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      Frequently Asked Questions About Celiac Disease   04/07/2018

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


    Jean Duane


    • Journal of Gluten Sensitivity Winter 2018 Issue


    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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    An example of food-allergy ridicule is found in a scene in The Smurfs 2 when the unctuous "Corndog King" presents every child at a birthday party with a corn-dog. A concerned parent asks if the corn-dogs contain peanuts, and he says, "No, I would never use peanuts." Meanwhile, a little boy is shown eating the corn-dog just as the Corndog King recalls that they are fried in peanut oil. The parents rush to the little boy urging him to spit it out. Here is the snippet:

    . 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.

    Image Caption: Image: CC--Jimmy G
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    Guest Kiya

    Posted

    Thank you for raising this issue. I thought perhaps I was being overly sensitive. A related issue is the proliferation of media articles claiming that most people who are on a gluten free diet do not need to be and do not even know what gluten is (based on unscientific survey someone claims to have done somewhere!), and giving dire warnings about the hazards of a gluten free diet. And that only people with doctor diagnosed celiac disease should ever avoid gluten. And that the problem is very rare. The media has the public convinced that we are just following a fad diet they know nothing about. I am getting sick of having acquaintances and relatives warn me about these things, as if they are concerned I am killing myself by not eating enough enriched flour. I used to politely give people a little education about the broader spectrum of gluten related disorders, including DH, and the difficulty of diagnosis. But lately have started to get a bit testy with them. As for waiters, I have even had them ask me if I was diagnosed by a physician and what happens if I eat gluten. I have resorted to just telling every waiter: "This is a medical issue not a lifestyle choice."

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    Guest Michelle Pease

    Posted

    Thank you for a wonderful article. Unfortunately it's not just the media. I have doctors "roll their eyes" when I say I can't digest gluten and experience rather severe reactions. It so happens that neither could my father and neither can my oldest son, it's not just me. I don't even discuss these issues with doctors any more, my son won't even go to a doctor about it. My insurance will cover a dietitian if I have diabetes but not for a food allergy/ sensitivity. If doctors won't acknowledge food sensitivities and allergy why would the media?

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    Guest Trish

    Posted

    Great article! That is shameful how some shows are portraying people with food allergies. I wish I did not have them, but I do, and to feel my best I have to avoid certain foods. Food allergies and/or sensitivities are serious business! So many people are unaware that their health issues are tied to the food they eat.

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    Guest CJ Russell

    Posted

    I had a similar experience with a waitress a few months ago. I made it clear when ordering that I needed my food gluten free. When my food was delivered the steak had a breaded and fried onion ring on top of it! When I told her that I couldn't eat the steak because of possible contamination she told me that I should have made it clear that it was a health issue so she could have been more vigilant. I have to take a doctor's order to a restaurant in order to not be served something hazardous to my health?

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    Guest Barbara

    Posted

    Thank you for this great article. It seems a lot of comedians find it necessary to poke fun at gluten free sufferers. They should walk in the shoes of someone that has this disease. Or care for a child that cries because they can't have a cupcake at a party. Or go to dinner with their wife and opt out of the movie after because they will not know whether the meal was truly safe. It is not an easy life to live. It is not a peanut allergy where your life could hang in the balance, but their are many consequences to bear. I'm sure most people who suffer from autoimmune diseases, or allergies hear most of the comments you state above. If I were to hear them 15 years ago when I was first diagnosed I would have been devastated. Over the years I have come accustomed to people's behavior and attitudes. I didn't chose this disease, it chose me.

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    Guest Joe E.

    Posted

    Here's the problem--for all of us with actual medical issues, there are likely 2 or 3 times as many following gluten-free as a fad diet. I see so many people supporting going gluten-free for non-medical, woo-based reasons, that I'm not surprised we aren't always taken seriously. Those articles telling people to not eat gluten-free if it's not a medical necessity? I'm all for them if they bring us to the a point where our needs are taken seriously. It isn't a nutritionally balanced diet--especially when chosen by someone with no thought given beyond the woo of "we aren't evolved to digest gluten." They're the ones most likely to be harmed by it, because they're likely cutting out a lot of other perfectly healthful foods. I have no problem with a server asking if my diet is a choice or a medical necessity if it gets me food that I know I can eat.

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    Guest Scott Adams

    Posted

    Here's the problem--for all of us with actual medical issues, there are likely 2 or 3 times as many following gluten-free as a fad diet. I see so many people supporting going gluten-free for non-medical, woo-based reasons, that I'm not surprised we aren't always taken seriously. Those articles telling people to not eat gluten-free if it's not a medical necessity? I'm all for them if they bring us to the a point where our needs are taken seriously. It isn't a nutritionally balanced diet--especially when chosen by someone with no thought given beyond the woo of "we aren't evolved to digest gluten." They're the ones most likely to be harmed by it, because they're likely cutting out a lot of other perfectly healthful foods. I have no problem with a server asking if my diet is a choice or a medical necessity if it gets me food that I know I can eat.

    What about people who eat a low-sugar diet but don't have diabetes? There is some evidence that gluten is harmful to everyone, not just celiacs. What evidence is there that it isn't taken seriously due to more people eating gluten-free? For me, more people seem to know about it than every before.

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    Guest D Glynn

    Posted

    I have experienced scrutiny as well at restaurants. I expect it to some extent - not everyone is educated in this area. I try to be as nice as I can and explain that it is Celiac and gluten will hurt me. If I do not feel comfortable then I will never eat there again. Money drives most things in this society so I would hope that restaurants that bother to have a gluten free menu see the value in the gluten free customer. When I go out it is with family and friends. It's not just one customer that you lose, it is many - over and over. And to the person who said that their DOCTOR rolls their eyes - please, please find yourself a new COMPETENT doctor. They are supposed to be educated, trained professionals. If this person doesn't recognized this as the legitimate disease it is, I don't see how you can trust or respect them.

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    Guest WendyKat

    Posted

    What about people who eat a low-sugar diet but don't have diabetes? There is some evidence that gluten is harmful to everyone, not just celiacs. What evidence is there that it isn't taken seriously due to more people eating gluten-free? For me, more people seem to know about it than every before.

    I agree. I've been diagnosed Celiac since 2003 and back then people had NO idea what you were talking about. I had waitresses, chefs and restaurant managers look me straight in the eye and say, "I've never heard of such a thing," as if medical degrees come with a food service job. Nowadays, even if there´s some eye rolling, people KNOW WHAT YOU MEAN and don't give you that blank stare. I much prefer that. Obviously, knowledge and NO eye rolling would be the best case scenario, but we can work towards that. In the meantime, I just make it clear that it's a medical issue right up front, and that seems to help.

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    Guest Michael Mann

    Posted

    Thank you for raising this issue. I thought perhaps I was being overly sensitive. A related issue is the proliferation of media articles claiming that most people who are on a gluten free diet do not need to be and do not even know what gluten is (based on unscientific survey someone claims to have done somewhere!), and giving dire warnings about the hazards of a gluten free diet. And that only people with doctor diagnosed celiac disease should ever avoid gluten. And that the problem is very rare. The media has the public convinced that we are just following a fad diet they know nothing about. I am getting sick of having acquaintances and relatives warn me about these things, as if they are concerned I am killing myself by not eating enough enriched flour. I used to politely give people a little education about the broader spectrum of gluten related disorders, including DH, and the difficulty of diagnosis. But lately have started to get a bit testy with them. As for waiters, I have even had them ask me if I was diagnosed by a physician and what happens if I eat gluten. I have resorted to just telling every waiter: "This is a medical issue not a lifestyle choice."

    "This is a medical issue not a lifestyle choice."EXACTLY! If I am asking a food server about gluten-free, I tell them that up front. And that those of us who are allergic, are glad there may be a number of neurotic people who have made gluten-free into a mass market. But for us, it IS a medical issue. If they ask what happens if I eat gluten, I just put on a poker face and say "I'll probably catch fire and burst into flames." They´re never willing to take a chance on that.

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    Guest Linda

    Posted

    I saw a cartoon, Jumpstart, written by Robb Armstrong poking fun at gluten free so I wrote an e-mail. When I replied that I was glad he realized he should not have done that he wrote back an angry reply. If you listen carefully, many times gluten free thrown out in conversation on comedy sitcom´s. Being gluten free is not an easy lifestyle and because you don´t fall over with an immediate bad response, people think well a little won´t hurt. I´ve had to explain many times that it is an autoimmune response and yes a little will hurt.

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    Guest coloradosue

    Posted

    I quit going out for the exact reasons stated above. Pretty much become a hermit because no matter how sincere I am about having celiac disease, show the information on cell phones, give them documents explaining what celiac disease is, it is never enough! Short of having an actual reaction 20 minutes after ingesting a supposed gluten free food in front of everyone, I have given up trying. I did all this at a Super Bowl party 2 years ago (Super Bowl 50) in front of family and friends. I am still embarrassed to this day. The new gluten free testing device, called Nima, is the only way I would even think about going out again. Going to try to get my HMO to pay for it (or a part of it ). We'll see. Good Luck everyone!And Stay Safe!

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    Guest Guest larazotide acetate

    Posted

    Just wait about 3 years.  The drug larazotide acetate is expected to go into Clinical trial level 3 this year (2nd quarter of 2018).  The drug is expected to stay in level 3 for 3 years.  It's expected to go into Clinical trial level 4 after that.  Level 4 is when the drug is given to doctors to give to the applicable general public.

    The drug is supposed to help people with celiac disease.  Larazotide acetate counteracts the effects of the hormone zonulin.

    When the drug enters level 4 expect to be inundated with ads everywhere telling people to get tested for celiac disease.  I'm thinking that the drug will be able to be used for people with non-celiac gluten sensitivity (NCGS), too.  I suspect that the medical industry will come out with a blood test for NCGS in 3 years, too.

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    In the face of overwhelmingly negative public feedback, Party City buckled. The company has withdrawn the commercial, and issued the following apology:

    "Party City values its customers above all else, and we take your feedback extremely seriously. We recognize that we made an error in judgment by running the recent Big Game commercial, which was insensitive to people with food allergies. We have removed the commercial from our website and all other channels, and sincerely apologize for any offense this may have caused. We'd also like to clarify that Sunny Anderson was not involved in the creation of this commercial in any way, and we apologize for any offense it has caused with her audience and fans. We will also be reviewing our internal vetting process on all advertising content to avoid any future issues. In addition, Party City will be making a donation in support of Celiac Disease research."
    In addition to the statement of apology, Party City has promised to make a donation to the Celiac Foundation.
    Read more at: BusinessInsider.com

    Jefferson Adams
    Celiac.com 02/20/2018 - Party City has pulled a controversial advertising spot that provoked outrage in gluten-free community by tagging gluten-free dieters as 'gross.'
    Moreover, both Party City, and the advertising firm behind the pre-Super bowl ad, Hill Holliday, have issued public apologies in an effort to mitigate the outrage caused by its obviously insensitive ad.
    The ad starred two women attending a Super Bowl party and standing in front of an "inflatable snack stadium."
    When one of the women points out the gluten-free options, the other asks "Do we even know people that are like that?"
    The first woman answers: "Tina."
    To which, the second woman says: "Oh, gross, yeah."
    Perhaps unsurprisingly, furious viewers wasted no time in launching the Twitter hashtag #IAmTina, which called out both Party City and Hill Holliday for insensitivity toward people with celiac disease or gluten-sensitivity.
    Party City apologized via Instagram, and also clarified that celebrity Sunny Anderson played no part in the campaign.
    The company statement reads, in part: "Party City values its customers above all else, and we take your feedback extremely seriously. We recognize that we made an error in judgment by running the recent Big Game commercial, which was insensitive to people with food allergies…We will also be reviewing our internal vetting process on all advertising content to avoid any future issues. In addition, Party City will be making a donation in support of Celiac Disease research."
    Read more at: Adweek.com

    Jefferson Adams
    Celiac.com 02/13/2018 - It is perhaps unsurprising that processed gluten-free foods are less nutritious than their gluten-containing counterparts.
    We've had data showing gluten-free foods to be high in sugar. We've had studies that show us they contain more salt. And now, for the trifecta, we have a recent study that shows us they contain more fat, sugar and salt.
    A study by the University of Hertfordshire surveyed more than 1,700 products from five UK supermarket chains and found that gluten-free foods have more fat, salt and sugar than their gluten-including counterparts, despite consumer perception that they "healthier" options. Except for crackers, every gluten-free food in the survey had more saturated fat, sugar and salt than non-gluten-free counterparts.
    On average for gluten-free brown bread and white bread had more than double the fat of regular breads. Gluten-free products also had significantly lower protein content than their gluten-containing equivalents, and were generally lower in ï¬ber and protein.
    Gluten-free products were also more likely to break the budget. On average, gluten-free products were also more than 1½ times more expensive than their counterparts, while gluten-free brown and white bread and gluten-free white and wholegrain flour sold at more than four times the price of comparable regular breads, on average.
    Overall, gluten-free foods are likely to be less nutritious and more expensive than their non-gluten-free counterparts.
    Basically, people on a gluten-free diet need to be extra careful about getting nutritious food. Simply substituting gluten-free versions of a a standard non-gluten-free diet likely means more fat, sugar and salt in your diet, along with less fiber. If you don't have a medically diagnosed reason for avoiding gluten, then be mindful about four food choices.

  • Recent Articles

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

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

    Jefferson Adams
    Celiac.com 04/19/2018 - Previous genome and linkage studies indicate the existence of a new disease triggering mechanism that involves amino acid metabolism and nutrient sensing signaling pathways. In an effort to determine if amino acids might play a role in the development of celiac disease, a team of researchers recently set out to investigate if plasma amino acid levels differed among children with celiac disease compared with a control group.
     
    The research team included Åsa Torinsson Naluai, Ladan Saadat Vafa, Audur H. Gudjonsdottir, Henrik Arnell, Lars Browaldh, and Daniel Agardh. They are variously affiliated with the Institute of Biomedicine, Department of Microbiology & Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Division of Pediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden; the Department of Clinical Science and Education, Karolinska Institute, Sodersjukhuset, Stockholm, Sweden; the Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; the Diabetes & Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; and with the Nathan S Kline Institute in the U.S.A.
    First, the team used liquid chromatography-tandem mass spectrometry (LC/MS) to analyze amino acid levels in fasting plasma samples from 141 children with celiac disease and 129 non-celiac disease controls. They then crafted a general linear model using age and experimental effects as covariates to compare amino acid levels between children with celiac disease and non-celiac control subjects.
    Compared with the control group, seven out of twenty-three children with celiac disease showed elevated levels of the the following amino acids: tryptophan; taurine; glutamic acid; proline; ornithine; alanine; and methionine.
    The significance of the individual amino acids do not survive multiple correction, however, multivariate analyses of the amino acid profile showed significantly altered amino acid levels in children with celiac disease overall and after correction for age, sex and experimental effects.
    This study shows that amino acids can influence inflammation and may play a role in the development of celiac disease.
    Source:
    PLoS One. 2018; 13(3): e0193764. doi: & 10.1371/journal.pone.0193764

    Jefferson Adams
    Celiac.com 04/18/2018 - To the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service animals.
    If you’ve flown anywhere lately, you may have seen them. People flying with their designated “emotional support” animals. We’re not talking genuine service animals, like seeing eye dogs, or hearing ear dogs, or even the Belgian Malinois that alerts its owner when there is gluten in food that may trigger her celiac disease.
    Now, to be honest, some of those animals in question do perform a genuine service for those who need emotional support dogs, like veterans with PTSD.
    However, many of these animals are not service animals at all. Many of these animals perform no actual service to their owners, and are nothing more than thinly disguised pets. Many lack proper training, and some have caused serious problems for the airlines and for other passengers.
    Now the major airlines are taking note and introducing stringent requirements for service animals.
    Delta was the first to strike. As reported by the New York Times on January 19: “Effective March 1, Delta, the second largest US airline by passenger traffic, said it will require passengers seeking to fly with pets to present additional documents outlining the passenger’s need for the animal and proof of its training and vaccinations, 48 hours prior to the flight.… This comes in response to what the carrier said was a 150 percent increase in service and support animals — pets, often dogs, that accompany people with disabilities — carried onboard since 2015.… Delta said that it flies some 700 service animals a day. Among them, customers have attempted to fly with comfort turkeys, gliding possums, snakes, spiders, and other unusual pets.”
    Fresh from an unsavory incident with an “emotional support” peacock incident, United Airlines has followed Delta’s lead and set stricter rules for emotional support animals. United’s rules also took effect March 1, 2018.
    So, to the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service and emotional support animals.
    Source:
    cnbc.com

    admin
    WHAT IS CELIAC DISEASE?
    Celiac disease is an autoimmune condition that affects around 1% of the population. People with celiac disease suffer an autoimmune reaction when they consume wheat, rye or barley. The immune reaction is triggered by certain proteins in the wheat, rye, or barley, and, left untreated, causes damage to the small, finger-like structures, called villi, that line the gut. The damage occurs as shortening and villous flattening in the lamina propria and crypt regions of the intestines. The damage to these villi then leads to numerous other issues that commonly plague people with untreated celiac disease, including poor nutritional uptake, fatigue, and myriad other problems.
    Celiac disease mostly affects people of Northern European descent, but recent studies show that it also affects large numbers of people in Italy, China, Iran, India, and numerous other places thought to have few or no cases.
    Celiac disease is most often uncovered because people experience symptoms that lead them to get tests for antibodies to gluten. If these tests are positive, then the people usually get biopsy confirmation of their celiac disease. Once they adopt a gluten-free diet, they usually see gut healing, and major improvements in their symptoms. 
    CLASSIC CELIAC DISEASE SYMPTOMS
    Symptoms of celiac disease can range from the classic features, such as diarrhea, upset stomach, bloating, gas, weight loss, and malnutrition, among others.
    LESS OBVIOUS SYMPTOMS
    Celiac disease can often less obvious symptoms, such fatigue, vitamin and nutrient deficiencies, anemia, to name a few. Often, these symptoms are regarded as less obvious because they are not gastrointestinal in nature. You got that right, it is not uncommon for people with celiac disease to have few or no gastrointestinal symptoms. That makes spotting and connecting these seemingly unrelated and unclear celiac symptoms so important.
    NO SYMPTOMS
    Currently, most people diagnosed with celiac disease do not show symptoms, but are diagnosed on the basis of referral for elevated risk factors. 

    CELIAC DISEASE VS. GLUTEN INTOLERANCE
    Gluten intolerance is a generic term for people who have some sort of sensitivity to gluten. These people may or may not have celiac disease. Researchers generally agree that there is a condition called non-celiac gluten sensitivity. That term has largely replaced the term gluten-intolerance. What’s the difference between celiac disease and non-celiac gluten-sensitivity? 
    CELIAC DISEASE VS. NON-CELIAC GLUTEN SENSITIVITY (NCGS)
    Gluten triggers symptoms and immune reactions in people with celiac disease. Gluten can also trigger symptoms in some people with NCGS, but the similarities largely end there.

    There are four main differences between celiac disease and non-celiac gluten sensitivity:
    No Hereditary Link in NCGS
    Researchers know for certain that genetic heredity plays a major role in celiac disease. If a first-degree relative has celiac disease, then you have a statistically higher risk of carrying genetic markers DQ2 and/or DQ8, and of developing celiac disease yourself. NCGS is not known to be hereditary. Some research has shown certain genetic associations, such as some NCGS patients, but there is no proof that NCGS is hereditary. No Connection with Celiac-related Disorders
    Unlike celiac disease, NCGS is so far not associated with malabsorption, nutritional deficiencies, or a higher risk of autoimmune disorders or intestinal malignancies. No Immunological or Serological Markers
    People with celiac disease nearly always test positive for antibodies to gluten proteins. Researchers have, as yet, identified no such antobodies or serologic markers for NCGS. That means that, unlike with celiac disease, there are no telltale screening tests that can point to NCGS. Absence of Celiac Disease or Wheat Allergy
    Doctors diagnose NCGS only by excluding both celiac disease, an IgE-mediated allergy to wheat, and by the noting ongoing adverse symptoms associated with gluten consumption. WHAT ABOUT IRRITABLE BOWEL SYNDROME (IBS) AND IRRITABLE BOWEL DISEASE (IBD)?
    IBS and IBD are usually diagnosed in part by ruling out celiac disease. Many patients with irritable bowel syndrome are sensitive to gluten. Many experience celiac disease-like symptoms in reaction to wheat. However, patients with IBS generally show no gut damage, and do not test positive for antibodies to gliadin and other proteins as do people with celiac disease. Some IBS patients also suffer from NCGS.

    To add more confusion, many cases of IBS are, in fact, celiac disease in disguise.

    That said, people with IBS generally react to more than just wheat. People with NCGS generally react to wheat and not to other things, but that’s not always the case. Doctors generally try to rule out celiac disease before making a diagnosis of IBS or NCGS. 
    Crohn’s Disease and celiac disease share many common symptoms, though causes are different.  In Crohn’s disease, the immune system can cause disruption anywhere along the gastrointestinal tract, and a diagnosis of Crohn’s disease typically requires more diagnostic testing than does a celiac diagnosis.  
    Crohn’s treatment consists of changes to diet and possible surgery.  Up to 10% of Crohn's patients can have both of conditions, which suggests a genetic connection, and researchers continue to examine that connection.
    Is There a Connection Between Celiac Disease, Non-Celiac Gluten Sensitivity and Irritable Bowel Syndrome? Large Number of Irritable Bowel Syndrome Patients Sensitive To Gluten Some IBD Patients also Suffer from Non-Celiac Gluten Sensitivity Many Cases of IBS and Fibromyalgia Actually Celiac Disease in Disguise CELIAC DISEASE DIAGNOSIS
    Diagnosis of celiac disease can be difficult. 

    Perhaps because celiac disease presents clinically in such a variety of ways, proper diagnosis often takes years. A positive serological test for antibodies against tissue transglutaminase is considered a very strong diagnostic indicator, and a duodenal biopsy revealing villous atrophy is still considered by many to be the diagnostic gold standard. 
    But this idea is being questioned; some think the biopsy is unnecessary in the face of clear serological tests and obvious symptoms. Also, researchers are developing accurate and reliable ways to test for celiac disease even when patients are already avoiding wheat. In the past, patients needed to be consuming wheat to get an accurate test result. 
    Celiac disease can have numerous vague, or confusing symptoms that can make diagnosis difficult.  Celiac disease is commonly misdiagnosed by doctors. Read a Personal Story About Celiac Disease Diagnosis from the Founder of Celiac.com Currently, testing and biopsy still form the cornerstone of celiac diagnosis.
    TESTING
    There are several serologic (blood) tests available that screen for celiac disease antibodies, but the most commonly used is called a tTG-IgA test. If blood test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.
    Testing is fairly simple and involves screening the patients blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis. Also, it is now possible to test people for celiac disease without making them concume wheat products.

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

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

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

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

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