Jump to content



Celiac.com Sponsor (A1):



Celiac.com Sponsor (A1-m):


  • You've found your Celiac Tribe! Join our like-minded, private community and share your story, get encouragement and connect with others.

    💬

    • Sign In
    • Sign Up
  • Scott Adams
    Scott Adams

    More Heart-Related Hospitalizations for Celiacs, But Lower Death Rates

    Reviewed and edited by a celiac disease expert.

    A new study shows that hospital admissions for celiac patients with acute myocardial infarction rose more than five-fold from 2005-2014, but for unknown reasons, in-hospital death rate in these patients is lower than in patients without celiac disease.

    More Heart-Related Hospitalizations for Celiacs, But Lower Death Rates - Bruce Lee with a big heart. Chinatown San Francisco. Image: Scott Adams
    Caption: Bruce Lee with a big heart. Chinatown San Francisco. Image: Scott Adams

    Celiac.com 04/20/2020 - From 2005 to 2014, hospitals recorded a sharp rise in the numbers of celiac disease patients admitted for acute myocardial infarction (AMI), according to researcher presenting at the ACC.20 World Congress of Cardiology. 

    A team of researchers recently set out to review the Nationwide Inpatient Sample for adults with AMI as a primary diagnosis, and celiac disease as a secondary diagnosis, between 2005-2014. The research team included Manish Gupta, Muhammad Umair Bakhsh and Kamesh Gupta. They are variously affiliated with the Danbury Hospital, Danbury, CT, USA, and the Baystate Medical Center in Springfield, MA, USA. 



    Celiac.com Sponsor (A12):






    Celiac.com Sponsor (A12-m):




    The team identified nearly 6.2 million AMI hospitalizations, of which 3,169 also had a diagnosis for celiac disease. Using survey regression, the researchers figured adjusted odds ratios (aOR) for hospital mortality, and other outcomes. The data showed that the rate of AMI-related hospitalization of celiac patients rose from 0.015% in 2005 to 0.076% in 2014. 

    The results showed that celiac+AMI patients tended to be a few years older, on average, and substantially more likely to be female. After adjusting for age, gender, race, Charlson Comorbidity index and hospital level characteristics, the researchers observed that celiac+AMI hospitalizations had a lower odds-ratio for hospital mortality. 

    Also, the results showed a slightly shorter length of stay for celiac+AMI patients, but much higher average hospitalization charges of just over $64,058 for celiacs, compared just over $60,000 for non-celiac AMI patients.  

    The data show that the number of celiac disease patients admitted for acute myocardial infarction (AMI) rose five times from 2005 to 2014, yet, for unknown reasons, the rates of in-hospital mortality is lower for these patients than in patients without celiac disease. 

    The study shows that even though inflammation seems to be causing more AMI hospitalizations in people with celiac disease, celiac patients seem to fare better than non-celiacs.

    This study illustrates very clearly some of the higher costs, both physically and monetarily, of having celiac disease. Celiacs see more hospital admissions for AMI-related issues, and it costs them more money, even though their stay is usually a bit shorter. The fact that their odds of dying as a result are lower is just one small consolation.

    Have you or a loved one been treated for an AMI-related heart condition? Do you have celiac disease? Share your thoughts below.

    Read more in the Journal of the American College of Cardiology. Volume 75, Issue 11 Supplement 2, March 2020

    Read more at Openwirenews.com

    Edited by Scott Adams


    User Feedback

    Recommended Comments

    Why are the costs higher for a celiac patient even though their stay could be shorter? Are there additional tests being done? Are they charged extra for food? Are special gluten-free medications being ordered? An interesting observation that requires an answer.  Thank you. 

    Link to comment
    Share on other sites


    Join the conversation

    You are posting as a guest. If you have an account, sign in now to post with your account.
    Note: Your post will require moderator approval before it will be visible.

    Guest
    Add a comment...

    ×   Pasted as rich text.   Restore formatting

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • About Me

    Scott Adams

    Scott Adams was diagnosed with celiac disease in 1994, and, due to the nearly total lack of information available at that time, was forced to become an expert on the disease in order to recover. In 1995 he launched the site that later became Celiac.com to help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives.  He is co-author of the book Cereal Killers, and founder and publisher of the (formerly paper) newsletter Journal of Gluten Sensitivity. In 1998 he founded The Gluten-Free Mall which he sold in 2014. Celiac.com does not sell any products, and is 100% advertiser supported.


  • Celiac.com Sponsor (A17):
    Celiac.com Sponsor (A17):





    Celiac.com Sponsors (A17-m):




  • Related Articles

    Jefferson Adams
    Celiac.com 03/14/2016 - Compared with the general population, people with celiac disease are almost twice as likely to have coronary artery disease (CAD), and 1.4 times as likely to suffer a stroke, according to a large retrospective study presented at the American College of Cardiology (ACC) Scientific Sessions.
    The data indicate that people with celiac disease might be at higher risk of CAD, even if they do not have standard cardiovascular risk factors, said co-investigator Dr Rama Dilip Gajulapalli of the Cleveland Clinic in Ohio.
    His team is calling on primary-care physicians, gastroenterologists, and other healthcare practitioners to be "mindful of their celiac patients," and to "be on the watch for probable cardiac diseases."
    Higher risk levels were seen even in patients under 65 years old, and may be due to the gut inflammation that can damage the small intestine in people with celiac disease. According to Dr Gajulapalli, "low-grade inflammation in the gut…can spill immune mediators into the bloodstream, which can then accelerate the process of atherosclerosis and, in turn, CAD."
    These findings are important for people with celiac disease, and for the doctors treating them. They support the idea that chronic inflammation of any kind can have a negative impact on heart health. For people with celiac disease, this can lead to higher rates of CAD, among other complications.
    So, the takeaway here is for people with celiac disease to check in with their doctors, and to be aware of any potential problems.
    Source:
    American College of Cardiology (ACC) 2014 Scientific Sessions


    Jefferson Adams
    Celiac.com 05/08/2017 - Do non-celiacs who eat a gluten-free diet face a greater risk of developing coronary heart disease?
    To shed some light on this question, a team of researchers recently set out to assess levels of long-term term gluten consumption in connection with the development of coronary heart disease. The research team included Benjamin Lebwohl, Yin Cao, instructor, Geng Zong, Frank B Hu, Peter H R Green, Alfred I Neugut, Eric B Rimm, Laura Sampson, Lauren W Dougherty, Edward Giovannucci, Walter C Willett, Qi Sun, and Andrew T Chan.
    They are variously affiliated with the Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA; the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; the Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA; and the Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
    For their prospective cohort study, the team looked at 64,714 women in the Nurses’ Health Study and 45,303 men in the Health Professionals Follow-up Study. None of the subjects had any history of coronary heart disease, and all completed a 131 item semiquantitative food frequency questionnaire in 1986 that was updated every four years through 2010.
    The researchers estimated gluten consumption based on the results of the food frequency questionnaires. Their study looked for patients who developed coronary heart disease, specifically fatal or non-fatal myocardial infarction. The team’s study data covered 26 years of follow-up, totaling 2,273,931 person years, 2431 women and 4098 men developed coronary heart disease.
    Participants in the lowest fifth of gluten intake had 352 incidences of coronary heart disease per 100,000 person years, while those in the highest fifth had a rate of 277 events per 100,000 person years. This equates to 75 fewer cases of coronary heart disease per 100,000 person years.
    After adjusting for known risk factors, the researchers noted that patients in the highest fifth of estimated gluten intake had a multivariable hazard ratio for coronary heart disease of 0.95 (95% confidence interval 0.88 to 1.02; P for trend=0.29).
    After further adjusting for intake of whole grains, and leaving the remaining variance of gluten corresponding to refined grains, the multivariate hazard ratio was 1.00 (0.92 to 1.09; P for trend=0.77).
    In contrast, after additional adjustment for intake of refined grains (leaving the variance of gluten intake correlating with whole grain intake), estimated gluten consumption was associated with a lower risk of coronary heart disease (multivariate hazard ratio 0.85, 0.77 to 0.93; P for trend=0.002).
    Long term dietary intake of gluten was not associated with risk of coronary heart disease. However, the researchers do stress the importance of dietary whole grains, and that their absence may increase the risk of cardiovascular disease. Because of this, the team discourages people without celiac disease, or some other medical reason, from adopting a gluten-free diet.
    Source:
    BMJ 2017;357:j1892 (Published 02 May 2017)


    Brian Dean, R.D., MS
    Celiac.com 12/07/2018 - What do hypertension, obesity, smoking and celiac disease have in common? They’re all important risk factors for coronary heart disease (CHD), a disease that kills more than a half a million people annually in the U.S. alone.(1) Based on emerging research, celiac disease may be a major contributor to heart disease in the Western world –making celiac disease an even greater public health threat than is currently understood. 
    CHD and Celiac Disease: A Brief History
    The connection between CHD and celiac disease has a 35-year history. It began with a 1976 study conducted by Southampton University Hospital researchers, who found that there was an “… apparent protective effect of coeliac disease on CHD risk which “…might result from malabsorption of dietary lipids.”(2) However, this study had a number of significant flaws including a small sample size of only seventy seven.  The most significant confounder in this study was the mortality rate of young subjects, which precluded them from the privilege of living long enough to develop CHD. Additionally, our understanding of CHD has undergone a paradigm shift since the low-fat 1970’s. CHD is not the result of excess dietary fat consumption, but instead is a manifestation of prolonged inflammation.(3)
    Based on this study and two others published around the same time period which found no link between CHD and celiac disease, researchers largely stopped investigating the heart health of people with celiac disease. The assumption was that celiac disease provided protection or, at the very least, was benign in terms of CHD risk. 
    Then came a paper published in the July 2003 Archives of Internal Medicine which reported that celiac disease patients had a sixty percent increased risk of CHD death.(4) More recently, in a January 2011 Circulation paper, Swedish researchers published eye-catching results from an investigation of more than 15,000 individuals with celiac disease.(5)
    The key finding from this research was an approximately twenty percent increased risk of CHD death in people with celiac disease.  While this research remains in its infancy, the biological connections between celiac disease and CHD are crystal clear, bolstering the epidemiological findings that people with celiac disease are at heightened CHD risk. 
    CHD Today
    Before delving into the physiological link between CHD and celiac disease, it’s crucial to understand the pathogenesis of atherosclerosis, or narrowing of the heart’s arteries. 
    Atherosclerosis begins with an injury to the endothelial lining of the coronary artery. A hyperactive response by immune cells, particularly macrophages and inflammatory cytokines, causes macrophage cells to become lodged inside the injured endothelium. Through a complex cascade of cell signaling, “trapped” macrophages transform into what are known as foam cells. These foam cells take in circulating blood lipids, especially low density lipoproteins (LDL). Over time this LDL/foam cell mishmash transforms into the arterial plaque most people are familiar with.(6)
    Inflammation fuels atherosclerosis from start to finish –from the initial injury to the development and accumulation of plaque. 
    The Inflammation Connection
    Unfortunately, inflammation is something that people with celiac disease have more than enough of. Serum C-reactive protein (CRP) is a commonly used parameter for celiac disease diagnoses –suggesting that nearly all uncontrolled celiac disease patients have elevated inflammation levels.(7)
    CRP also happens to be a more sensitive indicator of impending heart disease risk than serum cholesterol. Cleveland Clinic cardiologist Eric Topol claims that “…in the past, people talked about their cholesterol levels. In the next decade everyone will need to know their C-reactive protein level (a marker of inflammation).”(8)
    Other inflammatory mediators –such as IL-6 and TNF-a—are also present in greater amounts in celiac disease patients compared to the general population. In addition to the inflammatory response to ingested gluten, a March 2009 genetic analysis found that individuals with celiac disease were more likely to have polymorphisms that promote inflammatory cytokine production. (9)
    Other Links in the Chain
    And, there’s more to this celiac disease/CHD story than inflammation. People with celiac disease tend to have comorbidities that compound celiac disease’s damage to the cardiovascular system. 
    Fat Malabsorption
    Dietary fats are a heart-health double edged sword. Excessive intake of trans fats are strongly linked to dyslipidemia and heart disease. However, a recent American Journal of Clinical Nutrition meta-analysis which included over 340,000 research subjects in its analysis found no connection between saturated fat and heart disease. (10)
    Monounsaturated and polyunsaturated fats are protective against atherosclerosis. Omega-3 fats appear to confer a particularly strong cardiovascular disease prevention benefit.(11) Adequate intake and absorption of fats is crucial for CHD prevention. Indeed, a low-fat dietary pattern was shown to increase heart disease risk in a large-scale randomized control trial involving more than 48,000 subjects.(12)
    Absorption of dietary fats is severely impacted by celiac disease due to villous atrophy, pancreatic insufficiency and dysbiosis. Lewis et al found that untreated celiac disease patients had approximately twenty one percent lower serum cholesterol levels compared to the general population, suggesting severe fat malabsorption.(13) Based on this research and others it’s conceivable that many celiac disease patients don’t absorb the dietary fats required to combat heart disease. 
    Vitamin Malabsorption
    Suboptimal nutrient absorption is a near-universal issue in celiac disease patients – even for individuals consuming a gluten free diet. Fat soluble vitamin absorption is particularly affected by celiac disease.(14) Poor absorption of fat soluble vitamins E and D has been tied to increased heart disease risk in several studies. (15)
    Homocysteine
    Homocysteine is an amino acid that becomes elevated in cases of vitamin B6, folic acid or vitamin B12 deficiency. Poor B-complex vitamin absorption is common in both newly diagnosed celiac disease and in celiac disease patients following a gluten free diet.(16) An October 2002 Meta-analysis found that homocysteine levels twenty five percent above normal levels boosted heart attack risk by eleven percent.(17)
    Due to its strong correlation with heart disease, the American Heart Association suggests that individuals with malabsorption symptoms, including celiac disease, should be screened for homocysteine.(17) Simone Saibeni, MD and her University of Milan colleagues justified this recommendation by finding that celiac disease patients were 3.5 times more likely to have elevated hyperhomocysteinemia than the general population.(16)
    Type 1 Diabetes (DM1)
    Approximately five percent of people with celiac disease also suffer from DM1.(18) Hyperglycemia promotes inflammation, endothelium stiffness and arterial plaque formation.
    Rheumatism
    Symptoms of rheumatism, especially Sjogrens syndrome and unexplained joint pain, are common symptoms of undiagnosed celiac disease. Lubrano et al found that twenty five percent of individuals with celiac disease also have arthritis.(19) A 2008 population study discovered that people with rheumatoid arthritis have double the heart attack and stroke risk of the general population.(20)
    Whole Grain Intake
    Whole grain intake is strongly associated with a decreased risk of CHD.(21). Avoidance of fortified whole grains by people with celiac disease may impact dietary intake of B-vitamins, dietary fiber and antioxidants. 
    How People With Celiac Disease Can Fight CHD
    Preventing CHD in the celiac disease population isn’t dramatically different from what’s typically recommended to the general population. Maintaining a healthy body weight, eating adequate amounts of dietary fiber, staying physically active, avoiding trans fats and consuming monounsaturated fats regularly are the keys to cardiovascular health whether or not one has been diagnosed with celiac disease.
    However, there are a few important heart health caveats that those with celiac disease should keep in mind.
    Gluten-Free Diet
    The importance of a 100 percent gluten free diet for CHD risk reduction and overall health cannot be emphasized enough. Not only is it the most effective treatment for celiac disease, but it is also critical for limiting the inflammatory response that promotes atherosclerosis.(22,23)  Additionally, a strict gluten free diet allows the intestine to heal and recover, boosting absorption of nutrients necessary for cardiovascular health. 
    Multivitamin Supplementation
    Multivitamin/Multimineral supplementation is standard treatment for celiac disease today.(24) Supplementation helps partly compensate for malabsorption and suboptimal intake of vitamins and minerals. A multivitamin supplement for CHD prevention should include at least 100 percent of the RDA for folic acid, vitamin B12, vitamin B6, and fat-soluble vitamins D and E.
    Dietary Fats
    “Fat is the most commonly and severely affected nutrient in celiac disease,” reports
    Jay W. Marks, M.D., of Baylor University College of Medicine.(25) Individuals with celiac should aim to consume at least twenty five percent of their calories in the form of dietary fat. Healthy monounsatured and polyunsatured fat sources such as extra virgin olive oil, nuts, legumes, fatty fish, and seeds should form the foundation of a heart healthy celiac disease diet.  Pancreatic enzymes may be used to aid lipid absorption and reduce gastrointestinal symptoms like diarrhea and bloating. 
    Omega-3 Fats
    Omega-3 fats reduce inflammation, increase HDL cholesterol and make cardiovascular arteries resistant to injury. Zhang et al discovered that habitual fish consumption was associated with a forty percent reduction in CHD mortality in healthy populations.(26) Omega-3 fatty acids may have additional benefits for celiac disease patients, especially acceleration of intestinal healing. Celiac disease patients should consume fatty fish like mackerel and salmon at least twice weekly. 
    Conclusion
    Celiac disease needn’t be an automatic CHD death sentence. Although the connection between heart disease and celiac disease is very real, lifestyle changes can dramatically reduce the chances that someone with celiac disease will develop CHD. Simply eating a gluten-free diet, supplementing with vitamins, minerals and pancreatic enzymes and consuming omega-3 fats –four measures that those with celiac disease should be doing anyway – will shield the cardiovascular system from much of the celiac disease-derived damage that can lead to CHD.
    In fact, this new link can ultimately become a net positive for many celiac disease patients as it can motivate them to become more proactive and aggressive in their self-care. 
    References:
    1. Centers for Disease Control and Prevention; Heart Disease Facts; Available at: https://www.cdc.gov/heartdisease/facts.htm. Accessed April 18th 2011. 
    2. Whorwell PJ, Foster KJ, Alderson MR, Wright R. Death From Ischaemic Heart-Disease and Malignancy in Adult Patients With Celiac Disease. Lancet 1976;113-114.
    3. Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease, application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation  [serial online].2003;107:499-511
    4. Peters U, Askling J, Gridley G, et al. Causes of death in patients with
    celiac disease in a population-based Swedish cohort. Arch Intern Med. 
    2003;163:1566–1572.
    5. Ludvigsson JF, James S, Askling J, Stenestrand U, Ingelsson E. Nationwide cohort study of risk of ischemic heart disease in patients with celiac disease. Circulation. 2011 Feb 8;123(5):483-90
    6. Gotta A, Farmer F. Atherosclerosis: Pathogenesis, Morphology, and Risk Factors. Cardiovascular Medicine. 3rd Edition, Springer, London, pp. 1593-1613.
    7. Lahat N, Shapiro S, Karban A, et al. Cytokine profile in coeliac disease. Scand J Immunol 1999;49:441–446
    8. Role of inflammation-Growing proof inflammation is a major risk factor for heart disease. Available at: http://www.clevelandclinic.org/heartcenter/pub/news/hot/inflammation8_02.asp?firstCat=1&secondCat=429&thirdCat=524. Updated 8/02.  Accessed April 18th 2011.
    9. Dema B, Martínez A, Fernández-Arquero M, The IL6-174G/C polymorphism is associated with celiac disease susceptibility in girls. Hum Immunol 2009;70:191-4
    10. Siri-Tarino SW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr [serial online]. 2010;91:535-546.
    11. Perez-Jimenez F, Lopez-Miranda J, Mata P. Protective effect of dietary monounsaturated fat on arteriosclerosis: beyond cholesterol. Atherosclerosis 2002;163:385–98
    12. Howard BV, Van Horn L, Hsia J, et al. Low-fat dietary pattern and risk of cardiovascular disease: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006; 295:655-66
    13. Lewis NR, Sanders DS, Logan RF, Fleming KM, Hubbard RB, West J. Cholesterol profile in people with newly diagnosed coeliac disease: a comparison with the general population and changes following treatment. Br J Nutr. 2009 Aug;102(4):509-13
    14. Hallert C, Grant C, Grehn S, Granno C, Hulten S, Midhagen G, Strom M, Svensson H, Valdimarsson T. Evidence of poor vitamin status in coeliac patients on a gluten-free diet for 10 years. Aliment Pharmacol Ther. 2002;16:1333–1339
    15. Sesso HD et al.Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians’ Health Study II randomized controlled trial. JAMA. 2008 Nov 12;300(18):2123-33
    16. Saibeni S, Lecchi A, Meucci G, et al. Prevalence of hyperhomocysteinemia in adult gluten-sensitive enteropathy at diagnosis: role of B12, folate, and genetics. Clin Gastroenterol Hepatol 2005;3:574e80    
    17. Malinow MR, Bostom AG, Krauss RM. Homocyst(e)ine, diet, and cardiovascular diseases: a statement for healthcare professionals from the Nutrition Committee, American Heart Association. Circulation. 1999;99:178–182
    18. Ludvigsson JF, Olsson T, Ekbom A, Montgomery SM. A population-based study of coeliac disease, neurodegenerative and neuroinflammatory diseases. Aliment Pharmacol Ther 2007; 25:1317
    19. Lubrano E, Ciacci C, Ames PR, et al. The arthritis of celiac disease: prevalence and pattern in 200 adult patients. Br J Rheumatol 1996;35:1314-8
    20. Dhawan SS, Quyyumi AA. Rheumatoid arthritis and cardiovascular disease. Curr Atheroscler Rep. 2008;10:128-133
    21. Jensen MK, Koh-Banerjee P, Hu FB, et al. Intakes of whole grains, bran, and germ and the risk of coronary heart disease in men. Am J Clin Nutr. 2004;80(6):1492-1499
    22. Meresse B, Cerf-Bensussan N. Celiac disease: from oral tolerance to intestinal inflammation, autoimmunity and lymphomagenesis. Mucosal Immunol. 2009;2:8e23
    23. Popa C, Netea MG, van Riel PL, van der Meer JW, Stalenhoef AF. The role of TNF-a in chronic inflammatory conditions, intermediary metabolism, and cardiovascular risk. J Lipid Res. 2007;48:751–62    
    24. See J, Murray JA. Gluten-free diet: the medical and nutrition management of celiac disease. Nutr Clin Pract. 2006;21(1):1-15.
    25. Marks, J. “Celiac Disease (Gluten Enteropathy)”Available at: https://www.medicinenet.com/celiac_disease_gluten_enteropathy/article.htm. Accessed April 29th 2011. 
    26. Zhang J, Sasaki S, Amano K, et al. Fish consumption and mortality from all causes, ischemic heart disease, and stroke: an ecological study. Prev Med. 1999; 28: 520–529.


    Sarah  Curcio
    Celiac.com 07/11/2019 - If you have ever had to spend time in a hospital, whether it was for an overnight care or an emergency visit, and you have celiac disease, then you know how difficult it can be.
    Hospital cafeterias are not equipped to handle cross-contamination on a whim’s notice. A nutritionist or dietitian needs at least a week of advanced notice before you arrive to notify and prepare their chefs and kitchen staff with appropriate directions. That way, you will not have to be fearful of cross-contamination to your breakfast, lunch, or dinner. Plus, you can even work with them to be able to bring your own prepared food with you and store it appropriately in their pantry or refrigerator.
    However, if you are going in for testing or a procedure this is most likely adding more stress to your already nerve-wracked mind. There really should be a better way for hospitals to have safe options available automatically, especially since celiac disease diagnosis has been on the rise over the last decade, if not longer.
     
    Having gluten-free options such as fresh fruit, vegetables, eggs, and nuts should be the easiest food items to keep in stock. Hospitals really need to think outside the box of traditional foods such as gluten/wheat, corn, and soy, especially in today’s world. 
    Celiac disease is an autoimmune disease that needs to be taken care of with special consideration in various venues from your own home, to restaurants, grocery stores, work, college, hospitals, and more. Having gluten-free menus, accommodations at business meetings, being able to have a dorm room to yourself, and more are all just a part of the Americans with Disabilities Act.
    So, if you thought that sharing a non-gluten free kitchen with your loved ones was a hard experience, it really is a piece of cake in comparison to a hospital stay. 
    References:
    https://www.cliac.com/forums/topic/118442-overnight-hospital-stay/  https://glutenfreern.com/ada-celiac-gluten/ 


  • Popular Now

×
×
  • Create New...