while children who developed celiac disease showed increased levels of Bifidobacterium breve and Enterococcus spp.
    The data from this study suggest that early changes in gut microbiota in infants with celiac disease risk could influence immune development, and thus increase risk levels for celiac disease. The team is calling for larger studies to confirm their hypothesis.
    Source:
    Microbiome. 2018; 6: 36. Published online 2018 Feb 20. doi: 10.1186/s40168-018-0415-6