• Join our community!

    Do you have questions about celiac disease or the gluten-free diet?

  • Ads by Google:
     




    Get email alerts Subscribe to Celiac.com's FREE weekly eNewsletter

    Ads by Google:



       Get email alertsSubscribe to Celiac.com's FREE weekly eNewsletter

  • Member Statistics

    72,016
    Total Members
    3,093
    Most Online
    Blonde121057
    Newest Member
    Blonde121057
    Joined
  • Announcements

    • admin

      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
  • 0

    GLUTEN-FREE CONVENIENCE


    Betty Wedman-St Louis, PhD, RD


    • Journal of Gluten Sensitivity Spring 2015 Issue - Originally published April 8, 2015


    12/22/2015 - Eating Gluten-Free is not complicated and certainly not less nutritious than conventional menu choices. But there are challenges for the person with celiac disease. Gluten containing substances are used throughout a wide variety of convenience foods—soups, sauces, salad dressings, etc.—so a gluten-free label became necessary to minimize the possibility of gluten contamination.


    Ads by Google:




    ARTICLE CONTINUES BELOW ADS
    Ads by Google:



    Those celiacs wanting to minimize cooking were excited when more Americans started to endorse gluten-free eating. Now supermarkets were filling the shelves with gluten-free flour blends, baking mixes, brownie mixes, chocolate chip cookie mixes, and even a banana bread mix.

    Keep in mind, the gluten-free label in the United States means that the gluten level in that product must be less than 20 ppm. This level may still be too high to tolerate for those with gluten enteropathy—even very low levels of gluten very sensitive individuals may mean continued symptoms. Also realize that there is NO independent or government agency overseeing the truth in labeling that celiacs expect from the gluten-free label.

    It is also important to consider the nutritional value of gluten-free products. Recently eleven gluten-free products were purchased from local supermarkets and tested for quality and convenience. Here is a summary of the evaluations:

    King Arthur Flour gluten-free Banana B read mix made a delightful bread but sugar is the first ingredient. One slice= 16g or 4 teaspoons sugar. Whole grain brown rice flour was the second ingredient which added more nutritional value than white rice flour.

    Chocolate chip cookie mixes from Betty Crocker (13g or 3+ teaspoons sugar per 2 cookies), Hodgson Mill (15g or ~4 teaspoons sugar per 2 cookies) were crispy and delicious but could have reduced sugar content like Among Friends Double Chocolate Cookie Mix (8g or 2 teaspoons sugar per 2 cookies). King Arthur Flour gluten-free cookie mix allows customization of your cookie so nutrition labeling indicates 7g or ~2 teaspoons sugar BEFORE adding chocolate chips or dried fruit.

    Hodgson Mill Brownie mix (13g or 3+ teaspoons sugar) and King Arthur Flour Company Brownie mix (18g or 4 1/2 teaspoons sugar) list sugar as the first ingredient so moderation in consumption is recommended.

    Among Friends Baking Mix for fruit crisp (8g or 2 teaspoons sugar before adding fruit) is oat based providing a whole grain topping for peaches, strawberries, or blueberries. Some celiacs may not tolerate oats even when processors certify that they have been milled on dedicated equipment.
    Hodgson Mill Cookie mix offers 5 recipe choices from one mix. The nutrition label indicates 13g or 3+ teaspoons sugar in the basic mix before chocolate and sugar for one variation or chocolate pieces for another are added to the batter.

    XO Baking Company All Purpose Flour offers the combination of tapioca (cassava) flour, potato starch, and coconut flour for use in cookies, brownies, cakes, pancakes, muffins, etc. No sugar is in the flour blend so the baker can determine how much sugar or what kind of sweetener to use.

    Pillsbury All Purpose gluten-free Flour Blend features a chocolate chip cookie recipe on the package. It is a blend of rice flour, potato starch, pea fiber, and tapioca starch so the sweetener of choice can be determined by the cook.

    Seven out of eleven baking mixes contained xanthan gum. It is a frequent food additive in baking products to make the dough sticky or moist. Xanthan gum is derived from the bacteria Xanthomones campestris which is used as a thickener in salad dressings and sauces. This bacteria strain is the same one that causes black mold on broccoli, cauliflower and leafy green vegetables which results in a slimy coating.

    For those wanting to limit their exposure to genetically modified foods, xanthan gum is not recommended. In the USA it is derived corn. Since no studies have been done on sensitivities to xanthan gum, those with gastro-intestinal sensitivities would be wise to limit or avoid products containing it since labels do not state the carbohydrate source used in production.

    Celiacs with intestinal bloating and gas issues may find that similar symptoms can be caused by too much xanthan gum. In addition, as a thickening agent (salad dressing, ice cream or egg substitute products like egg beaters) xanthan gum can act as a very effective laxative.

    Convenience products can be a lifesaver for someone who does not like to cook or has limited time. Many convenience mixes like those evaluated above can be high in sugar and fat. Foods with high sugar have a high glycemic index which has been shown to contribute to chronic diseases like diabetes, high blood pressure and cardiovascular disease.

    Whole foods offer better nutrition for people with celiac disease. Convenience foods and bakery products are a treat—they can add variety to a gluten-free diet—but a paleo diet is the healthiest choice for anyone, including those on a gluten-free diet.


    Image Caption: Photo: CC--istolethetv
    0


    User Feedback

    Recommended Comments

    Thank you for the article, but I wish I could agree that eating gluten free isn't complicated, people with celiec and high sensitives are extremely limited, especially outside of the home. For example, something I am starting to see more and more are products that say they're gluten free on one side of the product only to have the words "processed/produced in a facility that also processes/produces wheat" on the other. So, if someone gets sick from one of these products they can wash their hands clean and say while we said our product is gluten free we also warned you that it may not be. Celiacs with high sensitivities are still faced with challenges while being on the not so "complicated" Gluten Free Diet. If it says "Certified gluten-free" I will trust it, now if it just states "Gluten Free" I have to keep reading, and if it says nothing at all I am extremely hesitant purchase it.

     

    Another ingredient that those with already comprised GI systems should be aware of is Inulin. Inulin seems to be in a lot of Gluten Free cereals, snack bars, cookies, ice cream and other treats. The side effects will mirror the gas and bloating of one being contaminated. And there are plenty of links a Google search can yield that talks about Inulin, some good, but most and not so good.

    Share this comment


    Link to comment
    Share on other sites


    Your content will need to be approved by a moderator

    Guest
    You are commenting as a guest. If you have an account, please sign in.
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoticons maximum are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • Popular Contributors

  • Ads by Google:

  • Who's Online   6 Members, 0 Anonymous, 1,211 Guests (See full list)

  • Related Articles

    Jefferson Adams
    Celiac.com 09/11/2015 - At Celiac.com, we're generally of the opinion that any publicity about celiac disease and gluten sensitivity is good publicity. We've always believed that the less people know about celiac disease, the more those who have it are at risk.

    Undoubtedly gluten-free celebrities are bringing a huge awareness to celiac disease and the gluten-free diet, and this has lead not only to increased awareness of the disease, but also may have directly contributed to lowering the overall risk for those of us who have it by vastly increasing the number of people who are on the gluten-free diet. This has ultimately led to an explosion in the number, variety and availability of gluten-free products. 
    Interestingly, articles about gluten-free celebrities have prompted some our strongest and most vocal backlash. The main thrust of many of these negative comments seems to be the idea that the seriousness of their own celiac disease will somehow be adulterated by celebrities who "come out" about the gluten-free diet but don't actually have celiac disease. Somehow they believe that this could lead to others not taking the diet seriously enough, or there is the belief by some that these celebrities just want to make a buck off of those who need to be on the diet.
    A partial list of some noteworthy celebrities and athletes who reportedly follow a gluten-free diet due to celiac disease, gluten-intolerance, or other reasons include: news host Keith Olbermann, actor Billy Bob Thornton, Elizabeth Hasselbeck, Katherine, Dutchess of Kent, pro quarterback Drew Brees, news anchor Heidi Collins, Katherine, Dutchess of Kent, news host Keith Olbermann, actor and writer Billie Bob Thornton, author Sarah Vowell, and actresses Zooey Deschanel, Susie Essman, Jennifer Esposito, Goldie Hahn, Gwyneth Paltrow, Emily Rossum, and Rachel Weisz.
    We've mentioned a few of them in articles over the years, and boy have we gotten some spirited responses. Here are a few:
    The above article prompted this comment:
    "I'm very surprised celiac.com would promote this kind of stuff on their site. Celebrities going gluten free does not help our cause. It just diminishes it." We've selected some of our favorites comments for your reading pleasure. Celebrities who've drawn the ire of our readers include Lady Gaga, about whom one reader wrote: 
    "Great. One more celebrity jumping on the gluten-free bandwagon 'to lose weight'. This doesn't help establish credibility for the celiacs who truly need to follow a gluten-free diet." While another wrote:
    "It is very aggravating when there is publicity for a notorious star on a gluten-free diet without good reason. I think it trivializes the serious medical problem of celiac disease. This needs to be recognized as the dangerous condition it is and the diet needs to be followed for life. This is NOT A FAD DIET!" Our article about good old Gwyneth Paltrow caused one reader to write:
    "Paltrow - not my cup of tea. Nose in the air and head - we need better examples of celebrity concern and involvement." One reader took particular exception to the idea that Novak Djokovic occasionally breaks his gluten-free diet:
    "He is a disgrace to the gluten-free diet. Go on Youtube and search Novak Djokovic Interview On Live With Regis & Kelly 09-13-2011 watch from 4.35 where he admits he still eats gluten. Thanks to celebs like him celiac disease is seen as a joke!" Elizabeth Hasselbeck doesn't fare much better, sparking one reader to comment that:
    "Elizabeth Hasselbeck is trying to get attention. Her story is no different than thousand of others." When actress Charlize Theron called BS on gluten-free diet faddists, our readers wrote:
    "Stop giving airtime to people who have obviously not done their research and/ or do not know how to read and interpret scientific studies." And:
    "Charlize has a real potty-mouth, and is not overly bright. Does she think that gluten free means sugar free, since she blasted the cupcake for not having sugar. I don't believe actors are medical experts, just because they are popular. And I sure wouldn't take any advice or change my diet on their say-so." More than a few readers commented on our article entitled Jimmy Kimmel Skewers Clueless Gluten-free Dieters, including one who wrote:
    "Why is gluten intolerance or coeliac disease supposed to be hilariously funny and only something that hypochondriacs obsess about? At least most of these people showed some awareness of what foods contain gluten, I do not see that it matters much if they cannot give a scientific definition." Another reader agrees, noting:
    "this is no 'joke' to those who have the slightest crumb and get very, very ill. Everyone is affected differently, but I wouldn't wish those cramps and the pain on my worst enemy." Practically the only celebrity to come out of a gluten-free celebrity article unscathed was The Daily Show's Jon Stewart.
    We did get overwhelmingly favorable comments about Jon Stewart's handling of the topic of celiac disease, and its effects upon him as a dad.
    Proving perhaps that, if you're a popular celebrity with an accurate, compassionate and serious message about celiac disease, people probably won't hate you.
    Oh, and then there is Chelsea Clinton. If you count Chelsea Clinton as a celebrity, then it's fair to mention that folks had nice things to say about her gluten-free wedding cake.

    Jefferson Adams
    Celiac.com 09/18/2015 - That old saw about death and taxes might need a bit of amending to include complaints about pharmaceutical companies working on celiac drug treatments.
    One interesting facet of our coverage of the development of various drugs to treat and/or cure celiac disease has been the regular presence of comments questioning the motives,and actions of the companies involved.
    It's funny, but no one complains that companies still make money selling aspirin, and that no one has cured a headache, and that there must be some conspiracy to profit off of those who suffer a headache.
    There's no doubt that there's money to be made producing drugs that treat disease. But, if a company can develop and produce a safe drug to protect celiacs against contamination, or to help reduce symptoms, what's wrong with that?
    Just like an aspirin, I can take it or not take it.
    In the old days, ten years ago or more, people with celiac disease generally suffered in silence, with scant gluten-free food choices, and little information. However, in just a decade, we've got a wealth of information, and multi-billion dollar gluten-free foods market and a number of companies developing drugs to treat or cure celiac disease.
    To me, that's a good thing. Still, there are naysayers. Here's a rundown of comments by readers who seem less than enthused about celiac drugs in development.
    Our recent article, An Update on Every Celiac Disease Drug Currently in Development included the comment:
    "Article's fine. Concept's disturbing. Eating a gluten-free diet is the free, already-proven cure for celiac and gluten-intolerance. They don't have to torture mice and likely other animals to find a 'cure' for something that there already is a cure for. I imagine there is $$ for the researchers here and $$ for the animal labs and $$ for the pharmaceuticals."
    Of our article entitled, How Close Are New Celiac Disease Treatments? one reader wrote:
    "I would be very cautious about taking any of these until it was proven absolutely to have no side effects. There always are some and history has shown some to be deadly." Commenting on our article ALV003 Reduces Gluten Damage in Celiac Disease Patients, one reader commented:
    "I only want to know: how long until random internal organs begin to fail or malfunction as a result of yet another new mystery drug? I'd rather starve to death than be a guinea pig for big pharma again."
    Our article on NexVaxx, entitled Is a Vaccine for Celiac Disease Just Around the Corner? included the following comments:
    "Totally agree with vhill seems like a ploy to poison people with GMO foods that come up with a supposed "'cure'. Eat healthy whole foods this is not a curse its a wake up call to be healthy if you didn't have celiac you'd probably be eating processed crap." Balm wrote: "Thanks but no thanks. I'll remain a celiac and continue to eat healthy. While trying to fix one problem, some will end up with far worse problems." Jonnys wrote: "Stupid idea! Just another way to make more money off of people." These are but a few of the largely positive comments we receive, and we hope you enjoyed them as much as we do.

    Jefferson Adams
    Celiac.com 09/28/2015 - The Irish Daily Star is reporting that more than two dozen inmates at the country's top security Portlaoise Prison are set to protest prison authorities' refusal to give them gluten-free bread and better food.
    The inmates, including RIRA boss Michael McKevitt, say prison officials have broken an agreement to supply gluten-free bread as part of the prison diet.
    The availability of gluten-free bread seems to be an issue in what sounds like a larger complaint about the quality of food at the prison. Prisoners can purchase better food at the prison shop, at what prisoners claim are astronomical prices.
    According to the Daily Star, prisoners have begun stockpiling rubbish in preparation for a "dirty protest" in a bid to get the authorities to change their mind. The Prison Services have declined to comment. There has been no word about a direct connection to celiac disease in regards to the prisoners' demand for gluten-free bread.
    Earlier this week, republican prisoners group Cogus issued a statement highlighted food as one of the prisoners' main complaints.
    While that particular statement made no mention of gluten free bread, it read in part:
    "The food has seriously deteriorated over the last number of months and in general is sub-standard, at times unfit for human consumption, comprising of basic small portions which are totally inadequate."
    "This has resulted in men having to purchase food with the little money they have through the prison shop which charges extortionate prices. Numerous attempts have been made by the prisoners to resolve this issue but to no avail."
    Stay tuned for more developments.
    What do you think? Are prisoners entitled to gluten-free bread?
    Read more at: The Irish Daily Star

    Jefferson Adams
    Celiac.com 10/07/2015 - The number of Americans who say they include gluten-free foods in their diet has hit a whopping 20%, while 17% say they avoid gluten-free foods altogether. However, nearly 60% of adults say they don't think about gluten-free foods either way.
    In the July, as part of its annual Consumption Habits poll, Gallup asked just over a thousand Americans about foods they include or avoid in their diet.
    The was the first year the poll included questions about "Gluten-free foods."
    Demographic differences in those who seek out gluten-free foods are fairly minor.
    One in three non-white Americans say they actively include gluten-free foods, compared with 17% of whites.
    Age seems to influence the purchase of gluten-free foods, with
    25% of adults under 50 buying gluten-free, compared with 17% of those aged 50 and older.
    Men and women bought gluten-free food at about the same rates.
    Interestingly, more educated and wealthier Americans tend to be less likely to include gluten free-foods in their diet than Americans with no college experience and lower-income Americans, respectively, though the differences were fairly small.
    The report's overall bottom line is that the gluten-free food market has grown substantially in the past five years, as has the introduction of more foods that do not contain gluten.
    With one in five Americans now seeking to include these products in their diet, the prevalence goes well beyond the roughly 1% of Americans with celiac disease, who have a serious medical reason to avoid gluten.
    Many Americans say they eat gluten-free foods as part of an attempt to lose weight, a version of a no-carb diet, while others claim it improves their well-being.
    Though it's unclear how healthy a gluten-free diet is for people who do not have celiac disease, the percentage of Americans who say they are attempting to include gluten-free food in their diet shows how widespread the practice is.
    Source:
    Finchannel.com

    Amie  Valpone
    Celiac.com 02/23/2016 - Rather than enjoying the youth of my 20's, some of the 'best years of my life,' I suffered from over a decade of chronic illness—everything from Lyme disease to C-diff colitis to hypothyroidism and chronic systemic candida. It started with severe leg swelling and chronic pain on a daily basis. By mid-afternoon, I carried what felt like bricks of water in my legs. On top of that, I was plagued by horrible digestive issues that left me feeling sick, lethargic and just plain gross. This was what I suffered with before I started my journey of detox, which led me to feeling younger and more energetic than I had felt since I was a kid.
    During my decade of chronic illness, on a daily basis I focused on eating clean and detoxing my body by eating lots of fresh, organic foods such as fresh herbs, raw nuts, seeds and tons of veggies that helped support my thyroid, gut and liver function and to support the removal of toxins in my body. When you're trying to detox, organic salads filled with fresh, whole ingredients are always a good idea!
    'Eating Clean' is all about adding in whole, organic fresh foods to your lifestyle and feeling good about what you are putting into your body. It's not about feeling deprived or going on a diet. Wellness is more than just calories, it's nourishment for your body to keep you healthy and strong. At this point in my life, I can honestly say that after reading almost every detox and medical book, seeing over 500 doctors including an entire week at Mayo Clinic, I've learned that the answers were within me the whole time. I had to be my own doctor and put the missing pieces together. My doctors could only do so much and they didn't communicate with each other, plus they didn't understand anything outside of their specialized field, which left me feeling hopeless and lost.
    Whether you're suffering from chronic illness or just the occasional headache or bloated belly, I hope to inspire you to be your own doctor and realize that wellness starts with what's on your plate. Start tossing out the processed foods in your fridge and pantry today, add in beautiful, fresh foods and I promise you'll feel better just looking at the beautiful colors and tasting their amazing flavors. Get creative, go out and pick up a bunch of fresh herbs and start adding them to your meals—you will be amazed at how much flavor they can add to your them without having to add refined, unhealthy oils or other processed ingredients.
    This is a fun recipe to pack in a mason jar with a lid and take to work for lunch, or you can toss it all together and serve it in a big bowl for a quick weeknight for dinner. I love to cook quinoa in large batches on Sunday nights for myself and my clients, so that I always have it ready in my fridge to add to quick salads for lunch, stir-fry's for dinner, and even warmed up on the stove top for breakfast with almond milk and cinnamon.
    Simple Honey Sunflower Quinoa Bowl
    Serves 4
    Ingredients:
    ½ cup quinoa 2 medium yellow summer squash or zucchini, thinly sliced or diced 1/3 cup thinly sliced jicama or peeled apple 2 tsp. finely chopped fresh basil, plus more if desired 2 Tbsp. sunflower seeds Juice of 2 medium lemons ½ tsp. honey 2-3 Tbsp. extra-virgin olive oil Sea salt and pepper, to taste Pinch crushed red pepper flakes, optional Directions:
    Cook quinoa according to package directions. Remove from heat; fluff with a fork, cover and set aside.
    Meanwhile, steam squash in a steamer basket over medium heat for about 5-7 minutes or until tender. Add to quinoa mixture and toss to combine. Add jicama, basil and sunflower seeds; toss again.
    In a small bowl, whisk lemon juice, honey, olive oil, sea salt and pepper. Drizzle over quinoa mixture and toss to combine. Season to taste and transfer mixture to a sealed container and place in the lunchbox with a spoon and napkin.
    Amie Valpone, founder of TheHealthyApple.com, wrote her first cookbook, over 200 recipes free of gluten, dairy, soy, eggs, corn, sugar, peanuts and processed foods, Eating Clean: Detox, Fight Inflammation, Reset Your Body & Get to the Root Cause of Illness, which is available for pre-order now on Amazon.com.

    Dr. Rodney Ford M.D.
    Celiac.com 03/15/2016 - "Creating health comes down to the food we eat and how we choose to live our lives." – Dr. Terry Wahls
    Lots of people find it hard to believe that such a common food as wheat/gluten could possibly be implicated in causing skin diseases. They say something like this: "Everyone eats wheat, but not everyone gets skin troubles—so it can't be wheat!" This logic is flawed. I have written this book so that you can read all of the evidence about gluten-related skin disease in one place. "Cutaneous gluten sensitivity" is one of the new terms applied to the group of gluten-related skin diseases.
    Max belongs to this leg in the photo. He is very itchy and sore. He is 18-years old and not getting any better—in fact he has been getting worse. He came to me seeking help. Mum wrote,
    "Max has been suffering from debilitating dermatitis over his whole body for the last 3 years. He is withdrawn, self-conscious, covered with sores, and feels he will never get better. Unfortunately, the creams he is putting on just seem to irritate him."
    So, I am investigating him for gluten-related eczema. It will be a relief for him if the tests come out positive for gluten. What should be the strategy to get him better?
    I don't want him to go through the rest of his life like Elizabeth Whitesell, from the Gluten Zero Facebook page, who explains:
    "I was frantic with itching before my celiac diagnosis. The dermatologists never addressed the possibility of celiac, just gave me new treatments for my itching. I cannot name all of the creams, oils, pills and ointments I used, along with a blue-light treatment. Steroid shots, creams and pills were a major part of my treatment." "I received some temporary relief and never traveled without my creams. Itching on my hands was so fierce that I carried a frozen ice block (the kind used in coolers) in my purse. When we were at a public event, I gripped my hands around the ice to ward off a noisy itching attack. Ice was my godsend to keep the itching from following its neurological path. All of my blouses had blood dot stains from clawing my upper arms like I was an ape when into full-time mode." "My best treatment was freezing 2-liter bottles of water and holding them between my knees as I laid down to go to sleep. If I could fall asleep before the freaking stage began, I was on a roll. More frozen bottles were kept in a cooler by my bed for when the thaw came and I was too tired to walk downstairs to replace them." "What a saint of a husband I had. Once I went gluten-free, so many changes came for the better. I did not suddenly notice the absence of itching but, one day, looked back and realized I was not traveling and sleeping with frozen bottles anymore. I hope dermatologists are more informed now." Skin Diseases Associated with Celiac Disease
    Gluten is known to cause skin disease. Gluten can definitely cause itchy skin. Collectively, these skin-diseases provoked/triggered/caused by gluten can be called "cutaneous gluten sensitivity". This is an umbrella term which includes:
    Dermatitis Herpetiformis (DH); Celiac associated skin diseases; Non-celiac associated skin diseases. So what is the evidence?
    1) Dermatitis Herpetiformis: To summarise the previous chapter, the classic skin complaint is dermatitis herpetiformis. It usually affects the elbows, knees, buttocks, scalp, and back. It begins as little bumps that then change into little blisters. People say that they are driven mad by the itching. It is caused by an immune reaction to gluten in the skin. Microscopic clumps of immune-complexes get deposited just under the skin. This creates the very itchy rash. These tiny particles of immunoglobulins can take years to clear up once you start on a gluten-free diet. It is reported that it can take up to ten years before you make a full recovery.
    2) Celiac Associated Skin Diseases: Marzia Caproni and co-workers have detailed the skin diseases that have so far been associated with celiac disease (and perhaps by implication, with gluten).
    In their paper, "Celiac Disease and Dermatologic Manifestations: Many Skin Clues to Unfold Gluten-Sensitive Enteropathy" they include common skin complaints that most people do not associate with gluten-illness:
    Dermatitis Herpetiformis Psoriasis Alopecia Areata Chronic Urticaria Hereditary Angioneurotic Edema Cutaneous Vasculitis Atopic Dermatitis Eczema Vitiligo They also remind us that enamel defects, delayed eruption, recurrent aphthous ulcers, cheilitis, and atrophic glossitis are gluten-associate conditions and that "the diagnosis of celiac disease can sometimes be made from a smile!"
    Their important message is that anyone with any of these conditions should be investigated for celiac disease.
    3) Non-celiac Associated Skin Diseases
    The skin is a frequent target organ in gluten-sensitivity. The skin, hair and teeth can all be disturbed by gluten. However, eczema is a much more common manifestation of gluten-sensitivity.
    Humbert and his dermatology colleagues (Gluten intolerance and skin diseases, 2006) wrote this about gluten and skin disease:
    "Gluten sensitivity, with or without celiac disease symptoms and intestinal pathology, has been suggested as a potentially treatable cause of various diseases. There have been numerous reports linking celiac disease with several skin conditions. Dermatitis herpetiformis is actually a skin manifestation of celiac disease. Autoimmune diseases, allergic diseases, psoriasis and miscellaneous diseases have also been described with gluten intolerance." "Dermatologists should be familiar with the appraisal of gluten sensitive enteropathy and should be able to search for an underlying gluten intolerance. Serological screening by means of anti-gliadin, anti-endomysial and tissue-transglutaminase antibodies should be performed. Gluten intolerance gives rise to a variety of dermatological manifestations which may benefit from a gluten-free diet." This is an important statement.
    In 2010, Korossy reported a skin eruption that he called "gluten-sensitive dermatitis" which he says is clinically indistinguishable from dermatitis herpetiformis but lacks the IgA connection. (Non-dermatitis herpetiformis gluten-sensitive dermatitis: a personal account of an unrecognized entity, Korossy, 2010).
    Cutaneous Gluten Sensitivity
    Bonciolini et al (2015) have made a study of the skin manifestations of people with Non-Celiac Gluten Sensitivity (NCGS) Cutaneous Manifestations of Non-Celiac Gluten Sensitivity: Clinical Histological and Immuno-pathological Features, Bonciolini et al 2015
    They have adopted the term 'cutaneous gluten sensitivity'. They describe 17 consecutive patients affected by NCGS. They had excluded celiac disease and wheat allergy. They said:
    "The skin lesions observed were similar both to eczema and psoriasis and did not show a specific histological pattern. Furthermore, no serological marker was useful to identify these patients. The only data common to most of these patients affected by NCGS associated to non-specific skin manifestations are: the itching; the presence of C3 at the dermoepidermal junction; a rapid resolution of lesions when adopting the gluten free diet. Therefore, dermatologists must be familiar with the cutaneous manifestations and symptoms of gastrointestinal disorders. An appropriate understanding, work-up, consultation and management will help to identify the important cutaneous–gastrointestinal connection and ensuring that this important gastroenterological disease in patients with skin manifestations is not ignored.
    Finally, we suggest an accurate follow-up of all patients who report intense itching and gastrointestinal disorders, even when histology and morphology of the skin lesions do not identify a specific skin disease.
    We also suggest the adoption of gluten-free diet for at least three months assessing any positive effects."
    A Family Affected by Cutaneous Gluten Sensitivity
    Katrina Ojakaar writes this about the severe skin problems in her family that were eventually shown to be related to gluten-harm: "I had terrible eczema on my legs as a child. As an adult I had recurrent eczema on my eyelids and hands in addition to severe dry, itchy skin on my scalp, back, and legs. I also developed rosacea on my face that was treated unsuccessfully with antibiotics and topical ointments. At the age of 44, I had a lab test that showed gluten was making me sick. I immediately stopped eating food that contained gluten and within weeks watched my skin transform. I no longer have raw eczema patches or dry skin; and my rosacea has disappeared." "My daughter, Lila, had horrific diaper rash as an infant and nothing seemed to heal her sore bottom. Even as she grew out of diapers, her bottom was always irritated. Lila's skin was also very dry and irritated. Lotions and even plain bath water caused a sting. But when Lila stopped eating gluten, her skin simply healed. She now has smooth, soft, and moist skin without irritation and enjoys a relaxing bath." "My mother suffered from psoriasis on her legs and scalp until she stopped eating gluten at the age of 72. She is now 75, and the psoriasis has disappeared. Her skin is healthy, and she doesn't eat gluten, dairy, or oats." My father had rosacea on his face and was diagnosed with the autoimmune disease called lichen planus about 12 years ago. He had raw, bleeding sores on his scalp. And his fingernails and toenails disintegrated where he was left with only tender skin. Three years ago my dad stopped eating gluten, and two months later, his fingernails started to grow back. He now has a thin narrow layer of nail at the age of 80. The lesions related to his lichen planus disease on his scalp are gone. And, my father's rosacea, like mine, also healed when he stopped eating gluten." Keratosis Pilaris
    Keratosis pilaris, or sometimes called 'chicken skin' is blamed on gluten by many people. It is very common, occurring in about 10% of people, and there seems to be a hereditary nature to it. It tends to lessen with age, being prominent in toddlers. Any gluten connection remains speculative.
    Anne Luther writes:
    "One of the many pleasant surprises I had when I stopped eating gluten was the disappearance of three different skin rashes. There were non-itchy bumps on my back and arms, non-itchy red bumps on the soles of my feet and a very itchy rash on my legs behind my knees. None of these were ever diagnosed by a doctor but they all disappeared after I had totally eliminated gluten from my life." Keratosis pilaris is skin condition characterized by rough patches of skin caused by small, acne-like bumps. It is found mostly on the upper arms, upper thighs, and cheeks. It can feel a bit like sandpaper or goose-flesh. These little bumps are usually white, but can be red. They do not hurt. Sometimes they can feel a bit itchy.
    Keratosis pilaris seems to be caused by a build-up of keratin, the protein that helps create the protective skin barrier. Once keratin has formed into a hard plug at the opening of the hair follicle, this can block the oil and sweat glands. Consequently, these substances cannot escape out onto the skin, and results in these patches of rough, bumpy skin.
    I see a lot of keratosis pilaris in my Clinic. The gluten connection not clear, but many parents report its disappearance on a gluten-free diet.
    What happened to Max?
    Remember Max's legs at the beginning of this Chapter? Well it turned out that Max had two copies of the HLA gene DQ2 which gives him a 1-in-7 chance of developing celiac disease. It also increases his likelihood of having gluten sensitivity. However his blood tests for gluten (AGA) and celiac disease (tTG) were negative. But he did have evidence of a wheat allergy from his EAST tests. His total IgE levels were extremely high as well (over 4000), showing his heightened allergic status.
    So he has now embarked on a trial of a gluten-free diet. Mum says, "I feel that we are starting to get to the bottom of it now." It will be another 6 months before we know his results of his gluten-free diet. It can take a long time to heal.
    This was an excerpt from Dr Rodney Ford's latest eBook: "Dermatitis Eczema: Gluten Wheat – Solving the Eczema Puzzle." Available at: http://www.GlutenEczema.com

    Yvonne Vissing Ph.D.
    Celiac.com 03/23/2016 - Often when people hear that someone is "going gluten-free," they think that just means people are not eating wheat. This kind of thinking focuses on the obvious—since gluten is in foods it means watching what is eaten. They may associate this change in diet with some biological process or disease issue. In the world of the general public, they're not really sure what "gluten" is and they're not totally convinced that eliminating it will improve health. But for those of us who make a commitment to going gluten-free, it is far more than just eliminating certain food products. It is a personal transformation of self. What people don't often talk about is it being a psychological and social change as well.
    In many ways, making a commitment to seriously go gluten-free is an act of Zen. The Urban Dictionary defines Zen as "a state of focus that incorporates a total togetherness of body and mind. Zen is a way of being. It also is a state of mind. Zen involves dropping illusion and seeing things without distortion created by your own thoughts." What I've found is that going gluten-free requires thoughtful practice, observing the body, monitoring the mind, and seeking knowledge that one integrates into regular practice. The result is the personal expression of insight into daily life.
    Going gluten-free isn't just about eating. It is also about personal discipline. It has a lot to do about how we think and how we live. When we started going gluten-free we thought it was just going to entail a dietary switch. What we've learned over the last decade is that going gluten-free is an act of Zen. Our journey into becoming gluten-free started because health issues forced us down that path. We didn't willingly choose to go there. We would have been content with gorging on Texas toast, pasta, and Oreos for the rest of our lives. But if we did, we would have been chronically sick. The Universe pushed us onto the gluten-free road. At first, we did not go gracefully. We stumbled and fell and made a mess of going gluten-free. Going gluten-free seemed miserably hard and terribly inconvenient. We couldn't find products that tasted good, and those we found were expensive and weren't necessarily healthy (the amounts of eggs, butter or oil in many of them were mind-boggling). We spent too much money on poor-tasting products that were very difficult to find. We griped and complained. We felt alienated and imprisoned. Going out to eat was life-threatening because most restaurants didn't cook dishes that were safe, or if they did they cooked them in an environment in which they could be cross-contaminated. The idea of having to eat awful-tasting food and not being able to go out to eat for the rest of one's life was dreadful and depressing. Eating is one of the joys of life, and feeling like one was never going to be able to eat delicious food again felt like a fate worse than death. Going gluten-free seemed doomed to be an act of suffering. Sometimes, it is only through making a mess of our lives that we figure out how not to.
    Such is the case with our going gluten-free. What we didn't realize until later was that we had created this negative reality in our minds. You can go gluten-free smoothly, effortlessly, inexpensively, and easily with no disruptions in your daily lives. It need not be a big deal. This process may take a bit of time. The secret in this transformation has little to do with the gluten-free foods available. It has more to do with what is going on in our heads.
    Years of diligent practice, trial-and-error, patience and persistence, and learning have helped us to transform our perception of going gluten-free into an easy, inexpensive, and delicious way of eating. It has also fostered a different relationship with what we eat, why we eat, and how we eat. It has changed our relationship with food itself, how it is prepared, and how it is consumed.
    Thinking you can eat anything you want and not get sick is illusion for people who must go gluten-free. It requires mind-over-matter self-control when we're hungry and desire foods that may not be safe. Giving in to that longing for a certain cookie or a bite of Grandma's homemade lasagna can make a person with celiac very sick. Being mindful of why that food item creates desire in us is a useful mental exercise. Certain foods evoke memories and emotions that are more delicious than the foods themselves. We can still enjoy the memories without eating foods that aren't good for us.
    Food is very social and relational. Eating something served that isn't safe in order to please or not to appear rude, when it has a high likelihood of making us sick, isn't being kind to oneself. There have been times we've gotten annoyed when what-should-be-safe food has been contaminated. On the surface, it shouldn't be a big deal to redo the dish. But the symbolic message conveyed by serving someone with celiac glutened food is more problematic because it reflects that the server didn't really care about our needs. What happens to our relationships with family, friends, or certain establishments who go out of their way to make sure we can eat good foods, safely, in a no-big-deal manner? We care for them all the more. Frankly, we secretly want to see what goes on in the kitchen and read the ingredients on a product and not just take a waiter's declaration that "I'm sure it's gluten-free" to be an accurate reflection of reality until we are sure that what they say accurately reflects how actively sensitive they are to the needs of others who have dietary needs that are different from their own. Issues of trusting others, and trusting ourselves, is part of the gluten-free process. Helping to teach those who didn't understand the importance of being gluten-free in a constructive and thoughtful manner is much better than getting angry at them and refusing to eat with them again.
    Going gluten-free requires mindfulness. It gives us a relationship with our food as well as with others. Eating whole and healthy foods is better for us. Taking time to understand what's in our food really matters. Cooking ingredients in a thoughtful, less-hurried way creates lovelier dishes. Consuming them with gratitude and in communication with others makes them even more delicious. We want to know where the food came from, how it was cooked and what it was cooked with, and details of the dish's preparation. Were those oats grown next to a wheat field? Did these nuts get processed on machines that also processed other items that contained glutens? Were there croutons on the salad that you just picked off? Asking questions in a non-combative way is an art. Learning to read labels and knowing the list of unsafe ingredients must be transformed from being a big deal to it being just another routine step in an ordinary day. Learning how to shop, cook, clean, serve and eat are all actually complicated steps that require attention to detail. It is in the transformation of managing all these details into a smooth, seamless and calm process that going gluten-free becomes Zen.
    It took us a long time to realize that going gluten-free successfully has more to do with what's going on in our heads than what's going on in the kitchen. Look upon going gluten-free as a Zen experience, in which you have to change one pattern of behavior for a new, better one. You, like we, may find you have to change attitudes toward eating in general and eating gluten foods in particular—and you will be all the better for it.
    We'd love to help you to learn more about our approach to going gluten-free. Check out our book, Going Gluten-free, which is available from Amazon and NorLights Press, and let us know how your journey is going!

    Jefferson Adams
    Celiac.com 03/29/2016 - To remain healthy, people with celiac disease must follow a strict gluten-free diet. Good availability of gluten-free foods is critical to this. High prices or limited availability can have a greater impact on celiac patients from lower socioeconomic conditions in regards to their ability to follow a gluten-free treatment diet.
    A team of researchers recently set out to assess the availability and cost of gluten-free food in UK supermarkets and via the internet. The researchers included M Burden, PD Mooney, RJ Blanshard, WL White, DR Cambray-Deakin, and DS Sanders. They are variously affiliated with the Academic Department of Gastroenterology at Royal Hallamshire Hospital in Sheffield, UK, and with the University of Sheffield Medical School, Sheffield, UK.
    Their team analyzed data from supermarkets and internet shops delivering to homes in the city of Sheffield, UK, between February and March 2014. They used comprehensive internet searches to identify stores, and analyzed the costs of ten commonly purchased items, and then compared those with standard non-gluten-free alternatives. They also directly measured and compared the number of gluten-free foods available between stores, which were categorized according to previously published work.
    None of the budget supermarkets surveyed stocked any gluten-free foods. Premium and full-service supermarkets stocked the greatest gluten-free range, with an average of 22 items (IQR 39, p<0.0001). They found that when a store did stock gluten-free products, those products were, on average, at least four times more expensive than the non-gluten-free alternatives (p<0.0001). Gluten-free products are prevalent online, but half of the ten products surveyed were significantly more expensive than gluten-free equivalents in supermarkets.
    These results show that, for Sheffield at least, gluten-free foods are overall readily accessible, but also significantly more expensive than online versions, or comparable non-gluten-free store items. Still, that changes if you're in a low income neighborhood. Gluten-free food access was poor in low-income neighborhoods, as budget supermarkets stocked no gluten-free foods. This poor availability and added cost is likely to impact food availability and gluten-free diet adherence in low-income groups.
    These results are for one city in the UK, but they are likely not too different than results would be in the US. Access to gluten-free food becomes more difficult in poorer neighborhoods, and it's always more expensive than non-gluten-free food.
    Source:
    Postgrad Med J. 2015 Nov;91(1081):622-6. doi: 10.1136/postgradmedj-2015-133395. Epub 2015 Aug 26.

    Yvonne Vissing Ph.D.
    Celiac.com 05/03/2016 - How do you know when your child has gluten sensitivity, gluten intolerance, or celiac disease? If gluten issues run in your family and you know there is a predisposition to having problems with gluten in foods, then you may be alert to signs that it has been passed on to your child. But if you and your biological family members never had problems with it, then you're not expecting gluten to be an issue. Children arrive with a complicated genetic past that we may not always have the details about. We may not know the health history of the families of our child's other parent, or even sometimes our own. We may not know if anyone had reactions to gluten. Because celiac and gluten sensitivities can appear as chameleons, genes for it may be masked as other health issues. Parents may be a carrier and have no identifiable symptoms at all. People may have celiac disease without ever knowing it.
    It's complicated to raise a child. When they don't feel well, it's hard to figure out when their health problems are physical, emotional, social, or psychosomatic. When it comes to kids, having a belly ache is a common occurrence. So are a variety of symptoms that are linked to celiac disease or gluten intolerance or sensitivity, like headaches, fatigue, skin issues, depression, or GI track problems. When are signs pointing at the normal wear-and-tear of growing up—and when they are related to a syndrome like celiac disease? It takes a significant period of observation to figure this out.
    Celiac disease is regarded to be an immune-mediated enteropathy caused by a permanent sensitivity to gluten in genetically susceptible individuals. The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) found that the prevalence of celiac disease in children between age two-and-a-half and age fifteen ranges from 1 in 80 to 1 in 300 children. This means that in a pediatric practice of 1,500 children there are probably between 5 and 20 children with diagnosed or undiagnosed celiac disease—and potentially a lot more if one adds in gluten intolerance or sensitivities. According to the National Foundation for Celiac Awareness, celiac disease is genetically based, so reactions to gluten are more commonly found in those who have a family history of this autoimmune condition. They collaborated on a multi-phase research project with people diagnosed with celiac disease and at-risk family members who remained untested. Celiac disease was found in 5 to 10 percent of the family members of persons who had been diagnosed with celiac disease. But people may have reactions to gluten yet not have celiac disease. Some may have gluten intolerance or be sensitive to it without being diagnosed with celiac disease, so the actual relationship of health problems potentially associated with gluten may be considerably higher. First and second-degree relatives have more of a risk of developing celiac disease than are more distant relatives. For instance, their research found that celiac disease can occur in about 1 in 22 among children and their parents or siblings. But in analyzing the child's relationship to aunts, uncles, nephews, nieces, cousins, grandparents, half-siblings who may have celiac, the number decreases to 1 in 39. Detailed results of their research can be found from the NFCA's Seriously, Celiac Disease campaign.
    In our family, Chris never knew he was predisposed to celiac disease until he hit his twenties. Celiac is sneaky—while it can occur within people at any age, sometimes it doesn't show up until people get a bit older. As a child, he grew up on sandwiches, cookies, macaroni and cheese, and Grandma's home-made bread. When he had a tummy upset, as good mom I'd bring him chicken noodle soup and saltines. I never knew about celiac disease. My family came from a long line of gluten aficionados. As he hit adolescence and his teen years, signs of gluten intolerance emerged, only we didn't know that's what they were. Few parents link together migraines, skin problems with belly upsets and food "allergies." Chris's doctor dismissed his symptoms as independent, routine growing-up conditions without putting all the pieces of the puzzle together to realize that they were actually all a part of a larger celiac syndrome. It was only when he took a road trip and visited his father's sister and his cousins that he learned about the family's predisposition to celiac. His grandma always had stomach problems, I recall. She lived at a time and place where regular folks living in small towns were simply unaware of conditions such as celiac. As the old saw goes, you can't know what you don't know. In hindsight, she clearly had gluten issues. The gene seems to have been latent in her children, but passed on to take more active forms into the next generation of Chris and his cousin. It's confusing, because one child in the family can have a severe case of celiac while a full-blood sibling may have no sign of it at all! If he hadn't taken that road trip and stopped to visit his aunt, he may never have known that he had celiac. Upon that realization, suddenly everything made sense. All of his erratic symptoms were actually a picture-perfect portrayal of someone with celiac disease!
    We learned a bit about the disease, went to the store looking for gluten-free foods and quickly began modifying his diet. Since his MD couldn't figure out what was making him feel so bad, and if cutting out gluten could make him feel better, we decided that was a course worth pursuing. He felt better immediately. He has never been officially tested for celiac disease, although that would probably have been a better course of action. At that point in time, we simply didn't know about the testing options.
    Testing options have improved significantly over the last decade. The diagnosis of celiac disease can be done with a biopsy of the small intestine mucosa. Blood or serological tests are also helpful but less definitive. The University of Chicago Celiac Disease Center finds that the serum anti-tissue transglutaminase (tTG-IgA) is a widely used antibody blood test for screening for celiac disease, as is a total serum IgA test. The total serum test bolsters the reliability of the tTG test. A newer version of an old anti-gliadin antibody test has been developed called DPG or deamidated gliadin peptides test. Tissue transglutaminase (TTG) measures, endomysial antibody (IgA antibody to endomysium EMA) are recommended by many experts, while formerly used antigliadin antibody tests (AGA) are not as widely used.
    About 95% of people with celiac disease have the HLA-DQ2 gene and most of the remaining 5% have the HLA-DQ8 gene. Genetic testing can determine if someone has one or both of these genes. If someone has the gene it means they are at risk of developing celiac disease, but it does not mean that you necessarily have it. A positive genetic test should be followed up with a celiac blood panel to determine if someone has celiac disease. Celiac disease experts recommend family member testing as a proactive approach to diagnosis and then follow up with tests every 2-3 years or if potential symptoms start to emerge. They note that it is possible for someone to initially have a negative test result, but then test positive years later. This is worthwhile to know when trying to figure out if a child has celiac disease or not. It also means that re-testing may be a necessary process, since both the child's body and the disease propensity may change over time.
    What are warning signs that a child may have celiac disease? According to the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition and other celiac experts, there are both gastrointestinal and other symptoms to look for—symptoms that one may not logically associate with gluten. But remember that many of these symptoms may exist independently in children and have no relationship to having celiac disease at all! This is what makes trying to figure out whether or not a child has it extremely challenging.
    Once a determination is made that a child has celiac disease or is highly predisposed to be gluten intolerant or sensitive, changing the child's exposure to gluten in foods becomes of utmost importance. The problem is, most people aren't aware of gluten issues in general, and they particularly aren't thinking of it occurring in children. As Kay Chick (2014) describes in her article, there are many things that parents and teachers can do to proactively prevent problems in routine situations. She points out that many school cafeterias aren't equipped to safely serve children who have to go gluten-free. Most parents don't realize that making accommodations for children with celiac disease are assured under Section 504 of the Rehabilitation Act of 1973 and the Individuals with Disabilities Education Act; seventy-four percent of parents who participated in her study reported their children did not have a 504 plan or written into an Individualized Education Program (IEP) to help everyone make accommodations for their celiac disease. Children with celiac may also be eligible for services under the Individuals Disabilities Education Act (IDEA) if it has an impact on their ability to learn.
    Social events like birthday parties, camps, and field trips may expose children to gluten in foods and provide no alternatives for those who can't eat them. Sharing food is a common childhood occurrence, but an experience that leaves celiac kids out unless they are sure the food is safe. Going to another child's house to play or for a sleep-over may be an extra-big deal for a celiac kid. When the team goes out for a pizza party or ice cream cones after a game, the child with celiac has to be extremely careful. It helps enormously when adults and people in supervisory roles understand that when children need to avoid gluten, it is not because it is a choice—it is a health necessity. While a public awareness campaign to help people understand that there are children (and adults) who have to avoid gluten is underway, there's still a long way to go. Children need to learn self-advocacy skills to keep themselves healthy. This is sometimes hard to do when interacting with parents, teachers, and other adults who think that they understand the complications associated with needing to be gluten-free—and they actually don't.
    Going gluten-free doesn't have to be hard, but when it comes to children and youth, often it is. From identifying that celiac disease could be a problem, to diagnosing it, to addressing it in one's daily lifestyle, children are a special interest population. In order to help celiac children to live long and healthy lives, it begins with educating adults, most of whom will never have to personally go gluten-free. Speaking out on behalf of a celiac kid is an important thing to do. Adults in all professions need to learn what celiac is and how to institute celiac-safe strategies into their organizations. Even if they aren't affected, adults need to realize how their decisions and behavior may adversely impact children.
    Our youngest citizens count on adults to always be looking out for their best interests. Speak with your local schools, recreation groups, and youth-oriented civic organizations to make sure the leaders understand that the chances are high that they are serving children with celiac disease. Help them to understand that they should learn more about what it is, that they should make sure eating arrangements always take into consideration children with special dietary needs, and have food alternatives readily available. Every parent would expect the same concern and attentive care if their child had celiac. And as a community, aren't all children "our" children?
    For more information, see our book, Going Gluten Free (Norlights Press 2015). Yvonne Vissing has been appointed by the United Nations to be a Policy Chair for Child Rights, under the UN Convention on the Rights of the Child.
    Resources:
    Chick, Kay. The Educational, Social, and Family Challenges of Children with Celiac Disease: What Parents Should Know. 3/19/2014. Celiac.com Children's Digestive Health and Nutrition Foundation (CDHNF). www.cdhnf.org Diagnosis and Treatment of Celiac Disease in Children. Journal of Pediatric Gastroenterology and Nutrition. 2005; Volume 40, Number 1 (Jan): 1-19. National Foundation for Celiac Awareness. http://www.celiaccentral.org/ North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) http://www.naspghan.org//files/documents/pdfs/medical-resources/celiac/CeliacGuidelineSummary.pdf Raising Our Celiac Kids (ROCK). https://www.celiac.com/articles/563/1/ROCK-Raising-Our- celiac-Kids---National- celiac-Disease-Support-Group/Page1.html University of Maryland School of Medicine Center for Celiac Research http://glutendude.com/celiac/celiac-disease-symptoms/

    Sarah  Curcio
    Celiac.com 07/22/2016 - Some of us have the luxury of living in a household that is completely dedicated to being gluten-free. However, many of us don't have that luxury. So, there are certain precautions you must take, in order to avoid cross contamination.
    Now, here is a list of helpful tips to keep in mind for your kitchen:
    Always wear gloves or wash your hands thoroughly, especially if you have dermatitis herpetiformis (DH), when you are wiping down counter tops, tables and stove tops. Using paper towels would be a beneficial because you can throw it directly in the trash. As for hand towels, have a separate one for your hands. Having a dishwasher or even a counter top dishwasher, if possible, reduces your worries. Otherwise, be sure to have different sponges when washing because they are very porous and absorbs gluten. For your kitchenware, having glass, metal, stainless steel and ceramic would be best because plastic and wood absorb gluten as well. Just think about your flour sifters, colanders and cutting boards. As for appliances, have separate toasters, baking mixers, convection ovens, blenders, etc. Keep cabinets and refrigerator shelves separate, especially from foods like cakes, cookies, breads and crackers. Basically, anything that can cause a lot of crumbs. Also keep your flours and wheat flours in labeled, air tight containers, so they are completely sealed shut. You do not want flour flying everywhere. When reheating your food, cover all your plates in the microwave. Lastly, if you are following all of these instructions correctly and consistently, your celiac disease should stay under control. However, it might be best if you get your antibody levels tested at least once or twice a year by your gastrointestinal (GI) physician. That way you can see, in black and white, that all your antibodies are in range. That will prove you're keeping yourself perfectly healthy.
    References:
    http://strengthandsunshine.com/the-quick-dirty-guide-to-cross-contamination-prevention/ http://www.theceliacdiva.com/10-tips-to-prevent-cross-contamination/

    Jefferson Adams
    Celiac.com 08/19/2016 - Gwyneth Paltrow, Miley Cyrus and the clean-eating bloggers of Instagram have all helped propel gluten-free foods out of health-food stores and into the aisles of Whole Foods and Wal-Mart.
    Anyone who has ever tried a gluten-free bread or cake has likely found what sufferers of celiac disease have long known. They often don't taste very good. Gluten-free baked goods are often dry, crumbly and flat tasting.
    As long as there has been gluten-free bread, there has been mediocre gluten-free bread. This is not the fault of bakers. The problem is structural, chemical. Gluten, the protein found in wheat, rye, and barley, triggers adverse immune reactions in people with celiac disease. But that same gluten also has uniquely elastic properties that make it perfect for mixing with water, kneading into dough, and baking into chewy delicious bread.
    Gluten is what makes our breads spongy, and chewy, and delicious. Cereals and grains like rice, sorghum, buckwheat, which are often milled into gluten-free flours, lack this important component.
    Now two inventive Italian food scientists, Virna Cerne and Ombretta Polenghi, are being lauded for their isolation of a protein called zein, that is found in corn. Under the right temperature, humidity, and pH, zein forms an elastic network similar to gluten.
    These days, says Cerne, "gluten-free products include a lot of fiber but the fiber cannot be really elastic." Added to different gluten-free flours like rice or corn flour, Cerne adds, isolated zein protein "solves the problem of no elasticity." That means that products using zein protein can be used to develop gluten-free products with many of the same chewy, flaky attributes as bread and baked goods made from wheat flour.
    Currently, products using isolated zein protein are still in the research and development phase, but food scientists hope the abundance of low-priced corn will allow the protein to be made cheaply, and thus give rise to more affordable gluten-free alternatives. Cerne and her co-inventor Polenghi, who both work with Italian-based food company Dr Schär, say that their research remains focused on people with serious medical reasons to avoid gluten.
    Stay tuned to see how Cerne and Polenghi's work develops and what food breakthroughs might result from their efforts.
    Read more at Quartz.com.

    Miranda Jade
    Celiac.com 11/01/2016 - Homeopathy has been around for quite some time. You even see it in drug stores these days. Here are some basics behind homeopathy.
    Certain substances that create a reaction in a healthy person can cure a sick person with the same symptoms. Unlike conventional medicine, homeopathy is considered more effective when the substance is diluted and shaken and is considered more effective each time this dilution and shaken process is done. This also makes it much safer as there is so little of the active ingredient actually in the homeopathy. It is tailored to each person depending on their health record, physical symptoms, emotional state, etc. Not just a one size fits all approach. One point that is great about homeopathy as opposed to "regular" medicine is the side effects are next to nothing.  The dosages are so small and contain so little of the active ingredient that the worst thing to happen would be that no beneficial effect occurs.

    If your child is celiac, then you have probably had plenty of issues with ingredients in medications as well as sensitivities with substances in them that aren’t even gluten. I have run into many kids who are celiac who cannot handle all sorts of other substances due to their gut. The good thing about homeopathic preparations is that many of them are gluten-free. I actually have never come across one with gluten so far. This makes it very easy to find remedies that your celiac child can handle. No strange ingredients that are made in a laboratory either.

    I specifically use chamomile and arnica for my son when he is teething. There is a combination of specific ones for teething but the individual dosages always work best for my toddler. I see a large difference in his overall attitude and pain level when I administer these two. 

    Of course there is always a place for standard medicine but I try to avoid drugs when I can.  Especially with my damaged gut from being misdiagnosed for 17 years! This allows the body to learn and adapt to properly fighting germs so there is less of a chance in getting sick the next time a bug is being passed around. Plus, have you read some of the warning labels on these drugs that doctors recommend? Pretty scary, horrible side effects! Worse than the sickness you are treating.

    Give homeopathy a try and see if it gives you, your celiac child or your family any comfort.

  • Recent Articles

    Connie Sarros
    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
    Due to personal health reasons and restrictions, I find that I need to retire. My husband and I can no longer travel the country speaking at conferences and to support groups (which we dearly loved to do) nor can I commit to writing more books, articles, or menus. Consequently, I will no longer be contributing articles to the Journal of Gluten Sensitivity. 
    My following books will still be available at Amazon.com:
    Gluten-free Cooking for Dummies Student's Vegetarian Cookbook for Dummies Wheat-free Gluten-free Dessert Cookbook Wheat-free Gluten-free Reduced Calorie Cookbook Wheat-free Gluten-free Cookbook for Kids and Busy Adults (revised version) My first book was published in 1996. My journey since then has been incredible. I have met so many in the celiac community and I feel blessed to be able to call you friends. Many of you have told me that I helped to change your life – let me assure you that your kind words, your phone calls, your thoughtful notes, and your feedback throughout the years have had a vital impact on my life, too. Thank you for all of your support through these years.

    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.
    Source:
    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