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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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    ADULT CELIAC DISEASE: PSYCHOSOCIAL FACTORS AFFECT PATIENT SYMPTOMS AND HEALTH MORE THAN DISEASE ITSELF


    Jefferson Adams

    Celiac.com 09/15/2010 - Until the present study, no clinical research had been published regarding the relative effects of clinical and psychosocial variables on outcome in celiac disease.


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    A team of researchers examined psychosocial factors that may influence disease activity in celiac patients, such as relationships among demographics, psychosocial factors, and disease activity with health-related quality of life (HRQOL), health care utilization, and symptoms.

    The research team included Spencer D. Dorn, Lincoln Hernandez, Maria T. Minaya, Carolyn B. Morris, Yuming Hu, Suzanne Lewis, Jane Leserman, Shrikant I. Bangdiwala, Peter H. R. Green and Douglas A. Drossman of the Center for Functional GI and Motility Disorders at the University of North Carolina, Chapel Hill, USA.

    The team enrolled 101 adult patients with celiac disease with the goal of charting any relationships among demographics, psychosocial factors, and disease activity with health-related quality of life (HRQOL), health care utilization, and symptoms. All patients were newly referred to a tertiary care center with biopsy-proven celiac disease.

    The team examined: (a) demographic factors and diet status; (B) disease measures (Marsh score, tissue transglutaminase antibody (tTG) level, weight change and additional blood studies); and © Psychosocial status (psychological distress, life stress, abuse history, and coping). They then conducted multivariate analyses to predict HRQOL, daily function, self-reported health, number of physician visits, and GI symptoms, such as pain and diarrhea.

    They found that patients with psychological distress and poor coping skills suffered from impaired HRQOL and daily function.

    Patients who reported poorer health generally showed poorer coping, longer symptom duration, lower education, and greater weight loss. Patients with poorer coping, abnormal tTG levels, and milder Marsh classification generally had more physician visits.

    Patients with higher psychological distress and greater weight loss also showed higher pain scores. Patients with greater psychological distress and poorer coping also showed higher rates of diarrhea.

    Their results show that among patients at celiac disease referral centers, psychosocial factors have a greater impact on health status and GI symptoms than does disease activity. Such factors should be considered as part of the patient's treatment and prognosis.

    Source:


    Image Caption: New research on psychosocial factors and celiac disease
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    Gut bacteria, mechanisms of action of the intestinal microbiota in immune-mediated diseases, might be involved in the "relative effects" of clinical and psychosocial variables on outcome in celiac disease..

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    Guest CeliBelli

    Posted

    I am sorry that Mr. Adams did not critique this study from a celiac's perspective. For myself, I find the findings flawed and potentially detrimental to the diagnosis and treatment of celiac disease.

     

    The researchers conclude that psychosocial factors have greater impact on GI symptoms and health generally than celiac disease itself. What they do not consider is that it may be the celiac disease which is causing those so-called psychosocial factors. For instance, they find that subjects with psychological distress and poor coping skills suffered higher rates of diarrhea, poorer health, impaired daily function. They do not appear to have considered that people suffering from the degradations and humiliations, not to mention malnutrition, of chronic diarrhea are likely to suffer psychological distress and to cope poorly.

     

    Likewise, they find that subjects with high psychological distress and greater weight loss had higher pain scores. Did they not consider that people with high levels of chronic pain are likely to have advanced intestinal destruction leading to severe malnutrition caused by the inability to process food, and that the chronic pain and malnutrition might possibly cause the psychological distress?

     

    As with so many medical studies, the researchers are drawing questionable conclusions by misinterpreting and mis-attributing causality. This is a trend the celiac community should stand up against.

     

    It is difficult enough getting research attention, and getting the medical community to be informed. We do not need researchers leading the medical community down the wrong path by misinforming them about how celiac disease does and does not work. This misinformation is not simply bad science, but potentially harmful to vulnerable, and frequently fragile, patients.

     

    I hope in the future that Celiac.com will take the opportunity not just to reiterate the study abstracts, but to apply some critical thinking, and if necessary calling celiacs to action to hold such researchers to account for the flaws in their work.

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    CeliBelli, I completely agree with you. There is so much preconception about cause and affect. I also think psychosomaticism is paid too much attention. Drug use is blamed too much in my family for early deaths, instead of recognizing the use of drugs and alcohol as symptoms. I am the first and only one diagnosed among my relatives. A lot of negative emotions are largely symptoms of malnutrition, as well as attack by one's own immune system, let alone the ignorance of and abuse by gluten consumers, and the friction caused by the very real dangers to celiacs at the hands of the majority.

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    Guest Jeff Kelly

    Posted

    Disparaging type article that we don't need--we lived the preconceived baloney for far too long as per Jefferson's other article on here which tells a more accurate story and presents a more accurate picture.

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    Celiac disease is caused by two markers discoverable on a blood screen and endoscopy, period. Wheat has been engineered in recent years to contain five times as much gluten, a disaster for those of us who have celiac disease. Because there is no real money to be made by prescription drug makers or surgeons, the psychotropic drug industry is attempting to link yet another medical condition to some psychological element that they can add it to the hundreds of new entries in the DSM in recent years--all of which they "diagnose" as requiring their "services" and psychotropic medications (increasing their incomes); all it really requires is a gluten-free diet. I agree with Celli-Belli completely.

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    Am J Health-Syst Pharm 58(05):396-401, 2001
    Celiac.com 04/12/2001 - Patients with celiac disease must eliminate all gluten from their diets, including any that might be present in the pharmaceutical or nutritional products that they consume. Researchers Sister Jeanne Patricia Crowe and Nancy Patin Falini designed a study to identify pharmaceutical companies whose policy is to manufacture only gluten-free products, and to determine the accuracy of product information held by companies whose products might contain gluten. The accuracy of this information is crucial for the effective treatment of patients with celiac disease.
    The researchers mailed 172 surveys to pharmaceutical companies listed in the 1998 Physicians Desk Reference and the 1998 generics supplement to Pharmacy Times, and made follow up telephone calls to companies that did not respond. The survey was strictly designed to determine the companies’ policies with regard to the use of gluten in their products, and if they use gluten, to determine their knowledge with regard to its content in their products.
    Almost all of the 100 companies that responded to the surveys (52 surveys, 26 letters and 22 oral responses were received) warned that they could not guarantee the possibility that minute amounts of gluten contaminants existed in the raw materials for their inactive ingredients. Many also warned that their products were gluten-free at the time of the survey, but their suppliers of raw materials for their inactive ingredients could change at any time without notice, and this could affect the gluten-free status of their products.
    Out of all those who responded, only five had a policy of producing gluten-free products, and could guarantee the gluten-free status of their products. Another group of respondents did not refer to their products as gluten free but stated that they added no ingredients derived from wheat, oats, rye, barley, or spelt. Many companies responded with legal disclaimers stating that although they believed that their products did not contain gluten, they neither certified their gluten-free status nor tested them for gluten. Some said that they could not make this guarantee because of the uncertainty with their suppliers of raw materials. Some said that their responses concerning ingredients were only as current as the date of correspondence.
    Currently few medications are labeled “gluten-free,” and labeling medications as such would be a great help to those on gluten-free diets. With most products a patient, pharmacist or doctor must periodically contact the manufacturer to determine the continuing gluten-free status of the product. This process is time consuming and costly for all involved. A reliable means of determining the gluten-free status of medications and nutritional products is badly needed, and is essential to the health of people on gluten-free diets.

    Rebecca  Herman
    In 2010, the U.S. market for gluten-free products was valued at $2.6 billion.  Projected sales in this market are expected to exceed $5 billion by 2015.(1) 
    As the gluten-free product market expands, and as we continue to seek out new tools to aid us in our search for truly gluten-free products, we are in for a treat with the recent launch of Gluten Free Watchdog.  Tricia Thompson, the founder of Gluten Free Watchdog, agreed to discuss it with us.
    Can you explain what Gluten Free Watchdog is, and what is novel about it?
    Gluten Free Watchdog (www.glutenfreewatchdog.org) is a food testing site that was started to make expensive state-of-the-art gluten testing available to the gluten-free community at a fraction of the true cost. This is the first time this type of resource has been offered.
    Can you share your personal story – how you became interested in celiac disease and gluten sensitivity?
    I have been gluten free for over 27 years. In the early years, I became very frustrated by the contradictory information available on several key gluten-free issues—Are oats safe to eat? Why is wheat starch eaten by the gluten-free community in Europe? Why do some support groups say “grains” such as buckwheat, amaranth, and quinoa should be avoided? And then there was the issue of nutritional quality. Back then almost all gluten-free processed foods were made using refined rice/corn and starch. So after finishing graduate school I made a list of all the topics I wanted to research and then started writing (and writing and writing!). 
    In December 2008, the Chicago Tribune investigated three Wellshire Kids brand gluten-free products, sold exclusively at Whole Foods Market — Dinosaur Shapes Chicken Bites, Chicken Corn Dogs, and Beef Corn Dogs — and analytical results indicated that they contained gluten, ranging from 116 to 2,200 parts per million.  More recently, Paul Seeling, a North Carolina baker, was convicted of fraud relating to the packaging of wheat bread as a gluten-free product.  Have events like these influenced the Gluten Free Watchdog?
    Events such as what occurred with Wellshire Farms made me realize that some manufacturers, while well-intentioned, did not understand how consumers in the US define gluten free when they see it on a food label. It also made me realize that some manufacturers did not know how to accurately test their labeled gluten free products for gluten, and that some of them were operating under the mistaken belief that if a product is (or is made from) a naturally gluten-free grain the product does not need to be tested. We have learned a lot over the years about cross contamination, starting with the study published in the New England Journal of Medicine on gluten contamination of oats and more recently with the study on gluten contamination of naturally gluten-free grains and flours published in the Journal of the American Dietetic Association.
    Combined, these events and studies may have undermined consumer confidence in labeled gluten-free foods. Most manufacturers are doing things right. It is my hope that Gluten Free Watchdog will allow consumers to have confidence in the products they eat and feed their family.
    Over the last ten years, you have published a significant amount of research on gluten-free product labeling.  And you recently authored a chapter on gluten-free product labeling in Melinda Dennis’ and Daniel Leffler’s new book, Real Life with Celiac Disease:  Troubleshooting and Thriving Gluten Free, which was published by the American Gastroenterological Association.  How has your research influenced Gluten Free Watchdog?
    From the consumer perspective the most important thing to understand about allergen labeling is that it pertains to ingredients only—it does not pertain to allergens that may be in a product due to cross contact. Currently, Gluten Free Watchdog is only testing foods labeled gluten free. In the future, we may test foods that appear to be gluten free based on ingredients.
    The Food Allergy Labeling and Consumer Protect Act (FALCPA) does not currently require the disclosure of barley or rye; or, contamination by manufacturers on product labeling.  Can Gluten Free Watchdog help us to decipher product labeling that may be difficult to understand?

    Gluten Free Watchdog is primarily a food testing site. My other website www.glutenfreedietitian.com contains extensive information on labeling laws and ingredients.
    Under FALCPA, the Federal Food & Drug Administration (FDA) is considering a proposed government definition of the term “gluten-free” for food product labeling purposes.  Once FDA approves a final rule, will the role of Gluten Free Watchdog change?

    Possibly but it will remain primarily a food testing site. Consumers will still want to know the level of gluten at which foods are testing and will still want the added confidence that independent transparent third party testing provides.
    On your blog, Gluten Free Dietitian, you discuss R5 ELISA tests, Ridascreen 7001 and Ridascreen R7011.  What is the importance of these tests, and are these the tests that Gluten Free Watchdog is using?  Are home-test kits accurate?
    The standard sandwich R5 ELISA is one of only two commercially available ELISAs validated at the levels used for regulatory purposes and official governmental methods (the other is the Morinaga Wheat Protein ELISA). The R5 and Morinaga ELISAs also are included in the FDA’s proposed gluten-free labeling rule as possible methods for rule enforcement. The competitive R5 ELISA may be used in conjunction with the sandwich R5 ELISA when a food is highly hydrolyzed.
    Gluten Free Watchdog tests food using the standard sandwich R5 ELISA and will, if necessary, also use the competitive R5 ELISA.
    What products does Gluten Free Watchdog plan to test in the upcoming months?  Are there any products that are difficult to test; and if so, why?
    We have been and will continue to test a wide variety of products—grains, flours, breads, cereals, pastas, cookies, etc. Anyone can visit the site and browse through the products that have been tested to date. However, testing data is available only to subscribers. One of the nice features of Gluten Free Watchdog is that subscribers can request that certain products be tested.
    One of the keys to successful testing of products is getting a homogenized sample—meaning any contaminant is evenly distributed throughout the sample being tested and there are no “hot spots.” This is why we test two extractions of each “homogenized” sample at Gluten Free Watchdog—we want to make sure the sample is truly homogenized. It can sometimes be tricky to get a homogenized sample when testing raw grains in grain versus flour form.
    FALCPA does not cover foods regulated by the United States Department of Agriculture (USDA), and the Alcohol and Tobacco Tax and Trade Bureau (TTB) has yet to finalize an allergen labeling rule for distilled spirits, beer, and wine.  Under TTB’s current labeling provisions, the term “gluten-free” is considered a health claim and its use is prohibited.  Are USDA and TTB adequately protecting consumers?  If not, does Gluten Free Watchdog plan to test any products regulated by either?
    Neither the TTB nor the USDA have mandatory allergen labeling and it will be interesting to see how they proceed with gluten-free labeling once the FDA’s gluten-free labeling law is in place. I have been told by representatives of the USDA that they will adopt the FDA’s gluten-free labeling law rather than develop their own.
    Gluten Free Watchdog will test USDA-regulated foods that are labeled gluten free. As mentioned earlier, we may start testing foods that appear to be gluten free based on ingredients. When we do, we would be happy to test beverages regulated by the TTB.
    Is Gluten Free Watchdog affiliated with any companies that sell or market gluten-free products?
    Nope! That is why we really need the support of gluten-free consumers!! It is my hope that members of the gluten-free community will see the value in having this type of resource available and will be willing to contribute a relatively small amount in exchange for access to expensive testing and input on what is tested—similar to a co-op.
    Source:

    Gluten-Free Foods and Beverages in the U.S., 3rd Edition.  Packaged Facts, February 2011.

    Jefferson Adams
    Celiac.com 08/17/2012 - In an effort to promote the production of safe, reliable gluten-free food products, the Canadian Government has announced a $245,000 grant that will help the Canadian Celiac Association partner with ExcelGrains Canada, the Packaging Association of Canada and the Canadian Health Food Association to develop specific controls and the supporting tools for each of their existing food safety systems.
    The measure includes specific controls for gluten-free foods. The end result will be a group of gluten-free controls and guidelines that will help to eliminate the risk of gluten contamination in grains, packaging materials, and bakery products, across the entire product manufacturing chain.
    Once developed, these gluten-free controls and guidelines will be adaptable and transferrable to other producers and manufacturers across the Canada.
    The CCA's mission is to promote awareness of celiac disease and gluten intolerance, along with offering advice and information to manufacturers and distributors of gluten-free foods. ExcelGrains Canada is a farm food safety program for grain farmers managed by the Canada Grains Council.
    Member of Parliament Ron Cannan of Kelowna-Lake Country is a strong supporter of the measure. He says that food safety is one of the government's priorities, and that the investment "will help provide consumers with the gluten-free foods they need and boost consumer confidence in Canadian food."
    Thanking the government for passing the measure, Jim McCarthy, Executive Director of the CCA, noted how important it is for "government and industry to work together to ensure that foods labeled 'gluten-free' truly are safe for the consumers who need them."
    He added that the measure will help the three million or so Canadians who suffer from celiac disease and gluten intolerance to more easily and safely access a 100% gluten-free diet.
    The investment is part of the Canadian Integrated Food Safety Initiative, through which, the Canadian government helps organizations develop national, government-recognized on-farm and/or post-farm hazard analysis and critical control points (HACCP) or HACCP-based food safety systems.

    Jefferson Adams
    Celiac.com 02/28/2013 - An entry in the Patient Journey section of the British Medical Journal highlights the confusion around non-celiac gluten sensitivity (doi:10.1136/bmj.e7982).
    In the entry, a person without celiac disease describes how, after years of unexplained health problems, a chance conversation on an internet forum led him to try a gluten-exclusion diet.
    He claims he saw dramatic results: “Within a week of excluding gluten and lactose from my diet, all my symptoms had dramatically improved in just the same way as when I previously starved myself.”
    After accidentally eating gluten the symptoms returned “within hours.” Such dramatic relief of symptoms led him to seek out what he calls “proper diagnosis.”
    This, in turn, led him to Kamran Rostami, whose account of the condition supplements the patient’s story. Rostami says that the patient, like others had "negative immunoallergy tests to wheat and negative coeliac serology; normal endoscopy and biopsy; symptoms that can overlap with coeliac disease, irritable bowel syndrome, and wheat allergy.” Symptoms resolved on a gluten-free diet. Since there are no biomarkers, gluten sensitivity is the ultimate diagnosis of exclusion.
    However, these facts, along with the lack of a disease mechanism have left some clinicians unconvinced.
    Some, like Luca Elli are calling for aspects of gluten sensitivity clarified before doctors start “treating” people for this new “disease” (doi:10.1136/bmj.e7360).
    Elli asks some logical questions, such as "Is gluten sensitivity different from irritable bowel syndrome, or is it simply a variant that benefits from a common therapeutic approach?"
    To get an answer, many clinicians are looking to published literature (doi:10.1136/bmj.e7907). For example, a few randomized trials suggest that non-celiac gluten-sensitivity is a real condition, affecting 6% of nearly 6000 people tested in a Maryland clinic.
    A multi-center trial is currently recruiting people without celiac disease, but with gluten sensitivity for a challenge with gluten or placebo.
    Meanwhile, clinicians are advising that patients who have had celiac disease excluded through blood tests and duodenal biopsy be told that they may suffer from a newly recognized clinical condition which is not yet fully understood.
    In related news, a letter published this week by David Unsworth and colleagues describes an “explosion of requests” for serological testing since 2007, particularly from primary care physicians (doi:10.1136/bmj.e8120). They note that NICE guidance in 2009 has done little to reduce the requests.
    They also point out that, as the number of people being tested has risen, the rates of confirmed celiac disease has fallen to just over 1%, which is no better than rates achieved by random screening.
    They call for more targeted testing, limited to groups in whom detection rates are highest: children with failure to thrive, family history, or type 1 diabetes, and adults attending diabetes and gastroenterology clinics.
    However, such advice would seem to ignore cases like those described in the Patient Journey, cases where people with negative blood tests and biopsies benefit from a gluten-free diet.
    What do you think? Is non-celiac gluten-sensitivity a real condition? Do you or anyone you know come up negative on blood tests and biopsies, but suffer from gluten-sensitivity? How should doctors proceed? Share your comments below.
    Source:
    BMJ 2012; 345. doi.org/10.1136/bmj.e8450

  • Recent Articles

    Jefferson Adams
    Celiac.com 04/23/2018 - A team of researchers recently set out to learn whether celiac disease patients commonly suffer cognitive impairment at the time they are diagnosed, and to compare their cognitive performance with non-celiac subjects with similar chronic symptoms and to a group of healthy control subjects.
    The research team included G Longarini, P Richly, MP Temprano, AF Costa, H Vázquez, ML Moreno, S Niveloni, P López, E Smecuol, R Mazure, A González, E Mauriño, and JC Bai. They are variously associated with the Small Bowel Section, Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital; Neurocience Cognitive and Traslational Institute (INECO), Favaloro Fundation, CONICET, Buenos Aires; the Brain Health Center (CESAL), Quilmes, Argentina; the Research Council, MSAL, CABA; and with the Research Institute, School of Medicine, Universidad del Salvador.
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    Source:
    J Clin Gastroenterol. 2018 Mar 1. doi: 10.1097/MCG.0000000000001018.

    Connie Sarros
    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
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    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. 
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    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.
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    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.
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    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