Celiac.com 04/13/2023 - Contrary to popular medical wisdom, a recent study suggests that some celiac disease patients who occasionally ingest gluten may not experience significant clinical symptoms or small bowel damage. 

A gluten-free diet is currently the only medically accepted treatment for celiac disease, but adherence can be challenging, and many patients report occasional voluntary transgressions.

Eating a gluten-free diet lowers the quality of life for most celiac disease patients, many of whom frequently ask if it's okay to occasionally ingest gluten-containing food. 

To get a better idea of the issue, a research team evaluated celiac patients reporting voluntary and occasional transgressions to their gluten-free diet. 

The Research Team

The team included Luca Elli, Karla Bascuñán, Lorenzo di Lernia, Maria Teresa Bardella, Luisa Doneda, Laura Soldati, Stefania Orlando, Francesca Ferretti, Vincenza Lombardo, Giulio Barigelletti, Alice Scricciolo, Sabrina Fabiano, Maurizio Vecchi & Leda Roncoroni.

They are associated with the Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; the Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan; the Department of Health Sciences, University of Milan, Milan, Italy; and the Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.

Celiacs Voluntarily Eat Gluten- The Study

Researchers prospectively enrolled 109 celiac patients who reported occasional and voluntary gluten ingestion and a group of patients on strict gluten-free diet as controls. 

The study involved clinical examination, blood tests, duodenal biopsy, capsule enteroscopy, and a validated food-frequency questionnaire to assess gluten intake. The results showed that 57% of noncompliant patients did not present any histological alteration, and 70% did not present any alteration at capsule enteroscopy. 

Furthermore, 75% of patients reported no gastrointestinal symptoms after gluten ingestion. The findings suggest that celiacs can achieve a degree of tolerance towards gluten consumption can be reached, and occasional gluten intake may not necessarily lead to significant clinical symptoms or small bowel damage. 

However, the researchers highlight that strict gluten-free diet adherence is still the best course of action to prevent long-term complications, and more research is needed to understand the mechanisms behind tolerance towards gluten ingestion in celiac patients.

Clearly this result runs counter to popular wisdom, and even to some science. The conclusion will likely cause a stir in the celiac and the medical and scientific communities. For people with celiac disease, it's crucial to have a clear picture of the proper parameters of treatment. With so much at stake, for both doctors and, especially patients, it's clear that more research is needed to get a truly clear picture of the effects of minor gluten-consumption on people with celiac disease.

Read more at BMC Medicine

Celiac.com 04/05/2023 - Over the past few years, the gluten-free food market has grown significantly. However, it is important to question whether these products are actually contributing to balanced diets.

A recent study aimed to investigate the nutritional composition of various gluten-free products produced nine years apart. The study also compared the nutritional compositions of 104 gluten-free products currently marketed in Spain with their gluten-containing counterparts.

The Researchers

The study team included Claudia Mármol-Soler, Silvia Matias, Jonatan Miranda, Idoia Larretxi, María del Pilar Fernández-Gil, María Ángeles Bustamante, Itziar Churruca, Olaia Martínez, and Edurne Simón. They are variously affiliated with the Gluten Analysis Laboratory, Department of Pharmacy and Food Science, University of the Basque Country (UPV/EHU), 01006 Vitoria-Gasteiz, Spain; the GLUTEN3S Research Group, Department of Nutrition and Food Science, University of the Basque Country, 01006 Vitoria-Gasteiz, Spain, the Bioaraba, Nutrición y Seguridad Alimentaria, 01006 Vitoria-Gasteiz, Spain; and the Centro Integral de Atención a Mayores San Prudencio, 01006 Vitoria-Gasteiz, Spain.

The Methods

Three descriptive and comparative studies were done on gluten-free products. The first study compared the nutritional information panel (NIP) of 104 gluten-free products from 11 specific brands in 2013 against the same products currently available in 2022. The second study made a nutritional comparison between 104 currently available gluten-free products and their analogs with gluten. Both studies recorded NIP data and analyzed nutrient composition. The third study aimed to highlight the impact on nutritional value of a possible gluten-free product inclusion in a celiac diet by comparing a diet that includes gluten-free products and the same diet with gluten foodstuffs.

The Findings

Their research showed nutritional differences between gluten-free products produced in 2013 and 2022, particularly in the areas of cookies, breakfast cereals, doughs/puff pastries/pizzas, and breads. Additionally, the pasta group had significant decreases in energy, protein, simple carbohydrates, saturated lipids, dietary fiber, and salt.

When comparing gluten-free and similar gluten-containing products in 2022, the major differences were found in protein and salt. This indicates that gluten-free products lead to a diet lower in protein and higher in salt and carbohydrates.

Although there have been some improvements in the formulation of gluten-free products, the macronutrient profile still varies greatly, and gluten-free products cannot be considered nutritionally equivalent, let alone superior, to their gluten-containing counterparts.

Basically, in many cases, the nutritional value of gluten-free products has gone down over the years. Because of this, celiacs need to update our knowledge, and learn more about the nutritional composition of the foods we eat, especially gluten-free products. This will help us to make better choices, and and to better manage our condition. As always, stay informed, choose carefully, and trust your gut.

Read more in Foods 2022.

Celiac.com 04/03/2023 - People with celiac disease must follow a gluten-free diet for their entire lives in order to stay healthy. But, gluten-free foods are traditionally high in salt, sugar and fat, among other things. So, what's the impact of a gluten-free diet on the nutritional levels of people with celiac disease?

A team of researchers recently looked at studies of adults and children with celiac disease who followed a gluten-free diet, to see if they were getting the proper nutrients in their diets.

The Research Team

The research team included Monica Gessaroli, Leonardo Frazzoni, Usama Sikandar, Gabriele Bronzetti, Andrea Pession, Rocco Maurizio Zagari, Lorenzo Fuccio & Maria Luisa Forchielli. They are variously affiliated with theDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; the IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; the Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; and the Health Sciences and Technologies Interdepartmental Center for Industrial Research (CIRI-SDV), University of Bologna, Bologna, Italy.

The Gluten-Free Diet Nutritional Study

The researchers searched through several databases for studies, conducted through October 2022, that looked at the nutrient intake of celiacs who followed a gluten-free diet. They used statistics to combine the results from different studies and see if there were any patterns.

They found thirty-eight studies covering a total of 2,114 patients. On average, people with celiac disease on a gluten-free diet consumed 1,995 calories per day. Almost half of these calories came from carbohydrates, 16% from proteins, and 36% from fats.

Teenagers consumed the most fats, while adults did not get enough dietary fiber. Calcium, magnesium, and iron intake was particularly low in teenagers, while vitamin D intake was low for all age groups.

Conclusion

In conclusion, people with celiac disease who follow a gluten-free diet may not get enough essential nutrients, and may consume too much fat. Since a gluten-free diet is a lifelong treatment, it is important to regularly check on people's nutrient intake to prevent other health problems, and to take supplements if needed.

That means that people with celiac disease should work with their doctors to create a plan for monitoring their nutrition over time.

Read more in European Journal of Clinical Nutrition

Celiac.com 03/20/2023 - People with celiac disease who contract COVID-19 are twice as likely to be hospitalized as non-celiacs, according to a new U.S. study, published online in Clinical Gastroenterology and Hepatology. However, the study also found that COVID-19 vaccination decreased the risk of hospitalization by nearly 50% for both groups. 

This is the first study to show the effect of vaccination on reducing the risk of hospitalization in patients with celiac disease and COVID-19 infection. 

Despite the increased risk of hospitalization, patients with celiac disease did not experience significant differences in intensive care unit requirement, mortality, or thrombosis compared to non-celiacs. 

The study suggests that celiac disease patients with COVID-19 are not inherently at greater risk for severe outcomes. 

The researchers compared COVID-19 incidence and outcomes between patients with and without celiac disease before and after vaccination and found similar outcomes between the two groups before vaccination. 

The study analyzed 171,763 patients diagnosed and treated for COVID-19 at the institution between March 1, 2020, and January 1, 2022, with 110 of those adults having biopsy-proven celiac disease. 

The median time from biopsy diagnosis of celiac disease to COVID-19 was 217 months, with more than 2 out of 3 patients following a gluten-free diet.

Read more at Medscape Medical News

Celiac.com 02/28/2023 - Previous studies have suggested that viruses may trigger the development of autoimmune diseases such as celiac disease. 

A team of clinicians report on the case of a 75-year-old man who developed intractable diarrhea after contracting COVID-19. In their case report, the team describes what they believe is the first case report of asymptomatic celiac disease and microscopic colitis unmasked by COVID-19. 

The team includes Tze Shien Lo, MD, Joshua D. LeClaire, DO, Rajib K. Lala, MD, Fadel Nammour, MD, and Kristine Saunders, MD. They are variously affiliated with the Infectious Disease Service, Fargo VA Healthcare System, Fargo, North Dakota; the Pathology Service, Fargo VA Healthcare System, Fargo, North Dakota; the Medicine Service, Fargo VA Healthcare System, Fargo, North Dakota; the Gastroenterology Service, Fargo VA Healthcare System, Fargo, North Dakota; and the Pathology Service, Fargo VA Healthcare System, Fargo, North Dakota.

The team suspects that the COVID-19 either revealed or triggered histology-proven celiac disease and microscopic colitis, which caused the diarrhea. 

Viruses Can Trigger Celiac Disease

Multiple studies have suggested reovirus, rotavirus, enterovirus, adenovirus, hepatitis C virus, and other viruses may serve as triggers for the development of autoimmune diseases, such as celiac disease. 

The case report tells the story of a 75-year-old man was on a solo driving trip across the USA and developed COVID-19-related symptoms, and then subsequently developed symptoms of celiac disease and microscopic colitis. The man had no history of GI diseases, but developed symptoms of anosmia, dysgeusia, fatigue, weakness, nausea, vomiting, abdominal cramping, and frequent diarrhea. 

He sought medical attention at a hospital in North Dakota, where he tested positive for SARS-CoV-2. While hospitalized, he experienced severe dehydration and hypokalemia, which improved with intravenous fluids. 

Although his stool tests for SARS-CoV-2 and Clostridium difficile were negative, he was found to have celiac disease and microscopic colitis. 

The patient was treated with a gluten-free diet and oral budesonide, which resulted in a gradual improvement in his symptoms.  He has continued to have formed stool while following a strict gluten-free diet.

As of October 2022, the patient has been off budesonide for two years and continues to have formed stool by following a strict gluten-free diet. However, he experiences abdominal bloating and nausea when inadvertently ingesting food containing gluten. 

The case highlights the potential for COVID-19 to unmask underlying autoimmune or inflammatory diseases and the importance of considering noninfectious causes in patients with persistent GI symptoms.

The team advises clinicians to be aware of the potential for celiac disease and microscopic colitis unmasked by SARS-CoV-2 in a COVID-19 patients who develop intractable diarrhea.

Read more in Annals of Internal Medicine Clinical Cases

Celiac.com 02/27/2023 - Functional gastrointestinal disorders (FGIDs) are common in children, but are not connected to physical or biochemical defects. 

We know that celiac disease patients face a higher general risk for FGIDs, functional abdominal pain, even if they closely follow a gluten-free diet. However, even though several studies have evaluated an overlap between FGIDs and organic diseases, little information is available for children. To address this gap, a team of researchers conducted a study to evaluate the prevalence of FGIDs in children with celiac disease after one year of follow-up. 

The Research Team

The research team included Francesca Fiori Nastro, Maria Rosaria Serra, Sabrina Cenni, Daniela Pacella, Massimo Martinelli, Erasmo Miele, Annamaria Staiano, Carlo Tolone, Renata Auricchio, and Caterina Strisciuglio. They are variously affiliated with theDepartment of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II”, Naples Italy; the Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples; the Department of Public Health, University of Naples “Federico II”, Naples; and the Department of Woman, Child and General and Specialistic Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy.

They also compared the prevalence of FGIDs in children with celiac disease on a gluten-free diet with processed foods versus a gluten-free diet with natural products. 

Study to Evaluate the Prevalence of FGIDs in Children with Celiac Disease

The team recruited pediatric patients aged 1-18 years and randomized them into two groups: one on a gluten-free diet with processed foods, and the other on a gluten-free diet with natural products. 

The team conducted clinical monitoring, diet assessments, and questionnaires, and used a 3-day food diary to measure dietary intake. 

The results showed that children with celiac disease on a gluten-free diet have elevated rates of FGIDs, and suggest that FGIDs may be linked to caloric intake and food fat percentage, but this does not change between processed and natural gluten-free diets. 

However, more long-term monitoring is needed to fully evaluate the correlation between FGIDs and different gluten-free diets.

Keywords: Functional gastrointestinal disorders, Celiac disease, Gluten free diet, Gastrointestinal symptoms, Children

Read more at World J Gastroenterol 2022; 28(46): 6589-6598

Celiac.com 02/20/2023 - Celiac disease is a condition that is caused by the immune system's response to gluten, a protein found in wheat, rye and barely. In celiac patients, an immune response triggers a pro-inflammatory environment in the small intestine, causing damage to the tissue. A major role in the pathogenesis of celiac disease is played by the HLA-restricted gliadin-specific intestinal T-cell response generated in a pro-inflammatory environment. 

A recent review article highlights the growing body of research that supports the central role of inflammation in the development of celiac disease, and how it is influenced by factors such as sensitivity to gluten and other pro-inflammatory agents. 

The review is authored by researchers Maria Vittoria Barone, Renata Auricchio, Merlin Nanayakkara, Luigi Greco, Riccardo Troncone, and Salvatore Auricchio. The are variously affiliated with the Department of Translational Medical Science, University Federico II in Naples, Italy; and the European Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II in Naples, Italy.

Live studies on a population at risk have explored the mechanisms behind this inflammation. These studies show cellular and metabolic alterations in the absence of a T cell-mediated response, before the onset of the disease and before the introduction of gluten in the diet. Gluten exacerbates these constitutive alterations, both live and in the lab. 

The role of inflammation in celiac disease has led researchers to consider it as a chronic inflammatory disease, similar to other autoimmune disorders. 

The review also explores the crucial role played by the intestine in controlling inflammation both locally and systemically, and the impact of nutrients and gut bacteria on inflammation. 

Reduction of Early Inflammation Could Delay Onset of Celiac Disease

Celiac disease is characterized by inflammation, which plays a critical role in the onset of the disease. It begins with a pre-clinical phase where the body is set up for inflammation, making it susceptible to various pro-inflammatory agents, including gluten. Historically, research has focused on the T-cell response in celiac disease, but there is growing recognition of the importance of the pre-inflammatory state. Modulating this state with a Mediterranean-type diet or preventing intestinal viral infections could have a significant impact on the onset of celiac disease, and could be easier to manage than the more complex autoimmune response. The implications of this research extend to additional chronic inflammatory diseases including inflammatory bowel diseases and diabetes, where early intervention with the state of inflammation in at-risk subjects could have a lasting impact on their health.

Read more in mdpi.com

Celiac.com 02/09/2023 - Micronutrients include vitamins and minerals that help our bodies to work properly. People with micronutrient deficiencies can suffer form both short-term and long-term health issues. One of the main causes of micronutrient deficiencies is reduced nutrient intake and/or poor nutrient absorption by the gut. However, new research suggests that the gut microbiome also plays a crucial role in making micronutrients available for the body.

Researchers Monica Barone,  Federica D'Amico, Patrizia Brigidi, and Silvia Turroni recently looked at gut microbiome and micronutrient interaction as a potential key to controlling the bioavailability of minerals and vitamins. They are variously affiliated with the Microbiomics Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna Italy; and the Unit of Microbiome Science and Biotechnology, Department of Pharmacy and Biotechnology, University of Bologna, Bologna Italy.

The gut microbiome is made up of a diverse collection of microorganisms that live in the human gut. These microorganisms play a critical role in regulating levels of micronutrients in the body. They do this by influencing biochemical processes and the absorption of these micronutrients. For example, certain bacteria in the gut can produce vitamin K, while others can improve the absorption of iron and calcium.

Gut Microbiome Influences Vitamin Uptake and Availability

Vitamin B-12 is one of the most well-known vitamins influenced by the gut microbiome. B-12 is crucial for the proper nervous system function, and proper formation of red blood cells. B-12 is typically found in animal-based foods, and can be difficult for vegans and vegetarians to obtain through diet alone. However, certain gut bacteria have the ability to produce vitamin B12, which can then be absorbed by the host.

Vitamin D is also influenced by the gut microbiome. Vitamin D is important for proper bone and immune system health. Recent studies show that gut bacteria can influence the metabolism of vitamin D, and increase its bioavailability.

The gut microbiome also plays a role in the absorption of minerals such as iron, zinc, and calcium. Iron is essential for the production of red blood cells, and is often deficient in vegetarians and vegans. 

Some Gut Bacteria Improve Mineral and Vitamin Absorption

However, certain gut bacteria have been shown to improve the absorption of non-heme iron, which occurs in many plant-based foods. Zinc is important for immune function and wound healing. Some gut bacteria can improve zinc absorption. Calcium is essential for bone health and the proper functioning of muscles and nerves. Certain gut bacteria can aid in the absorption of calcium and can also produce compounds that can help to increase bone density.

In addition to influencing the bioavailability of micronutrients, the gut microbiome also plays a role in the composition and functionality of the microbiome. For example, a diet that is high in processed foods and low in fruits and vegetables can trigger an imbalance in the gut microbiome, which can then trigger micronutrient deficiencies. On the other hand, eating a diet high in fruits and vegetables helps to promote a healthier and more diverse gut microbiome that is more capable of producing and absorbing micronutrients.

Personalized strategies to improve gut microbiome health could become an effective tool to reverse micronutrient deficiencies. Factors including diet, probiotics, and prebiotics can all be used to influence gut microbiome health, and improve micronutrient bioavailability.

The gut microbiome plays a pivotal role in influencing the bioavailability of vitamins and minerals. Deficiencies in these micronutrients can have serious health consequences, but by understanding the role of the gut microbiome in regulating their levels, we can develop personalized intervention strategies that can improve micronutrient bioavailability and promote overall health. As research in this field continues to evolve, it will be interesting to see how these findings can be translated into practical, microbiome-based interventions for micronutrient deficiencies. 

Personalized dietary recommendations and probiotic or prebiotic approaches may prove to be effective in improving gut microbiome health to promote micronutrient bioavailability and overall health. However, more research is needed to fully understand the complex interactions between the gut microbiome and micronutrients. In the meantime, it is important to maintain a balanced and varied diet rich in vitamins and minerals, and to address any deficiencies through appropriate supplementation. 

The gut microbiome plays a crucial role in regulating the bioavailability of micronutrients, and understanding the interplay between the gut microbiome and micronutrients has the potential to pave the way for innovative and personalized interventions to counteract micronutrient deficiencies and promote overall health.

Read more at Biofactors. 2022 Mar-Apr; 48(2): 307–314

Celiac.com 02/01/2023 - Previous studies have pointed to a connection between celiac disease and anorexia nervosa. Research has mainly focused on children and teens, and with very few studies on adults. 

Both celiac disease and anorexia nervosa can share clinical features that can complicate a diagnosis for celiac disease. Delayed celiac diagnosis can degrade quality of life and cause serious complications for people with anorexia nervosa. For this reason, it's important to do a complete diagnostic workup, and get to the heart of the matter quickly. 

Case Study of Woman with Anorexia Nervosa

A team of clinicians recently reported the case of a woman with anorexia nervosa who was later diagnosed with celiac disease. Their report noted that a focused medical history remains the hallmark of a proper diagnosis. 

The clinical team included Antonios Tsakiris, Styliani Papantoniou, Panagiotis Kouvatsos, Charalampos Tamvakos, and Stavros Antonopoulos. They are variously affiliated with theDepartment of Cardiology, 'Elpis' General Hospital of Athens in Athens, Greece; and the Departments of Internal Medicine, Infectious diseases, and the Diabetes Center, Tzaneio General Hospital of Piraeus, Piraeus, Greece in Piraeus, Greece.

The Team's Report

Their recent report describes the case of their patient, a 43-year-old woman with anorexia nervosa, who was later diagnosed with celiac disease after a long bout of recurring diarrhea. Because the patient had a history of autoimmune disease, her doctors thought celiac disease might be a factor. For this reason, they were vigilant and were able to spot her celiac disease early.

The team's case study shows how important it is to be vigilant and to do detailed work-ups with anorexia nervosa patients who have persistent gastrointestinal symptoms. 

They recommend including medical history, clinical presentation, and laboratory findings in patient work-ups.

The difficulty and importance of diagnosing celiac disease in anorexia and many other conditions is serious business. Getting it right can often be the result of detailed patient work-ups, persistence and detective work on the part of physicians. In cases like this, the stakes are high, and the rewards to the patient are great.

Read more at Cureus.com

Celiac.com 12/26/2022 - Rates of celiac disease, and the use of medications that inhibit acid secretion, such as proton pump inhibitors, have both increased in recent decades. 

A team of researchers recently set out to explore potential connections between anti-secretory medication usage and risk for later development of celiac disease. Here's what they found.

The research team included Benjamin Lebwohl, MD, MS, Stuart J. Spechler, MD, Timothy C. Wang, MD, Peter H.R. Green, MD, and Jonas F. Ludvigsson, MD, PhD. They are variously affiliated with the Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA; the Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden; the Division of Gastroenterology, Department of Internal Medicine, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas; and the Department of Pediatrics, Örebro University Hospital, Sweden.

Population-based case control study

In their population-based case control study, the team identified patients diagnosed with celiac disease across all of Sweden's pathology departments from July 2005 through February 2008. The team then matched patients by age and gender with up to five control subjects.

The team identified previous prescriptions for proton pump inhibitors and histamine-2 receptor antagonists in all study subjects.

The team then used conditional logistic regression to measure the connection between these prescriptions and a later diagnosis for celiac disease.

Proton pump inhibitor prescriptions strongly associated with celiac disease

The data show that people with previous proton pump inhibitor prescriptions had a strong association with celiac disease.

Patients prescribed both proton pump inhibitors and histamine-2 receptor antagonists had a higher risk of celiac disease than those prescribed proton pump inhibitors alone or histamine-2 receptor antagonists alone.

Conclusions

From their findings, the team concludes that exposure to anti-secretory medications, such as proton pump inhibitors, is strongly correlated with a later diagnosis of celiac disease. This association remained, even after the team excluded prescriptions in the year preceding the celiac disease diagnosis, which points to the medications as a causal connection.

The idea that certain medications can influence rates of celiac disease is not new. The idea that medicines like proton pump inhibitors can influence celiac disease rates is both new and potentially powerful information that could change the way we use those medicines, and the way we understand celiac disease development.

Stay tuned for more on this and related stories.

Read more in Dig Liver Dis. 2014 Jan; 46(1): 36–40. doi: 10.1016/j.dld.2013.08.128

Celiac.com 12/12/2022 - Atopic dermatitis is associated with immune dysregulation, but epidemiological data on the pattern of autoimmune comorbidity in people with atopic dermatitis are limited.

A team of researchers recently set out to determine the risk of autoimmune conditions in people newly diagnosed with atopic dermatitis.

The research team included Simon de Lusignan, MD; Helen Alexander, BSc, MBBS; Conor Broderick, MB, BCh, BAO, MSc; Andrew McGovern, MD; Claire Feeney, PhD; Carsten Flohr, PhD. They are variously affiliated with theNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom; the Royal College of General Practitioners Research and Surveillance Centre, London, United Kingdom; the Unit for Population-Based Dermatology Research, St John’s Institute of Dermatology, Guy’s & St Thomas’ NHS Foundation Trust and King’s College London, London, United Kingdom; the Momentum Data, Pendragon House, St Albans, United Kingdom; and with Pfizer Ltd, Tadworth, United Kingdom.

A Retrospective Cohort Analysis

The team used the the UK-based Oxford–Royal College of General Practitioners Research and Surveillance Centre primary care database to conduct a retrospective cohort analysis that covered the period from January 2009 to December 2018. 

They compared baseline rates and incidents after diagnosis of autoimmune conditions in nearly 175,000 children and adults with new-onset atopic dermatitis, and nearly 700,000 control subjects, matched for age, sex, and general practitioner practice. 

Outcomes were a composite of any autoimmune condition, including Crohn disease, ulcerative colitis, celiac disease, pernicious anemia, type 1 diabetes, autoimmune hypothyroidism, Graves disease, psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, Sjögren syndrome, vitiligo, alopecia areata, and multiple sclerosis, and each individual autoimmune condition.

Their Findings

The team found that people diagnosed with atopic dermatitis were more likely to have an existing autoimmune condition, compared to control subjects. 

Once the team eliminated patients with preexisting autoimmune disease, they found a connection between atopic dermatitis and cases of new-onset autoimmune disease. Patients with more severe atopic dermatitis faced a greater risk than those with moderate or mild atopic dermatitis. 

People with atopic dermatitis also faced a significantly higher risk for psoriatic arthritis, Sjögren syndrome, Crohn disease, vitiligo, alopecia areata, pernicious anemia, ulcerative colitis, rheumatoid arthritis, and hypothyroidism, but not for other autoimmune conditions.

Conclusions

From their results, the team concludes that people with atopic dermatitis, especially those with severe atopic dermatitis, face significantly higher risk for developing numerous other autoimmune conditions.

Stay tuned for more on this and related stories. 

Read more in: Allergy and Clinical Immunology
 

Celiac.com 12/07/2022 - What is the nutritional and health impact of a long-term gluten-free diet on people with celiac disease? A team of researchers recently set out to take a deep look at the influence of a long-term gluten-free diet on nutritional status, body composition, and associated factors in adult Saudi females with celiac diseases. 

One Year Study of Fifty-one Diagnosed Celiac Patients

For their study, the team included fifty-one diagnosed celiac patients who had followed a gluten-free diet for over one year.  They collected data on patient dietary patterns, along with a complete analysis of anthropometric parameters, levels of vitamins B12 and D, and complete blood count (CBC). 

The data show that all patients suffered from an insufficient intake of all micro and macro-nutrients, including vitamin D, folate, calcium, and iron. Otherwise, their bloodwork fell within the expected ranges. 

While one-third of patients were slim, nearly half showed decreased total body fat, more than half of the patients showed low waist/hip ratios, and more than sixty-percent showed decreased levels of visceral fat. On the whole, patients with poor nutritional status also tended to have poor educational levels and some psychosocial factors that may have influenced their results.

However, the team did find that a gluten-free diet in women with celiac disease negatively affects their nutritional intake and anthropometric indices, and leads to a deficiency in major nutrients, vitamins, and ions.

Study Conclusions

This study confirms other studies that show that gluten-free foods often have poorer nutritional quality than their non-gluten-free counterparts, and that many people with celiac disease suffer from poor nutrition or malnutrition. 

The results highlight the need for women, but also for all celiacs on a gluten-free diet, to be extra vigilant about making sure to get enough nutrition, fiber and nutrients.

Nutrients 2022, 14(10), 2090

The research team included Aeshah Ibrahim Alhosain, Ghedeir M. Alshammari, Barakat Lafi Almoteri, Mohammed A. Mohammed, Manal Abdulaziz Binobead, and Mohammed Abdo Yahya. They are variously affiliated with theDepartment of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University in Riyadh, Saudi Arabia, and the Department of Gastroenterology, Buraidah Central Hospital, Ministry of Health in Buraydah, Saudi Arabia.