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Celiac.com 05/16/2017 - A number of studies have indicated that kids with celiac disease face an increased risk for mood disorders, anxiety and behavioral disorders, ADHD, ASD, and intellectual disability. A new study by a team of researchers in Sweden puts it more precisely. They put the increased risk for psychiatric disorders in children with celiac disease at 1.4-fold over kids without celiac disease. The research team assessed the risk of any type of childhood psychiatric disorders, including psychosis, mood, anxiety, and eating disorders, psychoactive substance misuse, behavioral disorder, ADHD, ASD, and intellectual disability, in children aged 18 and younger, along with their siblings. The researchers included Agnieszka Butwicka, MD, PhD, of the department of medical epidemiology and biostatistics, Karolinska Institute, Stockholm, Sweden, and colleagues. For each of the 10,903 children with celiac disease, the research team randomly selected 100 non-celiacs from the general population. These control subjects were then matched by gender and year and country of birth. For each of the 12,710 siblings of celiac disease subjects, the research team randomly assigned 100 healthy control siblings from the general population. These were also matched by gender, year and country of birth of both siblings. Both sets of siblings were required to be free of celiac disease to age 19. The researchers reviewed histological data on patients who showed villous atrophy in small intestine biopsy specimens between 1969 and 2008, and equated villous atrophy with celiac disease. In the main cohort study, the researchers estimated the risk for any psychiatric disease, as well as specific psychiatric disorders (ie, mood, anxiety, eating, and behavioral disorders, as well as neuropsychiatric disorders such as attention deficit hyperactivity disorder (ADHD), autistic spectrum disorders (ASD), and intellectual disability) in children with celiac disease, compared with general population controls. They used sibling analyses to assess whether underlying familiar factors could account for the associations. As a comparing factor, they compared the risk for psychiatric disorders in the siblings against the risk in siblings of the general population. The team conducted both univariate and multivariate analyses, adjusting for maternal/paternal age at the child's birth, maternal/paternal country of birth, level of education of highest-educated parent, and the child's gestational age, birthweight, Apgar score, and history of psychiatric disorders prior to recruitment. During follow-up, 7.7% of children were diagnosed with a psychiatric disorder. A positive association was found in the first univariate analysis between celiac disease and any psychiatric disorder, which remained even after the researchers adjusted for maternal/paternal age at childbirth and country of birth, parental education level, and child's gestational age, birthweight, Apgar score, and previous history of psychiatric disorders. The overall prevalence of psychiatric disease in the entire sample celiac disease patients was about 7%. That number remained steady in the 10 years after biopsy. However, once the researchers analyzed the findings by cohort, they found that rates of psychiatric disorders had actually increased 8-fold over that 10-year period. The siblings of celiac disease patients showed no increased risk for any psychiatric disorder. The study showed that psychiatric disorders "may precede a diagnosis of celiac disease in children." The research team called this finding "important." They write that their study also offers "insight into psychiatric comorbidities in childhood celiac disease over time." The study showed that children with celiac disease definitely faced an elevated risk for specific psychiatric disorders, including mood disorders, anxiety disorders, eating disorders, behavioral disorders, ADHD, ASD, and intellectual disability. Although the study showed that patients with celiac disease are more likely to have prior psychiatric disorders, the team notes that they have yet to determine "the mechanisms underlying the association between celiac disease and psychiatric orders." The fact that the siblings of celiac disease patients showed no increased risk of psychiatric disorders indicates that these may be an "effect of celiac disease per se rather than common genetic or within-family environmental factors," the researchers add. The researchers conclude that their study "underscores the importance of both mental health surveillance in children with celiac disease and a medical workup in children with psychiatric symptoms." This study offers yet another piece in the complex puzzle that is celiac disease. It emphasizes the need for doctors and parents to remain on the lookout for potential psychiatric issues when dealing with children who have celiac disease. Source: Psychiatry Advisor

Danna Korn founded R.O.C.K. in 1991 after her son, Tyler, was diagnosed with celiac disease. It has grown to international proportions, helping families all over the world deal with the unique challenges of raising a child on a gluten-free diet. When children are diagnosed with celiac disease at an early age, they usually have a severe intolerance to gluten, and are often extremely sick when ultimately diagnosed. Most parents share horror stories of visiting several doctors before finally arriving at a diagnosis, and are frustrated, exasperated, and angry, yet relieved to finally have a direction in which to turn. Sometimes it helps to talk about it, and it always helps to have some guidance when initially diving into the gluten-free diet. Raising Our Celiac Kids is a support group for parents, families and friends of kids with celiac disease or gluten intolerance. We welcome families of autistic kids involved in a gluten-free/casein-free dietary intervention program. We concentrate on dealing with the unique challenges that we have, including: Finding "fun" gluten-free treats for kids Menu ideas for school lunches, quick dinners, and sports snacks Helping the kids to take responsibility for reading labels, cooking and planning/preparing food How to prepare for unexpected birthday parties and food-oriented activities at school, church, and elsewhere Halloween, Easter, and other special days - how do we include our kids safely? Educating day-care providers and teachers - without burdening them Dealing with grandparents, babysitters, and "helpful" friends who offer gluten-containing foods to our kids Ensuring our kids won't cheat, and what to do WHEN they do Sending kids away to camp, friends' houses, and other times when we're not around to help The psychological impact of growing up with celiac disease (peer pressure, teenage years, and more) Visit their site at: https://www.raisingourceliackids.org/ R.O.C.K. Chapters in the United States Alabama Support Group - Mobile Contact: Marilyn Taylor ROCK’n Mobile, Alabama Tel: (251) 633-3528 E-mail: Taylor6211@bellsouth.net Slocomb - Support Group Contact: Nichole Alexander E-mail: mamma_hen3@hotmail.com Tel: (334) 886-7150 Alaska Chugiak - Support Group Raising Our Celiac Kids (R.O.C.K.) - ROCK'n Alaska Contact: Debbie Saddler Chugiak, AK 99567 Tel: (907) 688-6879 E-mail: alaskadebbie@gmail.com Arizona Gilbert - Support Group Raising Our Celiac Kids (R.O.C.K.) - Gilbert Chapter Contact: Deanna Frazee Gilbert, AZ Tel: (480) 641-8821 E-mail: deannafrazee@hotmail.com Phoenix - Support Group Greater Phoenix R.O.C.K. Contact: Lisa Potts Email: phoenixceliackids@gmail.com FB Page: facebook.com/PHX.ROCK Phone: (858) 442-5956 E-mail: lisa.potts4911@gmail.com Internet: www.phoenixrock.org Tucson - Support Group Raising Our Celiac Kids (R.O.C.K.) - Tucson Chapter Contact: Liz Attanasio Tel: (520) 877-9181 Tucson - ROCK'n Tucson Contact: Shelli Hanks Tucson, AZ 85750 Email: TucsonROCK@comcast.net Tel: (520) 577-0774 Arkansas Fayetteville, AR Melanie Faught Fayetteville, AR 72704 Tel: (479) 582-9232 E-mail: melaniefaught@cox.net California Conejo Valley - Support Group ROCK'n Conejo Valley Contact: Melissa Riches Westlake Village, CA 91361 Tel: (818) 706-0197 E-mail: melissa.riches@sbcglobal.net Danville - Support Group Contact: Ann Reigelman Raising Our Celiac Kids (R.O.C.K.) - Danville Chapter Danville, CA E-mail: areigelman@yahoo.com Lake Balboa - Support Group Contact: Melissa Gray Raising Our Celiac Kids (R.O.C.K.) - Lake Balboa Chapter Tel: (818) 510-0534 E-mail: Melissagray808@gmail.com Los Angeles - Support Group Contact 1: Amy Harley Tel: (818) 249-2432 E-mail: harleyhome@earthlink.net Contact 2: Cheryl Cohen Tel: (818) 784-4516 E-mail: cohencheryl@yahoo.com Moreno Valley - Support Group Contact: Kellee Shearer Raising Our Celiac Kids (R.O.C.K.) - Moreno Valley Chapter 10034 Snipe Circle Moreno Valley, CA 92557 Tel: (951) 242-8448 E-mail: Treshearer@aol.com Orange County - Support Group Contacts: Randi Leinen Raising Our Celiac Kids (R.O.C.K.) - Orange County Chapter E-mail: RMLeinen@aol.com ROCK’n Orange County, CA Contact: Drew Grant Tel: (949) 257-6349 E-mail: orangecountyrock@gmail.com Palo Alto - Support Group Contact: Kelly Velez or Debbie Duncan Bay Area ROCK E-mail: kellyvelez@comcast.net Tel: (650) 303-8409 E-mail: debbie@debbieduncan.com Tel: (650) 494-6959 San Diego - Support Group Raising Our Celiac Kids (R.O.C.K.) - San Diego Chapter Contact: Brenda McDowell E-mail: sdrockchapter@gmail.com San Francisco - Support Group Contact: Lisa Palme Raising Our Celiac Kids (R.O.C.K.) - San Francisco Chapter E-mail: palmer@smccd.net Sebastopol - Support Group ROCK North Bay Chapter Contact: Jennifer Iscol Sebastopol, CA 95472 Tel: (707) 824-5830 E-mail: iscol@aol.com Visalia (Central) - Support Group Contact: Shannon Williams Tel: (559) 741-1671 Visalia, CA Colorado Peyton - Support Group ROCK’n Peyton, CO Crystal Brauer Tel: (719) 494-8590 E-mail: Brauer.family@yahoo.com Connecticut Raising Our Celiac Kids (R.O.C.K) Fairfield County CT Contact: Karen Loscalzo/ Monika Lazaro/ Carolyn Caney E-mail: rockfairfieldcounty@gmail.com Internet: www.ROCKFairfieldCounty.com Simsbury - Support Group Raising Our Celiac Kids - R.O.C.K. - Simsbury Chapter Contact: Mark & Tracy Saperstein Tel: (860) 651-4857 E-mail: mtbahs@comcast.net Waterford - Support Group Raising Our Celiac Kids - R.O.C.K. - Waterford Chapter Contact: Donna Kensel Waterford, CT E-mail: CtCeliacKids@aol.com Florida Apopka - Support Group Contact: Deborah Pfeifle Raising Our Celiac Kids (R.O.C.K.) - Apopka Chapter Apopka, FL 32712 Tel: (407) 880-6104 E-mail: dpfeifle@earthlink.net Coral Springs/Palm Beach - Support Group Contacts: Janna Faulhaber and Stacey Galper Raising Our Celiac Kids (R.O.C.K.) - Coral Springs/Palm Beach Chapter Tel: (954) 255-7855 E-mail: Staceynagel@paxson.com Odessa (Tampa) - Support Group Contact: Terri Willingham Raising Our Celiac Kids (R.O.C.K.) - Odessa Chapter Orlando - ROCK'n Celebration - Support Group Contact: Rose Parvaz Celebration, FL 34747 E-mail: rose.parvaz@celebration.fl.us Palm Beach gardens - Support Group ROCK'n Palm Beach Gardens Contact: Kimberly Wade Palm Beach Gardens, FL 33418 E-mail: tkcrw@comcast.net Tel: (561) 625-9005 Tampa - Support Group Contact: Melissa Ransdell Raising Our Celiac Kids (R.O.C.K.) - Tampa Chapter 14521 Nettle Creek Rd. Tampa, FL 33624 Tel: (813) 265-8105 Georgia Atlanta - Support Group Contact: Jeff Lewis, M.D. Children's Center for Digestive Health Care Raising Our Celiac Kids (R.O.C.K.) - Atlanta Chapter E-mail: jlewis@ccdhc.org Illinois Chicago - Support Group ROCK'n Chicago Contact: Alexandra Vavouliotis Tel: (847)-962-7244 E-mail: alexvav24@mac.com Dekalb - Support Group Contact: Audrey O'Sullivan Raising Our Celiac Kids (R.O.C.K.) - Stillman Valley Chapter Dekalb, IL Tel: (815) 756-2606 E-mail: Audrey08@aol.com ROCKn DuPage & Cook County Aleksandra de Leon -DuPage County E-mail: aleksandra.deleon@gmail.com Tel: 630-745-7429 Ilene Harris- Cook County E-mail: isf27@yahoo.com Tel: 847-222-9950 Moline - Support Group Contact: Lesley Lamphier ROCK'n Illinois (Moline) Moline, IL 61265 Tel: (309) 736-1507 E-mail: celiackids@mchsi.com Springfield - Support Group Land of Lincoln Celiac Support Group Contact: Joyce Hall Raising Our Celiac Kids (R.O.C.K.) - Springfield Chapter Springfield, IL Washington - Support Group Heart of Illinois Celiac Kids Contact: Samantha Young E-mail: info@hoiceliackids.com Indiana Henryville - Support Group Contact: Kristie Williams ROCK'n Indiana (Henryville) Henryville, IN 47126 Tel: (812) 294-1179 E-mail: kristiewilliamsrn@hotmail.com Indianapolis - Support Group Contact: Kelly Kurzhal ROCK’n Indianapolis Indianapolis, IN 46217 Tel: (317) 697-4933 E-mail: kellykurzhal@hotmail.com Mooresville - Support Group Contact: Cindy Holder Raising Our Celiac Kids (R.O.C.K.) - Mooresville Chapter 375 E. Countyline Rd. Mooresville, IN 46158 Tel: (317) 831-9871 E-mail: Holders2@comcast.net Iowa Des Moines - Support Group Contact: Lindsay Amadeo Raising Our Celiac Kids (R.O.C.K.) - Des Moines Chapter Des Moines, IA E-mail: llamadeo@yahoo.com Maryland ROCK'n Maryland Contact: Steffani Mykins Tel: (410) 626-1958 E-mail: stfine@comcast.net ROCK’n Maryland Contact: Lindsay Moe Mt. Airy, MD 21771 (443) 799-3432 E-mail: lindsaymoe@ymail.com Massachusetts Longmeadow - Support Group ROCK'n MA Contact: Christie Freda Longmeadow, MA 01106 E-mail: cfreda126@comcast.net Tel: (413) 567-5748 Somerset - Support Group Contact: Stacey Nasrallah ROCK'n Somerset (MA) Somerset, MA 02726 Tel: (508) 674-6211 E-mail: info@somersetrock.org Internet: http://www.somersetrock.org Michigan Ann Arbor - Support Group Contact: Anne MacDougald ROCK’n Michigan E-mail: anniemacdougald@gmail.com Macomb Township - ROCK'n MI Support Group Contact: Kimberly Fanelli Macomb Township, MI 48044 Tel: (586) 226-8480 E-mail: kfanelli@mac.com West Bloomfield - Support Group Contact: Gail Smoler Raising Our Celiac Kids (R.O.C.K.) - West Bloomfield Chapter 4358 Strathdale Court West Bloomfield, MI 48323 Tel: (248) 851-9451 E-mail: GailS63@aol.com Minnesota Minneapolis/St. Paul Support Group Contact: Lynda Benkofske Raising Our Celiac Kids (R.O.C.K.) - ROCK-Minneapolis/St. Paul Chapter E-mail: twincitiesrock@gmail.com Mississippi Columbia - Support Group Contact: Beth Broom Raising Our Celiac Kids (R.O.C.K.) - South Mississippi Chapter 50 Wilks Road Columbia, MS 39429 E-mail: sbroom@dixie-net.com Missouri O'Fallon - Support Group Contact: Beth Anne Miller 7264 Sweetcider Lane O'Fallon, MO 63366 Tel: (636) 294-2037 E-mail: Frankbethm@aol.com Montana Billings - ROCK'n Montana Support Group Billings, MT 59102 Contact: Perrin Grubbs E-mail: perrin@bresnan.net Tel: (406) 655-7897 Nevada Reno - Support Group Contact: Carrie Owen Raising Our Celiac Kids (R.O.C.K.) - Reno Chapter Tel: (775) 857-2708 E-mail: Renorockgroup@yahoo.com New Hampshire Manchester - Support Group Contact: Michelle Ouellette ROCK'n New Hampshire Manchester, NH 03102 Tel: (603) 627-1831 E-mail: rocknh2006@gmail.com New Jersey Blairstown - Support Group Contact: Marla Benson Raising Our Celiac Kids (R.O.C.K.) - Blairstown Chapter Blairstown, NJ MBenson890@aol.com (808) 362-7752 Freehold - Support Group Contact: Elissa Carlin Raising Our Celiac Kids (R.O.C.K.) - Freehold Chapter Marlboro, NJ 07746 Tel: (732) 252-8309 E-mail: ElissaC75@aol.com Morristown - Support Group ROCK'n New Jersey Contact: Andrea Kitzis Smith Morristown, NJ 07960 Tel: (201) 965-7309 E-mail: akitsm@att.net Short Hills - Support Group Contact: Ellie Fried Raising Our Celiac Kids (R.O.C.K.) - North Jersey Chapter Tel: (973) 912-0253 New Mexico Albuquerque - Support Group Contact: Traci Shrader Tel: (505) 450-1156 E-mail: tashrader@msn.com New York Auburn - Support Group R.O.C.K.'n Auburn Contact: Nicki Hai Tel: (315) 252-2764 E-mail: jnhai@roadrunner.com Glens Falls Region - Support Group Contact: Lisa Fox Lake George, NY 12845 Tel: (518) 668-5838 E-mail: fox_lisa@hotmail.com ROCK’n Hudson Valley, NY Contact: Terresa Bazelow Thompson Ridge, NY Tel: (845) 609-7432 E-mail: HVNYROCK@aol.com Nassau County- Support Group Contact: Angela Silverstein Raising Our Celiac Kids (R.O.C.K.) - Lynbrook Tel: (516) 593-2904 E-mail: venusangmm1@optonline.net Nassau/Suffolk - Support Group Contact: Randi Albertelli Raising Our Celiac Kids (R.O.C.K.) - Long Island Chapter E-mail: rsquared31@optonline.net Contact 2: Jill Schneider Tel: (516) 551-4564 E-mail: jahms@verizon.net Rockland, NY - Bergen, NJ Raising Our Celiac Kids (R.O.C.K.) - Rockland, NY - Bergen, NJ Chapter Contact: Gabrielle Simon Telephone: (646) 342-6960 Email: nynjrockmom@yahoo.com Rome - Support Group Mohawk Valley R.O.C.K. (upstate New York) Contact: Rebecca Madeira Rome, NY Tel: (315) 337-7671 Upstate - Support Group ROCK'n Upstate New York Contact: Karen Dorazio Jamesville, NY 13078 Tel: (315) 469-8154 E-mail: kdorazio@twcny.rr.com Vestal, NY ROCK’n Vestal, NY Contact: Razi Lissy E-mail: raziher@gmail.com Western New York - Support Group Raising Our Celiac Kids (R.O.C.K.) - Western New York Chapter Buffalo / Niagara Falls NY Contact: Jeanette Yuhnke Tel: (716) 625-8390 Internet: http://www.glutenfreeinwny.com/WNYCeliacKids.php Westchester, NY ROCK’n Westchester, NY Contact: Erica Peltz E-mail: Eps2104@gmail.com Tel: (917) 612-4676 North Carolina Charlotte, Support Group Contact: Nikki Everett Raising Our Celiac Kids (R.O.C.K.) - Charlotte Chapter Huntersville, NC 28078 Tel: (704) 804-4090 E-mail: haircolorexpertise@hotmail.com Harrisburg - Support Group Contact: Linda Witherspoon 5018 Wynford Ct. Harrisburg, NC 28075 Tel: (704) 957-6100 E-mail: Linda.witherspoon@aol.com Stantonsburg - Support Group ROCK’n North Carolina Contact: Carrie Forbes Stantonsburg, NC 27883 Tel: (252) 238-3132 E-mail: gingerlemongirl@gmail.com North Dakota Fargo - Support Group Contact: Stacey Juhnke Tel: (701) 237-4854 E-mail: DSJuhnke@yahoo.com Ohio Akron - Support Group Contact: Sue Krznaric Raising Our Celiac Kids (R.O.C.K.) - Akron Chapter Akron, OH Tel: (330) 253-1509 E-mail: skrznaric@cs.com Akron - Support Group Contact: Therese Semonin Raising Our Celiac Kids (R.O.C.K.) - Akron Chapter CSA Chapter 111, S.O.S. Save Our Stomachs Cincinnati - Support Group Contact: Beth Koenig Raising Our Celiac Kids (R.O.C.K.) - Cincinnati Chapter Cincinnati, OH E-mail: BethKoenig@cinci.rr.com Tel: (513) 923-4435 Cleveland - Support Group ROCK’n Cleveland Contact: Tracey Lavine Solon, OH 44139 Tel: (216) 533-1285 E-mail: Tracey95@aol.com Toledo - ROCK'n Toledo Support Group Contact: Amy Kinkaid Toledo, OH 43615 E-mail: kinkaida@bex.net Tel: (419) 509-6913 Oregon Salem - Support Group Contact: Kristen Klay Raising Our Celiac Kids (R.O.C.K.) - Salem Chapter Tel: (503) 581-3884 E-mail: kristenklay@yahoo.com Pennsylvania Greenville - Support Group Contact: Fiona Garner Raising Our Celiac Kids (R.O.C.K.) - Greenville Chapter Greenville, PA Glenside - Support Group Raising Our Celiac Kids (R.O.C.K.) - Glenside Contact: Wilhelmina Green Glenside, PA 19038 Tel: (215) 756-2708 E-mail: Wilhelmina.green@gmail.com Greensburg - Support Group Contact: Martin Martinosky, Jr. Raising Our Celiac Kids (R.O.C.K.) - Greensburg Chapter Greensburg, PA Tel: (724) 834-3435 E-mail: ROCKchapter@aol.com Hanover - Support Group ROCK’n Hanover Contact: Melissa Panzer Hanover, PA 17331 Tel: (717) 633-1667 E-mail: Glutenfree4life@live.com Harrisburg - Support Group Gluten Intolerance Group of Harrisburg Harrisburg, PA Tel: (717) 520-9817 Lancaster/York - Support Group Contact: Janelle Gregory Tel: (717) 687-8586 E-mail: janellegregory@verizon.net Lansdale - Support Group ROCK Bucks Montgomery Contact: Holly and Steve Staugaitis Lansdale, PA 19446 Tel: (215) 997-2706 E-mail: hollystaugaitis@gmail.com South Carolina Charleston - Support Group Contact: Cathy Leeke Lowcountry R.O.C.K. Tel: (678) 637-3277 E-mail: cwleeke@yahoo.com Clover - Support Group Contact: Lauretta McInnis Raising Our Celiac Kids (R.O.C.K.) - Clover Chapter Tel: (803) 222-5143 E-mail: laurettamcinnis@gmail.com Easley - Support Group Contact: Laura Armstrong Raising Our Celiac Kids (R.O.C.K.) - Easley Chapter Easley, SC Tel: (864) 850-0344 Lexington - Support Group Contact: Gail Fox Raising Our Celiac Kids (R.O.C.K.) - Lexington Chapter Lexington, SC 29072 Tel: (803) 957-7658 E-mail: gailfox@sc.rr.com Tennessee Nashville - Support Group Contact: Janet Lowery Raising Our Celiac Kids (R.O.C.K.) - Nashville Chapter Tel: (615) 758-2674 Woodlawn - Support Group Contact: Shantal Green Woodlawn, TN Tel: (931) 648-2289 Texas Austin - Support Group Contact: Frances Kelley ROCK'n Austin - Alamo Celiac GIG Austin, TX 78739 E-mail: fkelley@austin.rr.com Tel: (512) 301-2224 Dallas/FortWorth - Support Group Contact: Kelly LeMonds, Leader Raising Our Celiac Kids (R.O.C.K.) - Wylie Chapter 1821 Spinnaker Way Drive Wylie, Texas 75098-7855 Tel: (972) 442-9328 E-mail: leader@dallasrock.org Internet: http://www.dallasrock.org Dallas/FortWorth - Support Group Contact: Diane McConnell Raising Our Celiac Kids (R.O.C.K.) - Dallas/FortWorth Chapter Tarrant County, TX Tel: (817) 849-8646 E-mail: fortworthrock@swbell.net Houston - Support Group Contact: Janet Y. Rinehart, Chairman Houston Celiac Sprue Support Group Raising Our Celiac Kids (R.O.C.K.) - Houston Chapter 13722 Ashley Run Houston, TX 77077-1514 Tel: (281) 679-7608 E-mail: txjanet@swbell.net Internet: http://www.csaceliacs.org/ Houston - Support Group Contact: Faye Sallee Raising Our Celiac Kids (R.O.C.K.) - Houston Chapter 14830 Sagamore Hills Houston, TX 77082 Tel: (281) 496-9166 Houston - ROCK'n Houston Support Group Comtact: Monica Ryan Houston, TX 77025 Tel: (713) 667-1963 E-mail: Mwryan@ipa.net Lubbock - Support Group Contact: Beth Trostle ROCK'n Lubbock Tel: (806) 794-5917 E-mail: calvintrostle@nts-online.net Victoria - Support Group Contact: Julie Bauknight Raising Our Celiac Kids (R.O.C.K.) - Victoria Chapter Victoria, TX 77901 Tel: (361) 572-9252 Utah Holladay - Support Group Contact: Cathy Snowball ROCK’n Utah Holladay, UT 84121 E-mail: kileyannsmom@hotmail.com Ogden - Support Group Contact: Eileen Leatherow Raising Our Celiac Kids (R.O.C.K.) - Ogden Chapter Ogden, UT Virginia Ashburn - Support Group Keith Bird Tel: (703) 348-7607 rock@birdmk1.plus.com Bristow - Support Group ROCK’n Bristow Contact: Michael and Elizabeth Brown Bristow, VA 20136 Tel: (703) 753-9161 E-mail: 2xx1xy@comcast.net Fredericksburg - Support Group ROCK’n Fredericksburg Contact: Kathy Paz-Craddock Tel: (703) 507-0609 E-mail: kalalilys@gmail.com Paeonian Springs - Support Group Raising Our Celiac Kids (R.O.C.K.) - Paeonian Springs Becky Shore Tel: (571) 252-0036 E-mail: zoo2u@comcast.net Virginia Beach - Support Group Contact: Cynthia Olson E-mail: glutenfreemom@hotmail.com Washington Bellingham - Support Group Contact: Jean McFadden Layton ROCK'n Washington Bellingham, WA 98229 Tel: (360) 734-1659 E-mail: glutenfreekids@yahoo.com Bothell, WA - Support Group Contact: Lynn Crutcher Rock'n Washington Bothell, WA 98011 Tel: (425) 205-1327 E-mail: gfkids1@yahoo.com Poulsbo - Support Group Contact: Tim & Dawn Simonson Raising Our Celiac Kids (R.O.C.K.) - Poulsbo Chapter Poulsbo, WA 98370 Tel: (360) 779-9292 E-mail: timsimonson@csi.com Seattle - Support Group Contact - Irina Risuhina Raising Our Celiac Kids (R.O.C.K.) - Seattle Chapter E-Mail: iris510@hotmail.com Spokane - Support Group Contact: Jennifer Fancher ROCK'n Spokane, WA Spokane, WA Tel: (509) 891-7250 E-mail: nelsonfancher@live.com Vancouver - Support Group Contact: Theressa Rachetto Vancouver, WA 98662 Tel: (360) 713-1504 E-mail: theressarachetto@gmail.com Yakima - Support Group ROCK’n Yakima, WA Contact: Shanta Gervickas Tel: (509) 965-1130 E-mail: Shanta@network7.com West Virginia Hurricane - Support Group Contact: Karen Daniel Raising Our Celiac Kids (R.O.C.K.) - Hurricane Chapter 340 Green Acres Dr. Hurricane, WV 25526 Tel: (304) 757-0696 E-mail: krdaniel@suddenlink.net Wisconsin DePere - Support Group Contact: Pam Rourke Tel: (920) 339-7867 E-mail: mrourke@new.rr.com Jackson - Support Group Contact: Yvonne Schwalen Raising Our Celiac Kids (R.O.C.K.) - Jackson Chapter E-mail: trainman280@netzero.net R.O.C.K. Chapters in Canada Alberta ROCK 'n Olds Olds, Alberta, Canada Amy Smart 403-415-5789 asmart@telus.net

Celiac.com 12/31/2021 - Having your children help out in the kitchen has many benefits. They will learn far more about cooking through hands-on experience than by watching Mommy or Daddy prepare everything. It will nurture their learning about the gluten-free diet and they will take a more active roll in watching what ingredients are used. It provides excellent bonding time and, as they get older, it will free the parent(s) from some of the kitchen duties. While parents concentrate on when and where to eat, kids usually decide how much and whether to eat! One of the best perks of having your kids help in the kitchen is that they are more likely to eat the things that they prepare for themselves! Since each child is different, it is important for parents to consider the developmental level and abilities of each child when assigning kitchen duties. Generally, children under 10 years old do not fully understand what ‘danger’ means, so they should not use the stove, electrical appliances, or sharp utensils, nor handle hot dishes. Never leave a child alone in the kitchen. Impress on them that they must never leave anything cooking on the stove unattended; that is the number one cause of house fires. By the time a child is 3 years old, they love to play cook and get ‘messy’ with kitchen foods. Direct that interest by letting them help with the preparation of breakfast, lunch, or dinner. It can be simple tasks at first, like laying cheese slices on a piece of GF bread for a toasted cheese sandwich, or sprinkling some grated cheese over salads. While you are preparing the bulk of dinner, fill up the sink with water and let them play with plastic measuring cups, filling the cups up to see what sinks and what floats. Between 4 and 5 years old, your child can wash fruits and vegetables, snap green beans, set foods on a relish platter, spoon drop cookies onto a cookie sheet, mix foods with their hands (meatloaf, tossed salads), stir ingredients together in a bowl, and sprinkle colored sugars on cookies. They can shape yeast dough and wrap potatoes in foil for baking. Give them raisins or sliced grapes to make ‘faces’ on their bowl of cottage cheese. With mini chocolate chips, let them create smiley faces on cookies. They love to peel hard-boiled eggs and oranges, and mash bananas. Wash their rounded childproof scissors with soap and water and let them cut breads into fun shapes for their sandwiches or cut green onions and parsley for a salad. They are able to handle a butter knife for spreading peanut butter and jelly or cheese spreads. It is also at this young age that it is important to introduce a large variety of foods into your child’s diet. Ask your child what he or she would like for dinner, suggesting two or three vegetables to pick from for a side dish. Remember—when a child helps in the preparation of a new food they will be more likely to taste it. Between 5 and 10 years old is the perfect time to let them help plan the meals and tell you what ingredients need to be added to the shopping list. This is the prime time when they will start to take an active role in their gluten-free diet. You can teach them the importance of reading labels and how to plan a well-balanced meal. Get them a gluten-free kids cookbook so they can begin to select the foods that they can prepare for themselves. Show them the importance of washing their hands before cooking and after handling meat or fish. They love to use cookie cutters to cut shapes out of dough and then decorate the cookies. Let them measure and sprinkle the spices for marinades, salads, and cookie mixes. Squeezing lemons and oranges is always fun, as is breaking eggs into a bowl. They can even pound down on a self-contained chopper to chop vegetables or nuts. By the time kids are 10 years old, they can use simple appliances like a blender, microwave and even a toaster oven. It is at this point that you need to impress upon them the correct usage of each appliance along with the potential dangers. They can shred cheese with a hand grater. Let them read their own recipes and follow the instructions and measure the ingredients without your help. They can take a more active part in the shopping experience and read labels themselves (although you should still double check to make sure the product is gluten-free). While at the store, ask your child to choose a new vegetable or fruit, from two to three choices, for a weekly “try-a-new-food” night. If you bribe your child to eat his spinach so that he can have a yummy dessert, you inadvertently reinforce the idea that sweets are better than nutritious food. Instead of rewarding your children with food, reward them with attention (hugs, kisses, and smiles) and playful activities. From age 12 and up, they can use a paring knife, electric can opener and stovetop burners. Let them flip pancakes, place a tray of cookies in the oven, and cut the vegetables for a salad. Show them how to use caution when draining spaghetti into a colander. They are old enough now to plan a meal on their own, including listing the ingredients needed. Think about having one night a week where they plan the meal, shop for the ingredients, and prepare the meal on their own—and oh yes, clean up the kitchen afterwards. Do you remember licking the bowl after your mom made chocolate frosting when you were a kid? Kids still like to do that. The kitchen can be the focal point of learning and bonding if you nurture that. Your children will learn far more about their special diet by helping out in the kitchen and going grocery shopping with you than they ever will through lectures. No matter the age of your child, there is something they can do to feel that they have contributed to the meal. Make helping in the kitchen a fun activity, not a chore that must be done. Gluten-Free Cherry Whip A kid-friendly recipe from the ‘Wheat-free Gluten-free Cookbook for Kids and Busy Adults. Ingredients: 1 can (10 oz.) crushed pineapple (undrained) 1 can (21 oz.) gluten-free cherry pie filling 3⁄4 tsp. almond extract 3⁄4 cup chopped walnuts 1 can (14 oz.) sweetened condensed milk 1 container (8 oz.) gluten-free nondairy whipped topping, thawed Directions: In a large bowl, stir together the pineapple with its juice, pie filling, almond extract, walnuts and condensed milk with a rubber spatula. Fold in the whipped topping until completely blended. Cover and chill for 3 hours. Makes 8 (3⁄4 cup) servings. Note: In place of the cherry pie filling and nuts, you can substitute peach pie filling and coconut. Calories: 250; Total fat: 8.6g; Saturated fat: 5g; Cholesterol: 8mg; Sodium: 58mg; Carbohydrates: 37g; Fiber: 1g; Sugar: 34.9g; Protein: 3.2g

Celiac.com 07/02/2019 - Does gluten intake in childhood influence the development of celiac disease later in life? It's a basic question that hasn't had a good answer, until now. That's mainly due to an absence of good data. Looking to change that, a team of researchers recently set out to examine the connection between the amount of gluten intake in childhood and later celiac disease. The research team included Karl Mårild, MD, PhD; Fran Dong, MS; Nicolai A Lund-Blix, PhD; Jennifer Seifert, MPH; Anna E Barón, PhD; Kathleen C Waugh, MS; Iman Taki, BS; Ketil Størdal, MD, PhD; German Tapia, PhD; Lars C Stene, PhD; Randi K Johnson, MPH; Edwin Liu, MD; Marian J Rewers, MD, PhD; and Jill M Norris, MPH, PhD. For their prospective Diabetes Autoimmunity Study in the Young, the team included 1,875 at-risk children with annual estimates of daily gluten intake from age 1 year. From 1993 through January 2017, the team used repeated tissue transglutaminase (tTGA) screening to identify 161 children with celiac disease autoimmunity and persistent tTGA positivity. A total of eighty-five children from this group met the celiac disease criteria of biopsy-verified histopathology or persistently high tTGA levels. The team used Cox regression to model gluten intake in children between ages 1 and 2 years, along with joint modeling of total gluten consumption throughout childhood to estimate hazard ratios adjusted for confounders (aHR). The data showed that children with the highest third of gluten intake between the ages of 1 and 2 years had double the chance of developing celiac disease, and celiac disease autoimmunity, compared with those in the lowest third. The results showed that every daily gram increase in gluten intake in 1-year olds increases the risk of developing celiac disease autoimmunity by 5%. The child's human leukocyte antigen genotype had no influence on the association between gluten intake in 1-year-olds and later celiac disease or celiac disease autoimmunity. Rates of celiac disease rose in direct relation to increased overall gluten intake throughout childhood. This is one of the first studies to show that gluten intake in 1-year-olds can influence the development of celiac disease, and celiac disease autoimmunity, in children at risk for the disease. Obviously, further study is needed, but the main takeaway from this study is that parents of 1-year old children with known risk factors for celiac disease might want to consider reducing the gluten intake in those children. Read more at the American Journal of Gastroenterology The researchers in this study are variously affiliated with the Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway; the Department of Pediatrics, Queen Silvia Children's Hospital, Gothenburg, Sweden; the Barbara Davis Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; the Department of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; the Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; the Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; and the Department of Pediatrics, Østfold Hospital Trust, Grålum, Norway.

Celiac.com 04/13/2020 - Current guidelines set by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN), permit doctors to diagnose celiac disease without upper endoscopy in children and adolescents who meet specific criteria. A team of researchers recently set out to to assess exactly how many pediatric gastroenterologists in Central Europe used the “no-biopsy” approach to make a celiac diagnosis, and how many biopsies could have been avoided. The research team included Petra Riznik, Márta Balogh, Piroska Bódi, Luigina De Leo, Jasmina Dolinsek, Ildikó Guthy, Judit Gyimesi, Ágnes Horváth, Ildikó Kis, Martina Klemenak, Berthold Koletzko,0, Sibylle Koletzko,, Ilma Rita Korponay-Szabó,, Tomaz Krencnik, Tarcisio Not, Goran Palcevski, Éva Pollák, Daniele Sblattero, István Tokodi, Matej Vogrincic, Katharina Julia Werkstetter, and Jernej Dolinsek. The team analyzed 2016 medical records for celiac patients under 19 years old, who were diagnosed in five European countries. They concentrated on transglutaminase antibody (TGA) levels at diagnosis, and on whether celiac diagnosis was confirmed with or without duodenal biopsy. Using diagnostic guidelines, they also noted clinical presentation and any delays in the final diagnosis. The gathered data from 653 children from Croatia, Hungary, Germany, Italy, and Slovenia. Subjects ranged in age from 7 months-18.5 years, with an average patient age of 7 years. Just under 64% were female, A total of 134 children were asymptomatic at diagnosis. Of 519 children who did show symptoms, 107, nearly 21%, were diagnosed without biopsy. Out of 412 children diagnosed via biopsy, 214, or nearly 52% had TGA at or above 10 times upper level of normal (ULN) and thus could have been diagnosed without biopsy. Signs and symptoms of malabsorption were more frequent in children diagnosed without duodenal biopsies. The data showed no differences in diagnostic times with the no-biopsy approach. In this study, about 60% of celiac patients who show symptoms could have been diagnosed without duodenal biopsies. However, only 20% of eligible patients are getting a biopsy-free celiac diagnosis. The research team recommends educating doctors about the ease and reliability of biopsy-free celiac diagnosis as part of the ESPGHAN guidelines. Read more in Hindawi The researchers are variously affiliated with the University Medical Centre Maribor, Department of Paediatrics, Gastroenterology, Hepatology and Nutrition Unit, Maribor, Slovenia; Markusovszky Teaching Hospital, Szombathely, Hungary, Pándy Kálmán Hospital, Gyula, Hungary; IRCCS Burlo Garofolo Trieste, Institute for Maternal and Child Health, Trieste, Italy; Municipality of Maribor, Project Office, Maribor, Slovenia; Jósa András County Hospital, Nyíregyháza, Hungary; Heim Pál National Paediatric Institute, Coeliac Disease Centre, Budapest, Hungary; Csolnoky Ferenc County Hospital, Veszprém, Hungary; St. Barbara County Hospital, Tatabánya, Hungary; Stiftung Kindergesundheit (Child Health Foundation) at Dr. von Hauner Children’s Hospital, LMU Munich, Munich, Germany; Dr. von Hauner Children’s Hospital, Clinical Medical Centre, LMU Munich, Munich, Germany; Department of Pediatrics, Gastroenterology and Nutrition, School of Medicine Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland; University of Debrecen, Faculty of Medicine, Department of Paediatrics, Debrecen, Hungary; University Hospital Rijeka, Department for Gastroenterology, Paediatric Clinic, Rijeka, Croatia; Ajka County Hospital, Ajka, Hungary; University of Trieste, Trieste, Italy; St. George Fejér County University Teaching Hospital, Székesfehérvár, Hungary; University Medical Centre Maribor, Department of Informatics, Maribor, Slovenia; and the Medical Faculty, Department of Paediatrics, University of Maribor, Maribor, Slovenia.

Celiac.com 02/03/2020 - Celiac disease is a common autoimmune condition that can have negative physical and psycho-social consequences in kids with the disease. A team of researchers recently set out to document health-related quality of life (HRQOL) in a large group of children with newly diagnosed celiac disease using the PedsQL 4.0 Generic Core Scales. They wanted to compare it against data for healthy children and children with non-celiac gastrointestinal (GI) problems using established data. The research team included Mary Shull; Tracy Ediger; Ivor Hill; and Rose Schroedl. They are variously affiliated with the Department of Gastroenterology, Hepatology, and Nutrition; the Department of Pediatric Psychology and Neuropsychology, Nationwide Children's Hospital, Columbus, OH; and the Gastroenterology, Hepatology and Nutrition Section, Children's Hospital Colorado, Aurora, CO. The team presented the PedsOL survey to 159 children with newly diagnosed celiac disease, and their parents, at either the time of diagnostic duodenoscopy, or prior to their first dietitian appointment for gluten-free diet instruction. The team calculated average parent-report and self-report PedsQL summary and sub-scale scores, then used 1-sample tests to compare to documented averages from a group of healthy children, and a group of children with non-celiac gastrointestinal symptoms. Compared to the healthy kids, those newly diagnosed celiac disease had lower Total Scores, Physical Health, Psycho-social Health, Emotional Functioning, and School Functioning on parent report with similar findings on self-report. Among kids and adolescents with celiac disease, the team found clinically significant scores in nearly 56% for School Functioning, nearly 63% for Physical Health, about 54% for Emotional Functioning, nearly 44% for Social Functioning, and 49% for Total Score. Quality of life scores were lower for kids and adolescents with newly diagnosed celiac disease than for healthy children, and more in line with QOL for patients with non-celiac GI conditions. The team points out that kids with lower QOL scores in areas like school or emotional function might be helped with early interventions, including a Section 504 plan or meeting with a psychologist or social worker. Children and adolescents with celiac disease, and non-celiac gluten sensitivity, face extra challenges with academic or emotional well-being. Catching those extra alleges early can help those kids to get the help they need to thrive. Read more in the Journal of Pediatric Gastroenterology and Nutrition

Celiac.com 01/24/2020 - Kids with celiac disease need to follow a gluten-free diet, and generally need to avoid exposure to gluten that might trigger a reaction. However, wheat, flour and gluten ingredients are common in school activities, particularly in early childhood classes like art and home-economics. Is that a problem? A team of researchers recently set out to measure gluten transfer from school supplies to gluten-free foods that a child with celiac disease may eat. Also, to measure efficacy of washing techniques to remove gluten from hands and tables. The research team included Vanessa M Weisbrod; Jocelyn A Silvester; Catherine Raber; William Suslovic; Shayna S Coburn; Blair Raber; Joyana McMahon; Amy Damast; Zachary Kramer; and Benny Kerzner. They are variously affiliated with the Children's National Health System, Washington, DC, USA; the Boston Children's Hospital, Boston, MA; and Temple Sinai Early Childhood Education Program, Summit, NJ, USA. The team conducted five experiments to check possible gluten contact in classrooms: They signed up 30 participants, ages 2 to 18. All participants completed the Play-Doh and the baking project tests. Participants then split into three groups of ten each to complete the tests using paper mâché, dry pasta in sensory table, and cooked pasta in a sensory table. After the activities, the team measured gluten levels on separate slices of gluten-free bread rubbed on subjects' hands and on table surfaces. Participants were then randomly assigned to wash their hands using soap and water, water alone, or a wet wipe. The team made repeat gluten transfer measurements from hands and tables using the R-Biopharm R7001 R5-ELISA Sandwich assay. The researchers found that paper mâché, cooked pasta in sensory tables, and the baking project all resulted in gluten transfer significantly higher than the 20 ppm threshold set by Codex Alimentarius Commission. However, Play-Doh and dry pasta resulted in few gluten transfers to gluten-free bread above 20 ppm. The data showed that soap and water was the best way to remove gluten from hands, though they note that other methods are as effective in certain cases. The team's study shows that the potential for gluten exposure during school activities is high for materials like paper mâché and wet pasta, and low for materials like Play-Doh and dry pasta. The team advises that schools provide gluten-free supplies for activities that rely on high-risk materials, and that they also have in place a viable plan to prevent contact with gluten. Making sure that kids, especially kids with celiac disease, wash their hands well with soap and water after any activity with these materials is always a good idea. Do you have a story about gluten exposure at school activities? Be sure to share it in our comments below. Read more at Journals.lww.com

Celiac.com 08/08/2019 - A strict gluten-free diet is the only currently accepted treatment for celiac disease. Current treatment guidelines for celiac disease recommend regular dietary interviews and blood tests to gauge dietary adherence. However, those guidelines might not be doing the job. A team of researchers recently set out to see if fecal gluten immunogenic peptides might help support the diagnosis, and determine the adherence to the gluten-free diet in celiac children. The research team included Isabel Comino, Verónica Segura, Luis Ortigosa, Beatríz Espín, Gemma Castillejo, José Antonio Garrote, Carlos Sierra, Antonio Millán, Carmen Ribes-Koninckx, Enriqueta Román, Alfonso Rodriguez-Herrera, Jacobo Díaz, Jocelyn Anne Silvester, Ángel Cebolla, and Carolina Sousa. They are variously affiliated with research institutions in Spain, Canada and the USA. The team's multi-center prospective longitudinal study included 64 children with celiac disease. For each child, the team assessed fecal gluten peptides, and tissue transglutaminase and deamidated gliadin peptide antibodies at diagnosis, and 6, 12 and 24 months afterward. The researchers used gluten peptide levels to estimate patient gluten consumption. A total of 97% of children showed detectable gluten peptides upon diagnosis. For patients on a gluten-free diet, the rate of gluten peptides rose from 13% at 6 months to 25% at 24 months. Average estimated gluten exposure fell from 5543 mg/d at diagnosis to 144 mg/d at 6 months, then rose to about 600 mg/d after two years. In contrast, antibodies to deamidated gliadin peptide normalized and only 20% of patients showed elevated tissue transglutaminase antibody after 24 months. Patients with detectable gluten peptides had longer periods of tissue elevated transglutaminase antibody. Overall, absolute levels of tissue transglutaminase antibody showed low sensitivity for identifying patients with detectable gluten peptides. Evaluation by a dietitian only moderately improved gluten peptide detection. At some point, testing for fecal gluten peptides could help to guide celiac treatment prior to diagnosis and to test adherence to a gluten-free diet. Further studies are needed to determine if spotting gluten exposure early can reduce the need for expensive/invasive investigations for non-responsive celiac disease. Read more in Alimentary Pharmacology & Therapeutics

Celiac.com 01/30/2019 - Children who receive the rotavirus vaccine may be less likely to develop type 1 diabetes than children who remain unvaccinated, a recent Australian study suggests. Rotavirus can cause severe watery diarrhea, vomiting, fever, and abdominal pain. In some cases, the virus can leave kids with dehydration that is serious enough to require a hospital visit. There is some data to indicate that rotavirus infections can accelerate the development of type 1 diabetes, though researchers don’t yet know why. In May, 2007, health officials introduced a routine oral rotavirus vaccine for infants six weeks and older. In the most recent study, the research team compared rates of type 1 diabetes in the eight years before and the eight years after the vaccine was introduced. The data showed that cases of type 1 diabetes cases declined 14 percent among children age four and younger in the period after the vaccine. The same data showed no significant change in type 1 diabetes cases among older kids. The study wasn’t set up to prove that rotavirus causes type 1 diabetes or how vaccination might help minimize this risk. The findings are only preliminary, lead study author Dr. Kirsten Perrett of the University of Melbourne says that “rotavirus vaccination may be one of possibly many as yet unknown protective environmental and modifiable factors against the development of type 1 diabetes in early childhood.” Perrett stresses that diabetes “has not been clearly linked to other modifiable lifestyle factors and cannot be prevented.” Rotavirus can interfere with insulin production in the pancreas, which could promote type 1 diabetes, Perrett said. The study does add more data to support the idea that viral infections likely contribute to autoimmune disorders like type 1 diabetes and celiac disease in otherwise susceptible people, said Dr. Federico Martinon-Torres a researcher at Hospital Clínico Universitario de Santiago and Instituto de Investigacion Sanitaria de Santiago in Spain. All infants who do not have severely compromised immune systems or a history of bowel obstruction should receive the rotavirus vaccine, says Martinon-Torres. The good news about this study is that a vaccine that is routinely given to most infants seems to offer protection against type 1 diabetes. Source: JAMA Pediatrics, online January 22, 2019.

Celiac.com 07/31/2018 - Using funds from the Canadian Institutes of Health Research Canada Research Chairs Program, researcher Charlene Elliott, PhD, of the Department of Communication, Media, and Film, University of Calgary recently set out to assess the nutritional quality of gluten-free products specifically marketed for children. For her assessment, Elliott bought child-targeted gluten-free food products from two major supermarket chains in Calgary, Alberta, Canada. Elliott used the Pan American Health Organization Nutrient Profile Model to compare the nutritional quality of products labeled gluten-free with those not so labeled. A secondary analysis compared the nutritional profile of child-targeted gluten-free products to their non-gluten-free “equivalents.” Elliott’s analysis showed that child-targeted gluten-free products generally had lower amounts of sodium, total fat, and saturated fat, However, those same foods also had less protein and about the same amount of calories from sugar as child-targeted products without a gluten-free claim. According to the Pan American Health Organization criteria, both gluten-free products and "regular" products designed for children can be classified as having poor nutritional quality (88% vs 97%). Compared to their non-gluten-free equivalents, products with a gluten-free claim had similarly high sugar levels, (79% vs 81%). So, the big picture is that gluten-free supermarket foods targeted at children are generally less nutritious than their non-gluten-free counterparts, and both types have alarmingly high sugar content. A gluten-free label is no guarantee of healthier, more nutritious food for kids, and it’s a mistake for parents to buy gluten-free products believing they are healthier than their non-gluten-free equals. The evidence shows that is simply not true. The takeaway here seems to be that, gluten-free or not, supermarket foods aimed at children are generally poor in nutrition and loaded with sugar, and parents should choose wisely when buying food for their children. Source: Pediatrics, July 2018

Celiac.com 07/20/2017 - It is common for school teachers in the United States not to know what student has celiac disease, or allergies of any sort. Most schools don't have formal systems so that the principal, school nurse, teacher, or cafeteria workers know when a child has celiac disease or food allergies. An informal game of roulette is played, where everyone assumes that everything is fine – that is, until a child has a heath reaction. In Montreal, Canada, the Lester B Pearson School Board has taken a different approach to dealing with food allergies and conditions such as celiac disease that their students might have. They regard these health conditions to be so important that how to handle them is present in their official Policy on Safe and Caring Schools. To summarize what they do, at the beginning of each school year parents are sent a form requesting them to inform the principal, homeroom teacher, and other relevant school personnel about health conditions and allergies. This includes children who have celiac disease and gluten issues. If a child changes schools, or if a student in an existing school gets a new health diagnosis or has newly identified health needs, this information should be made known to school personnel. A photograph of the student is taken and put on a card with the health condition so that others in charge may know that a particular child has gluten issues. In the cafeteria, workers have the photos of the children posted in the kitchen where they can see them so that they can know that brown-haired Lucinda in fifth-grade has celiac disease and should be served only foods that are safe for her. Children may not know what foods have gluten in them and which do not, so they may not always be the best informants for identifying which foods being served are safe for them and which are not. Given that additives may vary according who is doing the cooking or what ingredients are used, a food like macaroni and cheese may be made with wheat pasta, making it unsafe, or corn, rice or quinoa pasta, rendering it acceptable. Both may look identical to the naked eye, but they aren't so it is a food service worker's obligation to know whether Lucinda can have the dish or not. Likewise, teachers may be given the photograph and health card so that they remember when Billy brings in cupcakes for his birthday celebration, that there are gluten-free ones available (hopefully!) in the cafeteria freezer that can be pulled out and given to Lucinda so she is not left out. The photograph technique is especially helpful when there are new cafeteria workers or substitute teachers or other personnel who may not know a child's food allergy situation like someone who interacts with the child every day might. The Lester B Pearson schools' Food and Nutrition Policy is based in Canada's Food Guide and Policy on Health Eating and Active Living. All schools in Canada are to adhere to the same set of standards. This means that a celiac child living in Vancouver should be just as safe eating at school as one in Ottawa or one in Halifax. Having national standards that are uniformly enforced helps to make all children safe. Making sure that children's food consumption is safe for all of them, especially in public institutions like schools, is part of their human rights according to the Convention on the Rights of the Child. It is the responsibility of adults who are in local parent organizations to be in charge of the oversight and safety of all children and to think through food risk and safety policies.

Celiac.com 06/14/2017 - Some data have suggested a connection between celiac disease and eosinophilic oesophagitis (EoE)/oesophageal eosinophilia (EE). Any potential relationship has implications for treatment. Should the two conditions be treated together, or separately? To better understand any possible connection, and the implications for treatment, a team of researchers recently set out to characterize children with celiac disease+EE in-depth and assess the contribution of each condition to the clinical presentation and treatment response. The research team included Anne Ari, Sara Morgenstern, Gabriel Chodick, Manar Matar, Ari Silbermintz, Amit Assa, Yael Mozer-Glassberg, Firas Rinawi, Vered Nachmias-Friedler, Raanan Shamir, and Noam Zevit. They are variously affiliated with the Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children’s Medical Center of Israel, Petach Tikvah, Israel, the Pediatrics Center at Schneider Children’s Medical Center of Israel, Petach Tikvah, Israel, the department of Pathology at Rabin Medical Center in Petach Tikvah, Israel, and the Sackler Faculty of Medicine at Tel Aviv University in Tel Aviv, Israel. The research team conducted a retrospective review of medical records of children with both celiac disease+EE, or isolated EoE diagnosed between 2000 and 2014. They then compared these records with those of patients with isolated celiac disease or epigastric pain. To calculate the frequency of EE, they used endoscopy results of patients with suspected celiac disease or epigastric pain between 2011 and 2014. They used a telephone questionnaire to gather missing data. At a single large, tertiary pediatric center, the team assessed 17 patients with celiac disease+EE, 46 with EoE, 302 with isolated celiac disease, and 247 with epigastric pain. The patients with celiac disease+EE shared characteristics of both individual conditions. While age at diagnosis, family history of autoimmunity/celiac disease and anaemia were similar to most celiac patients, other characteristics such as male gender, personal/family history of atopy, peripheral eosinophilia and oesophageal white papules more closely resembled those of patients with EoE. Most patients with celiac disease+EE tended to present with celiac-associated symptoms, and 63% went on to develop typical EoE symptoms. In celiac disease+EE patients, only 21% saw their EE resolve after a gluten-free diet; another 21% saw their EE normalize after proton pump inhibitor treatment. The rest required EoE-specific treatment. Patients with celiac disease found to have EE share characteristics similar to both isolated celiac disease and EoE. This study indicates that celiac patients with concurrent EE are actually suffering from two separate conditions, rather than celiac-associated eosinophilia. Therefore, in such patients, doctors should consider treating each condition separately. Source: Archives of Disease in Childhood Published Online First: 12 April 2017. doi: 10.1136/archdischild-2016-311944

Celiac.com 06/05/2017 - Doctors diagnose celiac disease by confirming various clinical, genetic, serologic, and duodenal morphology features. Based on retrospective data, recent pediatric guidelines propose eliminating biopsy for patients with IgA-TTG levels more than 10-times the upper limit of normal (ULN), along with a few other criteria. One retrospective study showed that researchers using levels of IgA-TTG and total IgA, or IgA-TTG and IgG against deamidated gliadin (IgG-DGL) could identify patients both with and without celiac disease. A team of researchers recently set out to validate the positive and negative predictive values (PPV and NPV) of these diagnostic procedures. The research team included Johannes Wolf, David Petroff, Thomas Richter, Marcus KH. Auth, Holm H. Uhlig, Martin W. Laass, Peter Lauenstein, Andreas Krahl, Norman Händel, Jan de Laffolie, Almuthe C. Hauer, Thomas Kehler, Gunter Flemming, Frank Schmidt, Astor Rodriques, Dirk Hasenclever, and Thomas Mothes. Their team conducted a prospective study of 898 children undergoing duodenal biopsy analysis to confirm or rule out celiac disease at 13 centers in Europe. They then compared results from antibody tests with results from biopsies, follow-up data, and diagnoses made by the pediatric gastroenterologists. In all cases, diagnosis was made for celiac disease, no celiac disease, or no final diagnosis. Blinded researchers measured levels of IgA-TTG, IgG-DGL, and endomysium antibodies, while tissue sections were analyzed by local and blinded reference pathologists. The team validated two procedures for diagnosis: total-IgA and IgA-TTG, as well as IgG-DGL with IgA-TTG. Patients whose antibody concentrations for all tests were below 1-fold the ULN were assigned to the no celiac disease category. Those whose antibody concentrations for at least one test were above 10-fold the ULN were assigned to the celiac disease category. All other cases were considered to require biopsy analysis. The team calculated the ULN values using the cut-off levels suggested by the test kit manufacturers. They conducted HLA-typing for 449 participants. To extrapolate the PPV and NPV to populations with lower rates of celiac disease, they used models that accounted for how specificity values change with prevalence. In all, the team found 592 patients with celiac disease, 345 who did not have celiac disease, and 24 with no final diagnosis. The TTG-IgA procedure identified celiac disease patients with a PPV of 0.988 and an NPV of 0.934. The TTG-DGL procedure identified celiac disease patients with a PPV of 0.988 and an NPV of 0.958. Their extrapolation model estimated that PPV and NPV would remain above 0.95 even at a disease prevalence as low as 4%. Meanwhile, tests for endomysium antibodies and HLA type did not increase the PPV of samples with levels of IgA-TTG 10-fold or more above the ULN. Interestingly, the pathologists disagreed in their analyses of duodenal morphology about 4.2% of the time, a rate comparable to the error rate for serologic tests. This study validates the use of the TTG-IgA procedure and the TTG-DGL procedure in lieu of biopsy to diagnose pediatric patients with or without celiac disease. Source: Gastroenterology. DOI: http://dx.doi.org/10.1053/j.gastro.2017.04.023 The researchers are variously affiliated with the Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Medical Faculty of the University and University Hospital, Leipzig, Germany, the Institute for Medical Informatics, Statistics & Epidemiology (IMISE), University of Leipzig, Germany, the Department of Paediatrics, University of Oxford, Oxford, United Kingdom, the Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom, the, University Children's Hospital Halle, Germany, the Medical School, Hannover, Germany, Helios Hospital, Department of Paediatrics, Plauen, Germany, the Children's Hospital Prinzessin Margaret, Darmstadt, Germany, the University Children's Hospital Graz, Austria, the Children's Hospital, Justus Liebig University Giessen, Germany, the University Children's Hospital Leipzig, Germany, the Children's Hospital of the Clinical Centre Sankt Georg Leipzig, Germany, the Clinical Trial Centre, University of Leipzig, Germany, the DKD Helios Children's Hospital, German Clinic for Diagnostics, Wiesbaden, Germany, the University Children's Hospital, Technical University Dresden, Germany, and the Alder Hey Children's National Health Service Foundation Trust, Liverpool, United Kingdom.