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      Frequently Asked Questions About Celiac Disease   04/07/2018

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


    Tina Turbin


    • Journal of Gluten Sensitivity Spring 2016 Issue - Originally published April 14, 2016


    Celiac.com 05/17/2016 - The paleolithic diet, or paleo diet which happens to be gluten-free, has been growing increasingly popular among athletes and health advocates, but it has a history dating back to the mid-1970's as a means of preventing diseases and health conditions such as autoimmune diseases and cancer, when investigations were made of the eating patterns of our hunter-gatherer ancestors.


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    Photo: CC--U.S. ArmyThe paleo gluten-free diet, the "biologically appropriate" diet, is named for the Paleolithic era, which extended 2.5 million years ending in 10,000 B.C. with the advent of agriculture and animal husbandry. It's comprised of the foods our human ancestors consumed during this period, namely wild-caught fish, grass-fed meats, fruits, vegetables, roots, and nuts. Any "modern" foods introduced from the agricultural era forward such as grains, dairy, sugar, and processed foods are eliminated.

    People all over have found the paleo gluten-free diet is an effective answer for weight loss, optimizing health and fitness—and building muscle tone. According to research, pre-agricultural humans were free of the diseases of the civilized world such as cardiovascular disease, cancer, obesity, and autoimmune diseases. Modern studies, including clinical studies, have shown as well that the paleo diet and the restoration of the lifestyle conditions of our ancestors, such as exercise, have resolved numerous diseases.

    The theory behind the diet, supported by extensive archeological and anthropological evidence, is based on the premise that modern humans do best on paleolithic nutrition because human genetics have largely remained the same since the pre-agricultural era and thus our genetic makeup is best suited to the ancestral human diet.

    If you're looking to build muscle tone, meet with a qualified health practitioner to see if the diet is for you. I think you'll find that whatever your reason for starting the paleo diet and lifestyle, whether to optimize your fitness routine, lose weight, alleviate autoimmune disease symptoms such as celiac disease, or increase your longevity, eating in the biologically appropriate way for our bodies not only has the power to change your body and your health, but your quality of life.

    While many people are eating paleo gluten-free as a way to correct health conditions or improve their overall health, active individuals and athletes have been following the diet in order to lose fat and build muscle more efficiently, according to MuscleMag.

    In fact, one of the best known proponents of the paleo diet, Robb Wolf, former biochemist and author of The Paleo Solution, regards the diet as performance-enhancing and trains world-class athletes at his gym in Chico, California.

    According to Robb, our human ancestors were taller, leaner, and better built than humans now, as anthropological evidence shows us. According to MuscleMag, only during the last 10,000 years, since the advent of agriculture, have humans consumed grains, legumes and dairy—and during this same period, humans have also become "significantly shorter, fatter, less muscular and more prone to disease," as anthropological studies point out. Let's take a look at some of the reasons why the paleo gluten-free diet is optimum for building muscle tone.

    The paleo gluten-free diet, consisting wholly of unprocessed foods like seafood, lean meat, fruits and vegetables, nuts and roots, is much more nutritious than the foods from the Neolithic era and beyond. The optimal nutritional intake on the paleo gluten-free diet is a vital part of developing muscle tone.

    Although you'll hear grain advocates singing the praises of the fiber and B vitamin content of grains, you'll actually find more of these nutrients in grain-free foods, as long as you eat a variety of nutrient-rich whole foods. According to GrainFreeLifestyle.com, "If you can find the nutrient in grain, you can find the nutrient in better quantities in other foods." For example, 100 grams of whole wheat flour contains 44 mcg of folate, but a 100-gram serving of lamb liver yields 400 mcg of folate and a 100-gram serving of yard-long beans offers 658 mcg. Also, 100 grams of cooked brown rice has 1.8 grams of dietary fiber, whereas a 100-gram serving of cooked collard greens has 2.8 grams and green peas offer approximately 5 grams of fiber per serving.

    In fact, grains that are poorly prepared, which is most often the case, can prevent the absorption of vitamins and minerals. Your diet may be rich in nutrients, but if it's also rich in improperly prepared grains, you won't be able to absorb them due to substances in grain such as phytic acid, which binds with minerals so you can't absorb them properly.

    Gluten is a protein found in wheat, barley, and rye. The paleo diet is a naturally gluten-free diet because it is a grain-free diet. Studies show that 1% of the population has celiac disease, an autoimmune condition triggered by the ingestion of gluten, which causes the immune system to attack the lining of the digestive tract and inhibits the proper absorption of nutrients from your food.

    But experts are saying that a large proportion of non-celiac individuals are suffering from gluten intake as well. Some researchers estimate that as much as 40% of the population is also sensitive or downright intolerant to gluten, which can lead to the same symptoms and conditions of celiac disease. Celiac disease and gluten sensitivity are severely undiagnosed, and it could be the case that you yourself have gluten issues.

    Not only grains but other Neolithic and modern foods, such as legumes, dairy products, sugar, and processed oils can irritate the digestive tract as well. For example, legumes contain antinutrients such as lectins, saponins, and protease inhibitors, which cause damage to the intestines and hormonal and immune systems, leading to inflammation and increasing the risk of inflammatory and autoimmune diseases. All soy products and peanuts are actually classified as legumes and are to be avoided on the paleo gluten-free diet.

    With intestinal inflammation, nutrient absorption is severely limited, especially when it comes to protein. Furthermore, the inflammatory response in the gut can spread throughout the body. This systemic inflammation can lead to the retaining of water as well as weakening the immune system, while a strong immune system is vital when it comes to recovering from intense exercise and building muscle.

    Let's dive into how to get superior sources of protein, weaning off of detrimental grains and improve muscle tone and exercise recovery time in the next issue.


    Image Caption: Photo: CC--U.S. Army
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    I think it should also be pointed out in an article such as this that with the Paleo diet there is a risk of nutrient inadequacy (e.g. fibre, calcium, iron and vitamin D), and it may compound the difficulty some people find with following the gluten-free diet.

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    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.
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    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
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    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. 
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    Celiac disease can have numerous vague, or confusing symptoms that can make diagnosis difficult.  Celiac disease is commonly misdiagnosed by doctors. Read a Personal Story About Celiac Disease Diagnosis from the Founder of Celiac.com Currently, testing and biopsy still form the cornerstone of celiac diagnosis.
    TESTING
    There are several serologic (blood) tests available that screen for celiac disease antibodies, but the most commonly used is called a tTG-IgA test. If blood test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.
    Testing is fairly simple and involves screening the patients blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis. Also, it is now possible to test people for celiac disease without making them concume wheat products.

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

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

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

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

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

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