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Found 12 results

  1. Celiac.com 02/07/2020 - Gluten sensitivity during pregnancy can profoundly impact fetal brain development. Gluten is a protein found in wheat, rye, and barley. Many people who have a gluten intolerance may also have other food sensitivities to common antigens like corn, soy, dairy, and sugar. Many times, without a histamine response like hives, people can be blissfully unaware of their food sensitivity. Studies have shown gluten sensitivity destroys brain and nervous tissue more than any other tissue in the body, and is linked to a number of other neurological disorders. (Read my blog Gluten Intolerance Testing for more information about this.) Eating Gluten During Pregnancy May Potentially Put Your Child At Risk Beginning before birth, the left and right hemispheres of the brain develop in stages according to a very sophisticated schedule. Each hemisphere depends on the other to meet its developmental goals within a precise window of time. While in-utero and in early childhood, viruses, infection, and inflammation (such as that from a gluten sensitivity), can throw a wrench in this intricate timing and hinder proper brain development. This sets the stage for a wide range of neurological disorders, attention-deficit/hyperactivity disorder (ADHD), autism, Tourette's syndrome, depression, anxiety, and other childhood brain disorders. Childhood mental disorders now affect one in five children, and the rates are increasing. Wheat Can impact Brain Function There are at least 13 different ways I know of that a gluten sensitivity can impact the brain. Let's look at a couple of the big ones. One mechanism is that there can be elevated antibodies to wheat and the cerebellum and GAD-65. Your cerebellum controls your muscle movements. After years of your body attacking this brain tissue, the brain may shrink. People with GAD-65 antibodies indicate a high trigger for anxiety and ADHD. Another common mechanism is hypoperfusion, a lack of blood flow going to the brain. 73% of people with a sensitivity to wheat have hypoperfusion. Just like your cells need hydration, your brain needs to be saturated. So many people go undiagnosed with a gluten-related disorder for years. Imagine what we are doing to our children (and ourselves) when we eat that bowl of cereal or toast before school or work. We are not able to function optimally. This is why "brain fog" is the most common symptom for people with a sensitivity to wheat. In 2006, a study looked at 132 people with symptoms of ADHD who had a wheat sensitivity. When they put them on a gluten-free diet, the researchers reported markedly significant improvement in all behavioral markers within six months. Gluten sensitivity may also more than double your child's risk of developing schizophrenia later in life. The first study to reveal food sensitivity was linked to a greater risk for psychosis, autism and other brain disorders in the child. Researchers looked at blood samples of nearly 800 individuals born in Sweden between 1975 and 1985. What did they find? People with schizophrenia had high levels of gluten antibodies in their blood at birth - meaning a gluten sensitivity was passed from mother to child. You Might Have an Undiagnosed Gluten Sensitivity Awareness is growing as rates of celiac disease, an intestinal autoimmune disease caused by gluten, have quadrupled in the last 50 years. The numbers could be much higher. In fact, it's estimated that 95 percent of those with celiac disease go undiagnosed. Researchers also estimate the numbers of people with gluten sensitivity — a non-celiac inflammatory reaction to gluten — range from 10 to 30 percent of the population. During Pregnancy, Mom's Gluten Sensitivity May Affect Her Baby's Brain If you look at the current explosion in inflammatory disorders today, the rise of these brain-based disorders is less of a mystery. Immune-activated mothers are giving birth to immune-activated babies. If you can, don't wait until pregnancy to look into food sensitivities. Every woman needs to consider a screen for gluten sensitivity. Look for anti-gliadin antibodies and, if that test comes back positive, go on a gluten-free diet. We don't know at which point during pregnancy a mother's gluten sensitivity impacts the fetal brain, but we do know the baby's brain and nervous system begin developing in the first trimester. Although the association between a mother's gluten sensitivity and the baby's increased risk of psychosis as an adult is not yet fully understood, it makes sense to err on the side of caution. "During My Pregnancy, I Didn't Get Nauseous. I Must Not Have Gluten Sensitivity, Right?" Not Necessarily. A lack of gut symptoms doesn't mean you're in the clear. Everyone reacts differently to gluten sensitivity. One person can have chronic skin rashes, another may have joint pain, and a third brain fog. In fact, research suggests the majority of people with gluten sensitivity have no gastrointestinal symptoms whatsoever. For every person with gut symptoms caused by gluten, there will be eight who have none, despite there being a gluten sensitivity present. An undiagnosed gluten sensitivity during pregnancy is in no way a guarantee that your child will develop schizophrenia or other brain disorders either. However, when an expectant mother produces autoimmune antibodies to brain tissue, 86% of their children are on the autism spectrum. If mom has an autoimmune mechanism going on inside her body, it can affect the baby. One of the most common food sensitivities associated with neurologic problems is wheat. Only a fraction of people who have a problem with wheat have celiac. Many more have gluten sensitivity. Many women —and men—may be better off on a gluten-free diet even though they do not have celiac disease. How do you reduce antibodies? First, screen for antibodies against the brain. Two great tools for screening are the Cyrex Array #5 and the Neural Zoomer. If you are producing antibodies, you need to eliminate the trigger(s). The goal is to stop the autoimmune cascade, particularly during pregnancy when the fetus is developing its entire body and establishing its own immune system that will set him or her up for life. Bacterial Colonies Change in the Vaginal Tract During Pregnancy In the last trimester of pregnancy, the bacterial colonies in the vaginal tract change completely to the point that there's a very high count of prevotella [bacteria]. Most of the time, there are practically no prevotella that are measurable in the vaginal tract at all. The change in the last trimester occurs because the prevotella is the substance that coats the baby as it comes down the birth canal. Prevotella migrates through the baby's nasal cavity and its mouth and goes down to turn on the genes in the gastrointestinal (GI) tract. These genes say, "Okay, this is the mammal that is going to start feeding you. Here are the codes for the protein that's about to come to you for food." The baby's digestive tract then starts turning on the digestive enzyme production capability for the specific proteins that are encoded in the prevotella bacteria. My Personal Story When we were first married, my ex-wife and I, despite all efforts, could not get pregnant. I was an intern at the time, and I called the seven most famous doctors I'd ever heard of, holistic doctors, and asked, "What can we do?" Because I was an intern, they asked, "Do you know this?" "Do you know that?" I'd say, "No." And they would respond: "Learn." So I put a program together, and we were pregnant in six weeks. A lot of people know that this began my study of gluten and the many effects it has on the body. Since then, I've helped hundreds of couples with infertility, recurrent miscarriages, and hormonal imbalances. There's not much in medicine that's all or every, but this is an every. What we learned early was that every person with hormone-related symptoms, whether it was infertility, miscarriages, estrogen dominance, testosterone deficiency, all of them, when tested properly, had a sensitivity to foods that they were eating — foods that they did not know were making them sick. When you eat a food that you're sensitive to, it triggers inflammation in the body. The immune system responds to try to protect you from something it considers an invader, and it creates an inflammatory reaction. I have said this so many times over the years: "Ms. Patient. If you pull at a chain, the chain always breaks at the weakest link. So, the first thing to do is to learn what's pulling on the chain." We found out something amazing... Food Sensitivities Were a Component Every Time Often there were more, but it was an important component. I found that the most frequent food sensitivity was wheat. So I started reading the literature on wheat way back in 1980. Our daughter was also born in 1980, and I started talking about it shortly thereafter because the studies were blowing me away. By 2004, I was lecturing professionally onstage about wheat sensitivities with or without celiac disease. That progressed and progressed until 2008, when a nutritional company called Metagenics sponsored me to go around the world. I went to 26 different cities and gave full eight-hour presentations on wheat sensitivity. The presentation dropped everybody's jaw. No one had ever seen these studies about different types of spondyloarthropathy, rheumatoid arthritis, psoriasis, multiple sclerosis, attention deficit disorder, autism, or Alzheimer's and how it would benefit some of those people just by getting off of wheat. They started to get better, sometimes dramatically, but often to some degree. In 2009, I did the same 26 cities for a full eight-hour presentation on the development of autoimmunity. What triggers the development of autoimmunity? And what do you do to address autoimmunity? It was infertility, successfully addressed by looking at food sensitivities and a couple of other things that led me into learning about wheat sensitivity; gluten sensitivity; and the trigger of intestinal permeability. For example, in the United States, 78% of the prebiotic diet is wheat. If you take wheat out of your diet, which is a very important thing, what you're also taking out is the major source of your prebiotics. And prebiotics feed probiotics, which are the good bacteria in your gut. If you take wheat out of your diet without the right education or mentorship, you lose the main prebiotic source, and, as a result, probiotics in your gut (the good bacteria that need that food) start starving. Some probiotics begin to die off, and the bad guys in your gut that have been kept in check to some degree by those probiotics now become opportunistic and rear their ugly heads. This is why it is so helpful to find a certified gluten-free practitioner or nutritionist when you are on a gluten-free diet: This is especially important before and during pregnancy. You want to prepare your body to be free of antibodies prior to conception, and you want the proper nutrition to support both you and a developing baby.
  2. Celiac.com 11/05/2012 - Over the last 40 years, studies have shown higher rates of menstrual abnormalities and pregnancy complications among women with celiac disease. However, the data from these studies have been inconsistent, and inconclusive regarding the actual effects of celiac disease on female fertility. To get a better picture of the relationship between celiac disease and female fertility and pregnancy, researchers recently conducted a more comprehensive study. The research team was led by Stephanie M. Moleski, MD, of Thomas Jefferson University Hospitals in Philadelphia. Dr. Moleski presented an abstract of the study data at the American College of Gastroenterology Annual Meeting 2012. In the abstract, she points out that women with biopsy-proven celiac disease had significantly higher rates of fertility and pregnancy complications and gave birth to less children than those without the disease. Because it is an abstract, the study data and conclusions should be regarded as preliminary until they appear in a peer-reviewed journal, where they can be given a fuller context and be more widely scrutinized. For their study, Dr. Moleski and her colleagues recruited patients treated for celiac disease at Thomas Jefferson University Hospitals, as well as members of the National Foundation for Celiac Awareness and the Gluten Intolerance Group, to respond in an anonymous Internet-based survey about fertility and pregnancy. Women without celiac disease also completed the survey and served as a control group. The survey included questions about celiac diagnosis and history, menstrual history, fertility, spontaneous abortions, and pregnancy outcomes. Approximately 1,000 women who completed the survey. Of those, 473 had physician-diagnosed celiac disease, while 298 women had the been confirmed for celiac via small-bowel biopsy. The researchers used the group with biopsy-proven disease to compare against 560 women without celiac disease. The data showed that 41.2% of women with celiac disease had increased difficulty conceiving compared with 36.5% of control subjects (P=0.03). Women with celiac disease also had more consultations with fertility specialists and higher rates of spontaneous abortion, preterm delivery, and cesarean section, compared with control subjects. Additionally, women with celiac disease were shown to have a shorter duration of fertility, to have a later onset of menarche and be younger when they experienced menopause, said Dr. Moleski. The data also revealed important differences between women with and without celiac disease. In all, 22.4% of women with celiac disease had consulted with fertility specialists, compared with 19% of those without (P=0.04). Also, 43.3% of celiacs had a history of spontaneous abortion, compared with 36.6% of non-celiacs (P=0.02). Compared with the control group of non-celiacs, women with celiac disease also had higher rates of cesarean delivery, 26.4% versus 23.8% of non-celiac women. Lastly, rates of preterm delivery were 23.2% for celiac women, and 14% for those without celiac disease (P=0.007), while the group with celiac disease was was also slightly older at the onset of their first period (12.7 versus 12.4 years, P=0.01). Among women reporting a history of spontaneous abortion, more than 80% of miscarriages occurred prior to diagnosis of celiac disease, said Dr. Moleski. She concluded that the retrospective analysis done by her team shows a clear relationship between celiac disease, fertility, and pregnancy outcomes, and suggests that the results demonstrate "a need for increased awareness of this association among patients and physicians." Sources: Medpagetoday.com American College of Gastroenterology, 2012; Moleski SM, et al "Infertility and pregnancy outcomes in celiac disease" ACG 2012; Abstract 15.
  3. Celiac.com 06/24/2019 - A team of researchers recently set out to assess whether maternal diet during pregnancy plays any role in the later development of celiac disease in their children. Among other things, they found that moms who eat a high-fiber diet during pregnancy could reduce the chances of their children getting celiac disease later on, according to a new study, which is one of the first to investigate the link between fiber intake during pregnancy and children's risk of celiac disease. In the study, a team of researchers analyzed information from more than 88,000 Norwegian children and their mothers, who gave birth between 1999 and 2009. The research team included Dr. Ketil Størdal, a research professor at the Norwegian Institute of Public Health and a pediatric gastroenterologist at Østfold Hospital Trust in Norway, and other colleagues. The mothers answered questions about their fiber and gluten intake in their 22nd week of pregnancy, and the researchers tracked the children for about 11 years to see if any developed celiac disease. Kids of High Fiber Moms Have Lower Celiac Risk The researchers found that children born to mothers who ate the most fiber (over 45 grams per day) were 34% less like to develop celiac disease, compared with mothers who ate less than 19 grams of fiber per day. Mom's Fiber Intake May Influence Gut Bacteria in Kids It's known that fiber affects gut bacteria, aka, the gut "microbiome." Indeed, some studies have found that gut bacteria, aka, the gut "microbiome" is different in people with celiac disease than in those without it. The researchers think that the fiber levels of the mom might influence her child's gut flora, which could then reduce the child's celiac disease risk. The researchers cautioned people not to read too much into the early findings. The team, says Dr. Størdal, "cannot yet recommend any specific dietary measures during pregnancy to prevent celiac disease, and this needs to be further studied." No Connection to Gluten-Free Diet However, the study found no evidence for a link between the mother's gluten intake and her child's risk of celiac disease. The study's findings, said Dr. Størdal, "do not support gluten restriction for pregnant women." The study will be presented Friday (June 7) at the annual meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). It has not yet been published in a peer-reviewed journal. Read more at Medicalxpress.com
  4. Celiac.com 12/03/2014 - It is important for pregnant women seeking medical consultation to get good, evidence-based information. This is especially true for pregnant women with celiac disease, who might wonder whether they face an increased risk of adverse birth outcomes and pregnancy complications as a result of their disease. So, does celiac disease increase a woman’s risk for pregnancy complications and adverse birth outcomes? Until now, there hasn’t been much good, solid data to give women a clear answer. With that in mind, a research team in England recently conducted a population-based study on pregnancy outcomes and adverse birth conditions in women with celiac disease. The research team included Alyshah Abdul Sultan PhD, Laila J Tata PhD, Kate M. Fleming PhD, Colin J. Crooks PhD, Jonas F. Ludvigsson PhD, Nafeesa N. Dhalwani PhD, Lu Ban PhD, and Joe West PhD. They are variously affiliated with the Division of Epidemiology and Public Health, City Hospital Campus at the University of Nottingham, Nottingham, UK; the Department of Medical Epidemiology and Biostatistics at the Karolinska Institute in Stockholm, Sweden; and with the Department of Paediatrics at Örebro University Hospital in Örebro, Sweden. The team used linked primary care data from the Clinical Practice Research Datalink and secondary care Hospital Episode Statistics data to assess all singleton pregnancies between 1997 and 2012. They used logistic/multinomial regression to compare pregnancies of women with and without celiac disease for risks of pregnancy complications (antepartum and postpartum hemorrhage, pre-eclampsia, and mode of delivery), and for adverse birth outcomes (preterm birth, stillbirth, and low birth weight). They stratified risk levels based on whether women were diagnosed or undiagnosed before delivery. They found 363,930 pregnancies resulting in a live birth or stillbirth, 892 (0.25%) of which were among women with celiac disease. Women with diagnosed celiac disease showed no increased risk of pregnancy complications or adverse birth outcomes compared with women without celiac disease. However, pregnant women with diagnosed celiac disease did show a higher risk of postpartum hemorrhage and assisted delivery, with an adjusted odds ratio (aOR) of 1.34. Importantly, the team found no increased risk of any pregnancy complication among those with undiagnosed celiac disease. In all, they found just a 1% absolute excess risk of preterm birth and low birth weight among mothers with undiagnosed celiac disease, which corresponds to aOR=1.24 (95% confidence interval (CI)=0.82–1.87) and aOR=1.36 (95% CI=0.83–2.24), respectively. Overall, the results of this study offer some good news to pregnant women with celiac disease. Whether diagnosed or undiagnosed during pregnancy, celiac disease is not associated with a significantly higher risk of pregnancy complications and adverse birth outcomes. Source: Am J Gastroenterol. 2014;109:1653-1661.
  5. Celiac.com 10/22/2018 - A team of researchers recently set out to determine if there is any association between prenatal gluten exposure and offspring risk of type 1 diabetes in humans. The research team first designed a national prospective cohort study using the national health information registries in Denmark. They looked at data on pregnant Danish women enrolled into the Danish National Birth Cohort, between January 1996 and October 2002, and assessed maternal gluten intake, based on maternal consumption of gluten containing foods, as reported in a 360 item food frequency questionnaire at week 25 of pregnancy. The team gathered information on type 1 diabetes occurrence in the participants’ children, from 1 January 1996 to 31 May 2016 by linking to the Danish Registry of Childhood and Adolescent Diabetes. Overall, their study included data on 101,042 pregnancies in 91,745 women, of whom 70,188 filled out the food frequency questionnaire. Once they corrected the figures to account for multiple pregnancies, pregnancies ending in abortions, stillbirths, lack of information regarding the pregnancy, and pregnancies with implausibly high or low energy intake, they included 67,565 pregnancies and 63,529 women. Gluten intake averaged 13.0 grams per day, ranging from under 7 grams per day to more than 20 grams per day. There were 247 children with type 1 diabetes among the group, for an incidence rate of 0.37%, with an average follow-up of 15.6 years. Risk of type 1 diabetes in offspring increased proportionally with maternal gluten intake during pregnancy per 10 grams per day increase of gluten. Compared to women with the lowest gluten intake of under 7 grams per day, those with the highest gluten intake who consumed 20 or more grams a day had double the risk for type 1 diabetes development in their children. These numbers indicate that high gluten intake by mothers during pregnancy may increase the risk of their children developing type 1 diabetes. However, the team is calling for further study to confirm the findings, preferably in an intervention setting. Read more in BMJ 2018;362:k3547. doi: https://doi.org/10.1136/bmj.k3547 The research team included Julie C Antvorskov, assistant professor, Thorhallur I Halldorsson, professor in food science and nutrition, Knud Josefsen, senior researcher, Jannet Svensson, associate professor5, Charlotta Granström, statistician, Bart O Roep, professor, Trine H Olesen, research assistant, Laufey Hrolfsdottir, director, Karsten Buschard, professor, and Sjudur F Olsen, adjunct professor of nutrition. They are variously affiliated with the Bartholin Institute, Rigshospitalet in Copenhagen, Denmark; the Centre for Foetal Programming, Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark; the Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland; the Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland; the Copenhagen Diabetes Research Center (CPH-DIRECT), Department of Children and Adolescents, Copenhagen University Hospital Herlev, Herlev, Denmark; the Department of Diabetes Immunology, Diabetes and Metabolism Research Institute at the Beckman Diabetes Research Institute, City of Hope, Duarte, CA, USA; the Departments of Immunohematology and Blood Transfusion, Leiden University Medical Centre, Leiden, Netherlands; the Department of Education, Science, and Quality, Akureyri Hospital, Akureyri, Iceland; and the Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  6. Celiac.com 07/18/2018 - Despite many studies on immune development in children, there still isn’t much good data on how a mother’s diet during pregnancy and infancy influences a child’s immune development. A team of researchers recently set out to assess whether changes in maternal or infant diet might influence the risk of allergies or autoimmune disease. The team included Vanessa Garcia-Larsen, Despo Ierodiakonou, Katharine Jarrold, Sergio Cunha, Jennifer Chivinge, Zoe Robinson, Natalie Geoghegan, Alisha Ruparelia, Pooja Devani, Marialena Trivella, Jo Leonardi-Bee, and Robert J. Boyle. They are variously associated with the Department of Undiagnosed Celiac Disease More Common in Women and Girls International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America; the Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom; the Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom; the Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; the Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom; the Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, United Kingdom; and Stanford University in the USA. Team members searched MEDLINE, Excerpta Medica dataBASE (EMBASE), Web of Science, Central Register of Controlled Trials (CENTRAL), and Literatura Latino Americana em Ciências da Saúde (LILACS) for observational studies conducted between January 1946 and July 2013, and interventional studies conducted through December 2017, that evaluated the relationship between diet during pregnancy, lactation, or the first year of life, and future risk of allergic or autoimmune disease. They then selected studies, extracted data, and assessed bias risk. They evaluated data using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). They found 260 original studies, covering 964,143 participants, of milk feeding, including 1 intervention trial of breastfeeding promotion, and 173 original studies, covering 542,672 participants, of other maternal or infant dietary exposures, including 80 trials of 26 maternal, 32 infant, or 22 combined interventions. They found a high bias risk in nearly half of the more than 250 milk feeding studies and in about one-quarter of studies of other dietary exposures. Evidence from 19 intervention trials suggests that oral supplementation with probiotics during late pregnancy and lactation may reduce risk of eczema. 44 cases per 1,000; 95% CI 20–64), and 6 trials, suggest that fish oil supplementation during pregnancy and lactation may reduce risk of allergic sensitization to egg. GRADE certainty of these findings was moderate. The team found less evidence, and low GRADE certainty, for claims that breastfeeding reduces eczema risk during infancy, that longer exclusive breastfeeding is associated with reduced type 1 diabetes mellitus, and that probiotics reduce risk of infants developing allergies to cow’s milk. They found no evidence that dietary exposure to other factors, including prebiotic supplements, maternal allergenic food avoidance, and vitamin, mineral, fruit, and vegetable intake, influence risk of allergic or autoimmune disease. Overall, the team’s findings support a connection between the mother’s diet and risk of immune-mediated diseases in the child. Maternal probiotic and fish oil supplementation may reduce risk of eczema and allergic sensitization to food, respectively. Stay tuned for more on diet during pregnancy and its role in celiac disease. Source: PLoS Med. 2018 Feb; 15(2): e1002507. doi: 10.1371/journal.pmed.1002507
  7. This article originally appeared in the Autumn 2002 edition of Celiac.coms Scott-Free newsletter. At the University of Chicago Celiac Disease Program, women with celiac disease who have recently become pregnant often contact us. Remarkably, the questions we receive from these women seldom stray from one issue, that is, whether or not to maintain a gluten-free diet while pregnant. Most women mistakenly believe that the gluten-free diet will deprive their developing fetus with the nutrients it needs, and hurt the growing baby. In fact, for a pregnant woman with celiac disease, remaining ON the gluten-free diet is the best and only option for the health of mother and child. The gluten-free diet provides pregnant women and their babies with all of the nutrients they need to grow and be healthy. Fortunately, for all concerned, there have been excellent research studies on fertility, pregnancy and celiac disease conducted by top-notch investigators around the world. While this important research has mainly focused on women, it is important to note that researchers have established (since the 1950s) that men also suffer from infertility due to undiagnosed celiac disease. Celiac Disease and Fertility In research studies to date, the incidence of celiac disease in women with unexplained infertility has been estimated at four to eight percent. While a number of studies have demonstrated that unexplained infertility can be successfully treated with the gluten-free diet, others have shown that there are factors other than malabsorption of nutrients that result in infertility, delayed menarche (the start of the menstrual cycle) and early menopause. In two large case control studies, researchers examined the incidence of delayed menarche, amenorrhea (cessation of the menstrual cycle for short periods of time), and early menopause. Both studies enrolled women with celiac disease who were following the gluten-free diet or eating a gluten-containing diet. They found that women who were not on the gluten-free diet started their menstrual cycle up to a year and a half later than women with celiac disease who were following the diet. In addition, researchers found that up to 39% of women not on the diet experienced periods of amenorrhea, compared to only nine percent of women who were on the gluten-free diet. As you would expect, women with celiac disease who were not on the gluten-free diet were found to enter menopause four to five years earlier than women with celiac disease who were on the diet. Researchers who have studied women with infertility have found that they test positive for celiac disease-related antibodies at a rate that is ten-fold higher than the normal population. They have also demonstrated that women with infertility who are diagnosed with celiac disease do not always exhibit iron, B-12, or folate deficiencies, which points to other celiac disease-related explanations for the development of their infertility. Celiac Disease and Pregnancy Researchers have also studied the effect of the gluten-free diet in pregnant women with celiac disease, in order to determine any impact on the developing fetus and the pregnancy outcome. In a study of 25 patients and 60 pregnancies researchers found that 21% of women who were not on the gluten-free diet experienced pregnancy loss, and 16% of women experienced fetal growth restriction. Researchers also remarked, however, that successful pregnancies occurred before and after diagnoses for many women in the study. In a large Danish study with 211 infants and 127 mothers with celiac disease, researchers found that the mean birth weight of children born to mothers on a gluten-containing diet was significantly lower than babies born to mothers without celiac disease. Interestingly, this same study determined that women on the gluten-free diet gave birth to children weighing more than those born to mothers without celiac disease! In a case-control study that looked at the effect of the gluten-free diet on pregnancy and lactation, investigators learned that women with celiac disease who were not on the gluten-free diet experienced pregnancy loss at a rate of 17.8%, compared to 2.4% of women with celiac disease who were on the gluten-free diet. These researchers found that there was no difference in the occurrence of pregnancy and fertility problems in women with sub-clinical (positive blood test, negative biopsy) or clinical disease (positive blood test, positive biopsy). Finally, in a group of women with celiac disease who had been pregnant more than once, researchers looked at the effect of the gluten-free diet on their future pregnancies. They concluded that the institution of the gluten-free diet upon diagnosis caused a relative 35.6% drop in pregnancy loss, 29.4% drop in low-birth weight babies and an increase of two and a half months of breastfeeding. While the malabsorption of nutrients is not the only cause of fertility and pregnancy-related problems for women with celiac disease, the gluten-free diet is essential to improving the health of women and their babies.
  8. Celiac.com 05/02/2017 - Do women who use dietary supplements during pregnancy face higher rates of celiac disease in their offspring? To answer this question a team examined the maternal use of vitamin D, n-3 fatty acids (FA) and Fe supplements during pregnancy and looked for any corresponding risk for celiac disease autoimmunity, or celiac disease, in their children. The study, known as The Environmental Determinants of Diabetes in the Young, or "TEDDY," prospectively followed from birth children with increased genetic risk. The team defines celiac disease autoimmunity as the presence of persistently positive tissue transglutaminase autoantibodies (tTGA). The TEDDY research team includes Jimin Yang, Roy N. Tamura, Carin A. Aronsson, Ulla M. Uusitalo, Åke Lernmark, Marian Rewers, William A. Hagopian, Jin-Xiong She, Jorma Toppari, Anette G. Ziegler, Beena Akolkar, Jeffrey P. Krischer, Jill M. Norris, Suvi M. Virtanen, and Daniel Agardh. For their study, the team enrolled 6,627 children with confirmed celiac disease. They confirmed celiac diagnosis either with biopsy results, and also included those with likely celiac, if they had persistently elevated levels of tTGA>100 AU. Of the 6,627 children originally enrolled, 1,136 developed celiac disease autoimmunity at a median 3·1 years of age (range 0·9–10) and 409 developed celiac disease at a median 3·9 years of age (range 1·2–11). The data showed that 66% of mothers used supplements containing vitamin D, 17% containing n-3 FA, and 94% containing iron, at 3–4 months postpartum. Over the entire pregnancy, mothers consumed an average total intake of 2,014 μg vitamin D (sd 2045 μg), 111 g n-3 FA (sd 303 g) and 8,806 mg Fe (sd 7,017 mg). After adjusting for country of residence, child's human leucocyte antigen genotype, sex, family history of celiac disease, any breast-feeding duration and household crowding, Cox's proportional hazard ratios showed no statistically significant association between the intake of vitamin D, n-3 FA or Fe, and risk for celiac disease autoimmunity or celiac disease. The use of dietary supplements during pregnancy may improve nutrition, but it is not likely to have any effect upon the risk for celiac disease in the offspring. Source: Cambridge.org The researchers in this study are variously associated with the Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, The Diabetes and Celiac Disease Unit, Department of Clinical Sciences, Lund University, 20502 Malmö, Sweden, Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO, Pacific Northwest Diabetes Research Institute, Seattle, WA 98122, USA, the Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, the Department of Physiology, Institute of Biomedicine, University of Turku, Finland, the Department of Pediatrics, Turku University Hospital, 20520 Turku, Finland, the Institute of Diabetes Research, Helmholtz Zentrum München and Klinikum rechts der Isar, Technische Universität München, and Forschergruppe Diabetes e.V., 80804 Neuherberg, Germany, the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MA, the Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, the Unit of Nutrition, National Institute for Health and Welfare, 00300 Helsinki, Finland, the Health Sciences Center, Center for Child Health Research, University of Tampere, Tampere University Hospital, 33521 Tampere, Finland, and the The Science Center, Pirkanmaa Hospital District, 33521 Tampere, Finland.
  9. Celiac.com 04/27/2015 - We know that women with infertility have higher rates of celiac disease than women who are not infertile. There's been some evidence to suggest that celiac disease might have impact women's reproductive health. However, the quest for more solid answers continues. A team of researchers recently set out to assess fertility and outcomes of pregnancy among women with celiac disease. The research team included Stephanie M. Moleski, Christina C. Lindenmeyer, J. Jon Veloski, Robin S. Miller, Cynthia L. Miller, David Kastenberg, and Anthony J. DiMarino. The team crafted a retrospective cohort study in which they analyzed information gathered from patients at a tertiary care celiac center, along with information gathered from members of two national celiac disease awareness organizations. A group of women without celiac disease served as control subjects. Both groups answered an anonymous online survey of 43 questions about menstrual history, fertility, and pregnancy outcomes. The group included 329 women with small bowel biopsy-confirmed celiac disease and 641 control subjects. Of the 970 women included in the study, 733 (75.6%) reported that they had been pregnant at some point. In terms of pregnancy, there was no significant difference between women with celiac disease (n=245/329, 74.5%) and controls (488/641, 76.1%; P=0.57). However, fewer women with celiac disease than controls (79.6% vs. 84.8%) reported giving birth following 1 or more pregnancies (P=0.03). Women with celiac disease had higher rates of spontaneous abortion than did control subjects (50.6% vs. 40.6%; P=0.01). Women with celiac disease also had higher rates of premature delivery, at 23.6% compared to 15.9% among controls (P=0.02). The average age at menarche was a bit higher in the celiac disease group, at 12.7 years, than in the control group, which came in at 12.4 years (P=0.01). This retrospective cohort analysis examining reproductive features of women with celiac disease, found that celiac disease was associated with significant increases in spontaneous abortion, premature delivery, and later age of menarche. Source: Ann Gastroenterol 2015; 28 (2): 236-240
  10. Celiac.com 08/27/2014 - Can antibiotic exposure in pregnancy increase the risk of celiac disease in children? Some researchers suspect that infant microbiota play a pathogenic role in celiac disease. The idea that antibiotic treatment in pregnancy could significantly impact the infant microbiota, and thus influence the development of celiac disease, has led many to ponder the possible connection. To get a clearer picture, a research team recently set out to study the effects on offspring of antibiotic exposure in pregnancy. The team included Karl Mårild, Johnny Ludvigsson, Yolanda Sanz, and Jonas F. Ludvigsson. They are variously affiliated with the Deptartment of Medical Epidemiology and Biostatistics, Karolinska Institutet in Stockholm, the Astrid Lindgren Children's Hospital at Karolinska University Hospital in Solna, Sweden, the Division of Paediatrics in the Department of Clinical and Experimental Medicine at Linköping University, Östergötland County Council in Linköping, Sweden, the Department of Paediatrics of Örebro University Hospital in Örebro, Sweden, and the Microbial Ecology and Nutrition Research Group at the Institute of Agrochemistry and Food Technology of the National Research Council (IATA-CSIC) in Valencia, Spain. The team started by reviewing existing data on antibiotic exposure in pregnancy in 8,729 children recorded in the All Babies in Southeast Sweden (ABIS) cohort study. Through December 2006, 46 of the 8,729 had developed celiac disease. The team then used Cox regression to estimate celiac disease hazard ratios (HRs) in children whose mothers received antibiotics during pregnancy. The ratios were adjusted based on parent-reported diary data on breastfeeding, age at gluten introduction, and the number of infections in the child's first year of life. Of the 1,836 children exposed to antibiotics during pregnancy, 12 (0.7%) children developed celiac disease as compared with 34/6893 (0.5%) unexposed children (HR = 1.33; 95% CI = 0.69–2.56). Risk estimates remained unchanged after adjustment for breastfeeding, age at gluten introduction and infection load in the child's first year of life (HR = 1.28; 95% CI = 0.66–2.48). When all the data were factored, the team found no statistically significant connection between antibiotic exposure during pregnancy and celiac disease in offspring. The team suggests that this data may present an accurate picture, or it may be that they simply lack the statistical power to make a clear connection. Further studies are likely needed before researchers can confidently conclude that there is no connection between antibiotic exposure in pregnancy and celiac disease in offspring. Source: BMC Gastroenterol. 2014;14(75)
  11. 10/05/2009 - Pregnant women with celiac disease suffer early pregnancy loss more often than women without celiac disease. A team of Italian researchers recently set out to look at a possible role of genetic pro-thrombotic variants in early pregnancy loss in women with celiac disease. The research team was made up of C. Ciacci, R. Tortora, O. Scudiero, R. Di Fiore, F. Salvatore, and G. Castaldo. The team looked at 39 women with celiac disease, who had experienced at least two early pregnancy losses within the first 3 months of pregnancy, a control group of 72 celiac women with a history of one or more normal pregnancies with no pregnancy loss. Each of the women were enrolled in the study immediately upon diagnosis for celiac disease, whereupon, the researchers obtained a clinical history obtained from each woman. The researchers then screened leukocyte DNA for factor V Leiden (mutation G1691A), factor V R2 (H1299R), factor II (G20210A), methylenetetrahydrofolate reductase (MTHFR) (C677T and A1298C), beta-fibrinogen (−455 G>A), PAI-1 alleles 4G/5G, factor XIII (V34L), and HPA-1 (L33P). Women with pregnancy losses were notably older (p = 0.002) among the celiacs than in controls. Of the gene variants examined, the allelic frequency of 4G variant of PAI-1, and the frequency of mutant genotypes were significantly more frequent in the group of celiac women with early pregnancy loss (p = 0.00003 and 0.028, respectively). Interestingly, the beta-fibrinogen −455 G>A genotype distribution differs substantially between the two groups, though frequency of the variant allele remains the same. The control group showed more frequent variant genotypes (p = 0.009). Based on these data, the research team believes the 4G variant of the PAI-I gene may predispose some celiac women who carry the gene to early pregnancy loss, though they note that their data should be confirmed on larger populations. Digestive and Liver DiseaseVolume 41, Issue 10, October 2009, Pages 717-720
  12. Gut 2000;46:332-335 (Celiac.com 03/17/2000) In the latest issue of Gut, Italian researchers propose that celiac disease is more common than previously thought, and that pregnant women should be screened for celiac disease. They conclude that a screening could help women to avoid negative outcomes and miscarriages. Dr. L. Greco and his colleagues from the University of Naples Federico II screened blood samples from 845 pregnant women in an effort to determine the prevalence of celiac disease. They looked for elevated levels of endomysial antibodies against tissue transglutaminase to determine how many of them had celiac disease. Out of the 845, women 12 had celiac disease (1.4%), and only three of the 12 had been previously diagnosed and were not following a gluten-free diet. The other nine women underwent a small intestinal biopsy to confirm their diagnosis. Out of the 12 diagnosed women, seven had either a pre-term delivery, or their babies were smaller than normal. Out of the remaining five women, four had had at least one miscarriage. Three of the babies died. When following up with 11 of the women, eight had another pregnancy and seven of them had reached term at the time of publication. Out of the eight women, five followed a gluten-free diet, and six of their babies turned out healthy. According to the researchers: Coeliac disease is considerably more common than most of the diseases for which pregnant women are routinely screened. The authors conclude: Consideration should be given to screening for coeliac disease in pregnancy, because of the high incidence of avoidable outcomes and the chance of reversibility through consumption of a gluten-free diet.

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