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    In the USA Over 20% of Foods Labeled "Gluten-free" Could Contain Too Much Gluten


    Jefferson Adams

    Celiac.com 12/05/2014 - To remain healthy, people with serious gluten intolerance, especially people with celiac disease, must avoid foods containing gluten from wheat, barley, and rye. Accordingly, gluten detection is of high interest for the food safety of celiac patients.


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    Photo: Wikimedia Commons--SieBotThe FDA recently approved guidelines mandating that all products labeled as “gluten-free” contain less than 20ppm (20mg/kg) of gluten, but just how do products labeled as “gluten-free” actually measure up to this standard?

    Researchers H.J. Lee, Z. Anderson, and D. Ryu recently set outto assess the concentrations of gluten in foods labeled "gluten free" available in the United States. For their study, they collected seventy-eight samples of foods labeled “gluten-free,” and analyzed the samples using a gliadin competitive enzyme-linked immunosorbent assay. They then calculated gluten content based on the assumption of the same ratio between gliadin and glutenin, testing gluten levels down to 10ppm (10mg/kg).

    They found that forty-eight (61.5%) of the 78 samples labeled gluten-free contained less than 10ppm (10 mg/kg) gluten. Another 14 (17.9%) of the 78 samples contained less than 20ppm (20mg/kg) gluten, in accordance with the guidelines established by the Codex Alimentarius for gluten-free labeling.

    However, 16 samples, over 20%, contained gluten levels above 20 mg/kg, ranging from 20.3 to as high as 60.3 mg/kg. Breakfast cereal was the main culprit, with five of eight breakfast cereal samples showing gluten contents above 20ppm (20 mg/kg).

    The study does not name specific brands tested, nor do they indicate whether tested brands are themselves monitored by independent labs. Still, the results, while generally encouraging, show that more progress is needed to make sure that all products labeled as “gluten-free” meet the FDA guidelines. Until that time, it’s a matter of “caveat emptor,” or “buyer beware,” for consumers of gluten-free foods.


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    The article that you used to write your article doesn't help us celiacs much if they don't tell us which brands were tested and give us their scores. It actually makes it worse, because now we are left to worry that SOME brands can hurt us, but they won't tell us which ones even though they know!

    If they are giving us food containing 3 times the gluten that they say, then why not share your info?

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    Guest heather

    Posted

    Thanks for this article. Not a shock, but disturbing none the less. It would be helpful to know which of the products tested were labeled with the "certified gluten free" label/symbol versus just labeled as "gluten free" or just "contains no gluten ingredients". I'm always on the lookout for items that say they were manufactured in a facility that also processes items containing wheat. But I know that doesn't necessarily rule out facilities that process oats, barley, rye, spelt, etc. Label reading is the best thing we can do and we have to out so much trust. I wish there would be a simple, inexpensive home test to test foods ourselves (in addition to proper labeling). Maybe some day.

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    Guest Michelle

    Posted

    If a gluten FREE product "contains less than 20 ppm" of gluten then how is it "gluten FREE"?? A person with celiac disease is INTOLERANT of ANY gluten no matter the measure of ppms!! I am a celiac patient and I have recently tried some "Gluten Free" crackers. It was after I felt a little rumbly in my tummy (signs of a gluten attack) I read the ingredients on the side panel of the box. It was much to my surprise that it contained less than 20 ppms of gluten!! WHAT??!!! PLUS, it was manufactured on equipment that also processes WHEAT!! So it's not gluten FREE is it?? I am appalled that the FDA will allow for a company to label a product "GLUTEN FREE" when in fact it is NOT!! Needless to say, I became ill after consuming the "gluten free" crackers. Thanks a lot FDA and thanks to the company (I won't name them) for selling me a "gluten free" cracker and charging me as such!! This has to be stopped!!

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    I've had gluten reactions to rice cakes labeled gluten free. I found out from the company, that all of their rice cakes are processed on the same lines. Some of the varieties contain ingredients derived from food crops that are likely to be cross-contaminated during growing, harvest, storage, processing, etc. My complaints to the company were ignored.

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    Guest Linda Vanderhyde

    Posted

    Very helpful. I've been having gluten issues lately and couldn't figure out why. Perhaps it was the Chex mix. I never would have thought of it because I made the mix myself with supposedly gluten-free cereal.

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    Guest Michelle

    Posted

    I have suffered celiac for years. I missed my pizza, bread and pasta. But now I can have the real stuff. Sourdough bread (the starter fermented over 3 days) White flour from Italy and pasta from Italy. I can eat all this with no ill effect. Yeah!!! The longer the fermentation the less gluten in the sourdough. So give it a try, and good luck

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    Guest Uncle Bruce

    Posted

    Kilogram? Who eats a kilogram of anything, at least at one sitting. Gluten per 100 grams is realistic, as that is 3 ½ ounces, a reasonable serving.

    Let's turn this into beer, say Omission, a gluten-reduced beer through enzyme process. At 20 parts per million for a 355 milliliter bottle of the stuff, one would be ingesting 7 milligrams of gluten. Omission posts its test results for every batch, and it's been significantly below this when I've looked, but still, I got sick about three slugs into the second bottle.

    Check my arithmetic, please.

    For any 3 ⅓ oz serving of supposedly gluten-free comestible, one may be getting a 7 milligram dose of gluten, big enough to send you to the toilet.

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    I have suffered celiac for years. I missed my pizza, bread and pasta. But now I can have the real stuff. Sourdough bread (the starter fermented over 3 days) White flour from Italy and pasta from Italy. I can eat all this with no ill effect. Yeah!!! The longer the fermentation the less gluten in the sourdough. So give it a try, and good luck

    I would not recommend that anyone knowingly eat such a product when there are so many alternatives available.

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    Please for the sake of us celiacs, publish the names of the brands that exceed limits!

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    Guest Jefferson

    Posted

    The article that you used to write your article doesn't help us celiacs much if they don't tell us which brands were tested and give us their scores. It actually makes it worse, because now we are left to worry that SOME brands can hurt us, but they won't tell us which ones even though they know!

    If they are giving us food containing 3 times the gluten that they say, then why not share your info?

    Yes, naming brands would certainly be helpful for people with celiac disease. However, the researchers likely omitted that information to avoid potential legal issues with the companies whose products they tested.

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    Guest Jefferson

    Posted

    If a gluten FREE product "contains less than 20 ppm" of gluten then how is it "gluten FREE"?? A person with celiac disease is INTOLERANT of ANY gluten no matter the measure of ppms!! I am a celiac patient and I have recently tried some "Gluten Free" crackers. It was after I felt a little rumbly in my tummy (signs of a gluten attack) I read the ingredients on the side panel of the box. It was much to my surprise that it contained less than 20 ppms of gluten!! WHAT??!!! PLUS, it was manufactured on equipment that also processes WHEAT!! So it's not gluten FREE is it?? I am appalled that the FDA will allow for a company to label a product "GLUTEN FREE" when in fact it is NOT!! Needless to say, I became ill after consuming the "gluten free" crackers. Thanks a lot FDA and thanks to the company (I won't name them) for selling me a "gluten free" cracker and charging me as such!! This has to be stopped!!

    The fact is that the vast majority of people with celiac disease do not react to gluten levels below 20ppm. Also, the test currently used to test products are not sensitive enough to give accurate results below 20ppm, and they become less accurate the closer to zero they get. Taken together, these are a significant part of why the standard is set at 20ppm. Lastly, the FDA standard is the same as the European standard.

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    I agree with the above comments about not telling us what cereal!

    I know I have bought Walmart's gluten free version of Hamburger Helper and it gave me a gluten reaction.

    Interestingly, Wegman's pulled some of their gluten free products after the FDA standard came out.

    I don't think the FDA standard has helped those of use with celiac!

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    I would not recommend that anyone knowingly eat such a product when there are so many alternatives available.

    Unfortunately they're not required to label it as such if there's less than 20 ppm. It's very likely the majority of celiacs are unknowingly glutened quite frequently. Even going to basic ingredients and nothing processed is a risk if you eat meat when the meat market puts everything next to each other behind the glass when a plain cut of meat is stored right next to a questionably seasoned one, or worse in the fish section where breaded fish and crab cakes are right beside non breaded ones. Not to mention with meat and fish markets we don't know what surfaces were used to prepare what on and if they were fully cleaned between gluten items and non gluten items and you can be sure it is extremely rare to find a place with dedicated gluten free work surfaces and tools. I tend to check labels to be sure it doesn't say "Processed on shared equipment or in a shared facility", but I don't think they're required to put that on their label even, so it's still a risk.

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    Guest StrugglingCeliac

    Posted

    Seems to me there is an ethical obligation for the study to name the products.

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    Guest Jacquie

    Posted

    When writing those articles, please post the names of the items that might harm us. What is the sense of spending big bucks on products that are not safe for us to consume.

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    It is irresponsible of the researchers not to disclose the brands they tested. I also question why the writer and celiac.com chose to publish an incomplete article. All you have done is raise the panic level of celiac patients.

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    It is irresponsible of the researchers not to disclose the brands they tested. I also question why the writer and celiac.com chose to publish an incomplete article. All you have done is raise the panic level of celiac patients.

    We are reporting the findings of a study. Those who conducted the study opted not to publish brand names, thus, to report this study here, we are limited, but find the information important enough to share with our readers.

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    When writing those articles, please post the names of the items that might harm us. What is the sense of spending big bucks on products that are not safe for us to consume.

    The people who conducted the testing did not disclose the brands, thus we cannot share them here, or we would.

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    It is difficult but it can be done. If you have eaten a "Gluten Free" labeled product, go to the FDA website, dig until you find the form and NAME the Company. I am sorry that it has come to this. Progress? They are leaving it up to us to get sick before they will investigate. SO, REPORT the companies that are calling their products "Gluten Free."

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    Guest Jefferson

    Posted

    Seems to me there is an ethical obligation for the study to name the products.

    See my comment to Davi above. Naming brands would certainly be helpful for people with celiac disease. However, the researchers likely omitted that information to avoid potential legal issues with the companies whose products they tested.

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    I would not recommend that anyone knowingly eat such a product when there are so many alternatives available.

    It almost sounds like the sourdough post was a bot. This is what is wrong with the gluten reduced movement. They are mostly bought by people who are doing it as a lifestyle choice and they are impacting our regulations.

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    Kilogram? Who eats a kilogram of anything, at least at one sitting. Gluten per 100 grams is realistic, as that is 3 ½ ounces, a reasonable serving.

    Let's turn this into beer, say Omission, a gluten-reduced beer through enzyme process. At 20 parts per million for a 355 milliliter bottle of the stuff, one would be ingesting 7 milligrams of gluten. Omission posts its test results for every batch, and it's been significantly below this when I've looked, but still, I got sick about three slugs into the second bottle.

    Check my arithmetic, please.

    For any 3 ⅓ oz serving of supposedly gluten-free comestible, one may be getting a 7 milligram dose of gluten, big enough to send you to the toilet.

    We have a group for people who got sick drinking gluten reduced beers. To let the FDA and TTB know that we had an adverse reaction.

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    In addition, we need to be aware that eating more than one serving at a time will potentially put more ppm in your body. We need to be aware. Time to go grain free.

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    Guest Linda

    Posted

    I think we are quite naive about assuming that there are scientists in white coats out there checking the food we eat. I'm sure companies that produce foods are largely left to their own consciences, and rarely get actually checked by government officials...especially all the little companies, or those who can afford to pay off the officials... no one is baby sitting our food for us. It is up to us to choose cook and eat what is good for us. Even if a label says something is gluten free, how do you know that particular batch didn't have something different in it, maybe they were low on an ingredient and high on production pressure...maybe they substituted a little here and there... who would know the difference. I for the most part buy single ingredient foods, a piece of meat, a potato, some veggies and eat that. If we want meat that is safe, we need to buy local meat from a farmer and butcher we can shake hands with and talk to, someone in our community who lives up to their promises. If we buy food from mass producers whose motivation is to earn money, we should expect to be disappointing in their integrity a percentage of the time.

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    Serve is a bowl with tortilla chips and guacamole.

    Dr. Ron Hoggan, Ed.D.
    Celiac.com 06/15/2018 - There seems to be widespread agreement in the published medical research reports that stuttering is driven by abnormalities in the brain. Sometimes these are the result of brain injuries resulting from a stroke. Other types of brain injuries can also result in stuttering. Patients with Parkinson’s disease who were treated with stimulation of the subthalamic nucleus, an area of the brain that regulates some motor functions, experienced a return or worsening of stuttering that improved when the stimulation was turned off (1). Similarly, stroke has also been reported in association with acquired stuttering (2). While there are some reports of psychological mechanisms underlying stuttering, a majority of reports seem to favor altered brain morphology and/or function as the root of stuttering (3). Reports of structural differences between the brain hemispheres that are absent in those who do not stutter are also common (4). About 5% of children stutter, beginning sometime around age 3, during the phase of speech acquisition. However, about 75% of these cases resolve without intervention, before reaching their teens (5). Some cases of aphasia, a loss of speech production or understanding, have been reported in association with damage or changes to one or more of the language centers of the brain (6). Stuttering may sometimes arise from changes or damage to these same language centers (7). Thus, many stutterers have abnormalities in the same regions of the brain similar to those seen in aphasia.
    So how, you may ask, is all this related to gluten? As a starting point, one report from the medical literature identifies a patient who developed aphasia after admission for severe diarrhea. By the time celiac disease was diagnosed, he had completely lost his faculty of speech. However, his speech and normal bowel function gradually returned after beginning a gluten free diet (8). This finding was so controversial at the time of publication (1988) that the authors chose to remain anonymous. Nonetheless, it is a valuable clue that suggests gluten as a factor in compromised speech production. At about the same time (late 1980’s) reports of connections between untreated celiac disease and seizures/epilepsy were emerging in the medical literature (9).
    With the advent of the Internet a whole new field of anecdotal information was emerging, connecting a variety of neurological symptoms to celiac disease. While many medical practitioners and researchers were casting aspersions on these assertions, a select few chose to explore such claims using scientific research designs and methods. While connections between stuttering and gluten consumption seem to have been overlooked by the medical research community, there is a rich literature on the Internet that cries out for more structured investigation of this connection. Conversely, perhaps a publication bias of the peer review process excludes work that explores this connection.
    Whatever the reason that stuttering has not been reported in the medical literature in association with gluten ingestion, a number of personal disclosures and comments suggesting a connection between gluten and stuttering can be found on the Internet. Abid Hussain, in an article about food allergy and stuttering said: “The most common food allergy prevalent in stutterers is that of gluten which has been found to aggravate the stutter” (10). Similarly, Craig Forsythe posted an article that includes five cases of self-reporting individuals who believe that their stuttering is or was connected to gluten, one of whom also experiences stuttering from foods containing yeast (11). The same site contains one report of a stutterer who has had no relief despite following a gluten free diet for 20 years (11). Another stutterer, Jay88, reports the complete disappearance of her/his stammer on a gluten free diet (12). Doubtless there are many more such anecdotes to be found on the Internet* but we have to question them, exercising more skepticism than we might when reading similar claims in a peer reviewed scientific or medical journal.
    There are many reports in such journals connecting brain and neurological ailments with gluten, so it is not much of a stretch, on that basis alone, to suspect that stuttering may be a symptom of the gluten syndrome. Rodney Ford has even characterized celiac disease as an ailment that may begin through gluten-induced neurological damage (13) and Marios Hadjivassiliou and his group of neurologists and neurological investigators have devoted considerable time and effort to research that reveals gluten as an important factor in a majority of neurological diseases of unknown origin (14) which, as I have pointed out previously, includes most neurological ailments.
    My own experience with stuttering is limited. I stuttered as a child when I became nervous, upset, or self-conscious. Although I have been gluten free for many years, I haven’t noticed any impact on my inclination to stutter when upset. I don’t know if they are related, but I have also had challenges with speaking when distressed and I have noticed a substantial improvement in this area since removing gluten from my diet. Nonetheless, I have long wondered if there is a connection between gluten consumption and stuttering. Having done the research for this article, I would now encourage stutterers to try a gluten free diet for six months to see if it will reduce or eliminate their stutter. Meanwhile, I hope that some investigator out there will research this matter, publish her findings, and start the ball rolling toward getting some definitive answers to this question.
    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

    Jefferson Adams
    Celiac.com 06/14/2018 - Refractory celiac disease type II (RCDII) is a rare complication of celiac disease that has high death rates. To diagnose RCDII, doctors identify a clonal population of phenotypically aberrant intraepithelial lymphocytes (IELs). 
    However, researchers really don’t have much data regarding the frequency and significance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. Such data could provide useful comparison information for patients with RCDII, among other things.
    To that end, a research team recently set out to try to get some information about the frequency and importance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. The research team included Shafinaz Hussein, Tatyana Gindin, Stephen M Lagana, Carolina Arguelles-Grande, Suneeta Krishnareddy, Bachir Alobeid, Suzanne K Lewis, Mahesh M Mansukhani, Peter H R Green, and Govind Bhagat.
    They are variously affiliated with the Department of Pathology and Cell Biology, and the Department of Medicine at the Celiac Disease Center, New York Presbyterian Hospital/Columbia University Medical Center, New York, USA. Their team analyzed results of TCR-GR analyses performed on SB biopsies at our institution over a 3-year period, which were obtained from eight active celiac disease, 172 celiac disease on gluten-free diet, 33 RCDI, and three RCDII patients and 14 patients without celiac disease. 
    Clonal TCR-GRs are not infrequent in cases lacking features of RCDII, while PCPs are frequent in all disease phases. TCR-GR results should be assessed in conjunction with immunophenotypic, histological and clinical findings for appropriate diagnosis and classification of RCD.
    The team divided the TCR-GR patterns into clonal, polyclonal and prominent clonal peaks (PCPs), and correlated these patterns with clinical and pathological features. In all, they detected clonal TCR-GR products in biopsies from 67% of patients with RCDII, 17% of patients with RCDI and 6% of patients with gluten-free diet. They found PCPs in all disease phases, but saw no significant difference in the TCR-GR patterns between the non-RCDII disease categories (p=0.39). 
    They also noted a higher frequency of surface CD3(−) IELs in cases with clonal TCR-GR, but the PCP pattern showed no associations with any clinical or pathological feature. 
    Repeat biopsy showed that the clonal or PCP pattern persisted for up to 2 years with no evidence of RCDII. The study indicates that better understanding of clonal T cell receptor gene rearrangements may help researchers improve refractory celiac diagnosis. 
    Source:
    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023

    Jefferson Adams
    Celiac.com 06/13/2018 - There have been numerous reports that olmesartan, aka Benicar, seems to trigger sprue‐like enteropathy in many patients, but so far, studies have produced mixed results, and there really hasn’t been a rigorous study of the issue. A team of researchers recently set out to assess whether olmesartan is associated with a higher rate of enteropathy compared with other angiotensin II receptor blockers (ARBs).
    The research team included Y.‐H. Dong; Y. Jin; TN Tsacogianis; M He; PH Hsieh; and JJ Gagne. They are variously affiliated with the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School in Boston, MA, USA; the Faculty of Pharmacy, School of Pharmaceutical Science at National Yang‐Ming University in Taipei, Taiwan; and the Department of Hepato‐Gastroenterology, Chi Mei Medical Center in Tainan, Taiwan.
    To get solid data on the issue, the team conducted a cohort study among ARB initiators in 5 US claims databases covering numerous health insurers. They used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for enteropathy‐related outcomes, including celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy. In all, they found nearly two million eligible patients. 
    They then assessed those patients and compared the results for olmesartan initiators to initiators of other ARBs after propensity score (PS) matching. They found unadjusted incidence rates of 0.82, 1.41, 1.66 and 29.20 per 1,000 person‐years for celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy respectively. 
    After PS matching comparing olmesartan to other ARBs, hazard ratios were 1.21 (95% CI, 1.05‐1.40), 1.00 (95% CI, 0.88‐1.13), 1.22 (95% CI, 1.10‐1.36) and 1.04 (95% CI, 1.01‐1.07) for each outcome. Patients aged 65 years and older showed greater hazard ratios for celiac disease, as did patients receiving treatment for more than 1 year, and patients receiving higher cumulative olmesartan doses.
    This is the first comprehensive multi‐database study to document a higher rate of enteropathy in olmesartan initiators as compared to initiators of other ARBs, though absolute rates were low for both groups.
    Source:
    Alimentary Pharmacology & Therapeutics

    Jefferson Adams
    Celiac.com 06/12/2018 - A life-long gluten-free diet is the only proven treatment for celiac disease. However, current methods for assessing gluten-free diet compliance are lack the sensitivity to detect occasional dietary transgressions that may cause gut mucosal damage. So, basically, there’s currently no good way to tell if celiac patients are suffering gut damage from low-level gluten contamination.
    A team of researchers recently set out to develop a method to determine gluten intake and monitor gluten-free dietary compliance in patients with celiac disease, and to determine its correlation with mucosal damage. The research team included ML Moreno, Á Cebolla, A Muñoz-Suano, C Carrillo-Carrion, I Comino, Á Pizarro, F León, A Rodríguez-Herrera, and C Sousa. They are variously affiliated with Facultad de Farmacia, Departamento de Microbiología y Parasitología, Universidad de Sevilla, Sevilla, Spain; Biomedal S.L., Sevilla, Spain; Unidad Clínica de Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Celimmune, Bethesda, Maryland, USA; and the Unidad de Gastroenterología y Nutrición, Instituto Hispalense de Pediatría, Sevilla, Spain.
    For their study, the team collected urine samples from 76 healthy subjects and 58 patients with celiac disease subjected to different gluten dietary conditions. To quantify gluten immunogenic peptides in solid-phase extracted urines, the team used a lateral flow test (LFT) with the highly sensitive and specific G12 monoclonal antibody for the most dominant GIPs and an LFT reader. 
    They detected GIPs in concentrated urines from healthy individuals previously subjected to gluten-free diet as early as 4-6 h after single gluten intake, and for 1-2 days afterward. The urine test showed gluten ingestion in about 50% of patients. Biopsy analysis showed that nearly 9 out of 10 celiac patients with no villous atrophy had no detectable GIP in urine, while all patients with quantifiable GIP in urine showed signs of gut damage.
    The ability to use GIP in urine to reveal gluten consumption will likely help lead to new and non-invasive methods for monitoring gluten-free diet compliance. The test is sensitive, specific and simple enough for clinical monitoring of celiac patients, as well as for basic and clinical research applications including drug development.
    Source:
    Gut. 2017 Feb;66(2):250-257.  doi: 10.1136/gutjnl-2015-310148.