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      Frequently Asked Questions About Celiac Disease   04/24/2018

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to Celiac.com's FREE weekly eNewsletter   What is Celiac Disease and the Gluten-Free Diet? What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease?  Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes
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    Baking Quality Wheat Ancestors May be Safe for Those with Celiac Disease


    Scott Adams


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    Gastroenterology. 2005 Feb;128(2):393-401.

    Celiac.com 02/09/2005 – Norwegian scientists have been mapping gluten T-cell epitopes in various wheat ancestors and have found several varieties that may be suitable for those with celiac disease. The trigger for celiac disease has been identified as the epitopes that cluster within a stable 33mer fragment of wheat chromosome 6D. The scientists extracted and screened gluten from a variety of modern wheat ancestors to look for any T-cell stimulatory gluten peptides. They found that the 33mer fragment is encoded by alpha-gliadin genes on wheat chromosome 6D, which does not exist in the gluten of diploid einkorn or in certain types of tetraploid pasta wheat.

    These findings indicate that there may be grains that have long since been considered unsafe for those with celiac disease, but which may actually be safe and not contain any harmful gluten proteins. The most encouraging thing about this research is that baking and pasta-quality wheat ancestors could one day be added to our Safe List, which would greatly increase the quality of gluten-free products.

    Note: We strongly advise against celiacs including these grains in their diet until more testing and research is done to verify their safety.



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  • Related Articles

    Scott Adams

    Celiac.com 10/30/2006 - Triticum monococcum wheat is also known as Einkorn wheat and small spelt, but do not confuse it with common spelt which is not the same thing. Einkorn is the oldest and most primitive cultivated wheat, and recent studies have shown that it appears to lack gliadin toxicity and may be a safe wheat alternative for those with celiac disease. In the most recent study the researchers conclude that data show a lack of toxicity of triticum monococcum gliadin in an in vitro organ culture system, suggesting new dietary opportunities for celiac patients. If this is the case it appears that this grain is non-toxic to those with celiac disease. Scand J Gastroenterol. 2006 Nov;41(11):1305-11.
    Lack of intestinal mucosal toxicity of Triticum monococcum in celiac
    disease patients.
    Pizzuti D, Buda A, DOdorico A, DInca R, Chiarelli S, Curioni A, Martines D.
    Abstract:

    Objective. The treatment of celiac disease is based on lifelong withdrawal of foods containing gluten. Unfortunately, compliance with a gluten-free diet has proved poor in many patients (mainly due to its low palatability), emphasizing the need for cereal varieties that are not toxic for celiac patients. In evolutionary terms, Triticum monococcum is the oldest and most primitive cultivated wheat. The aim of this study was to evaluate the toxicity of T. monococcum on small intestinal mucosa, using an in vitro organ culture system.
    Material and methods. Distal duodenum biopsies of 12 treated celiac patients and 17 control subjects were cultured for 24?h with T. aestivum (bread) gliadin (1?mg/ml) or with T. monococcum gliadin (1?mg/ml). Biopsies cultured with medium alone served as controls. Each biopsy was used for conventional histological examination and for immunohistochemical detection of CD3?+?intraepithelial lymphocytes (IELs) and HLA-DR. Secreted cytokine protein interferon-? (IFN–?) was measured in the culture supernatant using an enzyme-linked immunoadsorbent assay.
    Results. Significant morphological changes, HLA-DR overexpression in the crypt epithelium and an increased number of CD3?+?IELs, found after bread gliadin exposure, were not observed in celiac biopsies cultured with T. monococcum gliadin. In contrast, with bread gliadin, there was no significant IFN-? response after culture with monococcum gliadin. Similarly, biopsies from normal controls did not respond to bread or monococcum gliadin stimulation.
    Conclusions. These data show a lack of toxicity of T. monococcum gliadin in an in vitro organ culture system, suggesting new dietary opportunities for celiac patients.
    Note: Celiac.com strongly advises against celiacs including these grains in their diet until more testing and research is done to verify their safety.
    Einkorn Breadmaking Sites:
    Cereal Chem. 73 (2):208-214
    Breadmaking Quality of Einkorn Wheat (Triticum monococcum ssp. monococcum).
    http://www.aaccnet.org/cerealchemistry/backissues/1996/73_208.pdf
    Cereal Chem. 76 (5): Pub. no. C-1999-0804-01R
    Einkorn Characterization for Bread and Cookie Production in Relation to
    Protein Subunit Composition.
    http://www.aaccnet.org/cerealchemistry/abstracts/1999/0804-01r.asp

    Jefferson Adams
    Celiac.com 12/19/2012 - Can scientists create gluten-free wheat strains that are safe for people with celiac disease, and suitable for making bread? According to a team of researchers writing in the journal PNAS, the answer is 'yes.'
    Gluten is a complex mix of proteins stored in kernels of wheat, barley and rye. Some, but not all, of these proteins trigger the immune reactions seen in celiac disease and gluten sensitivity.
    Scientists have already experimented with another method that involves sifting through various kinds of wheat and barley in search of types that contain little or no offensive gluten proteins in their grains.
    So far, researchers have found wheat varieties that lack some of the important allergenic proteins, but they have yet to find a variety that is completely safe for people with celiac disease.
    That fact led the research team led by Shanshan Wen of Washington State University in Pullman and colleagues, to try a new approach that focused on a key enzyme that helps to trigger a group of genes that produce the most reactive gluten proteins.
    To do this, they used a genetic engineering trick that eliminated the key enzyme altogether. The resulting seeds wheat kernels showed sharply lower levels of these reactive gluten proteins.
    The research team predicts that, with more more tinkering, they will be able to create a line of wheat that completely eliminates the problem proteins, and keeps the non-problem proteins in the wheat.
    According to their write-up, they feel that they have good odds of creating wheat that is safe for people with celiac disease, and suitable for producing good bread and baked goods.
    If successful, they will then begin testing the results in cell cultures, mice and gluten-sensitive apes.
    Source:
    Proceedings of the National Academy of Sciences

    Jefferson Adams
    Celiac.com 06/05/2013 - In the west, sorghum has traditionally been used to feed livestock. However, in Africa and India, it has long been used to feed people.
    Recently, U.S. farmers have begun producing sorghum hybrids that are white in color, known as "food-grade" sorghum. In an effort to determine if these new hybrids are safe for people with celiac disease, a team of researchers set out to make a detailed molecular study.
    The team included Paola Pontieri, Gianfranco Mamone, Salvatore De Caro, Mitch R. Tuinstra, Earl Roemer, Josephine Okot, Pasquale De Vita, Donatella B. M. Ficco, Pietro Alifano, Domenico Pignone, Domenica R. Massardo, and Luigi Del Giudice.
    They are variously affiliated with the Istituto di Genetica Vegetale (IGV), CNR−Portici, c/o Dipartimento di Biologia, Sezione di Igiene, Napoli 80134, Italy, the Istituto di Genetica e Biofisica “Adriano Buzzati-Traverso” (IGB-ABT), CNR, in Napoli, Italy, the Istituto di Scienze dell’Alimentazione (ISA), CNR, in Avellino, Italy, with the Consiglio per la Ricerca e la sperimentazione in Agricoltura, Centro di Ricerca per la Cerealicoltura (CRA-CER) in Foggia, Italy, the Dipartimento di Scienze e Tecnologie Biologiche e Ambientali at the Università degli Studi di Lecce, Italy, and the Istituto di Genetica Vegetale, CNR, in Bari, Italy, with the Department of Agronomy at Purdue University in West Lafayette, Indiana, the Nu Life Market in Healy, Kansas in the United States, with Victoria Seeds Ltd. in Kampala, Uganda.
    Their study, which includes molecular evidence that sorghum lacks the proteins toxic to people with celiac disease, appears in ACS' Journal of Agricultural and Food Chemistry.
    Paola Pontieri and colleagues explain that those gluten proteins, present in wheat and barley, trigger an immune reaction in people with celiac disease that can cause abdominal pain and discomfort, constipation, diarrhea and other symptoms.
    This strong new biochemical evidence shows that these sorghum hybrids are safe for people with celiac disease.
    The researchers describe evidence from an analysis of the recently published sorghum genome, the complete set of genes in the plant, and other sources, that verify the absence of gluten proteins. They also note that sorghum has provides high nutritional value.
    Their report concludes that "[f]ood-grade sorghums should be considered as an important option for all people, especially celiac patients."
    The authors acknowledge funding from the Regione Campania, the Istituto Banco di Napoli -- Fondazione and the Compagnia di San Paolo.
    Source:
    Journal of Agricultural and Food Chemistry ACS News Service Weekly PressPac: April 3, 2013

    Jefferson Adams
    Celiac.com 11/11/2014 - There have been claims that certain strains of wheat, especially ancient strains, such as einkorn, do not trigger adverse reactions in people with celiac disease, or that they trigger less severe reactions.
    Until now, researchers haven't been able to say for certain that celiac disease patients react adversely to all varieties of wheat, or whether there may be differences in reactions to certain strains.
    A research team recently evaluated the safety of ancient strains of wheat in celiac disease. The researchers included Tanja Šuligojemailemail, Armando Gregorinidemail, Mariastella Colombaeemail, H. Julia Elliscemail, and Paul J. Ciclitirac
    To get a better idea of the nature of celiac factions to wheat, the team studied seven Triticum accessions showing different origin (ancient/modern) and ploidy (di-, tetra- hexaploid).
    In all, they tested ancient Triticum monococcum precoce (AA genome) and Triticum speltoides (BB genome), accessions of Triticum turgidum durum (AABB genome) including two ancient (Graziella Ra and Kamut) and two modern (Senatore Cappelli and Svevo) durum strains of wheat and Triticum aestivum compactum (AABBDD genome).
    They evaluated small intestinal gluten-specific T-cell lines generated from 13 celiac patients with wheat accessions by proliferation assays. They found that all strains of wheat they tested triggered a range of adverse responses, independent of ploidy or ancient/modern origin.
    Based on these results, they suggest that all strains of wheat, even ancient strains previously suggested to be low or devoid of celiac toxicity, should be tested for immunogenicity using gluten-specific T-cell lines from multiple celiac patients rather than gluten-specific clones to assess their potential toxicity.
    They also emphasize the need for celiac patients to follow a strict gluten-free diet, including avoidance of ancient strains of wheat.
    Source:
    Clin Nutr. 2013 Dec;32(6):1043-9. doi: 10.1016/j.clnu.2013.02.003

  • Recent Articles

    Jefferson Adams
    Celiac.com 05/25/2018 - People with celiac disease need to follow a lifelong gluten-free diet. However, once their guts have healed, they can still be sensitive to gluten. Sometimes even more sensitive than they were before they went gluten-free. Accidental ingestion of gluten can trigger symptoms in celiac patients, such as pain in the gut and diarrhea, and can also cause intestinal damage. 
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    Jefferson Adams
    Celiac.com 05/24/2018 - England is facing some hard questions about gluten-free food prescriptions for people with celiac disease. Under England’s National Health Plan, people with celiac disease are eligible for gluten-free foods as part of their medical treatment. 
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    Read more about this research in the online journal BMJ Open.

    Jefferson Adams
    Celiac.com 05/23/2018 - Yes, we at Celiac.com realize that rye bread is not gluten-free, and is not suitable for consumption by people with celiac disease!  That is also true of rye bread that is low in FODMAPs.
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    In an effort to determine what, if any, irritable bowel symptoms may triggered by FODMAPs, a team of researchers recently set out to compare the effects of regular vs low-FODMAP rye bread on irritable bowel syndrome (IBS) symptoms and to study gastrointestinal conditions with SmartPill.
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    The team wanted to see if rye bread low in FODMAPs would cause reduced hydrogen excretion, lower intraluminal pressure, higher colonic pH, improved transit times, and fewer IBS symptoms than regular rye bread. 
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    The team used SmartPill, an indigestible motility capsule, to measure intraluminal pH, transit time, and pressure. Their data showed that low-FODMAP rye bread reduced colonic fermentation compared with regular rye bread. They found no differences in pH, pressure, or transit times between the breads. They also found no difference between the two in terms of conditions in the gastrointestinal tract.
    They did note that the gastric residence of SmartPill was slower than expected. SmartPill left the stomach in less than 5 h only once in 14 measurements, and therefore did not follow on par with the rye bread bolus.
    There's been a great deal of interest in FODMAPs and their potential connection to celiac disease and gluten-intolerance. Stay tuned for more information on the role of FODMAPs in celiac disease and/or irritable bowel syndrome.
    Source:
    World J Gastroenterol. 2018 Mar 21; 24(11): 1259–1268.doi:  10.3748/wjg.v24.i11.1259

    Jefferson Adams
    Celiac.com 05/22/2018 - Proteins are the building blocks of life. If scientists can figure out how to create and grow new proteins, they can create new treatments and cures to a multitude of medical, biological and even environmental conditions.
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    Meanwhile, Baker’s is working on a single vaccine that would protect against all strains of the influenza virus, along with a method for breaking down the gluten proteins in wheat, which could help to generate new treatments for people with celiac disease. 
    With new computing power, look for progress on the understanding, design, and construction of brain proteins. As understanding, design and construction improve, look for brain proteins to play a major role in disease research and treatment. This is all great news for people looking to improve our understanding and treatment of celiac disease.
    Source:
    Bloomberg.com

    Jefferson Adams
    Celiac.com 05/21/2018 - Just a year ago, Starbucks debuted their Canadian bacon, egg and cheddar cheese gluten-free sandwich. During that year, the company basked in praise from customers with celiac disease and gluten-sensitivity for their commitment to delivering a safe gluten-free alternative to it’s standard breakfast offerings.
    But that commitment came to an ignoble end recently as Starbucks admitted that their gluten-free sandwich was plagued by  “low sales,” and was simply not sustainable from a company perspective. The sandwich may not have sold well, but it was much-loved by those who came to rely on it.
    With the end of that sandwich came the complaints. Customers on social media were anything but quiet, as seen in numerous posts, tweets and comments pointing out the callous and tone-deaf nature of the announcement which took place in the middle of national Celiac Disease Awareness Month. More than a few posts threatened to dump Starbucks altogether.
    A few of the choice tweets include the following:  
    “If I’m going to get coffee and can’t eat anything might as well be DD. #celiac so your eggbites won’t work for me,” tweeted @NotPerryMason. “They’re discontinuing my @Starbucks gluten-free sandwich which is super sad, but will save me money because I won’t have a reason to go to Starbucks and drop $50 a week,” tweeted @nwillard229. Starbucks is not giving up on gluten-free entirely, though. The company will still offer several items for customers who prefer gluten-free foods, including Sous Vide Egg Bites, a Marshmallow Dream Bar and Siggi’s yogurt.
    Stay tuned to learn more about Starbucks gluten-free foods going forward.