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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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    ONE IN THREE AMERICANS NOW AVOIDING GLUTEN


    Jefferson Adams

    Celiac.com 04/05/2013 - One in three adults want to avoid or cut down on gluten in their diets, says a survey from the consumer research firm, NPD Group. NDP began asking consumers about gluten-free issues in 2009, and the responses for their January 2013 survey show the highest level of interest in gluten-free diets so far.


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    Photo: CC--kabelphotoNDP's chief industry analyst, Harry Balzer, said in a recent press release that avoiding gluten is the "health issue of the day," and compared the current efforts to avoid or reduce dietary gluten to efforts a generation ago to avoid fat, cholesterol, sugar and sodium.

    Specifically, Balzer said: a "generation ago, health was about avoiding fat, cholesterol, sugar and sodium in our diet. While those desires still exist for many, they no longer are growing concerns…Today, increasingly more of us want to avoid gluten in our diet and right now it is nearly 30 percent of the adult population...and it’s growing."

    Gluten-free foods are now a $4.2 billion a year industry, and interest has extended to the restaurant industry as well.

    NPD found that 200 million restaurant visits in the past year included a gluten-free order. “The number of U.S. adults who say they are cutting down on or avoiding gluten is too large for restaurant operators to ignore,” said Bonnie Riggs, a restaurant industry analyst for NDP, in the same release.

    Currently, some three million Americans have been diagnosed with celiac disease, which is now is four times more common than it was 50 years ago.

    While the rise in diagnosis and awareness of gluten-intolerance and celiac disease continues to fuel popularity of gluten-free diets, the supposed health benefits of eliminating gluten are also a factor.

    It is certainly true that some of this gluten-free diet trend has been triggered by pop culture and media celebrities, many of whom are not eating gluten-free out of medical necessity.

    Still, it's likely that the gluten-free trend will continue into the foreseeable future, at least. 

    Source:


    Image Caption: Photo: CC--kabelphoto
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    The proliferation of gluten-free products and gluten-free restaurant menus is great for me, a confirmed celiac since 2006. Gluten awareness was just taking off and there were few decent products and hardly any restaurants with gluten-free menus. I wonder if this popularity takes away the seriousness of the whole issue, with some people considering gluten-free just a fad and not a health issue. I have actually been asked in a restaurant with a gluten-free menu how gluten-free I was since my salad had been prepared on a non gluten-free board. Luckily, this time I was asked - how many other times has contamination happened and someone just shrugged it off? I find it better to say I am allergic - somehow that word seems to set off a bit of concern.

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    Great idea to mention allergic to those who do not understand how serious celiac disease is!

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    Guest Beverly

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    I found this article very interesting! More people need to take us seriously. I don't eat out because of my sensitivity to gluten and many other foods.

     

    Thank you for writing it.

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    I find it very hard to eat out. People don't realize when you have a gluten allergy it is most often not the only one, I am also allergic to MSG and lactose intolerant.

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    admin
    Gut Reaction is a one-hour radio documentary with The Gluten-Free Mall as a major underwriter, produced by Richard Paul for Public Radio with additional funding from the Celiac Sprue Association. Several stations across the USA have already aired it, and some got such a great listener response that they intend to air it again. You can help us spread the word about celiac disease in your community in a very simple way—we urge you to contact the program director of your local Public Radio station to request that they air Gut Reaction in your community. To locate the local director of your Public Radio station please click here:
    https://sgms.cpb.org/Public/PubPhoneBook.asp
    and use the info at the bottom of this article to fill in the form, which looks like this:
    SEARCH CRITERIA:
    First Name: Can be found in the list at the bottom of this article.
    Last Name: Can be found in the list at the bottom of this article.
    City: You can leave it blank if you dont know.
    State: (2 Character Postal Code): Can be found in the list at the bottom of this article.
    Entity Name: 4 digit radio call tag - Can be found in the list at the bottom of this article.
    Entity Type: Radio Station (select this).
    Once you have the contact information for the director of your Public Radio station, follow this advice from Richard Paul, the shows producer:
    Its best if you reach the program director directly and not leave a message on the listener-comment line and not send an email to the listener-comment email box.
    When you contact the program director, tell him or her that you want the station to play the show Gut Reaction. Dont have folks say You have to do this. Just, We want you to know that theres a community here that thinks this is important.
    It is vitally important to emphasize that Celiac Disease effects 1-in-133 Americans, though only 1-in-4,700 are ever diagnosed. And immediately after saying that, remind them of public radios public service mission. Tell them that it would be an enormous public service to notify the undiagnosed Celiacs in their listening audience. This point should be made strongly.
    Tell them that there will be a satellite feed of the show on January 7th and that the show is available right now via PRX (the Public Radio Exchange). Tell them that if theyre not a member of PRX, they can get the show at this web site – www.rlpaulproductions.com/interviews
    Tell them that she show is newscast compatible and that is has breaks at 20 and 40 (they will know what that means and they will consider it important).
    But EMPHASIZE the public service value of getting the word out to undiagnosed Celiacs. That will be the real drive-it-home point.
    If they ask how you found out about the show, mention how wired-together we Celiacs are -- how we share information with each other by email and so forth because doctors still know so little about the disease. You might suggest that because there is a large Celiac Community in their area, theres the chance that you could work together with the station on other get-the-word-out projects. Maybe if they have a daily talk show, people could come on and talk about celiac disease. Something like that.
    Anyway, I hope you can get folks together to get the word out.
    Thanks,
    Richard Paul
    rlpaulproductions, LLC
    List of Public Radio Program Directors by State (Search for their contact info here: https://sgms.cpb.org/Public/PubPhoneBook.asp). Find your station below:
    STATE: AL
    WBHM
    Michael Krall
    WJAB
    Ellen Washington
    WLRH
    Cheryl Carlson
    WLJS
    Josh Hilton
    WHIL
    JoAnn Breland
    WVAS
    Erica Fox
    WTSU
    Fred Azbell
    WUAL
    Roger Duvall
    STATE: AK
    KNBA
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    KSKA
    Bede Trantina
    KBRW
    Isaac Tuckfield
    KYUK
    Ron Daugherty
    KDLG
    Jeremy Cate
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    Tim Bodony
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    Jonathan Green
    KSKO
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    KCAW
    Valerie Lapinski
    KIAL
    Michael Edenfield
    KCHU
    Lisa West
    STATE: AZ
    KNAU
    KJZZ
    Scott Williams
    KUAT
    Lyle Kesterson
    KXCI
    Roger Greer
    KNNB
    Sylvia Browning
    KAWC
    Mark Reynolds
    STATE: AR
    KUAF
    Kyle Kellams
    KASU
    Marty Scarborough
    KUAR
    Ron Breeding
    STATE: CA
    KCHO
    Joe Oleksiewicz
    KVPR
    James Meyers
    KMUD
    Michael Jacinto
    KKJZ
    Sean Heitkemper
    KPFK
    Armando Gudino
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    Mary Aigner
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    Carl Watanabe
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    Guy Rathbun
    KUSP
    Bonnie Jean Primbsch
    KCRW
    Ruth Seymour
    KBBF
    Francisco Carbajal
    KRCB
    Robin Pressman
    STATE: CO
    KRZA
    Deb Nichols
    KAJX
    Brent Gardner-Smith
    KGNU
    KDNK
    Luke
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    Mario Valdes
    KBUT
    Shawna Claiborne
    KUVO
    Carlos Lando
    KUNC
    Kirk Mowers
    KSUT
    Steven Rauworth
    KVNF
    Jeff Reynolds
    KOTO
    Steve Kennedy
    STATE: CT
    WSHU
    Tom Kuser
    WNPR
    STATE: DC
    WAMU
    Mark McDonald
    WETA
    Ingrid Lakey
    STATE: FL
    WQCS
    Jim Holmes
    WGCU
    Haley Mitchell
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    WDNA
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    WUWF
    Joe Vicenza
    WFSU
    Caroline Austin
    WMNF
    Randy Wynne
    WUSF
    Robert Peterson
    WXEL
    Joanna Marie
    STATE: GA
    WUGA
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    WABE
    Lois Reitzes
    WCLK
    Bill Clark
    WRFG
    Evon Dooley
    WSVH
    Eric Nauert
    Stjohn Flynn
    network PD
    STATE: HI
    KHPR
    STATE: ID
    KBSU
    Jim East
    KRFA
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    STATE: IL
    WSIU
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    WEFT
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    WSIE
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    WQUB
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    WVIK
    Lowell Dorman
    WUIS
    Sinta Seiber-Lane
    WILL
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    STATE: IN
    WFIU
    Christina Kuzmych
    WVPE
    Lee Burdorf
    WNIN
    Daniel Moore
    WBNI
    Bruce Haines
    WFYI
    Richard Miles
    WBST
    Steven Turpin
    WVUB
    Michael Woods
    STATE: IA
    WOI
    Dave Becker
    KUNI
    Wayne Jarvis
    KCCK
    Bob Stewart
    KIWR
    Sophia John
    KSUI
    Joan Kirkman
    KWIT
    Gretchen Gondek
    KBBG
    Beverly Douglas
    STATE: KS
    KHCC
    Ken Baker
    KANU
    Darrell Brogdon
    KKSU
    Larry Jackson
    KRPS
    Tim Metcalf
    KMUW
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    STATE: KY
    WKYU
    Peter Bryant
    WNKU
    Grady Kirkpatrick
    WUKY
    Stacy Yelton
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    WFPL
    Terry Rensel
    WMKY
    Charles Compton
    WKMS
    Mark Welch
    WEKU
    John Gregory
    WMMT
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    STATE: LA
    WBRH
    Larry Davis
    WRKF
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    KSLU
    Todd Delaney
    KRVS
    James Hebert
    KEDM
    Mark Simmons
    WWNO
    Fred Kasten
    WWOZ
    Dwayne Breashears
    KDAQ
    Adam Giblin
    STATE: ME
    WERU
    Joe Mann
    WMPG
    Jim
    WMEA
    Charles Beck
    STATE: MD
    WBJC
    Jonathan Palevsky
    WYPR
    Andy Bienstock
    WSCL
    Pamela Andrews
    STATE: MA
    WFCR
    Bob Paquette
    WBUR
    Peter Lydotes
    WGBH
    Steve Charbonneau
    WUMB
    Brian Quinn
    WCAI
    STATE: MI
    WGVU
    Rick Bierling
    WUOM
    Jon Hoban
    WDET
    Judy Adams
    WKAR
    Curt Gilleo
    WMUK
    Klayton Woodworth
    WNMU
    Nicole Walton
    WBLV
    Steve Albert
    WEMU
    Clark Smith
    STATE: MN
    KSJR
    Chris McNamara
    KUMD
    John Ziegler
    KAXE
    Mark Tarner
    KFAI
    Dan Richmond
    KUOM
    Mark LaCroix
    WCAL
    Michael Rathke
    MPR
    Eric Nycklemoe
    STATE: MS
    WUSM
    Elliott Crawford
    WMPN
    Bob Holland
    STATE: MO
    KRCU
    Jason Brown
    KBIA
    John Bailey
    KOPN
    David Owens
    KJLU
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    John Francis
    KSMU
    Mike Smith
    KDHX
    Beverly Hacker
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    KCMW
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    STATE: MT
    KEMC
    Marvin Granger
    KUFM
    Michael Marsolek
    STATE: NE
    KUCV
    Nancy Finken
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    KIOS
    Robert Coate
    KVNO
    Mike Hagstrom
    STATE: NV
    KNPR
    Flo Rogers
    KUNR
    Bobbie Lazzarone
    STATE: NH
    WEVO
    Michael Arnold
    STATE: NJ
    WBJB
    Rick Robinson
    WBGO
    Thurston Briscoe
    STATE: NM
    KANW
    Judy Valdez
    KUNM
    Marcos Martinez
    KCIE
    Romaine Wood
    KRWG
    Colin Gromatzky
    KABR
    Ruby Herrera
    KENW
    Shannon Hearn
    KTDB
    Bernie Bustos
    KSHI
    Duane Chimoni
    STATE: NY
    WAMC
    David Galletly
    WSKG
    Kate Cook
    WFUV
    Chuck Singleton
    WBFO
    David Benders
    WNED
    Al Wallack
    Peter Goldsmith
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    Peter Iglinski
    WMHT
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    WUNC
    George Boosey
    WFAE
    Paul Stribling
    WDAV
    Frank Dominguez
    WNCU
    B.H. Hudson
    WFSS
    Janet Wright
    WSHA
    Rashad Muhaimin
    WZRU
    Brian Lewis
    WNCW
    Kim Clark
    WHQR
    Susan Dankel
    WFDD
    Jay Banks
    STATE: ND
    KEYA
    Jarle Kvale
    KCND
    Bill Thomas
    KMHA
    Clarence Sun
    STATE: OH
    WOUB
    Rusty Smith
    Bryan Gibson
    WGUC
    Robin Gehl
    WVXU
    George Zahn
    WCPN
    David Kanzeg
    WCBE
    Mike Randolph
    Dan Mushalko
    WOSU
    Susan Lyons-Johnson
    WKSU
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    John Hingsbergen
    WGTE
    Barbara Heslope
    WCSU
    Dr. John Logan
    WYSO
    Tim Tattan
    WYSU
    David Luscher
    STATE: OK
    KCCU
    Mike Leal
    KGOU
    Jim John
    KOSU
    Ted Riley
    STATE: OR
    KSJK
    Eric Teel
    KMUN
    Elizabeth Grant
    KOAC
    Lynn Clendenin
    Michele - asst.
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    KRVM
    Raymond Scully
    KMHD
    Greg Gomez
    KBOO
    Chris Merrick
    KBPS
    Donna Ross
    KOPB
    Lynn Clendenin
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    WDIY
    Neil Hever
    WQLN
    Tom Tysz
    WITF
    Craig Cohen
    WLCH
    Maria Delvalle
    WHYY
    Christine Dempsey
    WRTI
    Jack Moore
    WXPN
    Bruce Warren
    WQED
    Ted Sohier
    WYEP
    Rosemary Welsch
    WPSU
    Kristine Allen
    STATE: SC
    WLTR
    John Gasque
    WSSB
    Jimmy White
    STATE: SD
    KILI

    KUSD
    Matt Weesner
    STATE: TN
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    WUOT
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    Dan Campbell
    WYPL
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    Rod Zent
    KETR
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    KEDT
    Stewart Jacoby
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    KTEP
    Dennis Woo
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    Chris Maley
    KTSU
    Aaron Cohen
    KUHF
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    KTPB
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    Dan Hull
    KOHM
    Clinton Barrick
    KOCV
    Daphne Dowdy
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    Christine Williams
    KPCW
    Jan Govednik
    KBYU
    Walter Rudolph
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    STATE: VT
    WVPR
    Jody Evans
    STATE: VA
    WTJU
    Charles Taylor
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    WHRV
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    WCVE
    Wayne Farrar
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    Eugene Purcell
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    Jefferson Adams
    Celiac.com 02/01/2013 - In my opinion, donuts are right up there with beer and pizza among the beloved foods I missed most after going gluten-free. That said, there has been strong progress on developing delicious gluten-free beers, and gluten-free pizza is one of the hottest, fastest growing trends among pizza retailers. So, there is some relief on those two fronts. However, the delightful donut is one food I expected never to enjoy again, after going gluten-free.
    So, imagine my surprise and delight to learn that Dunkin' Donuts is testing gluten-free donuts at limited locations in southern Florida and the Boston area.
    There is currently no official word from Dunkin' Donuts on when they plan to expand their gluten-free offerings. An official statement from the company read, in part: "…we have received very positive feedback on the new products so far. We do not yet have a timeframe for potential national distribution.”
    Meanwhile, a south Florida franchisee has said that while the test is currently limited to a few stores, the company plans to expand it in February.
    According to the National Foundation for Celiac Awareness says that Dunkin' Donuts' gluten-free products will be individually wrapped and calls them "dangerously delicious."
    Dunkin' Donuts' efforts to break into the fast growing gluten-free market puts them in league with a number of other fast food chains seeking to add gluten free items to their menus, including Wendy's, Arby's, Domino's and Chick-Fil-A.
    Will Dunkin' Donuts be successful in their efforts to roll out a gluten-free donut worthy of the Dunkin' Donuts name? Are you one of the many gluten-free eaters who would welcome a nice little donut fix? Share your comments below and stay tuned for the latest gluten-free developments

    Jefferson Adams
    Celiac.com 05/24/2013 - Gwyneth Paltrow is gluten-free and on a publicity swing as part of her role in Iron Man 3 this spring.
    In an interview in Self magazine, Oscar winner Gwyneth Paltrow spoke a bit about the benefits of eating gluten-free, and about her gluten-free cook book due out next month.
    The 40-year old actor explained how giving up gluten has changed her life for the better. For one thing, she says, she feels lighter and more relaxed. Before going gluten-free, Paltrow says she had "a lot of unexpressed anger. I made everyone else’s feelings more important than my own. I’d suck it up and then be alone in my car yelling at traffic or fighting with hangers in my closet when they got stuck together.”
    Paltrow has been derided by some for perhaps being too strict with her children's diets, by some for making her children a gluten-free diet, and by others for allowing them to break that diet.
    But the "Iron Man" star explained to Dr. Mehmet Oz, that the dietary restrictions were due to her children's allergies, rather than stern parenting style. She said that Moses, 6, "has very bad eczema and he's allergic to gluten and she [daughter Apple, 8] is allergic to cow dairy."
    She adds that, at home, she tries "to make everything gluten-free for him because the difference in his comfort is unbelievable when he's sticking to what he's meant to be eating."
    Paltrow's new cookbook, "It's All Good," details how she steers clear of processed grains when feeding her children, and goes out of her way to avoid gluten.
    Read more: NY Daily News, The Hollywood Gossip

    Jefferson Adams
    Celiac.com 01/22/2014 - With many major grocery brands struggling to generate sales growth, and with top gluten-free brands Udi's and Glutino racking up combined net sales growth of 53% last quarter, the writing is on the wall: More and more wheat based brands will be looking to break into the gluten-free market in the next three to five years.
    Boulder Brands CEO Steve Hughes told analysts on the firm's Q3 earnings call that Boulder is seeing "strong, consistent velocity in distribution builds across all channels" for gluten-free products.
    According to Hughes, 5-10% of all wheat-based product categories will be gluten-free in the next three to five years, or else they will disappear from the market.
    Again, as many wheat-based brands struggle for market share, Udi’s remains the fastest-growing brand in the conventional grocery store channel, and retailers are responding.
    Hughes said that Udi's 3rd quarter net sales were up 74% year-over-year, adding that "Glutino net sales grew 29%. Combined, our gluten-free brands increased net sales 53%." Udi's and Glutino now average nearly twenty items on retail shelves, up from about fifteen and a half just a year ago.
    Meanwhile, Hughes notes, the gluten-free pizza business has been performing“extraordinarily well.” He points out that many retailers now have three dedicated gluten-free sections, including a 4-12ft section in the ambient grocery aisles, half the full door in the frozen food aisles, and a frozen or shelf-stable rack in bakery.
    Hughes wrapped up his presentation by adding that gluten-free items are also gaining a share of the club store channel. He said that they were "...starting to get some testing of bread into the club channel, which could be very meaningful next year.”
    Hughes' presentation does imply that growth also means the pressures of competition for market share, both among gluten-free manufacturers and retailers, and between gluten-free and wheat-based manufacturers and retailers.
    All of this is basically good news for consumers of gluten-free products, as it means more and, hopefully, better quality products.
    Source:
    Food Navigator USA

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

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

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

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

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

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

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

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

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

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

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

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

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

    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