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Found 10 results

  1. Celiac.com 12/09/2013 - People with celiac disease commonly suffer malabsorption, weight loss and vitamin/mineral-deficiencies. A team of researchers recently set out to assess the nutritional and vitamin/mineral status of current “early diagnosed” untreated adult celiac disease patients in the Netherlands. The research team included Nicolette J. Wierdsma, Marian A. E. van Bokhorst-de van der Schueren, Marijke Berkenpas, Chris J. J. Mulder, and Ad A. van Bodegraven. They are affiliated with the Department of Nutrition and Dietetics and the Department of Gastroenterology at Celiac Centre Amsterdam in VU University Medical Centre in Amsterdam, The Netherlands. Researchers assessed 80 newly diagnosed adult celiac patients, averaging 42.8 years old, ± 15.1 years. They compared vitamin concentrations for those patients against a sample of 24 healthy Dutch subjects. Before prescribing gluten-free diets to the patients, the researchers assessed nutritional status and serum concentrations of folic acid, vitamin A, B6, B12, and (25-hydroxy) D, zinc, haemoglobin (Hb) and ferritin. Almost nine out of ten celiac patients (87%) measured at least one value below the lowest normal reference levels. Specifically, for vitamin A, 7.5% of patients showed deficient levels, for vitamin B6 14.5%, folic acid 20%, and vitamin B12 19%. Likewise, 67% of celiac patients showed zinc deficiency, 46% showed decreased iron storage, and 32% had anaemia. Overall, 17% of celiac patients were malnourished, with more than 10% experiencing undesired weight loss, 22% of the women underweight (Body Mass Index (BMI) < 18.5), and 29% of the patients overweight (BMI > 25). Vitamin deficiencies were nearly non-existent in healthy control subjects, though they did show some vitamin B12 deficiency. Interestingly, vitamin and or mineral deficiencies were not associated with greater histological intestinal damage or with adverse nutritional status. This study shows that vitamin and/or mineral deficiencies are still common in newly “early diagnosed” celiac patients, even as rates of obesity upon initial celiac diagnosis continue to rise. Thorough nutritional monitoring is likely warranted for establishing a dietary baseline and maintaining nutritional levels during the course of celiac disease treatment. Source: Nutrients 2013, 5(10), 3975-3992; doi:10.3390/nu5103975
  2. Celiac.com 04/09/2012 - Many people with celiac disease suffer from fatigue and may limit theirsocial activities, both of which can lead to a decrease in physicalactivity, and potentially lower bone mass. A team of medical researchers recently set out to study the effects of exercise and gluten-free diet on bone-mass in women with celiac disease. The research team included Valentina Passanantia, Antonella Santonicolaa, Cristina Buccia, Paolo Andreozzia, Antonella Ranaudoa, Daniel V. Di Giacomoc, and Carolina Ciacci. They are affiliated with the Department of Clinical and Experimental Medicine at the University Federico II of Naples, Italy, the Gastrointestinal Unit of Salerno University Medical School in Salerno, Italy, and the Celiac Disease Center of the Department of Medicine at Columbia University in New York. For their study, the team recruited two groups of women. In both groups, they examined physical activity, fatigue and bone mineral density in women with celiac disease, both at diagnosis and while following a gluten-free diet. In the first group of 48 women, the team measured bone mineral density at diagnosis and after 2 years of a gluten-free diet. In the second group, this one with 47 women, researchers measured bone mineral density at diagnosis, and after 5 years of a gluten-free diet. The researchers questioned and assessed both groups regarding physical activity and ranked them on a visual analogue scale regarding their perception of fatigue at diagnosis and follow-up. The team also gathered data on smoking habits, alcohol use, gastrointestinal symptoms, drug therapy and body mass index. Across the board, for all factors, the two groups showed similar results. At follow-up, the mean body mass index and physical activity questionnaire scores were similar to baseline. Both groups showed increased bone density and unchanged scores for physical activity and visual analogue scale. For both groups, bone density improved significantly after two years on a gluten-free diet. In both groups, physical activity was often low and played only a small role in changes to bone mineral density. So, exercise does not seem to help increase bone mineral density in any significant way, and following a gluten-free diet is sufficient to re-establish bone mineral density to healthy levels. Source: 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. doi:10.1016/j.dld.2011.12.012
  3. Celiac.com 12/15/2014 - Non-celiac gluten sensitivity (NCGS), aka `wheat sensitivity’ (NCWS), is currently included in the spectrum of gluten-related disorders. Many people with celiac disease suffer from low bone mass density, but there has been no good data on low bone mass density in people with NCWS. A team of researchers recently set out to determine rates of low bone mass density in NCWS patients and to search for correlations with other clinical characteristics. The researchers included Antonio Carroccio, Maurizio Soresi, Alberto D'Alcamo, Carmelo Sciumè, Giuseppe Iacono, Girolamo Geraci, Ignazio Brusca, Aurelio Seidita, Floriana Adragna, Miriam Carta and Pasquale Mansueto. For their prospective observation study, the team assessed 75 NCWS patients (63 women; median age 36 years) with irritable bowel syndrome (IBS)-like symptoms, along with control groups of 65 patients with IBS and 50 with celiac disease. The team recruited patients from two Internal Medicine Departments. The diagnoses of NCWS were established using an elimination diet and double-blind placebo controlled wheat challenge. The team determined bone mass density in all subjects using Dual Energy X-Ray Absorptiometry (DXA), in addition to assessing all subjects for duodenal histology, HLA DQ typing, body mass index, and daily calcium intake. The double-blind placebo controlled wheat challenge revealed that 30 of the 75 NCWS patients suffered sensitivity to multiple foods. Osteopenia and osteoporosis frequency increased from IBS to NCWS and to celiac disease (P <0.0001). Thirty-five of the patients with NCWS (46.6%) showed osteopenia or osteoporosis. Low bone mass density was related to low body mass index and multiple food sensitivity. Levels of daily dietary calcium intake were significantly lower in NCWS patients than in control subjects with IBS. The study showed that patients with NCWS suffered from higher rates of bone mass loss; which correlated with low body mass index, and was more frequent in NCWS patients who showed sensitivity to multiple foods. The team also found that patients with NCWS generally had a low daily intake of dietary calcium. Source: BMC Medicine 2014, 12:230. doi:10.1186/s12916-014-0230-2
  4. Celiac.com 03/26/2014 - Metabolic bone disease (MBD) is one of the less recognized of the various symptoms of celiac disease, and is attributed to secondary hyperparathyroidism, which in turn is associated with increased bone remodeling. Bone mineral density (BMD) is known to improve for celiacs on a gluten free diet, but there is very little data on the efficacy of bisphosphonates in celiac disease patients. Bisphosphonates are potent inhibitors of bone resorption, and may be useful in celiac patients with low BMD. A team of researchers recently set out to assess the effect of the bisphosphonate zoledronic acid on BMD in celiac disease patients. The research team included Mukul Kumar, Ashu Rastogi, Sanjay Kumar Bhadada, Anil Bhansali, Kim Vaiphei & Rakesh Kochhar of the Departments of Endocrinology, Histopathology & Gastroenterology, Postgraduate Institute of Medical Education & Research, Chandigarh, India. The researchers recruited a total of 28 celiac disease patients, who were each randomized to receive gluten free diet, calcium and cholecalciferol (group A), and zoledronic acid (group . The team performed baseline biochemical tests and T-score by dual energy x-ray absorptiometer, and tested again after one year. They found T-score improvement in the control arm (group A) from -3.31 ± 1.46 to -2.12 ± 1.44, a gain of 35.9 per cent (P However, they found no difference in T-score improvement in zoledronic acid group as compared to the control group. Thus, administration of zoledronic acid was revealed to be no better than gluten free diet alone in increasing BMD in celiac disease patients with low BMD in this pilot study. Source: Indian J Med Res 138, December 2013, pp 882-887
  5. Celiac.com 11/11/2013 - Celiac disease affects about 1-2% of people, globally. Formerly regarded as a childhood disease, most people are now diagnosed with celiac disease as adults. Many of those adults with celiac disease suffer the consequences of an impaired bone mineralization. Researchers A.J. Lucendo, and A. García-Manzanares recently sought to provide new data on the relationship between low bone mineral density (BMD), osteopenia and osteoporosis, and celiac disease. To do so, they conducted a PubMed search of last 15 years, and reviewed sources cited in the results to find potential sources of information. They found that up to 75% of celiac patients show the effects of low bone mineral density. These effects can be seen can at any age, and they can be seen even with no positive serological markers an no digestive symptoms. Rates of celiac disease are also much higher among osteoporotic patients. Additionally, 40% of those diagnosed with celiac disease as adults show the effects of low bone mineral density. The researchers offer two possible theories to explain the causes of low bone mineral density in celiac patients. In the first theory, they note that malabsorption of micronutrients, including calcium and vitamin D, caused by villous atrophy has been related to secondary hyperparathyroidism and inability to reach normal bone mass levels. They also note that chronic inflammation is also related with RANKL secretion, osteoclasts activation and increased bone resorption. Whatever the cause, as a consequence, celiac patients have more than a 40% greater risk for bone fractures than their healthy counterparts. This study shows that up to 75% of celiac patients and 40% of celiacs diagnosed as adults have low BMD, and a variable increase in the risk of bone fractures. Such realities mean that bone density scans more important for adults with celiac disease. Source: Rev Esp Enferm Dig. 2013 May;105(3):154-162.
  6. Authors: Mautalen, Carlos, M.D. et al. Source: The American Journal of Gastroenterology, February, 1997, p. 313-318. In evaluating 14 newly diagnosed adult celiac patients who had been on a gluten-free diet (7 consumed the diet plus calcium at 1 gm. per day and vitamin D2 at 32,000I.U. given weekly compared to 7 diet only subjects) for 12 months, gluten restriction increased overall bone mass 5% in the lumbar spine and 5% in the total skeleton. When considering the 11 patients who strictly followed the gluten-restriction, bone density increased 8.4% in the lumbar spine and 7.7% in the total skeleton. The remineralization of patients treated with diet only was similar to that of patients treated with diet and supplements.
  7. Celiac.com 09/02/2013 - Most people with celiac disease are now diagnosed as adults, and many suffer from impaired bone mineralization. Researchers A.J Lucendo and A. García-Manzanares recently conducted a review of bone mineral density in patients with adult celiac disease. Their goal was to provide an updated discussion on the relationship between low bone mineral density (BMD), osteopenia and osteoporosis, and celiac disease. They conducted a search of relevant articles published in PubMed over the last 15 years. They also reviewed all sources cited in the article results to identify potential sources of information. They found that up to 75% of celiac patients can suffer from low BMD, which can occur at any age, independently of positive serological markers and presence of digestive symptoms. Patients with osteoporotic issues have significantly higher rates of celiac disease. The team proffers two theories which may explain the origins of low BMD in celiac patients. The first says that low BMD may result from malabsorption of micronutrients (including calcium and vitamin D) determined by villous atrophy, which has has been related to secondary hyperparathyroidism and incapacity to achieve the potential bone mass peak; The second theory says that low BMD may result from chronic inflammation, which was also related with RANKL secretion, osteoclasts activation and increased bone resorption. Whatever the cause of the low BMD, people with celiac disease have more than 40% higher rates of bone fractures compared to matched non-celiac individuals. Treatment of low BMD in celiac disease includes gluten-free diet, supplementation of calcium and vitamin D, and the use of biphosphonates, the effects of which on celiac disease have not been specifically studied. Up to 75% of people with celiac disease, and 40% of those diagnosed in adulthood show low BMD, along with increased risk of bone fractures. This information shows the potential importance of bone density scans for adults with celiac disease. Source: Rev Esp Enferm Dig. 2013 May;105(3):154-162.
  8. Pediatrics 2001;108:e89 Celiac.com 01/14/2002 - According to a report in the electronic version of Pediatrics for November 2001, Osteopenia is often found in children with untreated celiac disease. A strict gluten-free diet will promote an increase in bone mineral density (BMD) values, but even after a year of treatment they may not return to normal. In their study, Dr. Ayhan Gazi Kalayci, of Ondokuz Mayia University, Samsun, Turkey, and colleagues evaluated 32 children with celiac disease and 82 healthy control subjects. The patients were separated into two groups of 16, one that consisted of patients who had been recently diagnosed (within the average of 3.2 years), and the other which consisted of patients who had followed a strict gluten-free diet for 19 to 84 months. Results: Patients with recently diagnosed celiac disease had significantly lower BMD and bone mineral content levels than control subjects, and the BMD levels increased significantly after one year on a gluten-free diet. According to Dr. Kalayci, more follow-up studies will be needed to determine whether re-mineralization will continue in the subjects, and a complete recovery of bone mass can be achieved.
  9. Celiac.com 11/07/2011 - Fat-soluble vitamin malabsorption, inflammation and/or under-nutrition put children with celiac disease at risk for decreased bone mineral density. A research team recently set out to determine how vitamin D and K might influence bone mineral density and bone growth in children and adolescents with celiac disease. The study team included D. R. Mager, J. Qiao, and J. Turner. The team's goal was to examine the interrelationships between vitamin K/D levels and lifestyle factors on bone mass density in children and adolescents with celiac disease at diagnosis and after 1 year on the gluten-free diet. The team studied children and adolescents aged 3–17 years with biopsy proven celiac disease at diagnosis and after 1 year on the gluten-free diet. To measure bone mineral density the researchers used dual-energy X-ray absorptiometry, factoring in relevant variables including anthropometrics, vitamin D/K status, diet, physical activity and sun exposure. The children saw their lowest BMD-z scores for whole-body and lumbar-spine (−1) at diagnosis (10–20%) and after 1 year (30–32%), independent of symptoms. Older children (>10 years) showed substantially lower BMD-z scores for whole-body (−0.55±0.7 versus 0.72±1.5) and serum levels of 25(OH) vitamin D (90.3±24.8 versus 70.5±19.8 nmol/l) as compared with younger children (10 years) (P<0.001). Overall, forty-three percent showed suboptimal vitamin D status (25(OH)-vitamin D <75 nmol/l) at diagnosis. Nearly half of these vitamin D deficiencies corrected after 1 year on the gluten-free diet. Also, twenty-five percent of the children showed suboptimal vitamin K status at diagnosis. All vitamin K deficiencies resolved after 1 year. Both children and adolescents with celiac disease face a substantial risk for suboptimal bone health at time of diagnosis and up to 1 year after adopting a gluten-free diet. This higher risk is likely due in part to suboptimal vitamin D/K levels. Children and teens with celiac disease may benefit from treatment regimens that promote optimal vitamin K/D intake. Source: European Journal of Clinical Nutrition, (5 October 2011) | doi:10.1038/ejcn.2011.176
  10. Celiac.com 07/12/2012 - A research team affiliated with the Department of Endocrinology and Nutrition at Complejo Hospitalario Mancha Centro in Alcázar de San Juan, Spain, recently set out to study how bone mineral density correlates with duodenal Marsh stage in newly diagnosed adult celiac patients. The team made up of A. García-Manzanares, J.M. Tenias, and A.J. Lucendo. For their study, the researchers wanted to estimate the rates of low bone mineral density (BMD) in adult celiac patients and to better understand nutritional and metabolic factors associated with osteoporosis and osteopenia. To do so, they recruited patients a consecutive group of 40 adults (36 females/4 males), between the ages of 18 and 68, who were newly diagnosed with celiac disease. Average patient age was 44.25 years. For each patient, the researchers conducted bone density scans on the left hip and lumbar spine using dual-energy X-ray absorptiometry. They also assessed nutritional parameters and conducted a hormone study to exclude secondary low BMD. Overall, at diagnosis 45% of patients showed low BMD at both hip and lumbar spine. Risk of hip fracture was generally low, but climbed into the mild range for patients with villous atrophy (p = 0.011). The team also found that major fracture risk varied according to Marsh stage (p = 0.015). They found significant differences in nutritional status between patients with and without duodenal villous atrophy. Marsh III stage patients showed substantially reduced body mass index and blood levels of pre-albumin, iron, vitamin D and folic acid. The team found no differences found in blood hormone levels between Marsh stages or BMDs. They found that the amount of bone mass loss in the lumbar spine was directly tied to Marsh stage. They found a parallel association between BMD and Marsh stage in the hip, but this was not statistically significant. Overall, results showed that duodenal villous atrophy, through malabsorption, was the main factor for low BMD in patients with adult-onset celiac disease. Source: Scand J Gastroenterol. 2012 May 16.
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