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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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    GLUTEN-FREE ST. PATRICK'S DAY


    Jefferson Adams

    Celiac.com 03/11/2011 - St. Patrick's Day is once again upon us, which means it's a good time to prepare for a successful gluten-free celebration of the wearing of the green.


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    One good thing for people on a gluten-free diet is that most traditional corned beef and cabbage recipes are gluten free. So, of course, are carrots and potatoes.

    If you plan of making corned beef, you should know that most commercial corned beef is gluten free. Some brands that are specifically labeled 'gluten free,' or which the makers' websites claim to be gluten-free, include:

    • Brookfield Farms
    • Colorado Premium - all corned beef products
    • Cook's
    • Freirich - all corned beef
    • Giant Eagle
    • Grobbel's Gourmet corned beef briskets
    • Hormel
    • Libby's Canned Meats (Corned Beef and Corned Beef Hash)
    • Market Day: Corned Beef Brisket
    • Mosey's corned beef
    • Nathan's corned beef
    • Safeway, Butchers cut bulk-wrapped corned beef brisket, corn beef brisket, vac-packed cooked corn beef
    • Thuman’s cooked corn beef brisket, first cut corned beef (cooked and raw), top round corned beef (cooked), cap and capless corned beef
    • Wegmans corned beef brisket.
    Many other brands not listed are also gluten free. Be sure to read the ingredients on the package, including those for any extra seasonings. Some labels may list natural flavorings, which rarely contain gluten. Still, if you're not sure, try to check the manufacturer's website, or maybe look for another brand.

    Gluten-Free Corned Beef Recipe

    Ingredients:
    6 pounds corned brisket of beef
    6 peppercorns, or gluten-free packaged pickling spices
    3 carrots, peeled and quartered
    3 onions, peeled and quartered
    1 medium-sized green cabbage, quartered or cut in wedges
    Melted butter (about 4 tablespoons)

    Directions:
    Place the corned beef in water to cover with the peppercorns or mixed pickling spices (in supermarkets, these often come packaged with the corned beef). Cover the pot or kettle, bring to a boil, reduce heat and simmer 5 hours or until tender, skimming occasionally. During the last hour, add the carrots and onions and cover again. During the last 15 minutes, add the cabbage. Transfer meat and vegetables to a platter and brush the vegetables with the melted butter.

    Serve with boiled parsley potatoes, cooked separately. (The stock can be saved to add to a pot roast or stew instead of other liquid.)

    Serves 6, with meat left over for additional meals.

    **

    For those who love Irish soda bread, the following soda bread recipe is a modified version of the Irish Soda Bread recipe from Easy Gluten-Free Baking by Elizabeth Barbone (2009 Lake Isle Press). This version skips caraway seeds, because I hate them. However, if you are so inclined, you can add a tablespoon with the last dry ingredients before baking.

    Amazing Gluten-free Irish Soda Bread

    Ingredients:
    Vegetable shortening for pan
    White Rice Flour for pan
    3 1/2 cups white rice flour
    1/2 cup sweet rice flour
    1/4 cup cornstarch
    1/4 cup potato starch (not potato flour)
    5 teaspoons baking powder (Gluten Free)
    1 1/2 teaspoons salt
    1 teaspoon baking soda
    1/2 teaspoon xanthan gum
    1 1/2 cups currants
    1 cup (2 sticks) butter softened
    2 large eggs
    1 cup granulated sugar
    2 cups buttermilk

    Directions:
    1. Preheat oven to 350 degrees and Grease and rice flour a 9 inch springform pan.

    2. In a medium bowl, whisk together the dry ingredients

    3. In a large bowl, cream together butter, eggs, and sugar until light and fluffy, about 1 minute.

    Use high speed on a handheld mixer or medium-high on a stand mixer. Stir in half of the dry ingredients. Use low speed on a handheld mixer or stand mixer for this. Stir in buttermilk until thoroughly combined. Add remaining dry ingredients and caraway seeds (if desired) and raisins.

    4. Pour batter into prepared pan and spread evenly. Bake about 1 1/2 hours or until a tester inserted in center comes out clean.

    5. Place pan on a wire rack to cool. About 5 minutes. Remove Bread from pan and allow to cool completely on rack. Makes 1 loaf.


    Image Caption: The finished gluten-free corned beef for St. Patrick's Day. Photo: CC-flamingo331
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    admin

    makes 1½ pounds dough You will probably find many uses for this good, user-friendly dough. Recipe from Wendy Warks Living Healthy with Celiac Disease (AnAffect, 1998). Wendy uses this for pretzels, breadsticks, cinnamon rolls, and pizza crust. Use it as a substitution for wheat flour dough in your favorite recipes.
    2 teaspoons unflavored dry gelatin
    2¼ teaspoons active dry yeast
    2/3 cup warm water (105F-115F)
    2 tablespoons sugar
    2½ cups Wendy Wark's Gluten-Free Flour Mix
    2½ teaspoons xanthan gum
    ¼ cup instant non-fat dry milk powder
    ½ teaspoon salt
    3 tablespoons vegetable oil
    2 eggs
    Combine gelatin, yeast, water, and sugar together in a 2-cup glass measure. Let stand for 5 minutes, or until foamy. In the bowl of a stand mixer, add flour mix, xanthan gum, milk powder, and salt. Mix briefly, then add oil and eggs, followed by yeast mixture. Beat on high speed for 2 minutes, using the paddle attachment until a soft dough forms. Use dough in your favorite recipe.
    Karen Robertson

    Jules Shepard
    This recipe may be prepared using a mixer and oven or in a bread machine. This loaf is light and airy, yet substantial enough to use as sandwich bread (however, if you want a denser loaf, simply add 1/4 cup dry milk powder to the dry ingredients).
    The recipe boasts the addition of flax seed meal and flax seeds which contribute a large amount of dietary fiber and other beneficial nutritional properties like high omega 3.  The simple addition of two tablespoons of flax seed meal to this bread also adds four grams of dietary fiber and three grams of protein.  As an alternative, you can simply use 2 eggs in place of the flax seed and water mixture, and you will add the dry yeast to the dough at the final mixing step.
    When using a bread machine, always be sure to add all liquid ingredients to the pan first, followed by the dry ingredients. I recommend sifting all dry ingredients (except yeast) together in a bowl first, then pouring it into the bread machine pan. If the dough seems too thick, gradually add more yogurt, one quarter cup at a time, until the dough is still thick, but able to be smoothed with a spatula. Be sure to check the bread with a spatula throughout the mixing process to ensure that all the dry ingredients have been incorporated. Smooth the top with a rubber spatula and when done mixing, sprinkle any desired toppings on top of the loaf. Select either the gluten-free bread setting on your machine, or the quickest bake setting like a light crust 1 ½ pound loaf. Remove the pan from the machine when finished baking (internal temperature should be between 205-210F).
    When making with a mixer and oven, follow the specific directions outlined below.

    Ingredients:
    2 Tablespoons ground flax seeds or flax seed meal
    ½ cup very hot water
    1 tsp. granulated cane sugar
    1 Tablespoon rapid rise or bread machine yeast
    ¼ cup Earth Balance Shortening, cut into small pieces (or canola oil, if using a bread machine)
    3 ¼ cups Jules Gluten FreeTM All Purpose Flour *
    ½ teaspoon baking soda
    2 teaspoons gluten-free baking powder
    Pinch of salt
    2 Tablespoons honey
    1 teaspoon apple cider vinegar
    1 ½ cup vanilla yogurt (dairy or soy)
    1 Tablespoon flax seeds
    Toppings of choice (coarse sea salt, sesame seeds, flax seeds, etc.)

    (* I cannot predict how this recipe will work with any other flour mixture but my own.  The mix recipe may be found in media links on my website and in my book, Nearly Normal Cooking for Gluten-Free Eating, or pre-mixed from my website.)Directions:
    In a small bowl, add the hot water and flax seed meal and stir. Let sit for 5 minutes. Add the yeast and one teaspoon of sugar to this mixture and stir. Set aside for 5 more minutes for it to begin to bubble and grow; if the mixture does not bubble or grow, throw it out and re-mix with fresh yeast. Sift remaining dry ingredients together in a large bowl. Cut in the pieces of shortening using a pastry cutter or the dough paddle on your mixer. Add the remaining liquid ingredients next, mixing well. Finally, mix in the yeast/flax seed meal mixture and stir well using the dough paddle. If the dough seems too thick to form a loaf, gradually mix in more yogurt, one quarter cup at a time, until the dough is still thick, but able to be smoothed with a spatula.

    Scoop the dough into a greased bread pan (use a dark metal pan if you like a darker crust on your bread; lighter, shiny metal or glass if you like a light crust). Smooth the top, sprinkle with any toppings, then cover with a sheet of wax paper sprayed with cooking oil. Sit the covered dough for 30 minutes in a warm place like an oven warming drawer or even in your oven with the light on.
    Remove the raised dough to a preheated convection oven set to 275 F or a preheated static oven set to 300 F. Cook for approximately 60 minutes, or until the crust is browning nicely and a cake tester or skewer inserted into the center of the loaf comes out clean (internal temperature should be 205-210F). Remove to a cooling rack and rotate gently from side to side every 5 minutes or so if it looks like your loaf wants to sink at all in the middle. When cooled for 15 minutes or more, remove from the loaf pan to finish cooling before slicing.

    Jefferson Adams
    Stuffing is standard fare at just about every Thanksgiving or holiday meal that involves a bird. This recipe will help those with gluten-sensitivities to keep the stuffing right there on the plate next to the turkey. Served with mashed potatoes, gluten-free gravy, and maybe a little cranberry sauce, and you've got the makings of a great gluten-free holiday!
    Ingredients:
    5-6 cups white, gluten-free bread (about 2 loaves), cut into one-inch cubes, toasted and cooled
    2 tablespoons olive oil
    3 cups celery, chopped
    2 shallots, minced
    1 large or 2 medium yellow onions, chopped
    1 tablespoon fresh thyme, minced
    1 tablespoon fresh sage, minced
    1-2 teaspoons fresh rosemary, minced
    1-1½ cups gluten-free chicken broth
    ½ cup white wine
    1 egg yolk
    1 teaspoon salt
    ½ teaspoon pepper
    Bits of cooked sausage or bacon, diced chestnut, pecan, apple, cranberry, currant, or raisin (optional) *Make sure any sausage is gluten-free!
    Preparation:
    Sauté shallots, onion and celery in olive oil on medium-low heat until translucent.
    Stir in the rosemary, sage, and thyme, and cook another one or two minutes, until the aroma of the herbs fills the air. Add wine and continue cooking over medium heat until liquid is reduced by half. Remove from heat and allow to cool.
    Bring the chicken stock to boil on high heat. Note: If cooking stuffing inside turkey, add just 1 cup of chicken broth.
    Place the egg yolk in a large bowl and carefully spoon two or three ounces of the chicken stock into the egg yolk, slowly, while whisking the mixture.
    Add the rest of the chicken stock to the egg mixture. Make sure to blend a small amount of stock into the egg first to prevent scrambled eggs.
    Add the cooled celery, onion, and herbs mixture into the stock and egg mixture. Toss the bread cubes into this mixture and coat thoroughly. Add the salt and pepper and mix.
    Place the stuffing mixture into a greased casserole dish and cook  in 400°F oven for 40-50 min, covering as needed with aluminum foil, until done.
    Note: The stuffing is done when you can insert a toothpick into the stuffing and it comes out clean. Make sure you bake stuffing until the toothpick comes out clean.
    Serves about six to eight people. Scale recipe according to amount of stuffing required.
    Suggestion: Add finely diced cooked sausage or bacon bits to the sautéed vegetables, or toss in bits of diced chestnut, pecan, apple, cranberry, currant, or raisins.


    Connie Sarros
    This article originally appeared in the Summer 2002 edition of Celiac.com's Journal of Gluten-Sensitivity.
    What was your first reaction when your doctor told you that anything containing gluten had to be eliminated from your diet?  After you stopped screaming, “But I HAVE to have my pizza!” did you begin to panic?  Know this—there is almost NOTHING that you used to eat before being diagnosed that you cannot eat now; you just have to learn to make it a little differently.
    If you don’t know how to do something it can seem difficult at first, but with a little experience it becomes easy.  This same principle applies to the multitude of combinations of the various alternative flours used in gluten-free baking.  The basic gluten-free flour mixture consists of 2 cups rice flour, 1 cup potato starch flour, and 1 cup tapioca flour.  This combination may be used to replace wheat flour in most of your recipes.  However, there are as many combinations of flours as you have imagination, each serving a different purpose.  Do you want your cakes to be lighter?  Add a little bean flour to your mixture (not too much or it will leave an aftertaste).  Garbanzo and/or mung bean flours are excellent for this purpose.  Want to make bread?  Make a flour mixture with mostly potato starch flour, tapioca flour and cornstarch.  If you can find the elusive sweet potato flour (sold at most Asian markets), add it to your cookie flour mixture to improve its texture.  Each type of flour has its own unique properties and taste, and if you find a combination of flours that you really like, sift large amounts together, spoon it into freezer bags, and freeze them until needed.  This will put an end to you having to drag out all of the different bags and boxes of flours each time you want to bake.
    For those new to the gluten-free diet you will notice that when you bite into a muffin or cookie it may fall apart.  Alternative flours do not bind as well as wheat flour, so it is necessary to add a binder to them.  Do not be intimidated by the name xanthan gum.  It is a white powder that is usually packaged in a small pouch and can be found at most health food stores.  Add a little xanthan gum to a recipe to prevent your baked goods from crumbling.  Guar gum may also be used in place of the xanthan gum, but in some people it can have a laxative effect.  Unflavored gelatin may also be added as a binder in place of the gums; just be sure to use twice as much of it in the recipe to replace the gum.
    You will find that the alternative flours are heavier and don’t have as much taste as wheat flour.  Not to worry - add twice the amount of baking soda or baking powder called for in the wheat version of the recipe.  You can also double the amount of flavoring (vanilla, almond, etc.).  Use your imagination and add extra ingredients that will enhance the taste…toasted nuts or coconut, chocolate pieces, Kahlua, dried fruits, fresh fruits, etc.
    Many people with celiac disease also have other dietary concerns, such as high cholesterol, high blood pressure, lactose intolerance, casein-free, low or no sugar, allergies to yeast, corn, soy, berries, rice, nuts, eggs, etc.  Even with other dietary restrictions, you can usually find alternative methods of preparation for most foods.  The trick is to recreate the original taste and texture when you substitute ingredients.  For example, in place of cane sugar you can use date sugar, beet sugar, fructose, canned fruit packed in juice, unsweetened applesauce, a jar of baby strained prunes, shredded apples, mashed bananas or pure fruit juices.  Toasting unsweetened coconut brings out the natural oils and will add a wonderful toasty sweetness to a baked product.  If you need to limit your salt intake use herbs (lots of them!) as a replacement.  Adding a lot of chopped celery to soups and stews will alleviate the need to add so much salt.
    Eggs add moisture and act as a binder in a baked product.  If you cannot have them you can use one of the following replacement recipes for each 1 to 2 eggs called for in the recipe:

    1 teaspoon baking powder, 1 Tablespoon liquid, and 1 Tablespoon vinegar 1 teaspoon yeast dissolved in ¼ cup warm water 1 ½ Tablespoons water, 1 ½ Tablespoons oil, 1 teaspoon gluten-free baking powder 1 packet unflavored gelatin, 2 Tablespoons warm water (Do not mix until ready to use.) ¼ cup soft silken tofu and ¼ teaspoon baking soda per 1 cup of flour called for in the recipe 3 Tablespoons applesauce plus 3 teaspoons powdered egg replacer If you cannot tolerate rice, replace the rice flour in the baking mixtures with potato starch flour.  For casein-free diets, soy, rice, or coconut milk may be used as replacements for whole milk.  If you want to thicken gravy and can’t use cornstarch, use potato flour (not to be confused with potato starch flour).For those who have to watch their cholesterol, use oil (preferably olive oil) in place of butter.  Cholesterol is essential to life and is a necessary part of our cell structure.  The human body makes an ample amount, so we do not need to consume additional cholesterol.  Cholesterol is only found in foods of animal origin (meat, poultry, fish, eggs, and dairy products).  Do not confuse this with "fat".  While plants have zero cholesterol, they may be very high in fat content (such as palm and coconut oils).
    There are always ingredient alternatives no matter what your dietary restrictions are.  In most cases you can still make and enjoy your favorite foods.  Be confident that the foods you eat will be as varied and delicious as those you used to eat before.  Life is good and, with a little extra planning, there is no need to stress out about eating.

    Cold Poached Salmon (low fat, low cholesterol, low sodium)
    Here is a cool entrée for those hot summer days, from the WFGF Reduced Calorie Cookbook.When cooking salmon, wash well with cold water, then pat dry with paper toweling.  With a sharp knife, remove skin from fillets before cooking.  The salmon may be poached the night before, then wrapped in plastic wrap and refrigerated.  By eliminating the mayonnaise, this dish will be dairy-free.  To serve, place salmon on top of Julienne Vegetables (recipe on page 42).  Slice 4 thin slices of lemon; cut each slice almost in half, leaving one side of the rind in tact; twist to form an "S" shape, then lay on top of the salmon.
    Ingredients:
    2 cups water
    1 cup gluten-free white wine
    2 Tablespoons lemon juice
    6 bay leaves
    1/8 teaspoon salt
    1/8 teaspoon pepper
    4 fillets (4 oz.  each) salmon
    4 teaspoons gluten-free lowfat mayonnaise
    12 capers
    Directions:
    In a large skillet, combine water, wine, lemon juice, bay leaves, salt and pepper.  Bring to a boil.  Add fillets and simmer gently about 15 minutes or till opaque and fish flakes easily with a fork.  Drain salmon, reserving bay leaves, and cool.   Spread 1 teaspoon mayonnaise on top of each fillet.  To garnish, angle a bay leaf in the center; cluster 3 capers at the base of the leaf.


  • Recent Articles

    Jefferson Adams
    Celiac.com 04/20/2018 - A digital media company and a label data company are teaming up to help major manufacturers target, reach and convert their desired shoppers based on dietary needs, such as gluten-free diet. The deal could bring synergy in emerging markets such as the gluten-free and allergen-free markets, which represent major growth sectors in the global food industry. 
    Under the deal, personalized digital media company Catalina will be joining forces with Label Insight. Catalina uses consumer purchases data to target shoppers on a personal base, while Label Insight works with major companies like Kellogg, Betty Crocker, and Pepsi to provide insight on food label data to government, retailers, manufacturers and app developers.
    "Brands with very specific product benefits, gluten-free for example, require precise targeting to efficiently reach and convert their desired shoppers,” says Todd Morris, President of Catalina's Go-to-Market organization, adding that “Catalina offers the only purchase-based targeting solution with this capability.” 
    Label Insight’s clients include food and beverage giants such as Unilever, Ben & Jerry's, Lipton and Hellman’s. Label Insight technology has helped the Food and Drug Administration (FDA) build the sector’s very first scientifically accurate database of food ingredients, health attributes and claims.
    Morris says the joint partnership will allow Catalina to “enhance our dataset and further increase our ability to target shoppers who are currently buying - or have shown intent to buy - in these emerging categories,” including gluten-free, allergen-free, and other free-from foods.
    The deal will likely make for easier, more precise targeting of goods to consumers, and thus provide benefits for manufacturers and retailers looking to better serve their retail food customers, especially in specialty areas like gluten-free and allergen-free foods.
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    fdfworld.com

    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