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Celiac.com 12/26/2014 - Celiac disease can have such a wide-ranging number of symptoms, ranging over so many parts of the body, that it can be hard for doctors seeking to make a diagnosis to even suspect celiac disease as an underlying cause in the first place. A team of researchers set out to better understand the characteristics of celiac disease by looking at the findings in a large number of celiacs diagnosed in a single referral center, and to using clear definitions of the clinical, serological and histopathological aspects of celiac disease to get a better picture of how the disease presents itself. The research team included Umberto Volta, Giacomo Caio, Vincenzo Stanghellini and Roberto De Giorgio of the Department of Medical and Surgical Sciences at the University of Bologna’s S. Orsola-Malpighi Hospital, in Bologna, Italy. For their study, their team looked at data on celiac patients admitted to S. Orsola-Malpighi Hospital from January 1998 to December 2012. They found a total of 770 patients ranging from 18 to 78 years, averaging 36 years old. A total of 599 patients were female. The team broke celiac disease down into three types: The first type, classical, in which patients present with malabsorption syndrome. The second type, non-classical, in which patients experience extraintestinal and/or gastrointestinal symptoms other than diarrhea. The third type, subclinical, with no visible symptoms. The team evaluated patient serology, duodenal histology, comorbidities, response to gluten-free diet and complications. A total of 610 patients (79%) showed clear physical symptoms when they were diagnosed, while 160 celiacs showed a subclinical phenotype. In the symptomatic group 66% of celiacs were non-classical, that is, they experienced extraintestinal and/or gastrointestinal symptoms other than diarrhea. Only 34% of patients in the symptomatic group showed classical malabsorption syndrome. The team found that just 27% of the non-classically symptomatic group complained of diarrhea, while other gastrointestinal manifestations included bloating (20%), aphthous stomatitis (18%), alternating bowel habit (15%), constipation (13%) and gastroesophageal reflux disease (12%). Extraintestinal manifestations included osteopenia/osteoporosis (52%), anemia (34%), cryptogenic hypertransaminasemia (29%) and recurrent miscarriages (12%). Positivity for IgA tissue transglutaminase antibodies was detected in 97%. Th steam found villous atrophy in 87%, while 13% had minor lesions consistent with potential celiac disease. A large proportion of patients showed autoimmune disorders, such as autoimmune thyroiditis (26.3%), dermatitis herpetiformis (4%) and diabetes mellitus type 1 (3%). Complicated celiac disease was very rare. This study demonstrates that the clinical profile of celiac disease has changed over time, and now features much more non-classical and subclinical phenotypes. Source: BMC Gastroenterology 2014, 14:194. doi:10.1186/s12876-014-0194-x
Celiac.com 10/01/2014 - News that snack foods, like cookies, crackers, salty snacks and snack bars now account for more than half of new gluten-free product sales has some leading analysts and industry representatives sounding the alarm. Speaking at a webinar hosted by the Institute of Food Technologists, Ardent Mills’ director of commercial insights, David Sheluga PhD, announced that the market is starting to get a bit saturated with gluten-free snack products, and that he’d like to see "a little bit more distribution of other types of product categories." The top-selling gluten-free categories break down as follows: Crackers ($156m), salty snacks ($125m), bread and rolls ($120m), pasta ($78m), cookies ($60m), baking mixes ($55m), RTE cereal ($49m), ancient grains ($47m), snack bars ($45m), flour ($43m), and frozen pizza ($35m). Currently, market research company Mintel reckons the US gluten-free retail market topped $10 billion in 2013. This figure includes anything with a gluten-free label, including naturally-gluten-free products. When the category is limited to products specifically formulated to replace wheat and where gluten-free is "not just a minor claim among a bundle of others," Dr. Sheluga says the market is likely closer to $1.2 billion. 70% of these sales were driven by heavy buyers, who account for just 3.8% of US households. Still, he says that Ardent Mills remains 'pretty bullish' about gluten-free category growth overall. Sheluga points out that almost three-quarters of gluten-free products on the market in 2009 are still available today, whereas 85% of new products disappear from grocery market shelves after just two years. Still, Sheluga notes that the market for actual celiac disease patients is limited, and that we may be reaching a point where we can’t push consumers to eat more gluten-free snack. So, while he notes that there’s likely still plenty of room for the gluten-free food market to grow, he is among a growing chorus to wonder out loud if we reaching a breaking point where we can’t eat any more snacks? The entire webinar may be accessed for a fee at: IFT
Celiac.com 07/02/2012 - Dismal results on a simple, four-question quiz show that most chefs and restaurateurs lack the most fundamental knowledge of gluten-free facts and protocols; a reality that could leave many gluten-free diners at risk of gluten contamination. The quiz was administrated at the National Restaurant Association Show in Chicago by the National Foundation for Celiac Awareness (NFCA), a non-profit organization that promotes awareness of celiac disease and gluten sensitivity. Even though a large number of chefs and restaurateurs said they offered gluten-free options at their restaurants, less than 4 percent responded correctly to the gluten questionnaire. People with celiac disease or gluten-intolerance must avoid gluten from wheat, rye and barley, but fewer than half of the chefs could name a grain, other than wheat, that contained harmful gluten. The results showed that the chefs were both poorly informed, and unaware, said Alice Bast, founder and president of NFCA. In addition to asking chefs to name all three grains that trigger a reaction in people with celiac disease, the quiz asked what kind of oats are safe for those people. There were two other questions, one that asked chefs to identify a possible gluten-containing product (Worchestershire sauce) from a short list of foods and products, and another that asked if it was true that celiac disease was triggered by glucose (false). The results point to the need for more celiac disease and gluten-sensitivity training and awareness in the food industry, especially since the number of establishments seeking to offer gluten-free options for their patrons continues to grow. Source: http://www.pizzamarketplace.com/article/195015/Majority-of-restaurateurs-and-chefs-fail-celiac-test
Celiac.com 12/30/2004 - A new study on celiac disease was presented at the 69th Annual Scientific Meeting of the American College of Gastroenterology by S. Devi Rampertab, MD, from the North Shore Long Island Jewish Health System in New York. The study looked retroactively at 590 patients with a celiac diagnosis confirmed by biopsy from 1952 to 2004. They found that since 1980 the patient age of diagnosis has increased from 30.5 to 42, and the number of cases diagnosed after significant diarrhea decreased from 91% to 37%—and the time period from the development of the disease to its detection decreased from 11 years (before 1980) to four years now. New blood screening techniques are credited for the earlier detection of the disease, and the resulting decrease in the percentage of patients diagnosed after the development of a malignancy—which decreased from nearly 22% before 1980 to just over 5% now. The positive trends noted in this study further support the use of widespread serum screening to detect celiac disease, as it can prevent many of the complications caused by the disease. One thing that isnt clear, however, is why the age of diagnosis is getting higher—even though Italian studies have determined through mass-screenings that celiac disease is present in at least 1% of all children. Since that number is consistent with the number of people in the USA with the disease, it stands to reason that celiac disease may in fact be a childhood disease, and if so, the 42 year-old average age of diagnosis in the USA would indicate a massive failure of our health care system to detect the disease. More studies need to be done to determine the number of children in the USA with celiac disease. Since most celiacs have little or no symptoms—Celiac.com believes that the only reasonable way to get them properly diagnosed and treated would be to have widespread serological screenings of the general population. The disease affects at least 1% of the population in the USA, and the benefits for such screenings would far outweigh their cost.