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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 KIDS ARE BACK IN SCHOOL - TIPS FOR MAKING THE (GLUTEN-FREE) GRADE BY DANNA KORN


    Danna Korn


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    If you have a lot of tension and you get a headache, do what it says on the aspirin bottle: Take two aspirin and Keep away from children.

    The transition from summer to back-to-school is paradoxical. On one hand, summer means sleeping in, adventuresome vacations, evenings free of homework and obligatory assignments, and a chance for parents to take pleasure in their kids carefree, relaxed summer schedule (or lack thereof). On the other hand, mantras like, Im bored, Are we there yet? Theres nothing to do here, and the non-stop sibling bickering that seems to escalate when one child dares to breathe the same air as another has some parents singing, Its the most wonderful time of the year a good four months before Christmas.


    But its not always the most wonderful time of the year. For parents whose children cant eat gluten, sending kids to school can create an entirely new dimension of anxiety that extend far beyond the typical back-to-school blues: What will he eat for lunch? What if there are birthday parties and my child cant participate? Will kids make fun of him? Will the teacher take time to understand his condition? What if he eats the Play Doh? How can I make this easier for him?

    This is harder on you than it is on your child

    If your child is newly diagnosed with celiac disease, or is new to the gluten-free diet, I know youre thinking, Oh, no its not! She just doesnt understand how hard this is. When I speak at conferences and tell parents this is harder on them than it is on their kids, I inevitably have one or two - always the parents of newly diagnosed celiac kids - who respectfully (and usually temperamentally) disagree. They tell me I dont understand.

    Believe me, I do understand. But also believe me that this is harder on you than it is your child. Its harder, because of the very nature of being a parent. We love our kids so intensely that every pain they experience hurts us ten times more. Nothing breaks our hearts more than to know that our children may experience heartache. But remember, one of our most important jobs as parents is to teach our children how to deal with unpleasant experiences and emotions. As Anne Bronte said, If you would have your son to walk honorably through the world, you must not attempt to clear the stones from his path, but teach him to walk firmly over them.

    Tips to make it easier

    • Give your child control of his diet.
      Yep, even if hes just two years old. Anyone who has heard me speak or has read either of my books knows that Im an absolute nag about telling you to give your child control of his diet, because if he doesnt control his diet, his diet will control him.
    • Educate your teachers and principal.
      Set a meeting with your childs teacher(s) and principal to explain your childs condition and diet. The best time to do this is a day or two before school starts for the year. The teachers are usually at school setting up their classrooms, but theyre not yet distracted with new students, parents, and classroom responsibilities. Provide the teachers, principal, and the school nurse, if you have one, with clear, concise written materials explaining celiac disease and your childs diet. Some people find it helpful to give the book Kids with Celiac Disease to the school, so that the nurse, teachers, and principal can more thoroughly understand the condition and diet. Make sure they understand the severity of accidental gluten ingestion. Remind them that they should contact you if there are any questions, rather than taking a chance.
    • Lunches: use good judgment.
      Most of the time, the people in charge of preparing food for children in a preschool or school setting are already used to dealing with lactose intolerance, peanut allergies, and other dietary restrictions. Talk to the dietitian or person in charge of food preparation. Go over the menu plans, discuss the foods your child can and cant have, and talk about the importance of using clean utensils to avoid cross-contamination. If you feel comfortable with the persons understanding and acceptance of the diet, give them the opportunity to accommodate your childs special diet. You always have the option of sending in your own meals if you think its not working out. If you are interested in your childs legal rights to reduced-cost school lunches, see Kids with Celiac Disease under Section 504.
    • Talk to the adult lunchtime supervisors.
      Kids will swap food. Its an age-old tradition, and its not likely to stop with your child. Aside from the likelihood of getting gluten, your child may end up hungry. Sometimes your childs goodies are better than the other childs, and it makes your child so proud that shell gladly give them all away, to be left with nothing. So the best you can do is explain to your child why she cant trade food with her buddies, and make sure the lunch area monitors are keeping an eye out for swappers.
    • Out of snack and lunch ideas? See Kids with Celiac Disease.
      Its loaded with snack and menu ideas, many of which travel well in lunch boxes and bags.
    • Give the teacher a stash of gluten-free treats.
      A large bag of Halloween-sized individually wrapped candies works well, and because theyre individually wrapped, the teacher can keep them in a cupboard without the threat of ant invasions. Let the teacher know that these treats are to be used any time there is a special event during which treats will be served. Make sure the treats are your childs favorite; you dont want him feeling like hes being short-changed.
    • Get a schedule of classmates birthdays and scheduled holiday parties.
      Teachers are glad to provide you with a listing of everyones birthdays. This way you know in advance when there will be parties. You can coordinate with the other childs parent, or send your child in with her own cupcake or treat. If theres a surprise event, your child always has the stash of candy youve given the teacher.
    • On your childs birthday, bring a popular gluten-free treat for the entire class.
      Its best not to risk celebrating your childs birthday with gluten-free cupcakes. Its possible that everyone in your childs class might like your homemade gluten-free cupcakes. On the other hand, there may be one kid who, for whatever reason, takes one bite and spits it across the classroom, declaring, What IS this stuff? You can bet your child wont forget that incident for a very long time. Its best not to risk it. Instead, bring in ice cream bars or ice cream sundaes. Or, if you cant do frozen foods, bring cutely decorated candy bars or goodie bags filled with candy (brands that everyone knows). It will bring your child immense pleasure to share treats with the class that she can eat too (and kids like that stuff better than cupcakes anyway!). Of course, you will want to be sensitive to any of your childs classmates who might have peanut or other allergies, and choose treats that everyone in the class can enjoy.
    • Ask for liberal restroom privileges.
      Many teachers restrict the number of times children are allowed to go to the restroom, or they ask children to wait until a more appropriate, less disruptive time. Let the teacher know that your childs condition may require a hasty trip to the restroom, and that he should under no circumstances be restricted from going. You may even want to establish a little code between your child and her teacher, so that he can inconspicuously dismiss himself. Its a little less embarrassing than having to ask.
    • Consider talking to the parents at the parents-only back-to-school night.
      Most schools have a back-to-school night for parents only. This is a great time to talk to the other parents about your childs condition and diet. Not only will you be helping them to understand and accommodate your childs diet, but you will be educating dozens more people about celiac disease - something we should all be doing on a regular basis.

    Dont be mad when people dont accommodate your childs diet.

    Its going to happen. Someone will have surprise treats for the class that your child cant eat, and the teachers secret stash will be empty. Or someone will decide its baking day, and your child will be the only one not sampling the goods. Dont be annoyed, offended, or angry. These people arent intentionally trying to leave your child out, nor are they being insensitive. They simply forget sometimes!

    Most importantly, remember that your child is learning from your reactions. He will be in situations like this for the rest of his life - teach him to be gracious, politely declining the treats offered to him, and to accept the fact that this is just one of those little stones in his path of life that hell need to learn to step over...with a smile and the knowledge that people generally mean well.

     


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    Guest Sherrill

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    Very helpful---my 8 year old doctor's teacher called me today and requested information on celiac disease---very impressed--off to a great start!!

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    Thanks so much for the useful tips. My 21 month old child has just been diagnosed and this website gives me hope!

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  • Related Articles

    Danna Korn
    This article originally appeared in the Winter 2006 edition of Celiac.com's Journal of Gluten-Sensitivity.
    Celiac.com 04/30/2010 - The gluten-free lifestyle is a big part of who we are.  So when friends, relatives, and loved ones don’t get it—I should clarify—when they seem to choose not to get it—we sometimes get a little cranky.
    I know—I was reminded of how it feels when loved ones don’t choose to get it this past Thanksgiving when one of my relatives who shall remain nameless glutenized the mayo jar.  Now I realize it may seem petty to get tweaked about someone dipping a knife in a mayo jar—but it had gluten all over it, and worse yet, she did the same thing last Thanksgiving, and I threw a tizzy about it then.
    Realizing the first dip alone contaminated the entire jar (of course it was the club-sized jar that is the size of a small Volkswagen), there was no point in stopping her from doing it again.  But I watched incredulously as she taunted me, dipping the knife into the jar—then onto the (gluten) bread—over, and over, and over again.  How many gobs of mayo does one need on a piece of bread?!?  I found myself seething, and my blood boiled with every dip-and-spread motion; I swear she was doing it intentionally.
    Yes, I know I should have had a squeeze bottle handy, and I even write about that in my books. My mistake, but I also write about doing the “gob drop,” which is—as the name implies—the process of taking a gob of (insert condiment here) and dropping it onto said piece of gluten.  Using a separate knife, you spread.  It’s really not that tough.
    The bigger point here is that it made me wonder why, after fourteen years of going through this, she didn’t care more about our gluten-free lifestyle.  I spent about six minutes pondering this when I remembered that it’s not that she doesn’t care—maybe she does, and maybe she doesn’t.   The bigger point is that she wasn’t thinking about it at that moment—and that’s okay. 
    This is our lifestyle, and we love it.  Those friends and family who do care enough to call and make sure the meal they’re serving us is gluten-free are to be cherished.  Those who make a special trip to the health food store to buy a mix and make gluten-free cookies are to be downright hailed as saints.  Even those who make a beautiful gluten-free meal and then top it with teriyaki sauce (of the gluten-containing variety) because they don’t know any better are to be adored for trying.
    I write about this stuff in my books, and it surprised me a little to find myself getting miffed about such a petty thing.  I thought I had outgrown those feelings 14 years ago.  I guess my point is that we all face certain challenges from time to time, and we need to put our brightest face forward and meet those challenges with a good attitude, lest they get the best of us.
    The most important thing that helps keep me on track, for what it’s worth, is to remember that the gluten-free lifestyle is the key to our health and ultimate happiness.  We’re blessed to know that a simple change in lifestyle is all it takes to be perfectly healthy—and that’s worth a lotta mayo.


    Danna Korn
    This article originally appeared in the Summer 2003 edition of Celiac.com's Journal of Gluten-Sensitivity.
    Celiac.com 07/05/2010 - When “our product isn’t gluten-free” doesn’t necessarily mean “our product isn’t gluten-free”
    You’ve found a food you’d really like to eat. You’ve read the label, and it looks as though the product might be gluten-free.  You’re drooling!  You can dig in, right? Wrong. It’s a good idea to call the manufacturer to confirm that there aren’t hidden sources of gluten.
    Years ago, when we would call manufacturers and ask them if their products were gluten-free, they would either suspect us of making a crank call and hang up, leave us on “hell-hold” for 35 minutes while they “checked” (a euphemism for when they put you on hold and hope you hang up), or respond with a confident, “Oh no, honey, there’s no sugar whatsoever!”
    Before you bother calling the manufacturer, read the label.  If there is an obviously unsafe ingredient, don’t waste your time or theirs.  Tune in to the person on the other end of the phone.  Do they sound like they understand what you’re talking about? Are they giving you conflicting information?  Can you trust what they say?
    Fortunately, most product labels have a toll-free phone number listed on the packaging.  I highly recommend carrying your cell phone in the grocery store with you, so that you can call quickly while you’re still there—before you buy a product.  These days, most customer service representatives actually know what we’re talking about most of the time, and can offer a knowledgeable answer that instills confidence that the answer is accurate, albeit sometimes not all that helpful.  When you call a company to find out if its product is wheat or gluten-free, you’ll get one of four responses:
    No, our product is not gluten-free: Do not interpret this as meaning, “No, our product is not gluten-free.”  I realize that’s what they said, but it may not be what they mean.  Probe deeper by asking, for example, “Can you tell me what in your product has gluten in it?  I read the label and didn’t see anything questionable.” One time when I asked this, the woman told me it was “whey” that contained gluten.  Penalty flag!  Whey doesn’t contain gluten!  This is when you need to realize that you’re talking to someone who doesn’t understand the concept, and you should ask to be transferred to a quality control supervisor.
    Sometimes this response is accurate, and either an ingredient wasn’t clearly called out on the label (unfortunately, this still occurs from time to time), or you were calling about a questionable ingredient only to find out it’s a good thing you called.
    We can’t verify its status:  Translation: “It’s wheat-free/gluten-free, but we’re covering our rear ends because we don’t want someone to sue us.”  Sadly, in our litigious society, it may actually be a founded fear that they have.
    Of course, this response—”we can’t verify its status”—could actually mean what it says—that they can’t verify the status.  Usually they’ll tell you this is because they get their additives from other sources, and even though they claim to be gluten-free, Company A doesn’t want to be responsible in case Company B used gluten.  The risk factor in either case is probably low.
    Every now and then, this response is given because they have an “If we tell you what’s in our product, we’d have to shoot you” mentality.  Assure them that you’re not trying to steal their oh-so-treasured secret-sauce recipe, but that you have a serious medical condition that requires you to know if there are certain ingredients in the food you eat.  Sometimes you just can’t get an answer, in which case you fall back to the golden rule: When in doubt, leave it out!
    Yes, it is gluten-free:  This doesn’t necessarily mean, “Yes, it is gluten-free.”  You have to judge for yourself whether or not they truly understand the concept.  Sometimes they’ll follow it up with, “There are no sources of wheat, rye, or barley, and there are no questionable additives. Therefore it’s safe for someone with celiac disease, gluten intolerance, or wheat allergies.”  Ah, you just want to kiss these people.  Other times, when pressed, they get squirmy. If you say, for instance, “Oh, okay, then I can assume the modified food starch is derived from a non-gluten source?” and they give you an audible “blank stare,” you might want to dig a little deeper before trusting their answer.
    Huh? Thankfully, this isn’t a common response anymore, but it does happen. Politely try to explain what types of ingredients might be in the product you’re calling about, and if it doesn’t “click,” ask to speak to a quality control supervisor or nutritional expert.
    Of course it’s helpful and sometimes necessary to be specific in some cases, saying, “I’m calling to see if this product is gluten-free, which means it doesn’t contain wheat, rye, or barley.”  Not only is this clarification helpful for them, but you may have educated one more person about gluten.
    Many times, one of the added benefits of calling, even if the product you were calling about turns out not to be okay, is they’ll offer to send you a list of their wheat-free/gluten-free products (sometimes they even toss in a few coupons).  Always take them up on it, and save the lists for future reference.
    It’s important to learn from your answers.  If there was an ingredient on the label that you had never heard of, and you talked with a knowledgeable customer service representative who told you that product was gluten-free, take note.  That means the ingredient is gluten-free, too.  Add it to your own copy of the safe and forbidden list, and remember for future label-reading experiences.
    Excuse me for a moment while I put on my Miss Manners hat, but it’s important to be polite, professional, and appreciative when you call manufacturers.  Not only will you get much better service, but we need them!  We need them to comprehend the gravity of our questions and to understand how important it is to be 100 percent sure that the answers they give us are accurate.  We need them to realize that they can’t guess at their answers, and that we very much appreciate that they understand what we’re asking.
    Calling manufacturers can be a pain, for sure, but it’s an important part of living and loving the gluten-free lifestyle.  Not only is it a good habit for you since ingredients change frequently, but it sends companies the message that if their labeling was clarified, we wouldn’t bother them so often!  It also tells them that millions of people avoid wheat or gluten, and maybe they’ll think twice before using an ingredient that has a wheat source when they have the option to use one that is wheat and gluten-free.
    This article was partially excerpted from Danna’s book Wheat-Free, Worry-Free: The Art of Happy, Healthy, Gluten-Free Living.


    Danna Korn
    This article originally appeared in the Spring 2003 edition of Celiac.com's Journal of Gluten-Sensitivity.
    -Yes, there’s more to life than rice and corn!
    Variety, it’s been said, is the spice of life.  So what’s a person to do when they’re told to eliminate wheat and/or gluten from their diet?  Most turn to rice, corn, and potatoes—an adequate set of starches, but ones that are sorely lacking in nutrients, flavor, and imagination.
    The superheroes of gluten-free grains are often referred to as “ancient” or alternative grains, which are loaded with nutrients and unique, interesting flavors.  The following is a condensed excerpt from my newly published book, Wheat-Free, Worry-Free: The Art of Happy, Healthy, Gluten-Free Living.
    “Alternative” Grains: The Superheroes of Gluten-Free Grains
    If you’re an adventuresome eater, you’re in for a treat.  In searching for alternatives to wheat, rye, or barley, you’ll discover a variety of wheat-free/gluten-free grains that you may never have heard of before, many of them loaded with nutrients and robust flavors not found in typical grains like wheat and rice.  If you’re not the adventurous type and you just long for the ease of a few tried-and-true favorites, you’ll find them here as well.
    Perhaps you fall into still another category—you’ve been eating a wheat or gluten-free diet for a while and you think you already know everything there is to know.  Okay, what’s quinoa, and how the heck is it pronounced?  Is teff wheat-free?  Do Job’s Tears have religious significance?  If you don’t know the answers to these questions, or if you think ragi is a spaghetti sauce and sorghum is what you get when you have your teeth cleaned, it’s time to move on to lesson one.
    Alternative Grains and Non-Grains
    Even if you can’t eat wheat, rye, barley, or oats, there are several other grains, fruits, and legumes that are not only acceptable alternatives to them, but they also happen to be loaded with flavor and nutrients.  Here are some of the many choices available to those on a wheat and gluten-free diet (WF/gluten-free):

    Amaranth (WF/gluten-free) Buckwheat/groats/kasha (WF/gluten-free) Cassava (arrowroot) (WF/gluten-free) Chickpea (garbanzo) (WF/gluten-free) Job’s Tears (WF/gluten-free) Millet (WF/gluten-free) Montina (WF/gluten-free) Oats (WF/gluten-free, but oats can be contaminated with wheat and other grains) Quinoa (WF/gluten-free) Ragi (WF/gluten-free) Rice (WF/gluten-free; only brown rice is whole grain) Sorghum (WF/gluten-free) Soy (WF/gluten-free) Tapioca (WF/gluten-free) Taro root (WF/gluten-free) Teff (WF/gluten-free)
    Many of the proteins found in these alternatives are a great source of complex carbohydrates.  The fuel from these carbohydrates, found in plant kingdom starches, produces what nutritionists call a protein-sparing effect, which means the body can meet its energy requirements without dipping into its protein reserves. Several of these alternative grains and non-grains are high in lysine, an amino acid that controls protein absorption in the body.  Because this amino acid is absent from most grains, the protein fraction of those grains is utilized only if eaten in conjunction with other foods that do contain lysine.  All high protein grains are better utilized by the body when they are eaten with high-lysine foods such as peas, beans, amaranth, or buckwheat.
    Amaranth (WF/gluten-free): Loaded with fiber and more protein than any traditional grain, amaranth is nutritious and delicious, with a pleasant peppery flavor.  The name means “not withering,” or more literally, “immortal.”  While it may not make you immortal, it is extremely healthful, especially with its high lysine and iron content.
    Buckwheat (groat; kasha) (WF/gluten-free): It sounds as though it would be closely related to wheat, but buckwheat is not related to wheat at all.  In fact, it’s not even a grain; it’s a fruit of the Fagopyrum genus, a distant cousin of garden-variety rhubarb, and its seed is the plant’s strong point.  The buckwheat seed has a three-cornered shell that contains a pale kernel known as a “groat.”  In one form or another, groats have been used as food by people since the 10th century b.c.
    Nutritionally, buckwheat is a powerhouse.  It contains a high proportion of all eight essential amino acids, which the body doesn’t make itself but are still essential for keeping the body functioning.  In that way, buckwheat is closer to being a complete protein than any other plant source.
    Whole white buckwheat is naturally dried and has a delicate flavor that makes it a good stand-in for rice or pasta.  Kasha is the name given to roasted hulled buckwheat kernels.  Kasha is toasted in an oven and tossed by hand until the kernels develop a deep tan color, nutlike flavor, and a slightly scorched smell.
    Be aware, however, that buckwheat is sometimes combined with wheat.  Read labels carefully before purchasing buckwheat products.
    Millet (WF/gluten-free): Millet is said by some to be more ancient than any grain that grows.  Where it was first cultivated is disputed, but native legends tell of a wild strain known as Job’s Tears that grows in the Philippines and sprouted “at the dawn of time.”
    Millet is still well respected in Africa, India, and China, where it is considered a staple.  Here in the United States, it is raised almost exclusively for hay, fodder, and birdseed.  One might consider that to be a waste, especially when considering its high vitamin and mineral content.  Rich in phosphorus, iron, calcium, riboflavin, and niacin, a cup of cooked millet has nearly as much protein as wheat.  It is also high in lysine—higher than rice, corn, or oats.
    Millet is officially a member of the Gramineae (grass) family and as such is related to montina.
    Montina (Indian Rice Grass) (WF/gluten-free): Indian rice grass was a dietary staple of Native American cultures in the Southwest and north through Montana and into Canada more than 7,000 years ago, even before maize (corn) was cultivated.  Similar to maize, montina was a good substitute during years when maize crops failed or game was in short supply.  It has a hearty flavor, and is loaded with fiber and protein.
    Quinoa (“KEEN-wah”) (WF/gluten-free): The National Academy of Science described quinoa as “the most nearly perfect source of protein from the vegetable kingdom.”  Although new to North Americans, it has been cultivated in the South American Andes since at least 3000 b.c.  Ancient Incas called this annual plant “the mother grain,” because it was self-perpetuating and ever-bearing.  They honored it as a sacred food product, since a steady diet appeared to ensure a full, long life; and the Inca ruler himself planted the first row of quinoa each season with a gold spade.
    Like amaranth, quinoa is packed with lysine and other amino acids that make a protein complete.  Quinoa is also high in phosphorus, calcium, iron, vitamin E, and assorted B vitamins.  Technically a fruit of the Chenopodium herb family, quinoa is usually pale yellow in color, but also comes in pink, orange, red, purple, and black.
    Quinoa’s only fault is a bitter coating of saponins its seeds.  The coating comes off with thorough rinsing prior to cooking, and some companies have developed ways to remove the coating prior to delivering quinoa to stores.
    Sorghum (milo) (WF/gluten-free): Sorghum is another of the oldest known grains, and has been a major source of nutrition in Africa and India for years.  Now grown in the United States, sorghum is generating excitement as a gluten-free insoluble fiber.
    Because sorghum’s protein and starch are more slowly digested than that of other cereals, it may be beneficial to diabetics and healthy for anyone.  Sorghum fans boast of its bland flavor and light color, which don’t alter the taste or look of foods when used in place of wheat flour.  Many cooks suggest combining sorghum with soybean flour.
    Soy and Soybeans (WF/gluten-free): Like the ancient foods mentioned at the beginning of this section, soy has been around for centuries.  In China, soybeans have been grown since the 11th century b.c., and are still one of the country’s most important crops.  Soybeans weren’t cultivated in the United States until the early 1800s, yet today are one of this country’s highest yielding producers.
    Soybeans are a legume, belonging to the pea family.  Comprised of nearly 50 percent protein, 25 percent oil, and 25 percent carbohydrate, they have earned a reputation as being extremely nutritious.  They are also an excellent source of essential fatty acids, which are not produced by the body, but are essential to its functioning nonetheless.
    Teff (WF/gluten-free): Considered a basic part of the Ethiopian diet, teff is relatively new to Americans.    Five times richer in calcium, iron, and potassium than any other grain, teff also contains substantial amounts of protein and soluble and insoluble fiber. Considered a nutritional powerhouse, it has a sweet, nutty flavor. Teff grows in many different varieties and colors, but in the United States only the ivory, brown, and reddish-tan varieties can be found. The reddish teff is reserved for purveyors of Ethiopian restaurants, who are delighted to have an American source for their beloved grain.
    A Word About Sprouted Grains
    Some people believe that “sprouted grains,” even ones that contain gluten such as wheat, are gluten-free—not true!  The sprouting process sparks a chemical reaction that begins to break down gluten, so some people who are slightly sensitive to gluten may find that they can tolerate sprouted grains better, but too many of the peptides that are reactive for celiacs are still present, so sprouted grains are not safe for people with celiac disease or gluten intolerance.


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    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

    Jefferson Adams
    Celiac.com 04/16/2018 - A team of researchers recently set out to investigate whether alterations in the developing intestinal microbiota and immune markers precede celiac disease onset in infants with family risk for the disease.
    The research team included Marta Olivares, Alan W. Walker, Amalia Capilla, Alfonso Benítez-Páez, Francesc Palau, Julian Parkhill, Gemma Castillejo, and Yolanda Sanz. They are variously affiliated with the Microbial Ecology, Nutrition and Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), C/Catedrático Agustín Escardin, Paterna, Valencia, Spain; the Gut Health Group, The Rowett Institute, University of Aberdeen, Aberdeen, UK; the Genetics and Molecular Medicine Unit, Institute of Biomedicine of Valencia, National Research Council (IBV-CSIC), Valencia, Spain; the Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire UK; the Hospital Universitari de Sant Joan de Reus, IISPV, URV, Tarragona, Spain; the Center for regenerative medicine, Boston university school of medicine, Boston, USA; and the Institut de Recerca Sant Joan de Déu and CIBERER, Hospital Sant Joan de Déu, Barcelona, Spain
    The team conducted a nested case-control study out as part of a larger prospective cohort study, which included healthy full-term newborns (> 200) with at least one first relative with biopsy-verified celiac disease. The present study includes 10 cases of celiac disease, along with 10 best-matched controls who did not develop the disease after 5-year follow-up.
    The team profiled fecal microbiota, as assessed by high-throughput 16S rRNA gene amplicon sequencing, along with immune parameters, at 4 and 6 months of age and related to celiac disease onset. The microbiota of infants who remained healthy showed an increase in bacterial diversity over time, especially by increases in microbiota from the Firmicutes families, those who with no increase in bacterial diversity developed celiac disease.
    Infants who subsequently developed celiac disease showed a significant reduction in sIgA levels over time, while those who remained healthy showed increases in TNF-α correlated to Bifidobacterium spp.
    Healthy children in the control group showed a greater relative abundance of Bifidobacterium longum, while children who developed celiac disease showed increased levels of Bifidobacterium breve and Enterococcus spp.
    The data from this study suggest that early changes in gut microbiota in infants with celiac disease risk could influence immune development, and thus increase risk levels for celiac disease. The team is calling for larger studies to confirm their hypothesis.
    Source:
    Microbiome. 2018; 6: 36. Published online 2018 Feb 20. doi: 10.1186/s40168-018-0415-6