Nutrition Text Book Fails To Mention Celiac Or The gluten-free Diet!

[Guest Doll]

I had a very big eye opener after my Nutrition class (a university class) today. We've touched on food allergies, we've covered fibre, we've touched on "malabsorption" etc. I was waiting to see if any mention of Celiac would be *briefly* made. It was not. I figured, no big deal since we haven't gone in depth into "food allergies" and special dietary needs etc. yet.

So I checked my text book. NO mention of Celiac ANYWHERE, not even in the index! Wtf? How can this happen? Granted, this IS an American text (Canadian dietary guidelines I am told are slightly more progressive), but it is brand new, "up to date", and filled with info on trans fats, probiotics, Omega 3 EFAs, "nutritional medicine", and supplements, etc. All hot "modern" topics in nutrition as we speak.

There is a section on "Common Digestive Problems" which includes choking, "diarrhea" ("Irritable Bowel Syndrome" and "Colitis"), constipation, and "Belching and Gas".

Now, I do have to point out again that *overall* this is a comprehensive and highly detailed text with aspects of biochemistry and detailed biology (nutrition in the context of certain diseases). It is not a "mickey mouse" course.

The people who read this text and take this class are *usually* majors in: Nutrition, Food science, Nursing, Pharmacy, Pre-Medicine, and/or various scientific research programs. Now, I don't care if the local Social Worker knows about Celiac, although it may help someone down the line. What I DO care about is the fact that people who plan to work in the Nutrition and Healthcare fields are not being taught about Celiac. Granted, I understand it will be touched on in Med School, etc. But what about the Nursing students who only take this one Nutrition course as part of their program? And why is Celiac not even mentioned?! This is why doctors and nurses still think it is a "rare" disease. And perhaps why some dieticians know little about it...and don't think they need to find out more.

So...I'm thinking of asking my prof to let me create a 2 minute "lecture" on Celiac that she can present to the class. I think it will be a good experience for me.

What do you guys think?

How can Celiac Disease, a common "digestive" disorder treated BY DIET, not be mentioned in text book meant primarily for future healthcare workers and dieticians?!

[Canadian Karen]

Shaking my head in disbelief here.......

Can't say I'm surprised though. My family doctor is fairly young (my age, in her 40's) and told me the only thing they learned in MED school about celiac is to look for it in children with distended bellies......

No wonder all those "experts" coming out of university now still aren't making the connection of gluten to ADHD, autism, and all other related disorders......

[jerseyangel]

It's shameful, but I can't say I'm surprised.

I had classic symptoms for 20 years, and no doctor (and I saw many) ever mentioned the possibility of Celiac. I never heard the word myself until shortly before I was diagnosed and the only reason that happened was that I asked the gastro point blank if it might be my problem.

I think a lecture by you on the subject would be a great idea. The word has to start somewhere, and it sounds like you're going to have to get the ball rolling, so to speak.

[hathor]

Absolutely amazing. What is the copyright date of the text?

Your idea is a good one. I also think either you or the professor needs to write to the publisher and/or the authors, so that the next edition of the book won't contain this rather glaring flaw.

[Guest Doll]

Absolutely amazing. What is the copyright date of the text?

Your idea is a good one. I also think either you or the professor needs to write to the publisher and/or the authors, so that the next edition of the book won't contain this rather glaring flaw.

I agree. I was such in a rant that I forgot that I plan to mention it to her next class. She actually is well known in her field and may have some pull. I will try and write as well. The text is "Understanding Nutrition" put out by Thomson Higher Education, copyright "2008, 2005". Not quite sure how I have a "2008" copyrighted text book as of now, but it goes to show you how "updated" it is. Lol!

I am in just such shock! We will be covering virtually all "special diets" aside from Renal diets (that I can understand) and Celiac (which I cannot believe). You see, nurses for example will learn about Renal diets when they are trained about kidney disease. Celiac, well, no wonder no one knows about it!

It's so stupid because the text covers Absorption and intestinal villi, but NO mention of anything that can "go wrong" with that villi.

[DingoGirl]

What do I think....well, I'm not surprised, but I'm furious.

I am, all of the time, just trying to get the word out about a WHEAT-free diet, let alone Celiac. I am obsessed with wheat removal and mental health, and trying to introduce it to a couple of chronically depressed people I know. People just look at me with blankly....no one knows about this. (I try to be gentle and introduce the idea of no carbs before I give them the entire gluten-free spectrum.)

I am SO glad you're in the class......but so sad that this widely-used textbook makes no mention. Most dietitians know NOTHING about Celiac, and it's a darned shame. Guess it's up to US to educate everyone......

[Fiddle-Faddle]

2 minutes?? How about 30, plus Q & A time?????? (And of course, gluten-free samples of homemade bread and cookies so they know that it's POSSIBLE and not that hard--let's smash that fallacy about the gluten-free diet being "too hard!"

If that #%$^*(%( textbook covers IBS, could you please include a comparison chart of IBS and celiac symptoms, as they are identical, and most idiot doctors wouldn't dream of testing for gluten problems, they'd rather write an expensive prescription to mask the symptoms.

Heck, you might as well get into fibromyalgia, RA, thyroid disease, diabetes, MS, bipolar syndrome, autism...

You know, there's a whole COURSE here.

BTW, does anyone know anybody who was diagnosed with IBS, went completely off gluten, and didn't recover?

[Guest Doll]

I hate to mention what they say right after the "food allergies" section in this text. While the (IgE) "Food Allergy" section IS fairly good, which is at least a good thing, it's what's next that gets me. They do briefly mention the term "food intolerance's" and link it to.."in some cases"...are you ready..."a psychological aversion". They also say that "food intolerance" does not provoke an immune response or antibodies! Can you believe it!

Now granted Celiac is an autoimmune disease treated with diet and not an "intolerance". But it is not a food allergy and needs a category.

IgA and IgG *antibodies* are usually produced *due to an immune system response* to gliadin and the person's own tissue after consuming gluten. These antibodies are not the same as those found in a typical IgE allergic response seen due to histamine. Although the patient with Celiac may become severely ill due to gluten, this type of immune response is not known to cause an anaphylactic reaction . Celiac Disease appears to share a genetic link with other autoimmune diseases like Type 1 diabetes. Untreated Celiac Disease may lead to malabsoprtion, osteoporosis, infertility, and cancer.

What the text *should* say is the above with a more in depth "medical" explanation, followed by a few lines that say something like this. "There are other causes where people can react to food and not have any known disease or allergy. One example of a growing food intolerance appears to be an intolerance to gluten, a protein found in wheat, barley, and contaminated oats. People with "gluten intolerance" do not have the autoimmune intestinal damage seen in Celiac Disease, but still have a physical reaction when they consume gluten. Antibody levels of any kind and biopsies are often negative.More research is needed in this area in order to explain the pathology of non-Celiac gluten intolerance. Areas of study include heavy metal poisoning and looking at the link between non-Celiac gluten intolerance and infections like Lyme Disease. Another area of related research is what is called the "leaky gut", or gaps in the intestines due to excess production of zonulin. The "leaky gut" seems to be related to Celiac Disease, non-Celiac gluten intolerance, ADHD, Austim spectrum disorder, and autoimmune diseases.

The treatment for Celiac Disease and NCGI is a gluten-free diet for life. Studies may show in the future that a gluten free and casein free diet may help children with Autism as well (See sidebar). <Explain gluten-free diet in detail>.

I think something like this should be in the text, and maybe I will use some of this to present to my prof. I'll clean it up and little and condense it.

What's almost comical is that they mention "metal poisoning" in the "food allergy" section but fail to tie it it. They also say that parents need to be informed that "sugars and food allergies are not responsible for behaviour disorders like ADHD". Now, I know that there is not much *proven* research here. So I can't totally blame the text. And I know there are a lot of myths out there. But I think it is wrong to say that, when there just might be a link. At the very least, excess sugars can cause huge variations and swings in blood glucose levels, which *can* impair your mood and cognitive function. Ask any diabetic having a bad sugar day. There have been documented studies on this (granted in diabetic children, but still).

Oh well! At least obesity prevention and treatment, and preventing Type 2 diabetes (BIG problems today) take up a lot of the text...

[Fiddle-Faddle]

You are a good writer, DOll. Write it all up, include all sources and studies, and send it to the authors with a request that they revise their out-of-date info and credit you. (And see if your instructor will let you teach a gluten segment!)

[Guest Doll]

You are a good writer, DOll. Write it all up, include all sources and studies, and send it to the authors with a request that they revise their out-of-date info and credit you. (And see if your instructor will let you teach a gluten segment!)

Thanks. I don't know if they'd listen to me as a lowly undergrad, but I'm going to try and approach my prof, who like I said, is very well respected. All I know is that *something* has to be done. I still can't believe this text! I would LOVE to teach a whole class on all things gluten, but our classes are jam packed with info as it is. I think the best I could do would be a quick run down followed by a Q and A. I totally agree *it's needed*, perhaps next year it can be worked into the program if I make a big stink. Plus, I'm kinda shy (even though most people have no idea!), so I think 5 minutes or less in front of a class of 300 is good enough for me!

[Fiddle-Faddle]

Thanks. I don't know if they'd listen to me as a lowly undergrad,

If you include all the relevant studies, they should be MORTIFIED that they missed this. Not to mention the legal ramifications--what about suggesting that they are liable for any doctor's (any doctor who studied their textbook) malpractice suits for not having considered celiac as a possibility on all the patients who needlessly suffered for years before they had to figure it out for themselves? For that matter, the insurance companies could sue, too, claiming that they paid our hundreds of thousands of dollars for unnecessary medications that covered up the symptoms...

Call the media!!!!!!

[hathor]

Sounds like the nutrition book has more than one problem.

Unfortunately, this does happen. No one is an expert in everything or can be up on all the latest thinking on all subjects, particularly if you are talking about a broad-based text for an introductory course. So errors creep in. Things get said that simply reflect what the text authors were taught years ago or have otherwise heard.

Used to be, people thought celiac was rare. So the text authors might not ever have learned about it.

I love the "psychological aversion" crack. Yeah, I have an aversion to feeling sick. I suppose I could always choose to eat the things that make me sick, after all.

[happygirl]

Doesn't surprise me, and is evident in the many on here who have had horrific dietician appointments (myself included). Even one of the leading Celiac dieticians fully acknowledges that the profession doesn't have a clue.

[kbtoyssni]

Ditto what everyone else said - I'm disappointed/disgusted, but not surprised.

I think a lecture to the class is a good idea. If you have medical studies to back up your data, I don't see why they shouldn't take you seriously.

And I was also going to say a letter to the publisher is in order. Celiac should absolutely be mentioned in the next revision of this book.

[jerseyangel]

Doll, Please keep us posted on what happens with this

[taylor-]

I have the same book!!!!!!!

and i was just as shocked.

im a freshmen dietetics major, and "basics of nutrition" is a required course for i believe everyone in the college of human sciences, which includes everything from exercise science to textile manufacturing. When I got the book in August I was intrigued to see if they had anything about Celiac, so I looked it up in the Index, there wasn't anything, so I looked up Gluten and I couldn't find that either. A couple weeks ago we talked about malnutrition and villi and everything pertaining to celiac disease, except celiac disease. We also talked about the food pyramid and different types of diets and pyramids due to medical reasons, no mention of it there either. I was so disappointed! But I'm pretty quiet in school so haven't said anything to the Teachers Assistant that teaches the class, although now that I'm seeing this, I just might ask him about it.

Celiac Disease is one of the main reasons I'm studing Dietetics, I don't want to do it when I get older(I want to do Pediatric Occupational Therapy) but this was a good bachelor to get before O.T. school and I thought it would help me understand the science behind my own disease better.

So yea, let us know how it goes, and I definitly feel your disappointment when it comes to this book.

[taylor-]

Hey! so just a little update on my nutrition class..

I built up the courage and asked the guy that teaches my class if we covered celiac at all. He said he wasn't sure, that he doesn't make the lesson plans (he is just a teachers assistant) but that if i was interested in celiac disease, he could definitly get me information on it. I told that it wasn't in the book, so I was just wondering if it was covered in the class because i thought it was an important topic. And he said that he knows it is covered in later classes, and he actually seemed suprised at the fact that it wasn't in the book, and again asked me if I wanted information on it. I told him no, that I actually had it, so I didn't really need info, I was just making sure it was covered at some point in time. He was completely amazed, haha and went on to ask me questions about nutritional and personal aspects of it. He seemed really knowledgable about it, and the fact that he did both his undergraduate and now is doing his graduate at FSU and obviously learned about celiac in depth somewhere in there, gave me reassurance so I didn't ask about wanting to cover it in this class.

[Guest Doll]

Just to update, I will be asking my prof tomorrow after class, since we had an exam last week (the class only meets 2x week).

I'll let know you what becomes of this....