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More Black Americans Avoiding Gluten

Celiac.com 04/29/2015 - In addition to people with celiac disease, a number of people in the U.S. do not have celiac disease, but avoid gluten (PWAG).

Photo: CC--AsboluvResearchers don't know much about racial disparities in the rates of celiac disease, and among those without celiac disease, but who avoid gluten. A team of researchers recently set out to investigate and describe racial differences in the prevalence of celiac disease and PWAG, and evaluate the trends of celiac disease in the non-institutionalized civilian adult population of the US between 1988 and 2012. The research team included Rok Seon Choung MD, PhD, Ivo C Ditah MD, MPhil, Ashley M Nadeau, Alberto Rubio-Tapia MD, Eric V Marietta MD, Tricia L Brantner, Michael J Camilleri MD, S Vincent Rajkumar MD, Ola Landgren MD, PhD, James E Everhart MD, MPH, and Joseph A Murray MD.

They are variously affiliated with the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA, Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA, the Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA, the Myeloma Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA, and with the Department of Health and Human Services, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA

The team conducted a population-based cross-sectional study using data from the National Health and Nutrition Examination Surveys (NHANES) from 1988 to 1994, 1999 to 2004, and 2009 to 2012. They tested serum samples from the NHANES participants for celiac serology, which included IgA tissue transglutaminase (tTG IgA), and then tested any abnormal findings for IgA endomysial antibodies.

They used an interviewer-administered questionnaire to gather information about patient adherence to a gluten-free diet.

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Their review of NHANES 2009–2012 showed that adjusted rates of celiac disease were significantly higher (P<0.0001) in non-Hispanic whites (1.0%) than in non-Hispanic blacks (0.2%) and Hispanics (0.3%).

Meanwhile, blacks showed a significantly higher adjusted prevalence of PWAG of 1.2% (P=0.01), compared with Hispanics at 0.5% and whites 0.7%.

In adults aged 50 years and older, seroprevalence of celiac disease rose from 0.17% (95% confidence interval (CI) 0.03–0.33) in 1988–1994 to 0.44% (95% CI 0.24–0.81) in 2009–2012 (P<0.05).

Overall rates of celiac disease increased from 1988 to 2012, which is much more common in white Americans than in black Americans. Interestingly, black Americans make up a higher proportion of individuals maintaining a gluten-free diet in the absence of a celiac disease diagnosis.

It may be that celiac disease, or non-celiac gluten sensitivity, are more common in the black population that previously understood. Further study will undoubtedly shed some light on this issue.

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2 Responses:

 
Nieka Jones
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said this on
09 Jul 2015 1:28:02 PM PDT
The reason for the situation in the African-American Community is that most of us were misdiagnosed as having IBS which was coined by Doctors as "non-white celiac disease" as well as Food Intolerance and Hives or Eczema along with Hemorrhoids, Diverticulitis or Diverticulosis instead of being diagnosed with IBD such as Crohn’s and Ulcerative Colitis before 2009. The diagnosis of Celiac and IBD was common in the African-American Community if you’re light-skinned! After 2009, some doctors began to diagnose medium and dark skinned person as having Celiac and IBD! The reason for the jump is correlated conditions such as pre-type 1 diabetes and GYN issues like not having a period for 3 months along with better training to get everyone testes regardless of race or skin complexion in African-Americans! While a small portion are still clinging to old attitudes by not giving the proper diagnoses in spite of what the blood test reveals and not ordering follow up tests like Colonoscopy and Endoscopy; but a prescription for Probiotics for we can’t (in their opinion) afford GF products and better of preparing to take a turn for the worst by eventually getting and dying of Colon Cancer! Colon Cancer rates are higher in the community due to these biased ways of thinking!

This is considered a stigma in the African-American Community for your excluded from joining a church and/or get put out of your church (excommunicated) someone in the church notifies the pastor of this fact or asking for a GF Wafer to have during Communion by telling you to practice African-America Spirituality aka Afrocentric Voodoo if you insist on being a Christian—go Presbyterian or Episcopal (aka Anglican)! On top of things being excluded from going to a Soup Kitchen/Food Pantry because the pastor doesn’t want to pay the local Food Bank Distributors $40 for the Specialty Food Items for you to pick up at the church by telling you to go down to the Food Bank Distributors directly with a Doctor’s note and original documents (Birth Certificate; Social Security Card; Drivers or Non-Driver’s License and/or Passport) and Credit or Debit Card to pay $40 to have the stuff shipped directly to your home! The food is usually given past the expiration date! Another option if the pastor puts food in your home, you’ve got to host the pastor’s family as well as family members of various ministries in your home for 3 nights in a row in exchange for the fresh Specialty Food Items from Costco’s! These are the options in the African-American Community!

 
Nieka Jones

said this on
09 Jul 2015 1:39:29 PM PDT
I forgot to add, that since the availability of GF items being sold in grocery stores since 2010 or 2011 has skyrocketed because of the GF Craze; African-American can shop in their local grocery store instead of traveling to a ritzy neighborhood to buy GF products but if you’re on a fix income like SSI, SSD, or PA this could easily eat up your money in no time! Even though the some company such as Betty Crocker and Barilla Pasta have made GF versions alongside the wheat version that’s sold in local grocery stores, the GF option still costs more them the wheat based one but not organic!




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Cycling Lady, LMAO at IBeStumped! So true. Yes, he is trying the band aid approach it seems. That's probably the most frustrating thing of all. So yesterday I get a call back from his office and they say to stop taking the Viberzi and switch back to Imodium! I reminded them that Imodium didn't work, I had already used it 8 days with no changes. His assistant informed me that that is all he can recommend at this time until he sees me at my next appointment which is 5/24! I live near Chicago and I am about to make an appointment to go to the University of Chicago hospital which is the top celiac research hospital in the country. Hopefully they can give me better answers.

7Hi jen and welcome No-one can diagnose remotely via nterwe posts but if there was such a game as celiac / gluten sensitive bingo, I would be calling 'House!' having read your account above... Lots of things fit the pattern as I'm sure your lurking has revealed. It's a tricky condition to diagnose however so you may have a little wait before you join the coolest club in town and get your funky celiac membership card For now it's really important that you stay on gluten. Keep eating it as accurate testing requires it. Ask your doctor to check the boxes for celiac testing alongside your liver blood tests. There should be enough in your history to get this without hassle but if they're reluctant INSIST and don't be afraid to assert your reasonable suspicion and wish to clarify and exclude. A good liver specialis will be aware of the possible links so you should be ok. If not gt second opinion. Ask for a full celiac panel as there are variety of tests. Find further info here There's a lot to take in, but be positive, I think you are on the right track and if so, you could soon be feeling better than you ever thought possible!

Hello, I am in a job that I travel every 3rd week...It gets challenging becuase many times I am doing audits of warehouses and they dont even have a cafeteria. I usually bring gluten-free protein bars as a back up if I have to miss a meal and then eat when I get back to the hotel. Just a suggestion because they certainly fill me up....Have a safe trip...Kelly

Hello all, I'm a new member here but have lurked for a while. I'm looking for some advice regarding my medical history, possible symptoms of celiac and next steps. General info: female, low level smoker, drink alcohol, aged 32. I started having bad gastro issues when I was around 17. Since then I've consistently suffered from chronic diarrhoea, frequent discomfort in the tummy area, feelings of dehydration despite drinking at least eight glasses a day and frequent fatigue for no real reason. In 2008/9 I visited the doctor as my diarrhoea was having an effect on my studies at the time. The doctor tested me for allergies; eggs, fish, gluten and lactose and did a "standard" blood test. Everything came back fine except my liver results, which were elevated to double (I did not the see the results for myself so can't say which enzymes etc). I was told to drink less and take Imodium. The doctor implied that perhaps I was stressed and / or anxious and, still being young plus a student who regularly went out drinking, I accepted this advice and carried on with my life. I would here add that I am not an unusually stressed person - in fact, learning to deal with my unpredictable bowels has forced me to be quite a laid-back person! Fast forward to 2016. I had been living with my partner for two years by this point who had noticed my bowel habits and informed me that this was definitely not normal. He encouraged me to try out a gluten free diet since I was apprehensive about visiting a doctor only to be fobbed off with Imodium again. I did the diet as strictly as a newbie can for around two months before we set off travelling. During the diet I noticed that after a couple of weeks of extreme tiredness I felt quite a lot better - I kept a food journal at the time which showed that I almost immediately had diarrhoea once after eating an ice-cream, i felt bloated and unwell after an attempt to make oat muffins (maybe i didn't cook them very well though!) and I felt bloated and had diarrhoea after eating some fish fried in flour (We made a mistake in ordering them but I didn't want to complain). My partner also reported that my mood swings (which I admit can be a little unpredictable) were much better. Once we started travelling I gave up and ate what I was given as we were staying with friends etc much of the time. Toward the end of our trip I started to feel extremely tired, to the point of having to stay in for "rest" days, and my guts were very unhappy. I chalked it up to irregular eating patterns, too many beers and late nights in general. During the trip I also had an extreme hangover after drinking wheat beer. And, while of course I accept that any overindulgence can make you ill, I really felt that that level of hangover was quite out of the ordinary. Finally, I developed a strange lump under my armpit during this period. Now back at home, I decided to go to the doc and check out the odd lump under my armpit. The doctor was pretty confident that it was nothing to worry about cancer-wise but she ordered a battery of blood tests just to be sure. The lump is fine (good news) but the results showed elevated GGT, high-ish ALT and normal AST liver enzymes plus signs of dehydration in red bloods / higher (but not concerning) levels of white bloods. I'm scheduled to go back for another blood test to double-check liver function and discuss results - if it is again high she will send me for a ultrasound. Does this history chime with anyone here? I know that the correct course in basic health terms is to stop drinking for some time (easily done) and stop smoking forever (easy to say...) but I cannot help but think that something else is going on here. I will discuss this with my doctor and make clear that my bowel issues have not been resolved and that the initial IBS diagnosis wasn't based on any thorough testing so to speak. In the meantime - does anyone have any advice for me in times of avenues to research or experience of similar symptoms? Gluten remains in my diet but in all other respects it could be regarded as very healthy, I think anyway... (pescatarian, plenty of fruit and veg, little to no sugar on a daily basis, not much dairy to speak of...) Thanks in advance and sorry for bending everyone's' ear about this... I guess it's just taken a long time for me to admit I might be sick and I need some help. Jen

Wish I could give you a hug. Unfortunately I know how that feels with Neurologists, Internists, Endocrinologists, Rheumatologists, GIs..... I got so tired of crying my drive home after refusing yet another script for Prozac. I do hope your GI can give you some answers even if it is just to rule out other possible issues. Keep on the gluten and we are here for you.