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Celiac.com 11/14/2022 - Some studies have linked coronary artery disease with celiac disease, but hard evidence is scant. To date, there has been no solid medical literature on common risk factors linking celiac disease and coronary artery disease. Risk factors for coronary artery disease include hypertension, hyperlipidemia, type 2 diabetes, obesity, and tobacco use. However, common risk factors connecting celiac disease and coronary artery disease are poorly documented. A team of researchers recently set out with three goals. First, to assess potential demographic differences between celiac patients with coronary artery disease and without coronary artery disease. Secondly, to examine the risk factors of coronary artery disease in celiac patients. Lastly, to compare celiac-coronary artery disease patients and matched non-celiac coronary artery disease to see if there are more coronary artery disease risks for people with celiac disease. The research team included Maryam B. Haider, Paul Naylor, Avijit Das, Syed M. Haider, and Murray N. Ehrinpreis. They are variously affiliated with the Department of Gastroenterology Gastroenterology at Wayne State University in Detroit, MI; the DMC/Wayne State University - Sinai Grace Hospital in Detroit, MI; the Wayne State University School of Medicine in Detroit, MI; and Binghamton University in Binghamton, NY. For their nationwide retrospective case-control study, the team used the National Inpatient Sample (NIS) database to identify patients admitted between 2016 and 2018 with a principal or secondary diagnosis of celiac disease. They then assessed sociodemographic and clinical risk factors for coronary artery disease in celiacs, and compared the celiac-coronary artery disease patients with the matched non-celiac coronary artery disease group. Of nearly 24,000 hospitalizations with celiac disease from 2016 to 2018, nearly 20%, were found to have coronary artery disease. Established coronary artery disease risk factors for celiac patients included hypertension, hyperlipidemia, type 2 diabetes, and a family history of coronary artery disease. Interestingly, tobacco use is not a coronary artery disease risk factor in celiac patients. Odds of coronary artery disease were 55% less likely for female celiac patients, compared to male patients. The odds of coronary artery disease were 20% greater in patients with essential hypertension, double in patients with type 2 diabetes, and five times higher in celiac patients with hyperlipidemia. Patients with coronary artery disease had higher rates of iron deficiency anemia, which were nearly 10% for celiac-coronary artery disease patients, compared with just under 8.3% for non-coronary artery disease celiac patients, and just over 7.3% for people with non-celiac coronary artery disease. The team's findings confirm that, as with non-celiac individuals, males and individuals of Caucasian race with celiac disease face a higher risk of coronary artery disease. They also confirmed that celiac-coronary artery disease patients have a higher rates of hyperlipidemia than non-celiac coronary artery disease patients, while celiacs with type 1 diabetes have an early diagnosis of coronary artery disease, compared to celiacs with type 2 diabetes. Lastly, they found that iron deficiency anemia is an important risk factor for coronary artery disease in those with celiac disease. Teasing out the common links and risk factors for celiac disease and coronary artery disease is important work, and this study helps to advance that cause. Clearly further, and larger, study will be helpful in our ongoing journey to understand the puzzle that makes up the links celiac, coronary artery disease, and other diseases. Read more in Cureus 14(6): e26151 -
I really need a better list of high Salicylate products. I use Tea Tree Oil on my face because it's the only thing that works on me for redness due to mites I'm apparently allergic to. Any way, I usually just use one drop in skin cleanser, but my cat jumped up right when I was using the dropper. Oops! Oh well, I went ahead and washed my face with it and wiped it off. Now my heart is pounding out of my chest and the anxiety is horrible. It always happens with Sals for me among other symptoms. Does anyone else have these symptoms with Sals? Also, I don't know how much Sals is in Tea Tree Oil, because of conflicting information. I know it wasn't what I ate because I been eating plain oatmeal and drinking water all week. -
Celiac.com 01/15/2010 - The first thing you will notice about gluten-free cookies made by Beautifulsweets.com, is that they really are amazingly beautiful. The packaging is gorgeous, and each cookie looks like a work of art. Valentine’s Day is fast approaching, and you won’t find a better gluten-free Valentine’s Day gift than these wonderful heart-shaped gluten-free sugar cookies. They taste much like a traditional sugar cookie, with a twist of lemon! These beautifully decorated cookies taste very much how they look, and I think that anyone would be impressed if they received a box of them on Valentine’s Day. -
Celiac.com 04/20/2020 - From 2005 to 2014, hospitals recorded a sharp rise in the numbers of celiac disease patients admitted for acute myocardial infarction (AMI), according to researcher presenting at the ACC.20 World Congress of Cardiology. A team of researchers recently set out to review the Nationwide Inpatient Sample for adults with AMI as a primary diagnosis, and celiac disease as a secondary diagnosis, between 2005-2014. The research team included Manish Gupta, Muhammad Umair Bakhsh and Kamesh Gupta. They are variously affiliated with the Danbury Hospital, Danbury, CT, USA, and the Baystate Medical Center in Springfield, MA, USA. The team identified nearly 6.2 million AMI hospitalizations, of which 3,169 also had a diagnosis for celiac disease. Using survey regression, the researchers figured adjusted odds ratios (aOR) for hospital mortality, and other outcomes. The data showed that the rate of AMI-related hospitalization of celiac patients rose from 0.015% in 2005 to 0.076% in 2014. The results showed that celiac+AMI patients tended to be a few years older, on average, and substantially more likely to be female. After adjusting for age, gender, race, Charlson Comorbidity index and hospital level characteristics, the researchers observed that celiac+AMI hospitalizations had a lower odds-ratio for hospital mortality. Also, the results showed a slightly shorter length of stay for celiac+AMI patients, but much higher average hospitalization charges of just over $64,058 for celiacs, compared just over $60,000 for non-celiac AMI patients. The data show that the number of celiac disease patients admitted for acute myocardial infarction (AMI) rose five times from 2005 to 2014, yet, for unknown reasons, the rates of in-hospital mortality is lower for these patients than in patients without celiac disease. The study shows that even though inflammation seems to be causing more AMI hospitalizations in people with celiac disease, celiac patients seem to fare better than non-celiacs. This study illustrates very clearly some of the higher costs, both physically and monetarily, of having celiac disease. Celiacs see more hospital admissions for AMI-related issues, and it costs them more money, even though their stay is usually a bit shorter. The fact that their odds of dying as a result are lower is just one small consolation. Have you or a loved one been treated for an AMI-related heart condition? Do you have celiac disease? Share your thoughts below. Read more in the Journal of the American College of Cardiology. Volume 75, Issue 11 Supplement 2, March 2020 Read more at Openwirenews.com -
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Celiac.com 09/14/2019 (Originally published 04/05/2010) - Spring is finally here. It’s time to think of warmer weather, green buds on trees, green blades of grass poking through the straw-like landscape… think green. Think green about your food, too. Researchers claim that green vegetables promote good colon health and are good for the heart. They provide folic acid to pregnant women to help prevent birth defects. And greens in the kale family contain as much calcium as milk. They help balance all the sodium in our diets by providing healthy potassium. Age-related macular degeneration is a leading cause of blindness among individuals over the age of 50. A research study in Massachusetts found that people who ate spinach, collards, and other dark green, leafy vegetables five or six times a week had 43% lower risk of the disease than those who ate it less than once a month. And finally, green foods are loaded with antioxidants, minerals, and flavonoids. So how do you go about presenting green foods in enough different ways and with enough appeal to satisfy your family’s taste buds? First, learn how to cook each vegetable for peak presentation and nutrition. Then, concentrate on fun ways to incorporate “green” into your meal planning. The typical refrigerated shelf life for most leaf vegetables is ten to twelve days. When cooking broccoli, steam it to keep the green color and to retain all the nutrients. If you don’t have a steamer, put the broccoli in a colander and suspend it over a pot of boiling water for a few minutes. Steaming leafy greens (spinach, kale, Swiss chard) destroys the chlorophyll and will leave you with a messy gray wad. Precook leafy greens by boiling in water for 3 to 10 minutes then drain and season. Or sautéed in a little oil with some red pepper seeds and garlic. Cabbage can be added to soups, casseroles, stews, stir-fries. It can be rolled and stuffed, shredded for coleslaw, or eaten steamed with steamed potatoes. Leave the skin on zucchini for added fiber. Shred the zucchini into meatloaf, scrambled eggs, and muffins. This is a great vegetable to grill, or brush it with oil, sprinkle with seasoned breadcrumbs, then bake or broil. When selecting asparagus, thin spears are more tender than the thicker ones. Steam them lightly so they’re still tender-crisp, or brush lightly with oil and grill or broil. Sprinkling cooked asparagus with a little Parmesan cheese will enhance their flavor even more. Peas don’t need much boiling time, nor do green beans. When using frozen peas in a salad, you can just rinse them off under warm running water and not even bother pre-cooking them. Swiss chard and beet greens are delicious boiled, drained, then tossed with a little olive oil and vinegar. There are so many novel and delicious ways to incorporate more greens into your diet… Restaurants are now offering “lettuce wraps”. You’re served a dish of large lettuce leaves along with bowls of fillings and you create your own lettuce wrap. You can do the same thing at home using romaine lettuce leaves. Bread isn’t a necessary ingredient to make a fun and luscious sandwich. Fillings can vary from fajita (julienned veggies often with sautéed strips of beef or chicken) or a salad filling (egg, tuna, chicken, salmon, or ham salad) to a Mediterranean veggie filling of sautéed zucchini, mushrooms, onions, green pepper, kalamata olives, feta cheese, all sprinkled with Italian seasoning. Create your own pizza by doubling the amount of green pepper. Or leave off the pasta sauce and brush your pizza crust with olive oil, sprinkle with Italian seasoning, then top with chopped spinach or sautéed zucchini slices, roasted red peppers, and crumbled feta cheese. Vegetable soup can be a virtual pot of greenery! Stir in chopped spinach and mustard greens, peas, cut green beans, shredded cabbage, chopped kale and argula, shredded zucchini, and chopped parsley. Are you making gluten-free macaroni and cheese? Stir in peas and/or green beans. Pasta? Stir shredded zucchini into the marinara sauce or skip the sauce and just toss the pasta with sautéed chopped spinach and a little minced garlic. . Sometimes you just have to munch on something. Have a container of hummus or ranch dressing close by to dip broccoli florets, celery and cucumber sticks, and strips of green pepper. Quiche is a great for hiding greens. You can fold in chopped broccoli, spinach, artichokes, and/or asparagus tips. Stir-fry broccoli florets, snap peas, bok choy, celery, fresh baby spinach, and parsley; add a little gluten-free soy sauce and serve over rice. Put fresh parsley in everything. It adds color, flavor, and nutrition. It also helps keep your breath fresh. Another “green” you may not think of is green olives. Their oil doesn’t clog arteries and green olives can be added to salads, antipastos, salsa, Bruschetta, sliced on top of pizza, or simply marinated and enjoyed alone. Don’t overlook green herbs. Fresh mint is a glorious addition to salads, pesto, meatballs, peas, and iced tea. The darker the green, the healthier it is for you. So mesclun greens (often called spring mix), and baby spinach have more nutrition than iceberg lettuce. Dark green vegetables are high in fat-soluble vitamins A, K, D, and E. These vitamins require a little bit of dietary fat in order for the body to absorb them, so add a little olive oil when preparing the greens to make sure your body absorbs all of the vitamins you are eating. Spinach Mandarin Salad (Gluten-Free) This recipe is from the book “Gluten-Free Cooking for Dummies” Ingredients: ¼ cup pine nuts 2 tablespoons orange juice 1 ½ tablespoons balsamic vinegar 2 tablespoons olive oil 1/8 teaspoon salt 1/8 teaspoon pepper 2 teaspoons honey ½ teaspoon brown mustard 4 cups fresh baby spinach leaves ¼ red onion, sliced thin 1 can (15 ounces) mandarin oranges, drained Directions: Place the pine nuts in a small skillet that has been sprayed with nonstick spray. On medium-high heat, toast the nuts, stirring frequently, until they are lightly browned. Remove pan from heat and cool. In a large bowl, whisk together the orange juice, vinegar, oil, salt, pepper, honey, and mustard. Add the spinach and toss until evenly coated. Add the onion, oranges, and pine nuts then toss to distribute evenly. Serves 4. -
Celiac.com 03/14/2016 - Compared with the general population, people with celiac disease are almost twice as likely to have coronary artery disease (CAD), and 1.4 times as likely to suffer a stroke, according to a large retrospective study presented at the American College of Cardiology (ACC) Scientific Sessions. The data indicate that people with celiac disease might be at higher risk of CAD, even if they do not have standard cardiovascular risk factors, said co-investigator Dr Rama Dilip Gajulapalli of the Cleveland Clinic in Ohio. His team is calling on primary-care physicians, gastroenterologists, and other healthcare practitioners to be "mindful of their celiac patients," and to "be on the watch for probable cardiac diseases." Higher risk levels were seen even in patients under 65 years old, and may be due to the gut inflammation that can damage the small intestine in people with celiac disease. According to Dr Gajulapalli, "low-grade inflammation in the gut…can spill immune mediators into the bloodstream, which can then accelerate the process of atherosclerosis and, in turn, CAD." These findings are important for people with celiac disease, and for the doctors treating them. They support the idea that chronic inflammation of any kind can have a negative impact on heart health. For people with celiac disease, this can lead to higher rates of CAD, among other complications. So, the takeaway here is for people with celiac disease to check in with their doctors, and to be aware of any potential problems. Source: American College of Cardiology (ACC) 2014 Scientific Sessions -
Could Gluten-Free Food Be Hurting Your Dog?
Jefferson Adams posted an article in Additional Concerns
Celiac.com 08/15/2018 - Grain-free food has been linked to heart disease in dogs. A canine cardiovascular disease that has historically been seen in just a few breeds is becoming more common in other breeds, and one possible culprit is grain-free dog food. The disease in question is called canine dilated cardiomyopathy (DCM), and often results in congestive heart failure. DCM is historically common in large dogs such as Great Danes, Newfoundlands, Irish Wolfhounds, Saint Bernards and Doberman Pinschers, though it is also affects some Cocker Spaniels. Numerous cases of DCM have been reported in smaller dogs, whose primary source of nutrition was food containing peas, lentils, other legume seeds or potatoes as main ingredients. These reported atypical DCM cases included Golden and Labrador Retrievers, a Whippet, a Shih Tzu, a Bulldog and Miniature Schnauzers, as well as mixed breeds. As a result, the U.S. Food and Drug Administration's Center for Veterinary Medicine, along with a group of veterinary diagnostic laboratories, is investigating the possible link between DCM and pet foods containing seeds or potatoes as main ingredients. The good news is that in cases where the dog suffers no genetic component, and the disease is caught early, simple veterinary treatment and dietary change may improve heart function. According to Nutritional Outlook, an industry publication for makers of dietary supplements and healthy foods and beverages, there is a growing market for “free from” foods for dogs, especially gluten-free and grain-free formulations. In 2017, about one in five dog foods launched was gluten-free. So, do dogs really need to eat grain-free or gluten-free food? Probably not, according to PetMD, which notes that many pet owners are simply projecting their own food biases when choosing dog food. Genetically, dogs are well adapted to easily digest grains and other carbohydrates. Also, beef and dairy remain the most common allergens for dogs, so even dogs with allergies are unlikely to need to need grain-free food. So, the take away here seems to be that most dogs don’t need grain-free or gluten-free food, and that it might actually be bad for the dog, not good, as the owner might imagine. Stay tuned for more on the FDA’s investigation and any findings they make. Read more at Bizjournals.com -
Is a Gluten-free Diet Bad for Your Heart?
Jefferson Adams posted an article in Heart Failure and Celiac Disease
Celiac.com 05/08/2017 - Do non-celiacs who eat a gluten-free diet face a greater risk of developing coronary heart disease? To shed some light on this question, a team of researchers recently set out to assess levels of long-term term gluten consumption in connection with the development of coronary heart disease. The research team included Benjamin Lebwohl, Yin Cao, instructor, Geng Zong, Frank B Hu, Peter H R Green, Alfred I Neugut, Eric B Rimm, Laura Sampson, Lauren W Dougherty, Edward Giovannucci, Walter C Willett, Qi Sun, and Andrew T Chan. They are variously affiliated with the Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA; the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; the Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA; and the Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. For their prospective cohort study, the team looked at 64,714 women in the Nurses’ Health Study and 45,303 men in the Health Professionals Follow-up Study. None of the subjects had any history of coronary heart disease, and all completed a 131 item semiquantitative food frequency questionnaire in 1986 that was updated every four years through 2010. The researchers estimated gluten consumption based on the results of the food frequency questionnaires. Their study looked for patients who developed coronary heart disease, specifically fatal or non-fatal myocardial infarction. The team’s study data covered 26 years of follow-up, totaling 2,273,931 person years, 2431 women and 4098 men developed coronary heart disease. Participants in the lowest fifth of gluten intake had 352 incidences of coronary heart disease per 100,000 person years, while those in the highest fifth had a rate of 277 events per 100,000 person years. This equates to 75 fewer cases of coronary heart disease per 100,000 person years. After adjusting for known risk factors, the researchers noted that patients in the highest fifth of estimated gluten intake had a multivariable hazard ratio for coronary heart disease of 0.95 (95% confidence interval 0.88 to 1.02; P for trend=0.29). After further adjusting for intake of whole grains, and leaving the remaining variance of gluten corresponding to refined grains, the multivariate hazard ratio was 1.00 (0.92 to 1.09; P for trend=0.77). In contrast, after additional adjustment for intake of refined grains (leaving the variance of gluten intake correlating with whole grain intake), estimated gluten consumption was associated with a lower risk of coronary heart disease (multivariate hazard ratio 0.85, 0.77 to 0.93; P for trend=0.002). Long term dietary intake of gluten was not associated with risk of coronary heart disease. However, the researchers do stress the importance of dietary whole grains, and that their absence may increase the risk of cardiovascular disease. Because of this, the team discourages people without celiac disease, or some other medical reason, from adopting a gluten-free diet. Source: BMJ 2017;357:j1892 (Published 02 May 2017) -
Celiac.com 03/13/2015 - People who suffer from celiac disease with persistent villous atrophy do not face any higher risk of ischemic heart disease or atrial fibrillation, according to a recent study by a research team in Sweden. This is important, because patients with celiac disease do face an increased risk of death from cardiovascular causes, so it is mildly encouraging that persistent villous atrophy resulting from gluten exposure does not appear to affect overall or cardiovascular mortality. The research team, led by Dr. Jonas F. Ludvigsson from Karolinska University Hospital in Stockholm, studied 7,440 celiac disease patients, 43% with persistent villous atrophy, who had follow-up biopsies, along with up to five controls each, matched for age, gender, county, and calendar year. Overall risk of ischemic heart disease was not significantly higher in the patients with celiac disease. After adjusting for age at follow-up biopsy, gender, duration of celiac disease, and other factors, they found no significant difference in the risk of ischemic heart disease risk between patients with villous atrophy and those with mucosal healing. Similarly, patients with villous atrophy had no higher risk of atrial fibrillation than those with mucosal healing. Factors associated with ischemic heart disease risk included being male, older, and having lower educational levels. Factors associated with atrial fibrillation risk included being male and being older. Source: Open Original Shared Link -
Celiac.com 11/22/2012 - Cardiovascular disease has many causes, and can be influenced by so many factors. It also happens to be the main cause of death in developed countries. With regard to celiac disease and cardiovascular disease, there are two conflicting schools of thought. The first suggests that the gluten-free diet might help people with celiac disease to reduce the risk of developing cardiovascular disease. The second suggests the opposite: that a gluten-free diet may leave people with celiac disease at greater risk of developing cardiovascular disease. So far, the research has provided conflicting and data offer no clear answers. A group of researchers recently tried to figure out if a gluten-free diet protects people with celiac disease against the development of cardiovascular disease, or weather it increases their risk. The research team included Lorenzo Norsa, Raanan Shamir, and Noam Zevit, who are affiliated with the Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel at Clalit Health Services in Petach Tikva, Israel, with the Sackler Faculty of Medicine at Tel-Aviv University in Tel Aviv, Israel, and with the Department of Pediatrics at San Paolo Hospital and University of Milan in Milan, Italy. The idea that a gluten-free diet may protect celiacs against cardiovascular disease hinges on the fact that eating gluten-free reduces intestinal inflammation and improves intestinal absorption. This hypothesis argues that the reduction in inflammation is important because a number of studies over the past decade have shown that a large percentage of people with acute coronary syndrome show signs of increased inflammation. Studies also show that several clinical conditions that are accompanied by persistent low grade of inflammation, such as autoimmune disorders, may result in a higher risk of cardiovascular problems. Also, researchers note that, from a nutritional point of view, improving nutritional uptake may help lipid levels return to normal, and to increase HDL-C. Better nutritional uptake may also lead to an increase in soluble vitamin absorption, which may help to lower homocysteine levels in the blood. As such, supporters of this hypothesis argue that, by helping to reduce intestinal inflammation, and to increase nutritional absorption, a gluten-free diet may thus lower the risk of cardiovascular disease in people with celiac disease. For the most part, studies suggesting that a gluten-free diet may increase the risk of cardiovascular disease tend to hinge on the idea that an unguided gluten-free diet may be more likely to be unbalanced, and to include higher fat intake, which could increase risk factors for cardiovascular disease. Supporters of this hypothesis point to a recent study that suggests that consuming saturated fatty acids increases the LDL-C concentration in plasma and has therefore been suggested to increase the risk of ischemic heart disease (IHD), or myocardial ischaemia, which is a type of heart disease characterized by reduced blood supply to the heart muscle. Furthermore, studies have shown that a gluten-free diet can increase weight and percentage of fat, which may reveal an additional risk factor for cardiovascular disease in developed countries, where the incidence of overweight and obesity are rising, both in the general population, and in celiac disease patients. Unfortunately, a recently published review of the research team's available evidence on the relationship between celiac disease, a gluten-free diet, and cardiovascular disease and its risk factors does little to provide a clear answer one way or the other. In the face of conflicting data regarding gluten-free diet and cardiovascular disease, the takeaway seems to be that it is important that people with celiac disease follow a gluten-free diet that is well-balanced, and not too high in saturated fat; a conclusion that many would likely find to be good, common sense. Source: Nutritional Therapy & Metabolism 2012; 30 (1): 1-9
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Celiac.com 02/26/2003 - The subject of cardiology-related symptoms of celiac disease and celiac disease-associated cardiological disease has not been reviewed. So, here I attempt to summarize readings of research papers and abstracts of research papers dealing with the topic. My interest in cardiac related issues in association with celiac disease is related to a familial history of hypertrophic cardiomyopathy which like celiac disease can be missed and some times before a person is found to have it he/she may experience an episode of sudden cardiac arrest, or syncope (fainting). End stage hypertrophic cardiomyopathy can look like dilated cardiomyopathy. Dilated cardiomyopathy has been associated with celiac disease. Celiac disease and Cardiomyopathy and Heart Failure A study of 642 patients who were candidates for heart transplant in Italy found that 1.9% had anti-endomysial antibodies (AEA) (compared to 0.35% of 720 healthy controls) and that 2.2% of 275 patients with dilated cardiomyopathy were AEA-positive (compared to 1.6% in the remaining transplant candidates) (Prati D, et al, 2002, Am J Gastroenterol 97:218; Prati D, et al, 2002, Dig Liver Dis 34:39). Although an association was found, there was no way to assess cause and effect. The AEA-positive patients and AEA-negative patients presented with similar cardiologic criteria and had similar 2-year post-transplant survival. Similar, but more limited findings were described in preliminary data (Curione M, et al, 1997, Lancet 354: 222). The authors suggest a study of whether a gluten-free diet improves cardiac function in such patients. A study in Italy found that 5% of 60 elderly (over 65 years) celiac disease patients died during the study due to heart failure (Gasbarrini G, et al, 2001, Gerontology 47:306). The authors determined that this was significantly higher than the non-celiac disease population, but dont give a non-celiac disease rate. Furthermore, 0.4% of 226 non-elderly adult celiac disease patients died with heart failure as the cause and this rate was not significantly higher than the comparable non-celiac disease population. Other cardiological symptoms and disorders were not assessed. Common Causes? In a case study, similar cellular changes were found in both the intestinal microvilli and the heart muscle of a patient who had both idiopathic congestive cardiomyopathy and celiac disease (Chuaqui B, et al, 1986, Pathol Res Pract 181:604). While this was a limited study and the molecular causes of each were not evaluated, it is an intriguing find. In another case study, a celiac disease patient also had recurrent hemoptysis and developed heart block (Mah MW, et al, 1989, Can J Cardiol 5:191). The authors hypothesize that there is a common cause of the symptoms above. The cause is undefined by the authors. Similarly, a patient who had chronic anemia, cardiomyopathy, and heart block but did not have digestive symptoms was found to have anti-gliadin antibodies (AGA), AEA, and anti-reticulin antibodies (ARA) as well as the typical celiac biopsy (Rubio JLC, et al, 1998, Am J Gastroenterol 93:1391). The authors found that after 1 year of gluten-free diet, blood tests and biopsy were normal and confirm celiac disease as a diagnosis; but they do not mention whether or not the cardiomyopathy and heart block resolved. Celiac Disease and Autoimmune Myocarditis In an Italian study, 187 patients, including 110 with heart failure and 77 with arrhythmias, diagnosed with myocarditis were tested for celiac disease (Frustaci A, et al, 2002, Circulation 105:2611). Thirteen patients had IgA tissue transglutaminase antibodies (tTGA); all had anemia. Nine of the thirteen were AEA-positive; these patients also had abnormal biopsies. Thus, 4.4% of myocarditis patients had celiac disease (they compare this to 0.6% in the non-myocarditis population; this was statistically significant. Eight of the nine myocarditis patients with celiac disease had HLA DQ2-DR3, the other patient had DQ2-DR5/DR7. Five of the nine myocarditis patients with celiac disease had heart failure and were treated with immunosuppression and gluten-free diet. The other four myocarditis patients with celiac disease had heart arrhythmias and were treated with gluten-free diet. All nine patients markedly improved in cardiologic features and were tTG- and AEA-negative post-treatment (8-12 months) . Other Cardiologic Diseases Celiac Disease and Ischemic heart disease: In a report made in 1976, celiac disease was associated with a decrease in ischemic heart disease in 77 members of the Coeliac Society of England and Wales (Whorwell PJ, et al, 1976, Lancet 2:113). In another study with 653 celiac disease patients, the authors found no decrease in ischemic heart disease or stroke for celiac disease patients (Logan RF, et al, 1989, Gastroenterology 97:265). A recent study examined the risk factors for ischemic heart disease in dermatitis Herpetaformis patients (Lear JT, et al, 1997, J Royal Soc Med 90:247). The authors found that, compared to the normal population, dermatitis Herpetaformis patients had lower cholesterol, lower triglycerides, lower apolipoprotein B, lower fibrinogen, higher HDL2, smoked less, and were generally of higher social class. Pericarditis Dermatitis herpetiformis has also been found to be associated with recurrent pericarditis (Afrasiabi R, et al, 1990, Chest 97:1006). The authors found IgG, IgA, and complement in the pericardium, thus demonstrating similarities with the skin deposition of IgA in dermatitis Herpetaformis lesions. Summary While there hasnt been a comprehensive review by a celiac disease researcher, the research papers summarized here point to a correlation of celiac disease with cardiomyopathy, heart arrhythmias, and heart failure. The authors of the articles summarized here often point to a probable association of autoimmune disease in both celiac disease and related heart diseases. Glossary of terms: Cardiomyopathy: aberrant heart muscle structure. Congenital: non-inherited, usually referring to what is considered a "birth defect." Heart block: blockage of the conduction of the heart electrical signaling system which regulates the heart beat. Hemoptysis: spitting blood, usually due to lesions to the respiratory tract or voice box. Idiopathic: often used to describe something whose origin is unknown. Ischemic heart disease: heart damage due to insufficient blood flow to the heart (i.e., via the coronary arteries). Myocarditis: inflammation of the heart muscle. Pericarditis: inflammation of the pericardium, a sac which encloses the heart.
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Artichoke Heart Dip (Gluten-Free)
Scott Adams posted an article in Snacks & Appetizers (Gluten-Free Recipes)
This recipe comes to us from Elysse Paige. 1 can of artichoke hearts (9 oz.) 2 tablespoons butter 1 large Spanish onion (diced) 1 10oz. bag fresh spinach- bite size pieces ( I use frozen, then thawed out chopped spinach, 2 boxes, we like spinach) 1 cup dry white wine 1 4.4 oz. boursin cheese 4 oz. softened gluten-free cream cheese 2/3 cup shredded mozzarella - dash hot sauce - salt & pepper Cut up artichokes after draining them. In large pot, melt butter, sauté onions, lightly browning them, add spinach and artichokes. cook until coated about 4 minutes, Add wine, then all ingredients except mozzarella. Mix until smooth with wooden spoon. Place in 1 quart dish, top with mozzarella bake in preheated oven at 350F for 5 minutes until bubbly. Serve with gluten-free crackers. -
Celiac.com 03/21/2011 - Two recent population-based studies, both performed in Sweden by Dr. Jonas Ludvigsson, have concluded that people who have had biopsies that reveal villous atrophy are at increased risk of both ischemic heart disease and asthma. But at least regarding heart disease, the bulk of the risk may simply be attributable to inflammation. The team of researchers looked at biopsy data collected from all twenty-eight of Sweden’s pathology departments between 2006 and 2008. The data included biopsies performed as far back as 1969, and represented 44,446 individuals: 28,190 with celiac disease, as ascertained by small intestine morphology; 12,598 with duodenal/jejuna inflammation lacking villous atrophy; and 3,658 with latent celiac disease, defined as those with positive celiac serology but normal mucosa. 219,392 healthy controls who had never had biopsies were included as controls. They concluded that celiac disease and inflammation of the small intestine were both modestly associated with ischemic heart disease, whereas latent celiac disease was not. Although these findings agree in kind, if not in degree, with reports previously published by others, this study had a number of flaws. First of all, the researchers lack data on individual adherence to a gluten free diet. The authors note that “low dietary adherence is associated with persistent inflammation and therefore might explain the increased risk of ischemic heart disease observed in patients with celiac disease.” They also lack data on blood pressure, smoking status, body mass index, lipid levels, exercise routines, and other established risk factors for ischemic heart disease. Because they found the highest risk in the first year following biopsy, they cede that this risk could be attributable to enhanced inflammation, enhanced stress surrounding a diagnosis with celiac disease, or even an increase in reporting rather than incidence due to more vigilant medical care immediately following the diagnosis with celiac disease. They even note that gastrointestinal and cardiac symptoms are easily confused, further confounding their analysis. The second study compared the same 28,190 Swedes with villous atrophy to 140,000 controls. It reported that people with celiac disease were 60% more likely to develop asthma than those without it, and conversely, that people with asthma are more likely to develop celiac disease. “A potential mechanism could be that asthma and celiac disease share some immunological feature,” said Dr. Ludvigsson. “If you have it, you are at increased risk of both diseases.” He also noted that vitamin D deficiency can play a causative role in both diseases, and should be assessed on both celiac patients and asthmatics. Sources: Circulation 2011; 123: 483-490 Journal of Allergy and Clinical Immunology February 11, 2011 / doi:10.1016/j.jaci.2010.12.1076 -
Celiac.com 04/20/2009 - Faced with cases of idiopathic dilated cardiomyopathy that seemed to coincide with celiac disease, a team of Turkish researchers recently set out to determine if a possible connection exists between the two conditions. The team was made up of Tugcin B. Polat, Nafiye Urganci, Yalim Yalcin, Cenap Zeybek, Celal Akdeniz, Abdullah Erdem, Elnur Imanov, and Ahmet Celebi, affiliated with the Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, and/or with the Clinic of Pediatrics, Sisli Etfal Hospital, Istanbul, Turkey. To date, little has been studied about cardiac function specifically as it relates to celiac disease. The researchers undertook their study to assess cardiac functions using Tissue Doppler Echocardiography in patients with celiac disease. The team evaluated 45 clinically stable patients. the time of echocardiographic evaluation, 25 patients showed positive serum IgA Antiendomysial Antibody levels (Group 1), 20 patients showed negative serum IgA Antiendomysial Antibody levels (Group 2). 30 healthy, disease-free children served as a control group. Group 1 showed substantially lower myocardial systolic wave velocity of the mitral annulus (p < 0.001), while Group 2 showed slightly longer myocardial precontraction and contraction times compared to controls (p = 0.015, p = 0.044, respectively). Researchers noted a negative association between the serum IgA Antiendomysial Antibody levels and myocardial systolic wave levels for all subjects (r =−0.633; p < 0.001). A myocardial systolic wave velocity of <8.9 cm/s showed 92% sensitivity and 80% specificity in anticipating patients with positive serum IgA Anti-endomysial Antibody levels. The team concluded that children with celiac disease coupled with prominent serum IgA Anti-endomysial antibody reactivity, show higher rates of subclinical systolic dysfunction of the left ventricle. They also noted that Tissue Doppler echocardiography offers a helpful quantifiable indicator for cardiac monitoring of disease during follow up. Digestive and Liver Disease 40 (2008) 182–187
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Celiac.com 12/11/2006 – A retrospective cohort study presented by Gunnar Midhagen with his Doctoral and Licentiate Theses at Linköping University, Sweden, found that those with diagnosed celiac disease actually have a 47% lower cancer risk than the normal population, presumably because a majority of them follow a gluten-free diet (although the study did not address this). The study also found that those with celiac disease have a 38% higher mortality rate than the normal population, which is due to a 48% higher rate of death due to ischemic heart disease. It would be interesting to determine what causes the higher heart disease risk, and I would speculate that it has to do with fat absorption—specifically the decreased ability of those with celiac disease to absorb omega-3 fatty acids. More on this topic can be found in this article: Heart Failure, Cardiomyopathy and Celiac Disease By Laura Yick Here is the abstract of the study: High Mortality in Ischemic Heart Disease in Patients with Celiac Disease Gunnar Midhagen Department of Internal Medicine, Skovde Hospital, Skovde, Sweden INTRODUCTION: "Previous reports about increased risks of malignancies and mortality in patients with celiac disease have been criticized as skewed by selection bias, because they emanate from referral centers. Recent register based studies indicate lower risks, but are contingent on complete registration." AIMS & METHODS: "Our aim was to perform a retrospective cohort study of all celiac disease patients residing in two Swedish counties and evaluate the risks of malignancies and excess mortality. All diagnosed celiac disease patients 15 years or older who were residents of the örebro and Linköping hospitals primary catchment areas on 31 Dec. 1986 were identified and followed up for at least 15 years. All celiac disease patients were checked against the Swedish hospital inpatient register. Standardized mortality ratios (SMR) and standard incidence ratios of cancer (SIR) were calculated." RESULTS: "There was a 47 percent lower risk of all malignancies in our total celiac population SIR=0.53 (95% C.I. 0.31-0.83) as compared with the general population. Total mortality was increased by 38% (SMR 1.38, 95% C.I. 1.08-1.75) as compared with the general population and was most pronounced in patients over 65 years (SMR 1.46).This was mainly explained by a 48% increased death rate in ischemic heart disease, significant in patients over 65 years (SMR 1.58, 95% C.I. 1.00-2.06). " CONCLUSION: "In a population based setting including all patients with celiac disease, there was no increased risk of malignancies. However, this study confirms an excess mortality risk, which appears to be attributable to ischemic heart disease mainly in patients over 65 years of age."
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