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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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    ALLERGENS IN CONFECTIONERY PRODUCTS


    Leszek Jaszczak


    • Journal of Gluten Sensitivity Summer 2013 Issue


    Celiac.com 03/23/2017 - Allergens in processed foods can be a significant problem in the confectionery industry. In the European Union, current estimates suggest that 17 million people suffer from food allergies and in recent years, the number of children under five years with significant food allergies has grown. Therefore, it is important to keep track of information and raise awareness among consumers and producers. It should also be noted that all the tragic events and unpleasant incidents related to food and quality level affect the economy of the entire food industry, not just one company. Managing food allergens is a first step in limiting these problems.


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    Since the term allergy is often misused it must be distinguished from food intolerance. The consequences related to these two conditions are very different. Intolerance is rarely life-threatening. People with a food intolerance can usually eat small amounts of problematic foods without adversely affecting their health. Food intolerance can be caused by metabolic disorders such as lactose intolerance. People with food allergies may react strongly even to trace amounts of allergenic ingredients (with respect to foods to which they are allergic) present in food. They cannot tolerate even very small amounts of allergens in their diet, with the risk that allergens can cause serious reactions and even death. Below we present fragment of a list of allergens form REGULATION OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL No. 1169/2011 of 25 October 2011 on the provision of information to consumers about food. For more complete information, please refer to the original text of the regulation.

    List of allergens under REGULATION OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL (EU) No 1169/2011 of 25 October 2011:

    • Cereals containing gluten,
    • Crustaceans and products thereof,
    • Eggs and products thereof,
    • Fish and products thereof,
    • Groundnuts (peanuts) and derived products,
    • Soybeans and products thereof,
    • Milk and products thereof (including lactose)
    • Nuts, such as almonds, hazelnuts, walnuts, cashews, pecans, Brazil nuts, pistachios / pistachios, macadamia nuts and Queensland nuts and derivative products
    • Celery and products thereof,
    • Mustard and products thereof,
    • Sesame seeds and products thereof,
    • Sulphur dioxide and sulphites
    • Lupin and products thereof,
    • Mollusks and products thereof.

    Confectionery may include many ingredients from this list of allergens. The best way to treat allergies is to avoid the banned products. From the manufacturer's point of view it is important to ensure correct labeling of their own products. It is worth paying attention to this information because allergic customers and their care-givers read this information carefully and require precise administration and declaration of these allergens. Once they trust the brand they are likely to be loyal. Companies should therefore take steps to ensure that the ingredients are carefully and thoroughly listed. A risk factor which is worth noting is unintentional cross-contamination where a minimum amount of an allergen can be transferred during the process of manufacturing a product that is otherwise completely free of allergens. Producers should do everything possible to keep allergenic products and ingredients out of those products for which they are not intended. Cross contamination or inadvertent introduction of allergens into the product is generally the result of exposure of the product during processing or handling. Cross contamination is when there are many kinds of products produced on the same production line, re-processing, or due to ineffective cleaning or preparations containing dust from allergens. Although some phenomena cannot always be prevented, by developing and implementing controls to reduce contact between allergens and other products, consumer safety and trust can be enhanced.

    One of the tools to help in the control of allergens is an integrated quality management system which includes an inspection for all allergens. An allergen Management Plan is a key element of efforts to ensure a safe product. This plan is a written document that lists the storage, handling, processing, packaging, and identification of allergenic foods and ingredients. But this is not a one-time effort. An allergen control plan must be implemented, enforced and audited and constantly updated. Every time you make a change in the manufacturing process or a product, you must evaluate your plan and, where necessary, update it. Of course every employee is an important part of the plan, and everyone must understand their role and the responsibilities they bear. Raising awareness among the employees in this area, through training, should also be documented. The plan must also take into account the cooperation with suppliers of raw materials. Not all of the recommendations of the quality control system may be used in any food processing plant. Despite this, consider any threat and determine the extent to which it may affect a business and its suppliers. And have procedures in place for allergen control. The risk assessment should be conducted in order to develop a plan for the control of allergens. The assessment should start with raw materials, their storage, each stage of production, packaging and labeling of the finished product. It should define the critical points where allergens may be introduced into the product and establish a system for monitoring these points to avoid unintentional cross contamination. This plan is part of health care, the acquisition and maintenance of consumer confidence, and also provides financial protection and preserves the manufacturer's reputation.

    Product labeling should assist consumers who have allergies or intolerances by providing them with more comprehensive information on the composition of the food they buy. Caution in the labeling of allergens is a voluntary warning to consumers added to the list of ingredients (eg. it may contain milk). When should we use labels informing about the possibility of allergens? In order to warn consumers about trace amounts of allergens we should use them only when it has been found that occasional contamination of the product cannot be avoided. This decision should be based on a thorough evaluation process and allergen control plan, if it is determined that unintentional cross-contamination cannot be eliminated by careful labeling of allergens. Caution in the labeling of products that may contain allergens can never be used as a substitute for good manufacturing practices or an allergen control plan.


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    Guest Laura

    Posted

    Brilliant assessments regarding food allergens & sensitivities. Of note is the rampaging cross reactions that occurred from celiac disease post the wheat hybridization of 2009. The gluten-sensitivity illnesses rose exponentially. Appropriate labeling along with gluten certification are the best protection from exposure. About 4 years ago, Fisher All Natural Nuts was the first company that purified its processing to the point that it does not have exposure to gluten or toxic seed/flower oils. Some products require a trial & error introduction. Yeast is added to most canned fish product labels. Olive oil -not- designated as "cold pressed" is a risk if ingested. Children seem to be the most impacted by processing and cross contamination. The same equipment is often used for foods containing allergens and non-allergens. Flavorings and preservatives are an added risk. I recently heard a newscaster interview. Gluten was being touted as a diabetic preventative. I laughed, since the gliadin in wheat is linked to an array of inflammatory diseases is believed to be an underlying cause of diabetes. Regarding labels, I exclude products that denote; "Processed in a facility that contains wheat, egg and/or dairy products." I had wondered why non-cold pressed oils resulted in GI ailments. Oil extraction requires chemicals and extreme heat. The heat produces toxins! It is good to know what foods or food-stuffs cause the physical ailments. It is equally important to know why. Thank you.

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    Lauren Lindsey
    Celiac.com 10/28/2013 - Meticulously picking apart menu items is not fun or convenient while enjoying a meal. At times, sticking to a gluten-free diet tends to result in unappetizing dishes and an unsatisfying experience. With a few alterations sushi is an excellent option for gluten-free dieting. Rice, fish, and vegetables contain simple, natural ingredients, and are gluten-free.
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    Before Ordering
    Always notify your server of dietary restrictions before ordering. Do not be afraid to speak up or feel like you’re being a nuisance. Servers prefer taking an order once, no matter how precise, as opposed to having their customer fall ill.
    Unsafe Items Commonly Found in Sushi
    Soy sauce: Be wary of all sauces but soy sauce undoubtedly contains wheat ingredients and is not safe to eat.  Gluten-free soy sauce has increasingly become more available in restaurants. Ask your server if there is gluten-free soy sauce in the back. Tempera: Fish or vegetable that has been battered and deep-fried. Imitation Crab: This is not crab at all! It’s processed fish parts that have been dyed orange, combined with food starch and flavorings, then frozen. Some restaurants are starting to indicate which items contain imitation crab. RA Sushi in Palm Beach Gardens, Florida has a disclaimer listed at the bottom of their menu. Eel Sauce: home-made and traditional eel sauce is made from sugar, rice wine, and soy. Each restaurant varies with added ingredients in their sauces and extra precaution should be taken before eating them.  Ask the manager to find out if the sauce is safe. Imitation Crab: This is essentially fish slush that has been processed, frozen, and dyed. It is not gluten-free. Teriyaki: Another unsafe wheat-containing sauce. Ponzu Sauce: contains soy sauce and is not gluten-free. Spicy: spicy tuna or any fish mix usually contains mayonnaise, which is not always gluten-free. Most contain unsafe sauces. Wasabi: In its original form is a root taken from a rare plant primarily grown in Japan. The wasabi served in restaurants is most always horseradish, mustard, and coloring, and it can be mixed with corn starch or wheat flour.  Mustard is not always gluten-free and neither is “coloring.” Unsafe key words:
    Crab, sauce, spicy, mayo, tempura, mixed, marinated, creamy, soy, dressing, crispy, wasabi.
    Safe Ingredients Commonly Found in Sushi
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    RA Sushi lists a “King Crab Roll” on their menu. It contains: king crab mix, cucumber, avocado rolled and topped with king crab; served with an Asian Pesto sauce. The king crab mix needs to be removed. Ask the server if the mix could be replaced with plain king crab- not imitation and not mixed with any mayonnaise, sauce, etc. The king crab on top needs to be confirmed that it is whole king crab. Replace the Asian pesto sauce with a bit of gluten-free soy sauce. If none is available, squeeze a bit of lemon on the roll for flavor.
    Also, stick with simple rolls such as the tuna and vegetarian rolls. Always double check to make sure there are no added ingredients! For instance, RA sushi added wasabi in their tuna roll. Ask the server to add tuna to your vegetable roll for some extra sustenance.
    Get Creative
    Order some kiwi on the side and place it on top of your roll. This adds sweetness and texture and is completely safe. There is no end to the alterations you can make with sushi. Learn how to make sushi and create renditions of your favorite recipes at home as well!
    Sources:
    www.sushifaq.com RA Sushi

    Lisa Cantkier
    Celiac.com 10/04/2016 - I have been following a gluten-free diet since being medically diagnosed with celiac disease as a toddler. My food choices have certainly evolved over the years. Many life experiences have influenced this evolution, including the loss of loved ones to cancer, experiencing my own health struggles resulting from celiac disease, and many surprising things I have learned from studying holistic nutrition.
    If I had to put everything I have learned over the years into one sentence, it would be, "Every bite matters." Those are words I live by now. After all, an overwhelming number of health experts agree that over 90% of our immune system exists within our gastrointestinal tract, so what we eat means more than ever. As a celiac with specific nutritional requirements, and being someone at risk of various deficiencies, this mantra can literally make or break me. I am always searching for new ways to maximize the potential of my food choices.
    Here are some of my favourite ways to turn everyday eating into meals that pack a greater nutritional punch.
    Avoid pre-packaged foods, particularly with long ingredient lists. Virtually all packaged foods contain preservatives, among other unhealthy things we can live without. The words "packaged" and "preservative" go hand in hand. That means you are getting unwanted ingredients in your food. Also, avoid products that contain ingredient names that look unfamiliar to you. Unfamiliar ingredients usually equate with unhealthy additives, preservatives and chemicals. Try to avoid processed/refined foods, and foods that are high in sugar and high on the glycemic index. Instead, select local, in season, whole foods. Choose organic when possible. When you choose foods that are organic, you are not only helping the eco-system in many ways, you are also helping your gut in more ways than you'd think. Organic foods are clean and free from harmful chemicals, pesticides, genetically modified processes, antibiotics and anything that is unnatural—from start to finished product. I find organic foods taste significantly better as well. Wipe out white rice, refined flours and crusts. For example, make your own gluten-free flours by grinding mineral-rich seeds such as sunflower seeds or pumpkin seeds. Bake homemade pizza and lasagna with a layered eggplant base (you'll need to cook the eggplant first). Replace nutrient poor, refined white rice with nutrient-dense quinoa. Make a wrap with seaweed or collard greens. Kick sugar to the curb. Use natural sweeteners lower on the glycemic index, such as stevia or organic coconut palm sugar to replace refined table sugar that has been stripped of its minerals and nutritional value. Although maple syrup and honey are not considered low glycemic, they certainly have more minerals and health benefits than white, refined table sugar. Organic honey is preferable. Pick quality protein and heart healthy omega 3 fats. Adding lean, quality protein and heart healthy omega 3 rich fats to your meals and snacks will help you absorb nutrients better, and help balance your blood sugar levels, which is good for you in the short-term and long-term. Reach for raw. Increase your intake of raw, nutrient-rich vegetables (especially cruciferous and sea vegetable varieties) and fruit in a wide range of colours to receive the benefits of an assortment of vitamins. Grab more green, such as kale, broccoli and spinach. Try juicing to conveniently get more veggies into your diet. Make your meals super. Add super-foods rich in antioxidants such as chia seeds, hemp hearts, flax seeds, gogi berries and other kinds of berries to cereals, stews, soups and sauces. A variety of colors will ensure you are consuming a variety of vitamins. Be mindful of your B's. Iron and B-vitamin deficiencies are extremely common among celiacs, even those who follow a gluten-free diet. Try to eat foods high in these nutrients. Foods high in B-vitamins include leafy greens, beans, eggs, fish, nuts and poultry. Foods high in iron include red meat, poultry, squash, pumpkin seeds, beans and various nuts. Savour the Season. Now that Spring is here, there is no reason why you can't visit your local farmer's market or farm for fresh, in season produce. Imagine the goodness lost when produce is packaged, shipped, sitting on store shelves and even cooked. Those steps, not to mention the time involved strip plant based foods of their nutritional value, and they leave a significant footprint on the environment. Consider creating your own veggie garden so you can take advantage of food that goes from soil to plate. Now that I've got you thinking differently, instead of reaching for what's inside the box, think outside the box and experiment with healthy whole foods. You might not love everything you introduce to your palate, however, you won't know until you try. One thing is certain—your gut will thank you.

    Dr. Sachin Rustgi
    Celiac.com 11/21/2016 - This article is the result of an email exchange between Scott Adams and Dr. Sachin Rustgi, which took place between January and March, 2014.
    Scott Adams:
    For many years researchers have known that a non-genetically modified, celiac safe wheat does, in fact, exist. Please see:
    Is Triticum Monococcum (Einkorn) a Safe Wheat for those with Celiac Disease? Baking Quality Wheat Ancestors May be Safe for Those with Celiac Disease I believe that what you are actually doing, which is supported by an approximately $900K corporate grant (if I recall correctly), is to create a GMO version that you can patent in order to make money selling the seeds. This may not be necessary, as what you seek already exists naturally, and I did explain this to your cooperator years ago.
    Sachin Rustgi:
    We are aware of these publications mentioned in your post. It is unfortunate that some of these research papers make broad claims not fully supported by the data presented in these reports. This practice is damaging to society in these two ways: i) These publications mislead the public, which gives rise to misconceptions or myths, making it difficult for the general public to accept other innovative ideas. ii) It could even negatively impact public health if the results were blindly accepted and changes were made in routine eating practices without having careful scientific scrutiny of the findings. The popular press and media is partly responsible, because without assessing the credibility of results, they pick broad claims from these publications and serve them to the public in language laden with emotional impact, which the public receives and bases their opinion on. This is also true for the general claims made in the publications cited earlier.
    Different celiac patients are sensitive to different ‘gluten' proteins (prolamins). If one feeds peripheral blood cells sampled from a patient or a small group of patients (from a specific geographical location) with gluten proteins derived from a wheat genotype, it is expected either to see a reaction (monitored by the production of interferon gamma) or no apparent effect. But in the latter case it does not mean that the wheat genotype is non-toxic to all celiac patients. Because the sample is not a good representative of the genetic variability for disease susceptibility available in the global population, and is likely representing the prevalent disease predisposition allele present in a population inhabiting a particular geographical area or a common disease predisposition allele existing in a larger population (like the one that interacts with the immunogenic 33-mer peptide derived from alpha 2 gliadin). Thus, these T-cell based assays using cell-lines restricted to specific gliadin epitopes are not sufficient to claim general low-toxicity of wheat lines for all celiac patients. I also recommend that readers consult the following publications: Kasarda DD (2007) Letter to the editor: Triticum moncoccum and celiac disease. Scandinavian Journal of Gastroenterology 42(9):1141-1142; Vaccino P, et al. (2009) A catalogue of Triticum monococcum genes encoding toxic and immunogenic peptides for celiac disease patients. Mol Genet Genomics 281(3):289–300.
    The results of screening hexaploid wheat material under the Celiac Disease Consortium (CDC) funded projects in the Netherlands resulted in a number of publications (Molberg et al. 2005; van Herpen et al. 2006; van den Broeck et al. 2009; van den Broeck et al. 2010). But the authors of these publications never claimed that the material can be used generally. Rather, they suggested these lines to have ‘low-toxicity', as they are devoid of specific epitopes or gluten proteins. Thus, they are good for consumption by a group of celiac patients who share a specific susceptibility allele. We have summarized this material and associated limitations in our publication under two headings, "Wheat Genotypes Naturally Deficient in Immunogenic Gluten Peptides" and "Discussion" [consult Wen et al. 2012 Proc Natl Acad Sci U S A 109(50):20543-20548 for details].
    In addition, there is a misconception that with breeding for improved yield, protein content and quality has enhanced the toxicity of the wheat lines, which has resulted in higher incidence of disease over the last couple of decades. Although careful analysis of the facts suggests that nothing has changed over time other than eating habits, procedures of disease diagnosis (became more sophisticated) and public awareness grew, which might have resulted in this increase in the estimated number of celiac patients [also consult Kasarda (2013) J Agric Food Chem 61:1155-1159; Brouns et al. (2013) J Cereal Sci 58:209-215].
    However, it is possible to identify low toxicity wheat lines showing reduced accumulation of certain prolamins or immunogenic epitopes, but these lines are not good for general use by celiac patients making labeling of these lines a nightmare, because with the present technology it almost impossible to make recommendations to the patients that they are sensitive only to a specific gluten protein and thus can consume a particular wheat variety.
    Thus, this trait is an obvious candidate for genetic engineering. Two major achievements in this direction are:
    i) Gil-Humanes J, Pistón F, Tollefsen S, Sollid LM, Barro F (2010) Effective shutdown in the expression of celiac disease-related wheat gliadin T-cell epitopes by RNA interference. Proc Natl Acad Sci USA 107(39):17023–17028. ii) Wen et al. (2012) Structural genes of wheat and barley 5-methylcytosine DNA glycosylases and their potential applications for human health. Proc Natl Acad Sci U S A 109(50):20543-20548. Collectively, as different celiac patients have sensitivities for different gliadins and glutenins, it is almost impossible to breed wheat lines safe for all celiac patients using conventional breeding approaches. A second issue is the identification of a product's suitability for a group of celiac patients and its labeling, which would be a great logistic challenge. After careful scrutiny of the literature and that the Codex Alimentarius Commission declared that all wheat, barley and rye species including spelt (Triticum spelta L.), khorasan or kamut (T. polonicum L.), durum, einkorn (T. monococcum), triticale, tritordium and their hybrids are immunogenic, and should be avoided by celiac patients (also consult http://wheat.pw.usda.gov/ggpages/topics/celiac.html) add to that challenge. Moreover, some individuals are now known to be sensitive to oat gluten proteins (however, all oat varieties are not toxic, e.g., PrOatina™), and in rare cases, some are even sensitive to maize gluten proteins.
    According to the latest (August 2, 2013) FDA recommendations any product having
    Another issue that I want to raise is genetic modification. Why can't we look at transgenics more objectively without having negative feelings toward the technology before we start? Of course, researchers should first look for a solution in nature, and that's what we did, but there is no perfect solution available in nature. Although, the approaches we undertook are inspired by nature, the only way to deliver them is through biotechnology. This approach is where we are silencing the transcriptional regulator of all immunogenic prolamins. It was inspired by a mutation in a regulatory gene in barley. But, this mutation is ‘leaky'. That means it is not completely devoid of immunogenic prolamins. Similarly, the approach to express gluten-detoxifying enzymes in wheat grains was inspired by a barley enzyme that expresses during grain germination and degrades gluten proteins, along with a similar enzyme (but with complementary function) from the black mold Aspergillus, which naturally grows on bread slices. Another example is enzymes secreted by Lactobacillus species, a cocktail of acidifying and proteolytic lactic acid bacteria traditionally used for long-time fermentation by sourdough. These natural enzymes are capable of detoxifying gluten but express at a wrong time or a wrong location or are industrially inapplicable.
    We have no intention to patent the technology or the product. We will license the varieties to the Washington Grain Commission, which is a general trend at Washington State University.
    Scott Adams:
    From my perspective, your endeavor faces two big problems:
    What you end up with will be a genetically modified form of wheat, which is not allowed in Europe and other places (the list seems to be growing here);
    What you end up with will still be called wheat, and according to current laws in the USA, cannot be labeled "gluten-free." This is a huge issue that would also be true for einkorn.
    It would likely be a much easier process to further test einkorn's safety in celiac patients than to create a new genetic variant (that would really be similar to einkorn...right?), then have to go through the same process of testing.
    Sachin Rustgi:
    I agree with you on the first point, but as I mentioned previously, this debate about the so-called ‘GMOs' will settle down with time, which has happened in the past with several other technologies. For instance, people initially learned to make genetic crossbreeds in the 18th century, but the general acceptance of this technology as a breeding tool had to wait until the rediscovery of the Mendel's laws in 1900. Embracing this technology resulted in the production of hybrid maize that significantly boosted its yield.
    The second example is the reluctance to use induced mutagenesis in plant breeding, which is now well accepted and used as a standard procedure to increase genetic variability. The major advantage of shifting to this technology was the production of semi-dwarf rice and wheat cultivars that resulted in the ‘green revolution'. Similarly, the general public will accept the transgenic approach, as there is no other way to meet the growing demand for quality food. I foresee the outcome as an ‘evergreen revolution'.
    Moreover, if you look in depth at the outcome of using any of the above mentioned procedures, it is always a genetically modified organism, but it is up to us where we would like to draw a line.
    We are not in favor of releasing ‘reduced or low-toxicity' wheat lines because, as I mentioned earlier, sensitive to, at present. there is no way of telling patients which gluten protein(s) they are sensitive to. In addition, the wheat varieties are not marketed on the basis of their protein composition (however, it is possible to determine the protein profile of a wheat variety). Thus, our ultimate goal is to develop ‘celiac-safe' wheat genotypes completely devoid of immunogenic prolamins or expressing large quantities of gluten detoxifying enzymes. In the former case, the gluten-level of the wheat line is expected to be lower than or equal to the FAO recommended limit of 20 ppm, allowing its labeling as a ‘gluten-free' commodity. In the latter case, the genotype will contain the dietary enzyme supplement within its grains, and hence, will be labeled differently, and will serve as a natural dietary therapy for celiac patients. (These grains or derived flours can be blended into normal flour to bake different products).
    Two research groups, one in the US and the other in The Netherlands, are producing large quantities of these therapeutic enzymes in bacteria, and their utility as a dietary therapy for celiac patients is currently under advanced clinical trials. In this situation it will be the consumer's decision whether to get enzymes derived from a bacterium to be use as a food supplement or from wheat bread. These enzymes will not only be advantageous for celiac patients but will also prove beneficial to healthy individuals as these enzymes dramatically improve gluten digestibility and bioavailability. Healthy individuals, like celiac patients, cannot fully digest gluten proteins, but unlike celiacs, their intestines are impermeable to the undigested/partially digested gluten proteins, thus they are capable of flushing it out of their systems before it can induce an immune response. (Healthy individuals also do not carry disease predisposition alleles.) This indicates that even in healthy individuals the bioavailability of gluten proteins is low, which can be improved by feeding on these enzyme-fortified grains. It will also reduce how much must be eaten to get a similar amount of nutrition.
    As I mentioned previously, Triticum monococcum (popularly known as einkorn), is good for consumption by one group of patients, but the major difficulty is determining who can have it without causing damage to their intestines. Thus, we are continuously working toward obtaining wheat genotypes that will be safe for all celiac patients, not just for a sub-group of celiac patients. This will avoid problems with labeling and diagnosis.
    Scott Adams:
    If possible, I also just want to clarify my point #2, and get your reply to it. I believe that you said anything testing below 20ppm can be labeled "gluten-free" in the USA, but the new regulations are a bit more complicated (http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm363069.htm):
    An ingredient that is any type of wheat, rye, barley, or crossbreeds of these grains;
    An ingredient derived from these grains and that has not been processed to remove gluten;
    An ingredient derived from these grains and that has been processed to remove gluten, if it results in the food containing 20 or more parts per million (ppm) gluten.
    I guess you could argue that the genetic modification process has removed the gluten, but this would be a legal argument that certainly isn't obvious in the new laws. For example, it is my understanding that beers which contain barley and have used an enzyme to render them gluten-free cannot, at present, be labeled "gluten-free" under the new law, even though they test below 20 ppm.
    Sachin Rustgi:
    I agree with you on the issue of labeling under the new regulations, but as you said it could be argued that these new wheat strains (devoid of immunogenic prolamins) should not be counted with the immunogenic wheat varieties, and should be classified as a new market class of wheat. The additional support for this argument comes from the preliminary feeding trials performed on transgenic gluten sensitive mice, and advanced trials performed under the NIH guidelines on existing gluten sensitive monkeys, and on interested celiac patients. Hopefully, the argument, supported by strong evidence, will foster reconsideration of the present labeling regulations.
    Scott Adams:
    What are the chances that cross-pollination of your celiac-safe variety of wheat by normal unsafe wheat will occur, and cause a percentage of the celiac-safe crop to become unsafe?
    Sachin Rustgi:
    Wheat is a strictly self-pollinated plant with a natural out-crossing rate of less than 4% in cultivated varieties (in exceptional cases up to 6.05% of out-crossing was reported). Out-crossing occurs mainly in the late emerging wheat spikes, which contribute very little to the total seed count of a plant. Moreover, wheat pollens are relatively heavier in comparison with the other grass pollens, thus could travel to a maximum of 1 m distance from the pollen source, and under optimal field conditions (20C and 60% relative humidity) can survive up to one half hour after release from anthers. Thus, if the APHIS (Animal and Plant Health Inspection Service) recommendations about isolation distances are followed a contamination of ‘celiac-safe' wheat with the ‘immunogenic' wheat can easily be avoided. In addition, a positive correlation between the rate of out-crossing in wheat and the length of flowering period was documented. Thus, the celiac-safe wheat genotypes can be selected for early and synchronously flowering phenotype to further reduce the rate of out-crossing.

    Leszek Jaszczak
    Celiac.com 12/27/2016 - For many years, nutritionists, doctors and the media declared a low-fat diet as an effective method of losing weight, lowering the level of so-called "bad cholesterol", and preventing health problems. We have since seen that it is not only fat intake but also the type of fat we eat is of paramount importance. So-called "bad fats" increase the level of LDL cholesterol and increase the risk of certain diseases, in contrast to the good fats that protect the heart and promote general health. Good fats, such as the ubiquitously advertised omega -3 are essential to physical and emotional wellness.
    Dietary health is becoming increasingly important to the consumer whose awareness is growing and will continue to grow. It is therefore important that in the face of these facts the wise producer will not only follow the trends set by the consumer but will try to get ahead of these shifts so he will be prepared when the new client asks for products suggested by these new insights.
    Walking through the store, it is easy to see health-oriented products displayed on the shelves, as well as customers looking for these products. When it comes to fats, the client is offered non-fat ice cream, low fat candies, cookies and cakes.
    While the number of low-fat products is growing, paradoxically increasing levels of obesity are also on the rise in our society. Thus, it becomes clear that low fat products and diets are not effective in the fight against obesity.
    Contrary to what has been widely proclaimed, fat is not always a negative factor in maintaining good health and a slim figure. Saturated fats and trans fats are unhealthy for humans. However, initially, all groups fats were considered the cause of the adverse consequences listed in the beginning paragraph. As it turned out, there are fats such as monounsaturated fat, polyunsaturated fat and omega-3 fatty acids that have the opposite effect. In fact, healthy fats play a huge role, affecting not only the appearance of the silhouette but also, human well-being and mental agility throughout life. For example, they are necessary for the proper development of a child's brain.
    This article is not a waiver for eating fat but suggests minimizing the consumption of those fats that negatively affect humans.
    To better understand these concepts about fats we should explain the way fats are grouped. In addition to the simplest categories of fat according to whether they come from animals or plants, they can be divided by the presence of bonds between carbon atoms in the chain and so on:
    unsaturated fatty acids containing a hydrocarbon chain having a double bond , are present in large quantities in plants. At room temperature they are usually liquids. monounsaturated fats - one unsaturated bond polyunsaturated fats - many unsaturated bonds saturated fats contain fatty acids having a hydrocarbon chain with only single bonds Trans fats are characterized by a specific molecular shape. They are found in natural animal fats, milk, and other dairy products. In larger quantities of solids they are present in vegetable fats such as margarine. Trans fats are normally fat particles that have been deformed by a process called hydrogenation . During this process, liquid vegetable oils are heated and combined with hydrogen gas . Partial hydrogenation of vegetable oils makes them more stable and less prone to loss of freshness, which is very good for food manufacturers, but not necessarily for the health of consumers.
    Monounsaturated and polyunsaturated fats are known to be "good" fats, and are thought to have a positive effect on heart health, cholesterol levels and general health.
    Saturated fats and trans fats are presented as "bad" fats because they increase the risk of disease and increase cholesterol levels.
    With so many different sources of fat in the diet, and increasing consumer awareness of these fats, customers will strive to reduce consumption of those ingredients that have a negative impact on their health. Thus, they will limit the intake of trans fats and saturated fats by the avoidance of products containing them.
    What is the impact of these facts on the behavior of the confectionery industry?
    Firms engaged in the production of confectionery fats have, for several years, been developing technologies and offering products with reduced trans and saturated fat content. Manufacturers are trying to limit the hydrogenation of oils and fats and produce other methods for processing fats and taking advantage of properties of existing fats. Many of those technologies are still being developed.
    In accordance with Article 30 REGULATION OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL (EU) No 1169/2011 of 25 October 2011 on the provision of information to consumers about food, which will take effect from 13 December 2014, the mandatory nutrition declaration shall include the following elements:
    a) energy value and the amounts of fat, saturates, carbohydrates, sugars, protein and salt. Therefore, please note that in future, European producers will have to adapt their labels to comply with the new laws. Consumers will have easier access to information on the composition of fatty products in foods, which can have a significant impact on their choices at the time of purchase.
    If you look for information on healthy eating in the basic knowledge base of general consumer... on the internet, you can find tips such as:
    Limit your intake of saturated fat to less than 10 % of calories Limit trans fats to 1% of calories The main source of trans fats in the diet is baked goods and snacks such as cookies, crackers , cakes , muffins, pizza dough , some types of bread and hamburger buns This shows how important the selection and appropriate control of fats is for confectionery production. Moreover, the producer is required to maintain a constant and reproducible quality of raw materials that can affect the final product, avoiding any unexpected ingredients. Growing consumer awareness can be seen today when shoppers pay much more attention to the labels and what is written on them. Increasingly, this is a decisive factor in their choice of whether to buy a particular product.
    On the other hand, the desired taste of food imparted by those elements that are not always the healthiest for people offers another perspective on confectionery food. We should keep in mind that when eating so-called sweets, we do not do it to be healthier and more beautiful. The most common motive is pleasure. If we were to look at food only from a chemical point of view, just the chemical names and function of substances that emit the aroma of coffee would stagger the average person. But what would coffee be like without its aroma? A truly conscientious consumer knows these facts.
    Again, it all comes down to common sense and moderation. Those who are able to be moderate are those who do not have to fear. But you cannot disregard the information flowing from the world of science. If we are able to produce safer food for people, we should go in this direction.

    Jefferson Adams
    Celiac.com 03/31/2017 - Imagine going to restaurants in the future and having your gluten-free food made and prepared to order using a 3D printer. That's the future envisioned by WASP, an Italian company on a mission to use 3D printing technology to solve serious problems that afflict people.
    WASP is in the business of improving quality of life through 3D printing, from spinal care to architecture to athletics, including their latest effort with celiac disease.
    Inspired by the opening of a 3D printed pop-up restaurant, Food Ink., WASP wants to allow restaurants to easily set up gluten-free kitchens inside their regular kitchens; something that is currently a challenging and expensive task.
    WASP envisions dedicated 3D printing equipment strictly for preparing gluten-free foods, with no risk of contamination from the other food prep equipment in the rest of the kitchen.
    To achieve their goals, the company enlisted the help of Francesco Favorito, a chef who specializes in gluten-free foods and who founded Zeroinpiú, a line of gluten-free flour and pastry mixes.
    Favorito devised a special gluten-free pastry mix, which he then put into a modified a DeltaWASP 20 40 by incorporating an extruder that heated and pre-cooked the mix during extrusion. The products were then finished in normal oven.
    At Sigep, a baking and coffee expo held each January, the WASP 3d food printer stirred considerable interest from attendees.
    Another demonstration of the printer was given at Carnival in Opificio Golinelli at the beginning of February, this time with the participation of Francesco Bombardi, an architect, designer and the founder of Fab Lab Reggio Emilia. Bombardi is also the founder of Officucina, a specialized space dedicated to food innovation and equipped with 3D printers, lasers, and other advanced technology.
    WASP says it learned a great deal from the early trials. For example, adding heated butter increases fluidity and helps the mixture extrude more smoothly.
    WASP notes that, even though the printer's main purpose is to create safe gluten-free foods for people with celiac disease, it can also be used to create complex shapes that would be impossible using normal methods.
    Are you ready for some 3D printed gluten-free food from your favorite restaurant? Stay tuned for updates on this and other stories about gluten-free end celiac-friendly food technology.
    Source:
    3DPrint.com

    Jefferson Adams
    Celiac.com 04/05/2017 - To mark the start of Coeliac Awareness Week, Coeliac Australia and Nestlé Professional have launched Gluten Free Online Training – an interactive learning resource for foodservice professionals looking to expand their understanding of gluten free food practice throughout the hospitality industry.
    Under the guidance of Australian chef and author Tobie Puttock, the project will train up to 30,000 students at all TAFEs and culinary institutes in the protocols for gluten-free food preparation and service.
    People who successfully complete the training earn a Certificate of Achievement, which covers them for three years under Coeliac Australia's Gluten Free Standard for Foodservice Providers.
    Cathy Di Bella, special projects officer at Coeliac Australia, says training in safe gluten-free food prep and handling practices is a huge stepping stone to meet the future needs of the foodservice industry.
    Karen Kingham, dietitian and brand nutritionist at Nestlé Professional, says that the online training is intended to help people working in foodservice to become familiar with gluten-free customer and prep and server issues.
    The goal is to promote gluten-free awareness and protocols to culinary and food industry workers, to benefit them, the industry, and its patrons.
    "As most of us know celiac disease is real and symptoms are easily triggered, and I believe this should be treated the same as someone with perhaps a peanut allergy, and therefore food handling is of the utmost importance," said Puttock.
    It's good to see such influential figures in the food industry bringing such seriousness and professionalism to the preparation and handling of gluten-free foods. Stay tuned for more on this and other gluten-free stories.
    For more information: Australia's Gluten Free Online Training.

  • Recent Articles

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

    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