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Showing results for tags 'malnutrition'.
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Celiac.com 09/05/2023 - Celiac disease is a T-cell-mediated gluten sensitivity that results in villous atrophy in the small intestine, leading to chronic malabsorption. Patients with celiac disease are prone to malnutrition. A team of researchers recently assessed the impact of malnutrition on in-hospital outcomes in patients with celiac disease. This study analyzed data from the National Inpatient Sample Database, encompassed 187,310 patients with celiac disease. The team included patients with a primary discharge diagnosis of celiac disease between January 2016 and December 2019 from the National Inpatient Sample Database. Data included patient demographics, hospital characteristics, the Charlson Comorbidity Index, and concomitant comorbidities. The association between malnutrition and outcomes, including mortality, deep vein thrombosis, pulmonary embolism, sepsis, acute kidney injury, length of stay, and total hospitalization charges, was analyzed using the multivariate regression model. Malnutrition Rate Among Hospitalized Celiacs at 8.3% and 108% Increase in Mortality Rate The rate of malnutrition among celiac patients was found to be 8.3%, aligning with similar rates seen in prior research. However, this study adds new insights by demonstrating the link between malnutrition and various detrimental outcomes in hospitalized celiac patients. The research reveals that malnourished celiac patients are at a significantly higher risk of in-hospital mortality and resource utilization, as well as a range of complications including deep vein thrombosis, sepsis, acute kidney injury, and prolonged length of stay. The heightened mortality risk is particularly alarming, with a staggering 108% increase in mortality rates observed in malnourished celiac patients. The complex pathophysiology behind malnutrition in celiac disease involves factors like intestinal damage-induced malabsorption and chronic diarrhea. Common nutritional deficiencies in celiac patients encompass iron, zinc, folic acid, vitamin B12, vitamin D, and calcium. Despite these challenges, many celiac patients display malnutrition-related symptoms. Malnutrition was also associated with an increased risk of deep vein thrombosis, suggesting that diet could influence thrombosis-related factors. Additionally, acute kidney injury was more likely to develop in malnourished celiac patients, possibly due to dehydration and reduced serum creatinine levels. Sepsis, a serious condition, was found to be 43% more likely in patients with malnutrition, linked to their lower immunity caused by inadequate dietary intake. The study underscores the significance of proper nutrition in celiac patients, both for mitigating immediate complications and preventing long-term adverse effects. However, the study's limitations highlight the need for further investigation into factors such as disease severity, pharmaceutical therapies, and treatment compliance. The findings emphasize the importance of a multidisciplinary approach to manage malnutrition in celiac patients, involving nutritional screening, medical therapy, and dietary recommendations, as well as interventions like enteral or parenteral nutrition. Lastly, the research highlights the need for further investigations into factors contributing to malnutrition in celiac disease, and the effectiveness of interventions to address it. Read more in cureus.com The researchers included Kanwal Bains, Shivam Kalra, Ishandeep Singh, Jay Patel, Isha Kohli, Mukul Dhiman, Dino Dukovic, Aalam Sohal, and Avin Aggarwal. They are variously affiliated with the department of Internal Medicine, University of Arizona College of Medicine, Tucson, USA; the department of Internal Medicine, Trident Medical Center in North Charleston, USA; the department of Internal Medicine, Dayanand Medical College and Hospital in Punjab, IND; the Digestive Disease and Surgical Institute, Cleveland Clinic in Cleveland, USA; the department of Public Health Sciences, Icahn School of Medicine at Mount Sinai in New York , USA; the Internal Medicine, Punjab Institute of Medical Sciences in Punjab, IND; the department of Internal Medicine, Ross University School of Medicine in Bridgetown, BRB; and the department of Internal Medicine, UCSF Fresno in Fresno, USA. -
Gluten-Free Diet Can Deprive Women of Crucial Nutrition
Jefferson Adams posted an article in Winter 2023 Issue
Celiac.com 02/22/2023 - When people with celiac disease consume wheat or gluten, they typically suffer damage to the lining of the small intestine, along with associated symptoms of the damage, including nutritional deficiencies. Most women with celiac disease follow a gluten-free diet. But, we still don't know very much about the potential long-term impact of a gluten-free diet on the nutritional, body composition, and other factors in women with celiac disease. To better understand the issue, a team of researchers took a closer look at this issue. The team studied a group of just over fifty adult Saudi females with celiac disease, all of whom had followed a gluten-free diet for more than one year. The study included a complete analysis of anthropometric data, levels of vitamins B12 and D, and a complete blood count. Even though it's a small study, the results are concerning. That's because all of the patients were deficient in micro and macro-nutrients, including vitamin D, folate, calcium, and iron. Moreover, nearly half of the patients had reduced total body fat, while nearly two out of three had decreased levels of visceral fat. We already know that most adult celiacs suffer from micronutrient deficiencies. We also have a good idea of which deficiencies are the most common. The team's findings echo those of earlier studies, which have shown that gluten-free foods often have poorer nutritional quality than similar non-gluten-free foods. This means that people with celiac disease who follow a gluten-free diet may be at risk for poor nutrition or malnutrition. To ensure proper nutrition for people with celiac disease, especially women, it's important to remain extra vigilant about getting food with enough nutrition, fiber, and other essential nutrients to promote good health. This may include working with a dietitian or nutritionist to create a well-balanced meal plan, and supplementing with vitamins and minerals, as needed. Women with celiac disease who are following a gluten-free diet, and those who care for them, should take this study seriously, share it with your doctor or nutritionist, and take steps to make sure they remain healthy. Read more in Nutrients -
Celiac.com 02/10/2022 - Researchers know that celiac disease is an autoimmune disorder triggered by gluten in genetically susceptible people, which, left untreated, can lead to chronic malabsorption and other disorders. However, the ways in which celiac disease manifests in clinical setting has changed over time. Today classic symptoms are more rare, while many patients, especially children, manifest atypical symptoms, or no symptoms at all. Considering the changes in the manifestations of celiac disease, a team of researchers recently set out to determine anthropometric indices and clinical indications in children with celiac disease. The research team included Zahra Setavand, Maryam Ekramzadeh, and Naser Honar. They are variously affiliated with the Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; the Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran, and the Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran. The team's cross-sectional study aimed to assess children with celiac disease who were referred to Imam Reza Celiac Clinic between 2016 and 2019. In all, the team identified 361 children, and noted their anti-tissue transglutaminase (TGA-IgA) level, weight, height, and Body Mass Index (BMI) from their records. They presented anthropometric indices based on the criteria of the Center for Disease Control and Prevention (CDC) and World Health Organization (WHO), along with assessing the main symptoms. Using CDC criteria, nearly twenty percent of the children had short stature, nearly thirty percent had low body weight, and more than twenty-five percent had low BMI. Furthermore, in addition to gastrointestinal symptoms, numerous patients suffered from skeletal pain and anemia. The most common symptoms among the children were abdominal pain in nearly 60 percent, skeletal pain in nearly 30 percent, constipation in more than twenty-five percent, and anemia in nearly twenty-five percent. The team's findings clearly show that growth failure, low height, weight, and BMI were common among children with celiac disease. Stay tuned for more on this and related stories. Read more in BMC Pediatrics volume 21, Article number: 147 (2021) -
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Hi, I have been loosing weight gradually in the last 8 -10 months and experience diarrhea once a day , cramps, and yellow mushy stool in the last month. I'm cutting out dairy and oats . I'm a bit worried that my weight will decrease , i cannot afford to loose anymore body weight . I would also like to know if your body will stop loosing weight ? I have stopped consuming gluten immediately after my visit to the Doctor. The Doctor suggested that i cut out gluten until my results , just to see if my simptome's subside. its to soon to see results so i will have to weight for my results , only got tested yesterday . Many thanks
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Micronutrient deficiencies remain common in adults with Celiac Disease despite increased non classic presentation new Mayo Clinic study shows; or How Under/Undiagnosed Malnutrition is making you Sick…. The Posterboys Story of How Taking Magnesium and a B-Complex help him address asymptomatic Vitamin Deficiencies in Celiac disease They (Mayo Clinic) titled it… Micronutrient Deficiencies Are Common in Contemporary Celiac Disease Despite Lack of Overt Malabsorption Symptoms…but as usual some of the usual suspect’s are missing… IE many B-Vitamins https://www.ncbi.nlm.nih.gov/pubmed/31248695 Like Niacinamide (best form to take without flushing side effects)…Thiamine, and Riboflavin… Eating a gluten free diet will make you low in Thiamine…. See this 5+ year old study on this effect/relationship to Malnutrition in Celiacs’ entitled…. Nutritional inadequacies of the gluten-free diet in both recently-diagnosed and long-term patients with coeliac disease commonly spelt Celiac disease in North America… https://www.ncbi.nlm.nih.gov/pubmed/23198728 And note quoting…someone eating a gluten free diet will become low in Thiamine... “The frequency of inadequacies was similar pre- and post-diagnosis, except for thiamine and vitamin A, where inadequacies were more common after GFD implementation.” Gluten free foods are un-enriched…and are from common sources like Rice that typically low in Thiamine already…. (A great argument for Fortification of Gluten Free Foods) keeping Thiamine levels’ low even in Celiac’s…who have been Gluten Free for some time… Now the Mayo Clinic is picking up on these same issues in Celiac’s 5+ years later…. Progress takes time….but it comes with awareness… And Why I am writing this posterboy blog post to share my experience…. Low Thiamine levels have been linked to Villi thinning… See this article explaining these connections….featured on celiac.com Here are a few links that will help you understand Magnesium vital role in the body… https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-11-229 https://www.ncbi.nlm.nih.gov/pubmed/29480918 https://onlinelibrary.wiley.com/doi/abs/10.1111/j.0954-6820.1985.tb08836.x Magnesium deficiency has also been shown to be a key way into how the Epstein Barr Virus (EBV) causes/contributes to Chronic Fatigue Syndrome (CFS) in people who have Chronic Active EBV… http://simmaronresearch.com/2015/08/epstein-barr-virus-the-magnesium-connection/ But people (doctors etc.) don’t really have a good understanding today of how important it (Magnesium) is to the body… I believe mainly because of all the confusion of different Magnesium supplement types….It is like a maze to just find one that your body can use….and why I have simply told you the best kinds to take… Find a Magnesium Glycinate or Magnesium Citrate and your body will think you with some very lucid dreams! Special Note: on Taking B-Complex’s….after a 3 or 4 days…urine color will often change…this is normal… Note: (Taking an Enzymic B-Vitamin) is often easier to absorb for people with low stomach acid because they have already been converted into their active form...used by the body (that normally takes) place with a strong stomach acid...sold usually as a CoEnzyme B-Complex etc...I hope this is helpful. B-Complex’s half life is 12 hours so…take them twice a day or with meals…they are water soluble and leak out… I describe it as being a quart low in blood etc…you just drag…when you are low….(same with Magnesium by the way)… you are said to “Waste Away” when low in Magnesium! You can test this by the color of your urine….take one every other day…and you will notice a change in your urine color…. as you become low in B-2 aka Riboflavin… Your now “yellow” urine will become clear 12 to 24 hours later… Taking them 2x a day ensures you have enough to get by for 24 hours in the day…without feeling a “quart” low… As the intensity of your urine color becomes brighter….this is a sign your body is now storing more in your body (liver mostly)…. Once…it begins to (GLOW) in the dark….your body is now bypassing all the B-2 (Riboflavin) through the kidneys… It is a sign you can give the B-Complex and/or Riboflavin a break… If I take B2 now…..it immediately (in 3 to 4 hours) turns…it yellow…and will stay that way for another 12 hours or so… (Similar to the Asparagus effect about 1/2 the population) encounters....of a strong order to their urine...harmless but noticeable... until being water soluble (and the body) not able to store extra…leaks out again… Another distinct sign (if you are NOT taking) an acid reducer now….is burping replacing bloating and indigestion in your stomach… As your acid rebuilds in the stomach (from the B-Complex) another sign you are getting your body’s stress under control is a distinct and noticeable burping….this will be your new normal… This effect (of burping without bloating) will usually take about 6 weeks to notice and 3 to 4 months to ensure it is your new normal…unless you are stressed “out” again… Stress is related to heartburn….see this research about it…entitled “The effect of life stress on symptoms of heartburn.” https://www.ncbi.nlm.nih.gov/pubmed/15184707 I have to stop for now…but I hope this is helpful to whomever might read this Posterboy blog post… Stress kills…but it maims us first! As always I hope this is helpful but it is not medical advise… I just know it helped me and I have tried diligently to share what helped me…. so that other could be helped the same way Lord willing. No people or blog post is perfect...but this covers the basics without it being Way Too Long (at least by my standards)... 2 Corinthians (KJV) 1:3,4 3) “Blessed be God, even the Father of our Lord Jesus Christ, the Father of mercies, and the God of all comfort; 4) who comforteth us in all our tribulation, that we may be able to comfort them which are in any trouble (fellow sufferer), by the comfort wherewith we ourselves are comforted of God.” 2 Timothy 2:7 “Consider what I say; and the Lord give thee understanding in all things” this included. Posterboy by the grace of God, -
Dear All, I am writing this post on behalf of my father, who at the age of 67 has been a diagnosed celiac for the last 37 years. He has a complete intollerance of gluten and has managed his disease extremely well over the last 37 years. However, starting approximately 12 months ago he started to lose weight, and started to suffer from low blood pressure and terrible headaches at the same time. He has terrible edema and fluids leak from his swellings. He has had several CT scans, endoscopies and blood tests. So far we know the following : he is currently in hospital in a bad way after being admitted 2 days ago. He has an albumin level of 14 when it should be around 60. He has little or no iron in his blood. His blood pressure when sitting was 70/55 and drops when he stands, so much so that the nurses are struggling to get a reading. he has terrible swellings in his legs and arms and stomach region. Fluid is leaking from the swellings. He has had a chest xray today and he has fluid in his lungs and his heart now looks enlarged. He is going for a heart scan this afternoon Please can anyone help us, or point us in the direction of a fix for this? the doctors have admitted that they have no idea how to even start fixing it - at the moment all they are doing are giving him a duretic via a port in his arm. lastly he has lost around 6 stone in the last 12 months. Its taken forever to get anything looked into and for a while they were looking into his heart as they had seen some markers in some blood tests and thought he was in heart failure...this has since been dismissed as incorrect. Thank you in advance for any help of advice you can possibly give. Rachel -
Did a Misguided Gluten-free Diet Kill Belgian Infant?
Jefferson Adams posted an article in Additional Concerns
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Celiac.com 05/22/2017 - After their seven-month-old baby died weighing less than 10 pounds, a mother and father in Beveren, Belgium, are standing trial on charges that they starved the child by negligently providing an alternative gluten-free diet, with no medical supervision. The couple, who ran a natural food store, put their son Lucas on an alternative gluten-free, lactose-free diet, which included quinoa milk, despite doctors describing it as unsuitable for developing infants. According to child gastroenterologist Elisabeth De Greef, from the University Hospital of Brussels, feeding quinoa milk and other such foods to infants is absolutely wrong. She says that "These kinds of milk, which you can buy in a supermarket, do not contain the necessary proteins, minerals and vitamins. They are not adjusted to infants and thus unsuitable." Lucas' mother said in a statement that "Lucas had an eating disorder. He got cramps when he was fed with a bottle and his parents tried out alternatives. Oat milk, rice milk, buckwheat milk, semolina milk, quinoa milk." These are all products the couple sold at their store. At the beginning of the trial, public prosecutors blamed the couple for their son's death. Prosecutors claim that the couple made their "own diagnosis that their child was gluten intolerant and had a lactose allergy," without any input from doctors. In fact, prosecutors allege that the couple kept the child away from doctors altogether. "Not a single doctor had a dossier about Lucas and child protection services did not know about them," said the public prosecutor. The infant's diet, said prosecutors, "led to him being less than half the expected weight for a boy his age," at the time of his death in June 6, 2014. An autopsy showed that Lucas' stomach was totally empty at the time of his death. Prosecutors say the parents did not seek medical attention, even when Lucas was gasping for air in the days before he died. When Lucas was in the final throes of starvation, and the parents finally did take action, prosecutors say that they compounded the child's medical crisis by driving to a homeopathic doctor on the other side of the country, instead of going to the nearest hospital. In their defense, Lucas's father, claimed the couple never took Lucas to a doctor "because we never noticed anything unusual." In fact, the parents believed Lucas had an eating problem, says the couple's lawyer. Under questioning, Lucas' tearful mother said that the couple never "wished for the death of our son." She also stated that Lucas ometimes…gained a little weight, sometimes he lost a little." Yet according the public prosecutor the actions by the couple amount to "intentionally denying food" to the boy. For now, the trial in this tragic case continues, with a verdict set for June 14. Read more: Metro.co.uk -
Celiac.com 06/17/2015 - Refractory celiac disease type II (RCDII) and EATL (Enteropathy Associated T-cell Lymphoma) are pre-malignant complications of celiac disease. However, there is scant medical literature and data what role malnutrition and intestinal absorption may play in these conditions. With this in mind, a team of researchers set out to conduct a comprehensive assessment of nutritional status and intestinal absorption capacity of patients with RCDII and EATL, and to compare that with data of newly diagnosed celiac disease patients. The research team included N.J. Wierdsma, P. Nijeboer, M.A. de van der Schueren, M. Berkenpas, A.A. van Bodegraven, and C.J. Mulder. They are affiliated with the Department of Nutrition and Dietetics, the Department of Gastroenterology, the Celiac Centre Amsterdam, the Department of Nutrition and Dietetics at VU University Medical Centre in Amsterdam, The Netherlands; and with the Department of Internal Medicine, Gastroenterology and Geriatrics at ATRIUM-ORBIS Medical Centre, Sittard, The Netherlands. They conducted an observational study in tertiary care setting in for 24 RCDII patients, averaging 63.8 ± 8.2 years of age, 25 EATL patients averaging 62.3 ± 5.7 years of age, and 43 celiac disease patients averaging 45.6 ± 14.8 years of age. At diagnosis, the team evaluated anthropometry (BMI, unintentional weight loss, fat-free mass index (FFMI), handgrip strength (HGS), nutritional intake, fecal losses and Resting Energy Expenditure (REE)). They found low BMI (<18.5) more often in RCDII patients than in celiac disease or EATL patients (in 33%, 12% and 12%, respectively, p = 0.029). Also, 58% of EATL patients had unintentional weight loss greater than 10% of total weight, compared to 19% of celiac disease patients, and 39% for RCDII patients (p = 0.005/0.082). The team found energy malabsorption (below 85%) in 44% of RCDII patients, and in 33% of EATL patients, compared with 21.6% in celiac disease (NS). Fecal energy losses were higher in RCDII than in celiac disease patients (589 ± 451 vs 277 ± 137 kcal/d, p = 0.017). REE was lower than predicted, with reulst greater than 10% in 60% of RCDII, 89% of EATL, and 38% of celiac disease patients (p = 0.006). Between one third and two thirds of all patients showed Low FFMI and HGS. Patients with RCDII and EATL show far worse nutritional profiles than untreated naïve celiac disease patients at presentation. This malnutrition is at least partly due to malabsorption as well as hypermetabolism. This study shows the importance of proper diagnosis, and of nutrition in the treatment of these conditions. Source: Clin Nutr. 2015 Apr 30. pii: S0261-5614(15)00124-7. doi: 10.1016/j.clnu.2015.04.014.
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Celiac.com 06/27/2007 - It is well known that following a gluten-free diet brings about a remission in celiac disease. But what are the true physiological effects of such remission? A study published recently in the American Journal of Clinical Nutrition shows that even when people with celiac disease follow strict gluten-free diets, they frequently have inferior body composition and nutritional uptake compared to healthy people without celiac disease. Faced with a shortage of solid data on the long-term benefits of a gluten-free diet for celiac patients, a team of Italian doctors conducted a study to determine body composition and nutritional status. They looked at data for patients with celiac disease who are following a strict gluten-free diet, and who were in full clinical, biochemical, and histological remission. The research team was made up of Maria Teresa Bardella, Clara Fredella, Luigia Prampolini, Nicoletta Molteni, Anna Maria Giunta and Paolo A Bianchi. They looked at data from 71 patients. Subjects included 51 women and 20 men. Subjects ranged from 17 to 58 years of age. The average age of test subjects was 27 years. Subjects were assessed for the following factors: body mass index; bone mineral content (as measured by dual-energy X-ray absorptiometry); fat and lean mass; height and weight. The team conducted a 3-d dietary questionnaire. They also measured total daily energy, fat, carbohydrate, and protein intakes. Important for Celiacs to Follow Strict Gluten-Free Diet to Avoid Malnutrition - Lower Weight and Body Mass Index for Celiac Patients Compared to control subjects, celiac patients had a lower intake of total energy (9686 ± 1569 and 11297 ± 1318 kJ/d in males and 6736 ± 1318 and 7740 ± 1715 kJ/d in females). The male celiacs showed lower weight, height, and body mass index than their control counterparts. Female celiac patients showed substantially lower weight and body mass index. For both male and female celiac patients, fat and lean mass differed dramatically from the control group. Female celiac patients diagnosed as adults showed a markedly higher lower bone mineral content compared to the control group. Males showed no such disparity. In general and celiac patients ate an unbalanced diet that contained higher amounts of energy from fat and lower amounts of energy from carbohydrates. Researchers Recommend Strict Follow-ups and Nutritional Advice for Celiac Patients The study showed that even when celiacs faithfully follow a gluten-free diet and their celiac disease is in total remission; their body composition and nutritional uptake differ substantially from healthy non-celiacs. For that reason, and in order to prevent malnutrition, the researchers recommend that all celiacs receive strict follow-ups and dietary evaluations regarding the nutritional composition of their food choices. American Journal of Clinical Nutrition, Vol. 72, No. 4, 937-939, October 2000 health writer who lives in San Francisco and is a frequent author of articles for Celiac.com.
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