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      Frequently Asked Questions About Celiac Disease   04/24/2018

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


    Jefferson Adams


    • Journal of Gluten Sensitivity Summer 2017 Issue


    Celiac.com 07/24/2017 - Are many non-celiac gluten-free eaters actually treating unkown medical conditions? Is the gluten-free movement less a fad than we imagine?


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    Currently, about 3 million Americans follow a gluten-free diet, even though they do not have celiac disease. Known colloquially as "PWAGs," people without celiac disease avoiding gluten. These folks are often painted as fad dieters, or hypochondriacs, or both.

    Call them what you will, their ranks are growing. According to a study in the journal Mayo Clinic Proceedings, the number of PWAGs tripled from 2009 to 2014, while the number of celiac cases stayed flat. A new study from the Mayo Clinic supports these conclusions. The study derived from data gathered in the National Health and Nutrition Examination Survey, as well as serological tests.

    There is also a growing body of data that support the existence of non-celiac gluten sensitivities, though the evidence is not conclusive. Moreover, researchers really don't have any idea how many non-celiacs on a gluten-free diet may have legitimate reactions to gluten. The phenomenon has emerged in the past five years in medical literature.

    For a long time, researchers just assumed that only people with celiac disease would eat a gluten-free diet. About a decade ago, when research into celiac disease and gluten-free dieting began in earnest, says Joseph Murray, a celiac researcher at the Mayo Clinic and an author of the new research, researchers "didn't think to ask why people avoid gluten. When we designed this study 10 years ago, no one avoided gluten without a celiac diagnosis."

    The latest research by Murray and his colleagues showed that the total number of celiac cases leveled off in the last few years, while more non-celiacs began to avoid gluten for different reasons. Researchers still aren't sure what's driving the trend, and whether it will continue. Part of the increase is doubtless to growing awareness of gluten sensitivity.

    However, Benjamin Lebwohl, the director of clinical research at Columbia University's Celiac Disease Center, estimates that more than half of the 3.1 million PWAGs noted in this latest study have legitimate gluten sensitivity. "An increasing number of people say that gluten makes them sick, and we don't have a good sense why that is yet," Lebwohl said. "There is a large placebo effect — but this is over and above that."

    Non-celiac patients with gluten sensitivity often complain of symptoms similar to those of celiacs, such as intestinal problems, fatigue, stomachaches and mental fogginess. And while researchers don't know the reason, clinical studies have shown that these symptoms are often relieved by eliminating dietary gluten.

    One theory that is gaining some credence is that these people may be sensitive to other irritants, such as FODMAPS, a class of carbohydrates shown to cause gastrointestinal symptoms found in wheat, milk, onions and cheese.

    Look for more studies into this topic, as researchers seek to nail down answers about celiac disease and gluten-sensitivity, and similar symptoms in non-celiacs.

    Meantime, the number of people who suspect they have non-celiac gluten sensitivity, and who seek improvement in their symptoms by eliminating gluten from their diets, continues to grow.

     Source:


    Image Caption: Are non-celiac gluten-free eaters responding to legitimate medical issues? Photo: CC--Mike Licht
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  • Related Articles

    Jefferson Adams
    Celiac.com 02/03/2016 - Gluten-free foods are more popular than ever, higher in quality, and increasingly seen as worth premium prices paid by consumers, according to a new research report by Mintel.
    The report shows that, despite widespread skepticism of gluten-free diets, more people are consuming gluten-free foods than ever before; with an increasingly positive attitude toward such foods.
    Mintel's latest numbers show that 25 percent of consumers surveyed report that they consume gluten-free foods regularly, a whopping 67 percent increase from 2013.
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    Mintel's report also shows that the vast majority of those who do consume gluten-free food are happy with existing gluten-free options, and that 35 percent feel that gluten-free foods quality are of higher than in the past.
    The greater availability and higher quality of gluten-free foods has resulted in a greater willingness on the part of consumers to pay premium prices for gluten-free products. The survey reflects this, with 26 percent of consumers who reporting that gluten-free foods are worth their higher prices. All of these figures are higher than those reported in a similar 2013 survey by Mintel.
    For those seeking to keep tabs on the gluten-free food industry, both in the US and beyond, Mintel compiles a wide variety of market reports.

    Jefferson Adams
    Celiac.com 02/15/2017 - There's been a lot of talk in the media and among researchers about the large numbers of people who adopt a gluten-free diet without a celiac disease diagnosis. Many of these dieters are regarded with a bit of suspicion. The question areises as to whether gluten was causing them any problems that could be improved by a gluten-free diet. Most have been regarded as simple fad dieters.
    Well, what if the gluten-free fad isn't such a fad after all? What if many of those without celiac disease who eat gluten-free are actually gaining some heretofore undiscovered benefits?
    That's the intriguing possibility raised by the latest study from the Mayo Clinic's Dr. Joseph Murray, and his colleagues at the forefront of research in celiac disease and gluten intolerance. Dr. Murray's colleagues and coauthors include Rok Seon Choung, MD, PhD, Aynur Unalp-Arida, MD, PhD, Constance E. Ruhl, MD, PhD, Tricia L. Brantner, BS, and James E. Everhart, MD.
    Today, according to the team's research, published this month in the journal Mayo Clinic Proceedings, some 3.1 million Americans currently avoid gluten without a celiac diagnosis for celiac disease. That number tripled between 2009 and 2014, while the number of cases of celiac disease stayed flat.
    When we designed this study 10 years ago, we didn't think to ask why people avoid gluten, because no one avoided gluten without a celiac diagnosis, said Murray. So, could these folks be avoiding gluten for legitimate health reasons? Very possibly, says Murray. There's definitely growing evidence that severe non-celiac gluten sensitivities exist.
    Patients with these sensitivities frequently experience intestinal problems, as well as fatigue, stomachaches and a sense of mental fogginess. And while researchers don't understand the underlying mechanism, clinical studies have shown that a gluten-free diet does relieve symptoms in many gluten-sensitive non-celiac patients. It's possible that gluten may play some role in inflammation, though this is unproven. It's also possible that non-celiacs who cut gluten from their diet might also cut out other irritants and allergens.
    The researchers call for further investigation of long-term health consequences of a gluten-free diet in people without celiac disease.
    How about you? Do you or someone you know not have celiac disease, but avoid gluten?
    Source:
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    Jefferson Adams
    Celiac.com 06/07/2017 - After nearly a decade of high double-digit growth, the US market for gluten-free foods is set to level off to single digit rates in coming years, according to a study from Research and Markets.
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    The report covers gluten-free food products sold through all types of retail outlets, including supermarkets, discount stores and super-centers, warehouse clubs, and mass merchandisers, along with convenience stores, drugstores, health and natural food stores, dollar stores, farms and farmers' markets. The report projects sales of more than $2 billion in 2020, up nearly $400 million from 2015.
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    Jefferson Adams
    Celiac.com 09/06/2017 - Gluten-free food is now so mainstream that its lack of gluten is no longer a highlight, but is now just another of the many ways manufacturers signal a healthy product.
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    Jefferson Adams
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    Gluten-Free Products Market Analysis breaks down the gluten-free market by product, by distribution, and by segment forecasts from 2014 to 2025.
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    Jean Duane
    Celiac.com 01/11/2018 - Gluten-free, food allergies and celiac disease have reached the media in the form of jokes and ridicule. This is a serious development because the media influences viewer's day-today reactions to various social situations. In many ways, TV becomes a role model for social interactions. DeVault (1991) says that "an enormous body of science, literature and even humor tells us how a middle-class man and woman might 'do' family life" (p. 16). This is the fundamental reason why the media jabs about gluten-free and food allergies are so impactful. What we see on TV, we emulate in life. If 'doing gluten free' is something to be ridiculed, as with the examples below, then those of us with food allergies need to unite our voices to be heard in public forums to change this practice.
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    . I think the producers thought this incident was funny. Newsflash: It isn't. This scene has been criticized on various blog sites as making light of allergies, but one criticism from a parent of a child who recently died from inadvertently eating peanuts is especially poignant. The parent said scenes like this are not funny, nor entertaining. Scenes of this nature on TV undermine the consequences of food allergies.As much as I love Frankie and Grace, the game that the siblings played in Season 3, Episode 1, called "Bud's Super Needy Girlfriend Game" is offensive. It shows them eavesdropping as Allison, Bud's girlfriend, talks about her allergies to a stranger at the art show. With each statement Allison makes, such as, "it is easier to tell you what I am not allergic to," the group takes a shot of liquor. Allison says, "and that's when I realized I have celiac disease" and the siblings laugh and take another shot. This goes on for several rounds. The siblings ridicule Allison's allergies and maladies in a very uncompassionate way, setting an example for viewers on how to respond when there is a person in the crowd who has allergies. In another episode, when Allison faints, the reaction from the siblings is, "…she always has to be the center of attention. She conjures up some kind of illness. But there's a name for it, 'Fictitious disorder.'" (For a transcript of this and similar scenes, please check out: http://thewalkingallergy.com/2017/08/grace-and-frankie-i-bet-allison-has-mcas/). These responses to Allison's physical malaise are callous and may encourage copycat behavior in real life situations.
    Humans are easily influenced, starting from infancy when they imitate their parents (McCall, Parke & Kavanaugh, 1977) and continue to be guided by what they view in the media, especially on TV. Ramasubramanian (2010) conducted a study to discover how stereotypes of laziness and criminality changed as a result of reflecting on TV depictions of racial/ethnic groups by white viewers (p. 109) and concludes that the ways these scenes influence opinions and attitudes is worrisome (p. 106), perpetuating stereotypes and prejudice. A study conducted by Tan and Kinner (1982) found that interracial children who watched a TV program showing cooperative, positive behavior, yielded "pro-social" (p. 654) social interactions, when compared with a control group. The impact of what is viewed on TV and how it translates to social (or anti-social behavior) has been validated. Humans imitate what they see. Similar to how racial stereotyping is reinforced by the media, so are people with food allergies who become the butt of jokes. The media is teaching unacceptable social norms disguised as humor.
    Disney's episode of Quitting Cold Koala (edited out after parents complained, but still on YouTube in a home-video snippet) shows the character named Stuart (who has a "five page list of dietary problems" according to his nanny) sitting at the breakfast table with other children. He is a cute little boy who wears glasses cocked awkwardly on his nose. He told the cook that he couldn't eat pancakes that contained gluten only to be attacked by other children throwing gluten-containing pancakes in his face! Here it is on:
    . Stuart reacts the way anyone would who has celiac disease. He says, "That's gluten!" and frantically tries to wipe it off his face. I agree with the person who put the video of it on YouTube. This is not "remotely funny. Depending on how sensitive Stuart is, he may have had to suffer through a reaction because of those mean kids. And though this segment was deleted from the final cut of the episode, several people captured videos of it so it remains on the Internet for anyone to see. It sets a sad, and arguably violent standard for how to treat the child that has special dietary needs. Huesmann and Taylor (2006) found that violent behavior on TV poses "a threat to public health inasmuch as it leads to an increase in real-world violence and aggression" (p. 393). Violence toward someone with food allergies, such as throwing pancakes at the person who has just declared they are sensitive to gluten is an example of how behavior seen on TV could be re-enacted in real-life.How do scenes like the three examples above translate into our everyday social interactions? Does the waiter who watches a scene on a sit-com ridiculing someone with food allergies doubt the customer the next day as she orders a gluten-free meal? Does the waiter play a derivation of the "Needy Game" seen on Frankie and Grace and have a shot of liquor in the back room with his waiter-buddies for every customer that orders a special meal? Ridicule in the media completely undermines the severity of celiac disease, and other food-related illnesses.
    I experienced a situation the may have been influenced by commercial programming recently while ordering at a restaurant. I special-ordered my salad, deliberately sitting on the end of the table and explaining to the waiter that I needed to ensure it was gluten and dairy free. I spoke quietly, but since there were only two others at the table, unfortunately the conversation stopped during ordering and the others heard me. The waiter rolled his eyes when I gave him my order, and moved on to the next person who said, "I'll take the salad 'regular' with all the fixings" in a kind of a sarcastic way that belittled my order. My dinner was spoiled because I was irked with my dinner companion, and because I was skeptical of the food I was served. This kind of slight happens all the time, and is likely because of the role models depicted on TV and other media that portrays that it is it socially acceptable to mock the person with special needs.
    It is hard to understand why food sensitivities trigger so much negativity. If someone says they have heart disease, they are taken seriously. Other autoimmune diseases such as rheumatoid arthritis, lupus, Hashimotos, and diabetes are met with seriousness, but gluten-sensitivities seem to be a charged 'trigger' reaction, that I believe has been perpetuated by the media. People ordering in a restaurant seem to be challenged by the waiter – scrutinized whether it is an 'allergy,' 'autoimmune response' or 'fad diet.' When did waiters have the prerogative to make that kind of decision? Where did this 'right' come from? I believe the media has perpetuated these attitudes.
    Nobody with special needs should endure scrutiny or ridicule. I'm frankly glad for the publicity gluten has received because it has enhanced awareness, but I am discouraged about how the media seems to think celiac disease, gluten intolerance and food allergies are a joke. Here is our call to action: When we see something offensive in the media ridiculing food allergies, we need to say something in a public forum to bring attention to this unacceptable portrayal of people with food sensitivities. Please post on social media, or on Celiac.com to create a buzz that this type of ridicule/humor is unacceptable. Perhaps by doing this, we can influence positive changes.
    And on another subject… the winners from the survey.
    A couple of months ago, a survey studying the impact of food sensitivities on adults living together offered a $25 gift card to Amazon to four lucky winners. Those are: Morgan, Angela, David and Tricia. (Winners have been notified and gift cards were sent via email.) Congratulations! And thank you for your participation in the study.
    References
    DeVault, M. L. (1991). Feeding the family: The social organization of caring as gendered work. Chicago, IL: University of Chicago Press. Huesmann, L. R., & Taylor, L. D. (2006). The role of media violence in violent behavior. Annual Rev. of Public Health (27), 393-415. McCall, R. B., Parke, R. D., Kavanaugh, R. D., Engstrom, R., Russell, J, and Wycoff, E. (1977). Imitation of live and televised models by children one to three years of age. Monographs of the Society for Research in Child Development 42(5), 1-94. Tan, A. S., Kinner, D. (1982). TV role models and anticipated social interaction. Journalism Quarterly 59(4), 654-656.

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    After being scoped at Children's Hospital of Chicago, and my daughters Celiac Disease officially confirmed, I worried about her getting all the nutrients her under nourished body so desperately needed. I already knew she had a peanut allergy from blood tests, but just assumed she would be safe with other nuts. I was so horribly wrong. After feeding her a small bite of a pistachio, which she immediately spit out, nuts would become her enemy. Her anaphylactic reaction came within minutes of taking a bite of that pistachio. She was complaining of horrible stomach cramps when the vomiting set in. She then went limp and starting welting. We called 911.
    Now we never leave home without our Epipens and our gluten free food supplies. We analyze every food label. We are hyper vigilant about cross contamination. We are constantly looking for welts and praying for no stomach pain. We are always prepared and on guard. It's just what we do now. Anything to protect our child, our love...like so many other parents out there have to do every moment of ever day!  
    Then, my second brush with a natural disaster happened, without any notice, leaving us once again scrambling to find a safe place to shelter. It was a warm and muggy summer morning, and my husband was away on a business trip leaving my young daughter and me to enjoy our summer day. Our Severe Weather Alert Radio was going off, again, as I continued getting our daughter ready for gymnastics.  Having gotten used to the (what seemed to be daily) “Severe Thunderstorm warning,” I didn’t pay much attention to it. I continued downstairs with my daughter and our dog, when I caught a glimpse out the window of an incredibly black looking cloud. By the time I got downstairs, I saw the cover to our grill literally shoot straight up into the air. Because we didn’t have a fenced in yard, I quickly ran outside and chased the cover, when subsequently, I saw my neighbor’s lawn furniture blow pass me. I quickly realized I made a big mistake going outside. As I ran back inside, I heard debris hitting the front of our home.  Our dog was the first one to the basement door! As we sat huddled in the dark corner of our basement, I was once again thinking where are we going to go if our house is destroyed. I was not prepared, and I should have been. I should have learned my lesson the first time. Once the storm passed, we quickly realized we were without power and most of our trees were destroyed. We were lucky that our house had minimal damage, but that wasn’t true for most of the area surrounding us.  We were without power for five days. We lost most of our food - our gluten free food.
    That is when I knew we had to be prepared. No more winging it. We couldn’t take a chance like that ever again. We were “lucky” one too many times. We were very fortunate that we did not lose our home to the Los Angeles wildfire, and only had minimal damage from the severe storm which hit our home in Illinois.
      
    In 2017 alone, FEMA (Federal Emergency Management Agency) had 137 natural disasters declared within the United States. According to FEMA, around 50% of the United States population isn’t prepared for a natural disaster. These disasters can happen anywhere, anytime and some without notice. It’s hard enough being a parent, let alone being a parent of a gluten free family member. Now, add a natural disaster on top of that. Are you prepared?
    You can find my Gluten Free Emergency Food Bags and other useful products at www.allergynavigator.com.  

    Jefferson Adams
    Celiac.com 04/23/2018 - A team of researchers recently set out to learn whether celiac disease patients commonly suffer cognitive impairment at the time they are diagnosed, and to compare their cognitive performance with non-celiac subjects with similar chronic symptoms and to a group of healthy control subjects.
    The research team included G Longarini, P Richly, MP Temprano, AF Costa, H Vázquez, ML Moreno, S Niveloni, P López, E Smecuol, R Mazure, A González, E Mauriño, and JC Bai. They are variously associated with the Small Bowel Section, Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital; Neurocience Cognitive and Traslational Institute (INECO), Favaloro Fundation, CONICET, Buenos Aires; the Brain Health Center (CESAL), Quilmes, Argentina; the Research Council, MSAL, CABA; and with the Research Institute, School of Medicine, Universidad del Salvador.
    The team enrolled fifty adults with symptoms and indications of celiac disease in a prospective cohort without regard to the final diagnosis.  At baseline, all individuals underwent cognitive functional and psychological evaluation. The team then compared celiac disease patients with subjects without celiac disease, and with healthy controls matched by sex, age, and education.
    Celiac disease patients had similar cognitive performance and anxiety, but no significant differences in depression scores compared with disease controls.
    A total of thirty-three subjects were diagnosed with celiac disease. Compared with the 26 healthy control subjects, the 17 celiac disease subjects, and the 17 disease control subjects, who mostly had irritable bowel syndrome, showed impaired cognitive performance (P=0.02 and P=0.04, respectively), functional impairment (P<0.01), and higher depression (P<0.01). 
    From their data, the team noted that any abnormal cognitive functions they saw in adults with newly diagnosed celiac disease did not seem not to be a result of the disease itself. 
    Their results indicate that cognitive dysfunction in celiac patients could be related to long-term symptoms from chronic disease, in general.
    Source:
    J Clin Gastroenterol. 2018 Mar 1. doi: 10.1097/MCG.0000000000001018.

    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.