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      Frequently Asked Questions About Celiac Disease   04/24/2018

      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 is Celiac Disease and the Gluten-Free Diet? 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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    WILL NEW OAT PURITY STANDARDS MEAN LOWER PRICES, SAFER OATS?


    Jefferson Adams

    Celiac.com 05/12/2017 - The Gluten Intolerance Group (GIG) is an organization that certifies gluten-free products and food services. The GIG's latest definition and requirements for the product purity protocol was published by AACC International. The purity protocol defines the way of growing, harvesting and processing oats to keep them safe from gluten contamination, GIG's CEO, Cynthia Kupper, said.


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    Until now, the term lacked a uniform definition, allowing companies who used it a degree of wiggle room. Under the new standard, companies will now have to provide documentation that prove the processes they follow are based on the newly standardized definition in order to use the claim 'purity protocol oats,' said Kupper.

    "Given the continuing growth of the market for gluten-free products, it is essential that terms like 'purity protocol' be defined for both food manufacturers and consumers," she added.

    Farmers collect higher fees for growing and managing oats under purity protocol conditions, and those higher prices usually get passed to consumers.

    Currently, the gluten-free products most commonly contaminated by wheat are granola and cookies that contain oats, Kupper told Bakery and Snacks.

    In addition to providing more confidence for consumers, the new protocol could lead to a price decrease, partly due to an expected increase in demand for products made with pure oats. That demand is partly driven by added consumer confidence in purity protocol products.

    In addition to tightening the purity protocols for oats, GIG plans to further standardize gluten-free screening for other grains, including rice, quinoa and other grains, according to the organization.

    Keep an eye on purity protocol oats to see if the predictions of lower prices, higher consumer confidence and safer oats hold true, and if so, whether those protocols can be applied to grains like rice and quinoa.

    Read more at BakeryandSnacks.com.


    Image Caption: Photo: CC--Matt Lavin
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  • Related Articles

    Dr. Rodney Ford M.D.
    This article originally appeared in the Autumn 2009 edition of Journal of Gluten Sensitivity.
    Celiac.com 02/27/2015 - The answer to the "oats questions" are becoming clearer.
    The long-asked question is "Can people with celiac disease or gluten sensitivity safely eat oats?" Some people are so sensitive, that even the tiniest bit of gluten makes them feel unwell. So this answer is important because people on a gluten-free diet should not restrict foods unnecessarily. There are several aspects to this question:
    1. Avenin: Oats do not naturally contain gluten ... but there is a similar protein called "avenin" found in oats that has the same properties as gluten (it is the "prolamine storage protein" of oat seeds, that helps protect the dormant seed and nourish it when it begins to grow).Fortunately, adverse reactions to this oat protein are rare. A study of 10 pertinent studies, with a total of 165 patients, found only 1 patient who had histological gut damage as a result of eating oats. This condition is now called "avenin-sensitive enteropathy" (ASE). This is documented by Garsed & Scott "Can oats be taken in a gluten-free diet? A systematic review" (Scand. J. Gastroenterol. 2007:42: 171–8.
    Clinical reports now provide strong evidence that oats very rarely cause damage to the gut mucosa in people with celiac disease. Subsequently, guidelines from many coeliac societies now reflect this new evidence. Moderate amounts of oats (half a cup of oats a day) can be consumed by most celiacs without risk of damaging intestinal villi. However, it is important to emphasise that these oats must be free of other contaminating gluten-cereals.
    What is not reported is whether some of these people experience symptoms (feel unwell) despite the healthy appearance of their gut under a microscope. These people might have an "avenin-sensitivity" similar to gluten-sensitivity without any accompanying gut damage. This question has not yet been investigated.
     
    Cross-contamination: The reason that many people apparently react to oats is not because of the avenin, but to inadvertent gluten contamination. In other words, wheat and other gluten-grains accidentally get into the oats.Traces of gluten are commonly found in packets of oats–this is from the cross-contamination of oats with other gluten-grains. This contamination can occur during any stage of the life-cycle of oat production: the planting, the harvesting, the transportation, the processing and the refining of oats. It is almost impossible to avoid such cross-contamination unless all this machinery is exclusively devoted to oats production. This requires large-scale production as is seen in the USA.
    One research group analyzed a total of 134 oats samples, comprising grains and commercial oat products collected from Europe, the United States and Canada. This study confirmed that most oats were contaminated with mixtures of wheat, barley and rye (Hernando et al. "Measurement of wheat gluten and barley hordeins in contaminated oats from Europe, the United States and Canada by Sandwich R5 ELISA". Eur J Gastroenterol Hepatol. 2008 Jun;20:545-54.)
     
    Level of gluten sensitivity: How intensely people react to gluten varies. Some people can eat moderate amounts of gluten and have no symptoms at all. Whilst many are so sensitive that even the tiniest amount upsets them. Thus, minimal cross-contamination of oats with gluten is a problem for a significant proportion of the gluten-sensitive community.It may be that people who have extreme gluten sensitivity are more likely to react to avenin. It is my observation that super-sensitive gluten reactors seldom tolerate oats. However, this subject has not been researched.
     
    Asymptomatic gluten damage: Oddly, some people can have the gut damage of celiac disease without experiencing noticeable symptoms. They have severe gut damage but are completely unaware of it. Such a diagnosis is usually discovered by screening blood test. As these people do not get any symptoms from gluten, they would not know if oats are upsetting them either! These asymptomatic celiacs need to be followed up with regular blood tests (and perhaps subsequent biopsy) to ensure that they are healing.
      Why bother with oats?The ability to use oats in your diet gives an important source of fibre as well as other important nutrients. They have a low glycemic index (GI) which makes them satisfying to eat. Also, eating oats will contribute to lower cholesterol levels. And of course, it gives you a valuable additional food to make the topping on apple-crumble, hot oat porridge on a cold morning, and a crunchy, tasty muesli.
    Some companies certify their oats to be gluten-free, which means they are free from any cross-contamination. If you are very sensitive to gluten, then you might not tolerate oats. The best thing to do is try a little and see.
     
    Do blood tests: "Get a blood test!" is my mantra. So many people go gluten-free without a blood test. So many people with celiac disease never get follow-up blood tests. It is important to get a firm diagnosis of celiac disease / gluten sensitivity. Then to get more tests a year or two later to make sure that your body is healing. One way to check out how you are tolerating oats in your body is to get regular blood test checks for gluten (IgG-gliadin) and for tissue damage (DGP/tTG)–for more details please visit me at my website.

    Jefferson Adams
    Celiac.com 08/31/2016 - Oats are traditionally one of the more commonly contaminated gluten-free grains on the market.
    According to Gluten Free Watchdog, "gluten-free" foods made with oat ingredients are more commonly contaminated than foods made with other "gluten-free" grains. In light of their survey results, people with a high sensitivity to gluten might want to consider taking some extra steps to make sure their oats are truly gluten-free.
    The solution? Know your oats! To be sure that your oats are safe, Gluten Free Watchdog recommends following these easy extra steps:
    1) Make sure you are sourcing oats from a supplier of purity protocol oats, such as gluten-free Harvest, Avena, or Montana Gluten-Free. Currently, Gluten Free Watchdog does not recommend any of the commercial suppliers of mechanically and optically sorted oats, such as Grain Millers or LaCrosse Milling.
    2) Ask for test results. Regardless of where you source oats, ask your supplier to provide you with test results, including how frequently oats are tested and what assay is used for testing.
    3) Test the oats yourself. There is no such thing as too much testing. If you really want to be sure, you can send samples of oats to a third party lab for testing using the sandwich R5 ELISA and cocktail extraction. Labs include Bia Diagnostics and FARRP.
    Read more at Gluten Free Watchdog.

    Jefferson Adams
    Celiac.com 08/03/2016 - As part of its mission, Gluten Free Watchdog performs gluten testing on gluten-free products and shares that information with the gluten-free community. They've tested many gluten-free products over the years, and collected data from their efforts.
    Over the past five years, Gluten Free Watchdog has been testing oat products labeled gluten-free that list oats as the first or second ingredient. In all, they've done professional testing on thirty-five different commercial products. They've recently released their findings, and while they don't name any names, they do offer some good general insight into gluten-contamination levels in general.
    All testing for Gluten Free Watchdog was conducted by Bia Diagnostics, LLC using the sandwich R5 ELISA (Ridascreen Gliadin R7001) and cocktail extraction—Mendez method.
    Based on testing data from Gluten Free Watchdog, oat products labeled gluten-free have an almost three times higher risk of gluten contamination as compared to labeled gluten-free foods as a whole. The results showed 28 of 35 or 80% of oat products testing below 5 parts per million of gluten, and 2 of 35 or 6% of oat products testing at or above 5 ppm but below 20 ppm of gluten. Meanwhile, 5 of 35 or 14% of oat products tested at or above 20 ppm of gluten.
    The good news, of course, is that 86% percent oat products tested below 20 parts per million of gluten, but that's not nearly as good as the 95% of all gluten-free foods tested to date that have tested below 20 ppm of gluten.
    So, the bad news is that the 14% of oat products testing at or above 20 ppm of gluten is nearly three times higher than for gluten-free foods in general.
    Main culprits testing at or above 20 ppm of gluten included "gluten-free" labeled oat breadcrumbs, rolled oats, granola, hot oat cereal, and granola.
    Gluten Free Watchdog's main recommendation for consumers is to know the source of the oats you are eating, and to make sure you're getting your oats form a safe and trustworthy source. If you have a concern, check with the manufacturer to make sure they source ALL oats from a supplier of purity protocol oats, such as gluten-free Harvest, Avena, Montana Gluten-Free.
    Read more at Gluten-free Watchdog.org.

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    Tammy Rhodes
    Celiac.com 04/24/2018 - Did you know in 2017 alone, the United States had OVER TENS OF THOUSANDS of people evacuate their homes due to natural disasters such as fires, floods, hurricanes, tornadoes and tsunamis? Most evacuation sites are not equipped to feed your family the safe gluten free foods that are required to stay healthy.  Are you prepared in case of an emergency? Do you have your Gluten Free Emergency Food Bag ready to grab and go?  
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    You can find my Gluten Free Emergency Food Bags and other useful products at www.allergynavigator.com.  

    Jefferson Adams
    Celiac.com 04/23/2018 - A team of researchers recently set out to learn whether celiac disease patients commonly suffer cognitive impairment at the time they are diagnosed, and to compare their cognitive performance with non-celiac subjects with similar chronic symptoms and to a group of healthy control subjects.
    The research team included G Longarini, P Richly, MP Temprano, AF Costa, H Vázquez, ML Moreno, S Niveloni, P López, E Smecuol, R Mazure, A González, E Mauriño, and JC Bai. They are variously associated with the Small Bowel Section, Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital; Neurocience Cognitive and Traslational Institute (INECO), Favaloro Fundation, CONICET, Buenos Aires; the Brain Health Center (CESAL), Quilmes, Argentina; the Research Council, MSAL, CABA; and with the Research Institute, School of Medicine, Universidad del Salvador.
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    A total of thirty-three subjects were diagnosed with celiac disease. Compared with the 26 healthy control subjects, the 17 celiac disease subjects, and the 17 disease control subjects, who mostly had irritable bowel syndrome, showed impaired cognitive performance (P=0.02 and P=0.04, respectively), functional impairment (P<0.01), and higher depression (P<0.01). 
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    Source:
    J Clin Gastroenterol. 2018 Mar 1. doi: 10.1097/MCG.0000000000001018.

    Connie Sarros
    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
    Due to personal health reasons and restrictions, I find that I need to retire. My husband and I can no longer travel the country speaking at conferences and to support groups (which we dearly loved to do) nor can I commit to writing more books, articles, or menus. Consequently, I will no longer be contributing articles to the Journal of Gluten Sensitivity. 
    My following books will still be available at Amazon.com:
    Gluten-free Cooking for Dummies Student's Vegetarian Cookbook for Dummies Wheat-free Gluten-free Dessert Cookbook Wheat-free Gluten-free Reduced Calorie Cookbook Wheat-free Gluten-free Cookbook for Kids and Busy Adults (revised version) My first book was published in 1996. My journey since then has been incredible. I have met so many in the celiac community and I feel blessed to be able to call you friends. Many of you have told me that I helped to change your life – let me assure you that your kind words, your phone calls, your thoughtful notes, and your feedback throughout the years have had a vital impact on my life, too. Thank you for all of your support through these years.

    Jefferson Adams
    Celiac.com 04/20/2018 - A digital media company and a label data company are teaming up to help major manufacturers target, reach and convert their desired shoppers based on dietary needs, such as gluten-free diet. The deal could bring synergy in emerging markets such as the gluten-free and allergen-free markets, which represent major growth sectors in the global food industry. 
    Under the deal, personalized digital media company Catalina will be joining forces with Label Insight. Catalina uses consumer purchases data to target shoppers on a personal base, while Label Insight works with major companies like Kellogg, Betty Crocker, and Pepsi to provide insight on food label data to government, retailers, manufacturers and app developers.
    "Brands with very specific product benefits, gluten-free for example, require precise targeting to efficiently reach and convert their desired shoppers,” says Todd Morris, President of Catalina's Go-to-Market organization, adding that “Catalina offers the only purchase-based targeting solution with this capability.” 
    Label Insight’s clients include food and beverage giants such as Unilever, Ben & Jerry's, Lipton and Hellman’s. Label Insight technology has helped the Food and Drug Administration (FDA) build the sector’s very first scientifically accurate database of food ingredients, health attributes and claims.
    Morris says the joint partnership will allow Catalina to “enhance our dataset and further increase our ability to target shoppers who are currently buying - or have shown intent to buy - in these emerging categories,” including gluten-free, allergen-free, and other free-from foods.
    The deal will likely make for easier, more precise targeting of goods to consumers, and thus provide benefits for manufacturers and retailers looking to better serve their retail food customers, especially in specialty areas like gluten-free and allergen-free foods.
    Source:
    fdfworld.com

    Jefferson Adams
    Celiac.com 04/19/2018 - Previous genome and linkage studies indicate the existence of a new disease triggering mechanism that involves amino acid metabolism and nutrient sensing signaling pathways. In an effort to determine if amino acids might play a role in the development of celiac disease, a team of researchers recently set out to investigate if plasma amino acid levels differed among children with celiac disease compared with a control group.
     
    The research team included Åsa Torinsson Naluai, Ladan Saadat Vafa, Audur H. Gudjonsdottir, Henrik Arnell, Lars Browaldh, and Daniel Agardh. They are variously affiliated with the Institute of Biomedicine, Department of Microbiology & Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Division of Pediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden; the Department of Clinical Science and Education, Karolinska Institute, Sodersjukhuset, Stockholm, Sweden; the Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; the Diabetes & Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; and with the Nathan S Kline Institute in the U.S.A.
    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