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Found 59 results

  1. Celiac.com 06/18/2018 - Celiac disease has been mainly associated with Caucasian populations in Northern Europe, and their descendants in other countries, but new scientific evidence is beginning to challenge that view. Still, the exact global prevalence of celiac disease remains unknown. To get better data on that issue, a team of researchers recently conducted a comprehensive review and meta-analysis to get a reasonably accurate estimate the global prevalence of celiac disease. The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India. For their review, the team searched Medline, PubMed, and EMBASE for the keywords ‘celiac disease,’ ‘celiac,’ ‘tissue transglutaminase antibody,’ ‘anti-endomysium antibody,’ ‘endomysial antibody,’ and ‘prevalence’ for studies published from January 1991 through March 2016. The team cross-referenced each article with the words ‘Asia,’ ‘Europe,’ ‘Africa,’ ‘South America,’ ‘North America,’ and ‘Australia.’ They defined celiac diagnosis based on European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines. The team used 96 articles of 3,843 articles in their final analysis. Overall global prevalence of celiac disease was 1.4% in 275,818 individuals, based on positive blood tests for anti-tissue transglutaminase and/or anti-endomysial antibodies. The pooled global prevalence of biopsy-confirmed celiac disease was 0.7% in 138,792 individuals. That means that numerous people with celiac disease potentially remain undiagnosed. Rates of celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was 0.6% in female vs 0.4% males. Celiac disease was significantly more common in children than adults. This systematic review and meta-analysis showed celiac disease to be reported worldwide. Blood test data shows celiac disease rate of 1.4%, while biopsy data shows 0.7%. The prevalence of celiac disease varies with sex, age, and location. This review demonstrates a need for more comprehensive population-based studies of celiac disease in numerous countries. The 1.4% rate indicates that there are 91.2 million people worldwide with celiac disease, and 3.9 million are in the U.S.A. Source: Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.
  2. Celiac.com 07/09/2009 - Rates of celiac disease are four times higher today than they were just fifty years ago, according to the results of a new study by scientists at the Mayo clinic. In addition, the study showed that people with undiagnosed celiac disease died at rates four times higher than non-celiacs over the 45 year follow-up period. Celiac disease is an immune system reaction to gluten in the diet which, left untreated, celiac disease causes damage to the lining of the digestive tract and leaves sufferers at risk for various cancers and other associated conditions. When people with celiac disease eat wheat, barley or rye, a protein called gluten triggers an immune system attack, which damages the villi in the small intestine.Villi are finger-like folds in the intestine that increase surface area for nutrient absorption. Celiac disease symptoms may include diarrhea, abdominal discomfort, weight loss, anemia, unexplained infertility, loss of teeth or even premature or severe osteoporosis, among others. Joseph Murray, M.D., the Mayo Clinic gastroenterologist who led the study says celiac disease "now affects about one in a hundred people. We also have shown that undiagnosed or 'silent' celiac disease may have a significant impact on survival. The increasing prevalence, combined with the mortality impact, suggests celiac disease could be a significant public health issue." So, celiac disease is striking a higher than ever portion of the population, yet doctors don't yet fully understand the reasons for this reality. A team of Mayo Clinic scientists team performed celiac disease antibody tests on blood samples gathered at Wyoming's Warren Air Force Base (AFB) between 1948 and 1954. They then compared those blood test results with results from two recently collected groups from Olmsted County, Minn. Tests for the first group were matched by age to those from the Warren AFB group at the time of the blood draw, while the second group was matched by birth years. Researchers found that young people today are 4.5 times more likely to have celiac disease than young people were in the 1950s, while those whose birth years matched the Warren AFB participants were four times more likely to have celiac disease. Celiac disease was once thought to be rare, and many physicians still regard it as so, but, according to Dr. Murray, that is no longer the case. "Celiac disease is unusual, but it's no longer rare," he says. Dr. Murray adds: "Something has changed in our environment to make it much more common. Until recently, the standard approach to finding celiac disease has been to wait for people to complain of symptoms and to come to the doctor for investigation. This study suggests that we may need to consider looking for celiac disease in the general population, more like we do in testing for cholesterol or blood pressure." For Dr. Murray, the findings underscore the importance of raising awareness of celiac disease, both among physicians and patients. He adds that some studies "have suggested that for every person who has been diagnosed with celiac disease, there are likely 30 who have it, but are not diagnosed. And given the nearly quadrupled mortality risk for silent celiac disease we have shown in our study, getting more patients and health professionals to consider the possibility of celiac disease is important." One interesting point not touched on in the study is the increase in the gluten content of commercial varieties of wheat now being grown compared to gluten levels of 50 years ago. Additionally, people are eating more wheat and gluten than ever before. (http://www.mayoclinic.org/bio/13032852.html) Gastroenterology, July 2009;137(1)pp 373-374
  3. Celiac.com 05/11/2011 - People with multiple sclerosis and their first-generation relatives have higher rates of celiac disease than the general population, according to a report by a research team in Spain. For the study, a research team led by Dr. Luis Rodrigo of University Hospital, Central Asturias, Spain looked at rates of serological, genetic, and histological disease markers in 72 multiple sclerosis patients and 126 of their first-degree relatives. They then compared the results against data from 123 healthy control subjects. The team found rates of celiac disease among multiple sclerosis patients that are 5 to 10 times higher than rates for the general population worldwide, which average between 1% and 2%. The team found similar levels of HLA-DQ2 markers in both multiple sclerosis patients (29%) and controls (26%) (NS). They found eight multiple sclerosis patients (11.1%) who showed mild or moderate villous atrophy (Marsh III type) on duodenal biopsy. Results also showed that 26 of 126 first-degree relatives (32%) had celiac disease. Multiple Sclerosis patients also displayed increased frequency of circulating auto-antibodies such as anti-TPO in 19 (26%), ANA in 11 (15%) and AMA in 2 (3%). Source: BMC Neurology 2011, 11:31doi:10.1186/1471-2377-11-31
  4. Celiac.com 03/01/2018 - Mortality rates for children under five have been falling steadily for decades. Additionally, there's plenty of data to indicate that rates of celiac disease have been rising in general population. Before doctors understood the role that gluten played in celiac disease, the prognosis for young children with the condition was grim. Since doctors didn't understand the underlying disease, many of these deaths were simply logged as deaths due to wasting or failure to thrive. Could fewer children dying from celiac disease help explain the apparent rise in celiac rates? In an attempt to answer that question, a team of researchers recently set out to to investigate a possible relationship between mortality rates in children under five years old and rates of celiac disease. The research team included F Biagi, A Raiteri, A Schiepatti, C Klersy, and GR Corazza. They are variously affiliated with the First Department of Internal Medicine, Coeliac Centre, and the Biometry and Clinical Epidemiology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy. A review of medical literature revealed 27 studies from 17 different countries concerning rates of celiac disease in schoolchildren between 1995 and 2011, 4 studies were performed in Italy. The researchers conducted a meta-analysis of prevalence rates and compared them between specific country under-5 mortality groups, publication year, and age. Over the last twenty years or so, mortality rates for kids under 5 have been decreasing all over the world. This reduction has mirrored an increase of the rates of celiac disease. The Spearman correlation coefficient was -63%, 95% confidence interval -82% to -33% (P < 0.001). The data show that higher mortality rates mirrored lower rates of celiac disease. This finding is confirmed by the meta-analysis of the four Italian studies. Rates of death for children under 5 years of age seem to influence rates of celiac disease in the general population. Basically, less kids dying young contributes to higher celiac disease rates later on. Because gluten-free diet treatment and numerous other developments allow a better survival of children with celiac disease, the number of people with celiac disease will likely increase for some time into the future. Source: J Pediatr Gastroenterol Nutr. 2018 Feb;66(2):289-294. doi: 10.1097/MPG.0000000000001696.
  5. Celiac.com 06/26/2013 - Do people with type 1 diabetes (T1D) and celiac disease die younger than people with T1D who do not have celiac disease? Do celiac patients without T1D live longer than those with T1D? Currently, not much is known about how celiac disease might influence mortality rates in people with T1D. A team of researchers recently set out to examine rates of death in patients with both T1D and celiac disease. The researchers include K. Mollazadegan, D.S. Sanders, J. Ludvigsson, and J.F. Ludvigsson. The are variously affiliated with the Clinical Epidemiology Unit of the Department of Medicine, Solna, Karolinska Institutet, and with St. Erik Eye Hospital, Karolinska Institutet in Stockholm, Sweden. The research team set out to examine mortality in patients with both type 1 diabetes (T1D) and celiac disease. For their study, the team used biopsy reports to identify all people diagnosed with celiac disease between 1969 and 2008, within all 28 pathology departments in Sweden. They defined T1D as a diagnosis of diabetes recorded in the Swedish National Patient Register between 1964 and 2009 in individuals aged ≤30 years. Their follow-up showed 960 patients with both T1D and celiac disease. For each individual with T1D and celiac disease, they selected up to five subjects with T1D alone (no celiac disease) as a reference group of 4608 individuals. They then matched all reference individuals for sex, age and calendar period of diagnosis. The team used stratified Cox regression analysis with celiac disease as a time-dependent covariate to estimate the risk of death in patients with both T1D and celiac disease compared to those with T1D alone. The results showed that celiac disease was not a risk factor for death in patients with T1D in the first 5 years after celiac disease diagnosis [hazard ratio (hazard ratio) 0.87, 95% confidence interval (CI) 0.43-1.73]. However, with the passage of time, that reality changed, and mortality risk rose in direct relation to follow-up time (5 to In the end, for people with T1D, having a celiac disease diagnosis for at least 15 years was associated with a 2.80 times greater risk of death (95% CI 1.28-6.12). Source: J Intern Med. 2013 May 23. doi: 10.1111/joim.12092.
  6. Celiac.com 05/01/2014 - While estimates indicate that about 1% of the world's population is affected by celiac disease, it is thought to be uncommon in both India and Asia. However, very little study has been done on celiac disease in Asian nations. A team of researchers recently set out to estimate rates of celiac disease in the Indian population. The research team included G.K. Makharia, A.K. Verma, R. Amarchand, S. Bhatnagar, P. Das, A. Goswami, V. Bhatia, V. Ahuja, S. Datta Gupta, and K. Anand. They are affiliated with the Department of Gastroenterology and Human Nutrition at the All India Institute of Medical Sciences in New Delhi, India. For their cross sectional study, the team estimated rates of celiac disease in urban and rural populations in the National Capital Region in Delhi, India. For their estimate, they made door-to-door visits with a structured questionnaire, collecting socio-demographic data, and screening for features of celiac disease, namely chronic or recurrent diarrhea and, anemia. In children, they included short stature, and failure to thrive/gain weight. All respondents who screened positive for any of the above factors, and 10% of screen negative individuals received blood tests for the anti-tissue transglutaminase antibody. Those with positive blood tests were invited to undergo further evaluation including endoscopic biopsy. Diagnosis for celiac disease was made on the basis of a positive blood test, the presence of villous atrophy and/or response to gluten free diet. Overall, the team had 10,488 participants, just over 50% of which were male. A total of 5622 participants (53.6%) showed positive first screens. Of those, 2167 (38.5%) received blood test. The team also blood tested an additional 712 (14%) negative first screens. The team found a total celiac disease blood screen rate of 1.44%, with 95% confidence interval [CI] 1.22 1.69, and a total celiac disease rate of 1.04%, with 95% CI 0.85 1.25. The prevalence of celiac disease in this north Indian community is slightly over one percent, which is about the same as many western nations, and higher than generally recognized in India. Source: J Gastroenterol Hepatol. 2011 May;26(5):894-900. doi: 10.1111/j.1440-1746.2010.06606.x.
  7. Celiac.com 08/15/2017 - Some evidence indicates that rates of celiac disease in the general population are increasing over time. Prior to the discovery of gluten's role in celiac disease, the prognosis for celiac sufferers was bleak. Did higher betas of death keep celiac disease rates correspondingly lower? To provide an answer, a team of researchers set out to examine a possible relationship between mortality rates for children under five, and prevalence rates of celiac disease. The research team included Federico Biagi; Alberto Raiteri; Annalisa Schiepatti; Catherine Klersy; and Gino R. Corazza. Their team conducted a review of literature, and found 27 studies done in 17 different countries between 1995 and 2011 describing rates of celiac disease in schoolchildren. Four of the studies were conducted in Italy. Their meta-analysis compared prevalence rates between specific-country under-five mortality groups, publication year and age. In recent decades, mortality rates for under-five year olds have been decreasing all over the world. This reduction is paralleled by rising rates of celiac disease. The Spearman correlation coefficient for these terms was -63%, 95%CI -82% to -33% (p < 0.001). So, the higher the mortality rate, the lower the prevalence of celiac disease. This finding is confirmed by the meta-analysis of the 4 studies conducted in Italy over time. The mortality rate for under five-year-olds seems to influence the rate of celiac disease in the general population. They predict a rise, in the near future, of the number of celiac disease patients, due to better survival rates of celiac children. Source: Journal of Pediatric Gastroenterology & Nutrition: Post Acceptance: July 27, 2017. doi: 10.1097/MPG.0000000000001696
  8. Celiac.com 07/19/2017 - Ever wondered what life is like in the celiac disease capital of the world? In Finland, an estimated 2.4 percent of adults from 30 to 64 years old, and one in 99 children are diagnosed with celiac disease. The country also holds the record for the most overall cases of the celiac disease in the world. If ever there was a world headquarters for celiac disease, it would be Finland. One of the best things about Finland is that awareness of keliaka (celiac disease) is common, and gluten-free food is readily available. Throughout the country, most folks you run into know some friend, colleague or family member with the condition. Everyone seems to be aware that celiac disease results from an adverse gut reaction gluten, a protein in wheat, barley and rye products. Meanwhile, supermarkets, high-end restaurants, convenience stores, fast-food joints, gas stations, and even international fast food chains like McDonald’s offer gluten-free options. As a nation, Finland places a heavy emphasis on research, diagnostics or government support for celiac disease. The nation embraces people who follow what the Finns call gluteeniton, or a ‘gluten-free’ diet. So if you’re looking for the closest thing to a gluten-free paradise on earth, consider a visit to Finland. Read more at AllergicLiving.com
  9. Celiac.com 07/05/2017 - Numerous researchers have documented a connection between celiac disease and type 1 diabetes. One team of researchers recently set out to examine international differences in celiac disease rates and clinical characteristics of youth with coexisting type 1 diabetes and celiac disease compared with type 1 diabetes only. The research team included Maria E. Craig, Nicole Prinz, Claire T. Boyle, Fiona M. Campbell, Timothy W. Jones, Sabine E. Hofer, Jill H.Simmons, Naomi Holman, Elaine Tham, Elke Fröhlich-Reiterer, Stephanie DuBose, Helen Thornton, Bruce King, David M. Maahs, Reinhard W. Holl and Justin T. Warner. To analyze the relationship between outcomes, including HbA1c, height-standard deviation score [sDS], overweight/obesity, and type 1 diabetes with celiac disease versus type 1 diabetes alone, adjusting for sex, age, and diabetes duration, the team created multivariable linear and logistic regression models. The analysis included 52,721 people under 18 years of age with a clinic visit between April 2013 and March 2014. The team used the following data sources: the Prospective Diabetes Follow-up registry (Germany/Austria); the T1D Exchange Clinic Network (T1DX) (U.S.); the National Paediatric Diabetes Audit (U.K. [England/Wales]); and the Australasian Diabetes Data Network (ADDN) (Australia). The researchers found biopsy-confirmed celiac disease in 1,835 young people, or 3.5%. These patients were diagnosed on average at age 8.1 years, with a range of 5.3 to 11.2 years. Most young people (37%) with diabetes upon celiac disease diagnosis had it for less than one year. Eighteen percent with diabetes had it for 1-2 years at celiac diagnosis, 23% had diabetes between 3 and 5 years at celiac diagnosis, while 17% had diabetes for more than 5 years at celiac diagnosis. Celiac disease rates ranged from 1.9% in the T1DX to 7.7% in the ADDN and were higher in girls than boys (4.3% vs. 2.7%, P < 0.001). Children with coexisting celiac disease were diagnosed with diabetes at 5.4 years on average, compared with those with type 1 diabetes only, who were diagnosed at 7.0 years of age, on average. Also, fewer children with both conditions were non-white, 15 vs. 18%. Height-SDS was lower in those with celiac disease (0.36 vs. 0.48) and fewer were overweight/obese (34 vs. 37%, adjusted P < 0.001), whereas average HbA1c values were comparable: 8.3 ± 1.5% (67 ± 17 mmol/mol) versus 8.4 ± 1.6% (68 ± 17 mmol/mol). This study clearly documented that celiac disease is not uncommon in young people with type 1 diabetes. Differences in disease rates may be due to variations in screening and diagnostic practices, and/or risk levels. Although the groups showed similar glycemic control, the research team encourages close monitoring of growth and nutrition in this population, due to the lower height-SDS. Source: Diabetes Care 2017 May; dc162508. The researchers in this study are variously affiliated with the Children’s Hospital at Westmead, Sydney, New South Wales, Australia; University of New South Wales, Sydney, New South Wales, Australia; Charles Perkins Centre Westmead, University of Sydney, Sydney, New South Wales, Australia; Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany; German Center for Diabetes Research, Munich-Neuherberg, Germany; Jaeb Center for Health Research, Tampa, FL; Leeds Children’s Hospital, Leeds, U.K.; The University of Western Australia, Perth, Western Australia, Australia; Telethon Kids Institute, Perth, Australia; Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria; Vanderbilt University Medical Center, Nashville, TN; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, U.K.; Women’s and Children’s Hospital, Adelaide, South Australia, Australia; Department of Pediatrics, Medical University of Graz, Graz, Austria; St. Helens and Knowsley Teaching Hospitals NHS Trust, St. Helens, U.K.; John Hunter Children’s Hospital, Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia; Lucile Salter Packard Children's Hospital Stanford, Stanford University Medical Center, Palo Alto, CA; and the Children's Hospital for Wales, Cardiff, U.K.
  10. Celiac.com 01/30/2017 - A team of researchers recently set out to analyze potential changes in occurrence of complicated coeliac disease over the last 25 years. The research team included W. Eigner, K. Bashir, C. Primas, L. Kazemi-Shirazi, F. Wrba, M. Trauner, and H. Vogelsang. They are variously affiliated with the Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University Hospital of Vienna, Vienna, Austria, and with the Department of Pathology at the Medical University of Vienna in Vienna, Austria. The team included and evaluated a total of 1,138 patients based on time of first presentation at the Medical University of Vienna, Austria. They assessed occurrences of refractory celiac disease and associated malignancies in 5-year intervals from January 1990 until December 2014, and then compared results over time. Twenty-nine patients, or 2.6%, were diagnosed with refractory celiac disease. Of these, 65.6% were females averaging 62.8 years of age at diagnosis. The proportion of those patients was 2.6%, 3.1%, 3.3%, 2.7% and 0.5% for the 5 year intervals from 1990 through 2014. The number of refractory cases has been generally decreasing since 2000 (P = 0.024). During that time, a total of seven patients presented with lymphoma, totaling 0.6%, 0.4%, 1.1%, 0.8% and 0% of patients each year, respectively. Similarly the number of patients with adenocarcinoma, four patients total, decreased to 0% until 2014. Nearly 50% of patients suffering from refractory disease died during the study period. Meanwhile, 71.4% all patients diagnosed with lymphoma died, with a 5-year survival rate of 28.6%. Over the past 15 years, rates of complicated celiac disease have been decreasing. This may be due to increased celiac disease awareness, along with optimized diagnosis and treatment with avoidance of long-term immunological disease activity. Known risk factors for refractory celiac disease and related cancer include untreated symptomatic disease and delayed diagnosis. Source: Aliment Pharmacol Ther, 45: 364–372. doi:10.1111/apt.13867
  11. Celiac.com 09/26/2016 - Previous studies have indicated an increase in celiac disease rates in the United States, but these studies have been done on narrow populations, and did not produce results that are nationally representative. Researchers recently released an new comprehensive report, called, Time Trends in the Prevalence of Celiac Disease and Gluten-Free Diet in the US Population: Results From the National Health and Nutrition Examination Surveys 2009-2014. The research team included Hyun-seok Kim, MD, MPH; Kalpesh G. Patel, MD1; Evan Orosz, DO; Neil Kothari, MD; Michael F. Demyen, MD; Nikolaos Pyrsopoulos, MD, PhD, MBA; and Sushil K. Ahlawat, MD. They are variously affiliated with the Division of Gastroenterology and the Department of Medicine at Rutgers New Jersey Medical School in Newark. Using data from the National Health and Nutrition Examination Surveys, a team of researchers recently examined current trends in both celiac disease rates, and gluten-free diet adherence. Currently, far more people follow a gluten-free diet than have celiac disease. The numbers of people eating gluten-free food far outpace the levels of celiac disease diagnosis. This may be due to perceptions that the diet is healthier than a standard non-gluten-free diet. This research teams recent surveys examine the current trends in the prevalence of celiac disease and adherence to a gluten-free diet, including people without celiac disease, using nationally representative data from the National Health and Nutrition Examination Surveys (NHANESs) 2009-2014. The study evaluated 22,278 individuals over the age of 6 who completed surveys and blood tests for celiac disease. The subjects were interviewed directly regarding their prior diagnosis of celiac disease and adherence to a gluten-free diet. The researchers found that 106 (0.69%) individuals had a celiac disease diagnosis, and 213 (1.08%) followed a gluten-free diet but didn't have celiac disease. These results correlate to an estimated 1.76 million people with celiac disease, and 2.7 million people who follow a gluten-free diet without a diagnosis of celiac disease in the United States. Overall, the researchers found that the prevalence of celiac disease has remained steady (0.70% in 2009-2010, 0.77% in 2011-2012, and 0.58% in 2013-2014), however, those who follow a gluten-free diet but don't have celiac disease have increased over time (0.52% in 2009-2010, 0.99% in 2011-2012, and 1.69% in 2013-2014). The researchers conclude that the two might be related, as the decrease in gluten consumption could contribute to a plateau in those who are being diagnosed with celiac disease. Source: JAMA Intern Med. Published online September 06, 2016. doi:10.1001/jamainternmed.2016.5254
  12. Celiac.com 10/03/2011 - A number of studies show that people with celiac disease have higher risk of depression and death from external causes, but there are no conclusive studies on death from suicide. A research team set out to more deeply examine the risk of suicide in people with celiac disease. The team included J. F. Ludvigsson, C. Sellgren, B. Runeson, N. Långström, and P. Lichtenstein. They are affiliated with the Department of Paediatrics at Örebro University Hospital in Sweden. The team examined suicide risk in individuals with celiac disease where the small intestinal biopsy showed no villous atrophy. For their study, the team collected biopsy data from all 28 clinical pathology departments in Sweden for 29,083 individuals diagnosed during 1969-2007 with celiac disease with Marsh 3 villous atrophy, with inflammation without villous atrophy (Marsh 1-2; n=13,263), or with positive celiac disease serology, but normal mucosa (Marsh 0, n=3719). The team used Cox regression to calculated hazard ratios for suicide as recorded in the Swedish Cause of Death Register. The team found that people with celiac disease have a higher risk for suicide compared to general population control subjects (HR=1.55; 95%CI=1.15-2.10; based on 54 completed suicides). The results showed that suicide was more common among those who suffered from inflammation (HR=1.96; 95%CI=1.39-2.77), but the team found no such increase in people who showed positive celiac disease serology, but normal mucosa. (HR=1.06; 95%CI=0.37-3.02). Overall, the team found a slightly higher risk of suicide in patients with celiac disease than in the general population. The increased risk is one that merits attention from doctors, when treating patients with celiac disease. Source: Dig Liver Dis. 2011 Aug;43(8):616-22.
  13. Celiac.com 06/03/2016 - Among patients diagnosed with celiac disease by small intestinal biopsy in the U.S., people from the Punjab region of India have the highest rates of disease, according to new research published in Clinical Gastroenterology and Hepatology. In an effort to better understand celiac disease distribution in Americans of various ethnicities, a team of researchers led by Benjamin Lebwohl, MD, Herbert Irving Assistant Professor of Medicine and Epidemiology at the Celiac Disease Center at Columbia University Medical Center in New York, recently looked at more than 400,000 intestinal biopsies from a nationwide database. The team identified patients with celiac disease based on the presence of villous atrophy in the small intestine. The researchers used a previously published algorithm based on patient names to identify celiac disease distribution among North Indian, South Indian, East Asian, Hispanic, Middle Eastern, Jewish and other Americans. The team's data shows that celiac disease is much less common among U.S. residents of South Indian, East Asian and Hispanic ancestry, while celiac disease rates among patients of Jewish and Middle Eastern ethnicities was similar to that of the general American population. Earlier studies have suggested that celiac disease might be more common in women, but these findings show that men and women have similar rates of celiac disease when tested, regardless of ethnicity. These findings show that, contrary to the previous medical thinking that celiac is a disease predominantly affecting Caucasian Europeans, the condition is better understood as "one of the most common hereditary disorders worldwide," noted Dr. Lebwohl. Source: American Gastroenterological Association
  14. Celiac.com 07/27/2011 - Based on associations made between microscopic colitis and celiac disease in scientific literature, but limited population-based data, a team of researchers set out to assess rates of microscopic colitis in celiac disease. The research team included M. Stewart, C. N. Andrews, S. Urbanski, P. L. Beck, and M. Storr. They were looking to better understand how these two diseases might be connected, and to identify any factors that might cause them to occur together. This led them to conduct a population-based review of all people diagnosed with celiac disease and microscopic colitis in a large Canadian medical center over a 5-year period. To do that, they searched endoscopy and pathology databases to find all diagnosis made for celiac disease and microscopic colitis within the Calgary Health Region between 2004 and 2008. To get accurate results, they made sure to standardize age and gender data from their study with 2006 Canadian Census data. They then used standardized incidence ratios (SIR) to figure out how often the two disease occur together. In the study population, they found, over a five-year period, 763 patients diagnosed with celiac disease, and 1106 diagnosed with microscopic colitis. In the general population, the standard rates of celiac disease ran from 10.4 to 15.7 per 100,000 people, while the standard rates of microscopic colitis ran from 16.9 to 26.2 per 100,000 people. The study team found 40 patients with both celiac disease and microscopic colitis, 21 of whom were females aged 40–60 years. In the celiac disease group, microscopic colitis occurred at an annual rate of 11.4 per 1000 cases of celiac disease with an overall SIR of 52.7. These findings showed a strong association between microscopic colitis and celiac disease. In fact, the diseases occurred together in the study population at rates of about 50-times those expected in the general population. One prominent finding was that middle-aged women suffered especially high rates of celiac disease together with microscopic colitis. Therefore, the team recommends that middle-aged women with celiac disease and persistent diarrhea undergo lower endoscopy with biopsies to check for microscopic colitis. Source: Alimentary Pharmacology & Therapeutics. 2011;33(12):1340-1349.
  15. Celiac.com 01/22/2016 - The number of children with gluten intolerance in one part of Scotland has more than doubled in just five years, according to a new survey. The results of the survey, which were presented at a major meeting of children's health experts, indicate that the number of children diagnosed with celiac disease in the Lothian health region rose sharply between 2010 and 2015. Between 2010 and 2014, data from the Royal Hospital for Sick Children revealed a total of 168 patients under the age of 16 with celiac disease, with 30 per cent of these diagnosed in 2014, compared to just 12.5 per cent in 2010. Statistics show 21 cases in 2010, a number which rises to 34 in 2012 and 49 by 2014. Doctors have not yet determined if the rise in celiac cases in Lothian is due to better disease awareness, and more stringent diagnostic techniques. They will undoubtedly be following up to determine the likely cause of the rise in celiac cases. Meanwhile, they are urging doctors and clinicians to do more to spot celiac cases early, so as to help patients avoid possibly serious celiac-related complications as they age. Source: heraldscotland.com
  16. Celiac.com 01/19/2016 - Cases of autoimmune diseases are on the rise, and mirror the expansion of industrial food processing and increased use of food additives. The intestinal epithelial barrier, with its intercellular tight junction, controls the balance between tolerance and immunity to non-self-antigens. Recently, a team of researchers set out to assess the role of tight junction dysfunction in the pathogenesis of autoimmune disease. Researchers Aaron Lerner and Torsten Matthias are associated with the Pediatric Gastroenterology and Nutrition Unit, Carmel Medical Center, B, Rappaport School of Medicine, Technion-Israel Institute of Technology, Michal in Haifa, Israel, and the Aesku Kipp Institute in Wendelsheim, Germany. Numerous common industrial food additives increase tight junction leakage. These include glucose, salt, emulsifiers, organic solvents, gluten, microbial transglutaminase, and nanoparticles, widely and increasingly used in industrial food production. According to manufacturers, these additives improve food quality. However, all of the aforementioned additives increase intestinal permeability by breaching the integrity of tight junction paracellular transfer. So why is this a problem? Well, it turns out that tight junction dysfunction is common in multiple autoimmune diseases, and the central part played by the tight junction in autoimmune diseases development is widely described. The researchers hypothesize that commonly used industrial food additives undermine human epithelial barrier function, which increases intestinal permeability through the opened tight junction, resulting in entry of foreign immunogenic antigens and activation of the autoimmune cascade, and the development of autoimmune conditions, such as celiac disease. The team is calling for additional research on the connections between food additives exposure, intestinal permeability, and autoimmunity interplay to expand our knowledge of the common mechanisms associated with autoimmune progression. Source: tx.technion.ac.il
  17. Celiac.com 01/25/2010 - A new systematic review by Italian researchers suggests that many studies showing rising or elevated rates of celiac disease are not backed up by clinical evidence, and are therefore suspect. The researchers say that rates of celiac disease are being over-estimated, mainly because tissue transglutaminase antibodies were the only diagnostic tool. As a result, many cases labeled as celiac disease in medical studies are not confirmed by biopsy. By the 1990s, celiac disease, which had been considered a rare condition, showed a marked increase, according to medical literature. Recently, researchers have projected celiac disease rates as high as 1 out of 100 people in the Western world. To better understand the true prevalence of celiac disease in the general population that drove the researchers conducted their systematic review of published papers. The research team included Federico Biagi, Catherine Klersy, Davide Balduzzi, and Gino Roberto Corazza, affiliated with the Coeliac Centre/First Department of Internal Medicine, and the Biometry and Clinical Epidemiology at the Fondazione IRCCS Policlinico San Matteo at the University of Pavia, Italy. They found that the overall prevalence of celiac disease in the general population appears to be around 1/160 people, but this varies widely according to the diagnostic criteria used in the original papers. Figures also vary by region and ethnicity, as has been well-established. Once studies were adjusted to include only biopsy-proven cases, rates of celiac disease remained within the historical averages, and show no signs of sharp rise or increase over time. Their initial search of medical literature for papers in English on celiac disease epidemiology since 1990 yielded 519 papers. Once the team eliminated studies with small sample sizes, and studies set up in primary care or endoscopy units, they were left with 40 papers focusing on the prevalence of celiac disease in the general population, plus an additional paper published in the present issue. The team realized that differences in study type, populations, diagnostic criteria, and sample sizes made a proper meta-analysis impossible. However, they divided and regrouped the papers according to their various characteristics and then classiï¬ed them based on the diagnostic criteria used in the original papers. They also determined whether there were any significant differences in rates when different types of populations, sample sizes, years of publications, geographic regions, and diagnostic criteria were assessed. The team was surprised to find that just four histologically confirmed studies suggesting a prevalence of celiac disease higher than 1/100. On the other hand, seven biopsy-based papers suggested a prevalence lower than 1/400. Prevalence obtained with tissue transglutaminase antibodies only was markedly higher than that obtained through a histological diagnosis, while post-hoc comparisons showed that the prevalence obtained with TTA was signiï¬cantly higher than that obtained using histology or EMA. From these results, the team concludes that the prevalence of celiac disease in the general population has been over-estimated, mainly due to tissue transglutaminase antibodies being used as the only diagnostic tool. Source: Annals of Medicine, 2010; 42: 557– 561
  18. Celiac.com 02/23/2015 - There's an interesting article over at Mother Jones regarding the possible role that shorter rising times in most commercial bakeries might play in celiac disease and gluten-intolerance. In the article, author Tom Philpott interviews Stephen Jones, a wheat breeder at Washington State University, who points out that bread rising times in commercial bakeries has been cut from hours or even days down to just minutes, through the use of fast-acting yeasts and additives. What's more, Jones points out, commercial bakers add a lot of extra gluten to their products. Many supermarket sliced breads, especially whole-wheat breads include something called "vital wheat gluten" among the top four ingredients. Because whole-wheat flour has a lower gluten density than white flour, and to make the bread more soft and chewy, like white bread, commercial bakeries add extra gluten in the form of vital wheat gluten. So bakers are using more gluten and fermenting very rapidly, compared with traditional fermentation techniques that take up to 12 hours and more. By contrast, the team in Jones' laboratory, located in a rural stretch along Puget Sound has found that the longer the bread rises, the more the gluten proteins are broken down in the finished bread. It's certainly true that long fermentation reduces the amount of gluten in bread, and that long fermentation using strains of lactobacillus, as in many sourdough breads, breaks down even more of the gluten; in some cases, enough to be tolerated by people with celiac disease. Celiac.com has written about this in several articles on the future of long-fermentation sourdough, its tolerability and gut healing potential in people with celiac disease. However, Jones' notion that modern baking techniques, rather than modern wheat breeding techniques, are responsible for rising rates of celiac disease, and gluten-sensitivity remains unproven.
  19. Celiac.com 03/04/2015 - Women with infertility face higher rates of celiac disease, according to a recent data analysis. Until now, data connecting celiac disease and infertility has been contradictory. There are currently no recommendations regarding celiac disease screening in female patients with infertility. A research team recently conducted a meta-analysis to find out whether women with infertility have a higher risk for celiac disease. The team included Prashant Singh MBBS; Shubhangi Arora MBBS; Suman Lal MD; Tor A. Strand MD, PhD; and Govind K. Makharia MD, DM, DNB, MNAMS. To source information for their analysis, the team performed a literature search using the MeSH keywords "celiac disease," "gluten," and "infertility." They based celiac diagnosis on positive patient serology and biopsies showing villous atrophy. The team extracted celiac disease data in 3 groups of women with "all cause" infertility, unexplained infertility, and a group of control subjects. They then calculated pooled odds ratio (OR) and prevalence, with 95% confidence intervals (CI). Of 105 relevant studies, they included five studies for calculation of pooled odds ratio. Four additional studies, where data on controls were not available, were also considered for calculation of pooled rates of celiac disease. The analysis showed that women with infertility had 3.5 times higher odds of having celiac disease compared with the control group (OR=3.5; 95% CI, 1.3-9; P<0.01). Similarly, odds for celiac disease in women with "unexplained infertility" were 6 times greater than for control subjects (OR=6; 95% CI, 2.4-14.6). Of 884 women with infertility, 20 had celiac disease indicating a pooled prevalence of 2.3% (95% CI, 1.4-3.5). Of 623 women with "unexplained infertility," 20 had celiac disease. The pooled prevalence of celiac disease in women with unexplained infertility was 3.2% (95% CI, 2-4.9). Celiac disease is more common in women with what is called "all-cause" infertility and "unexplained" infertility, than in general population. Infertility and unexplained infertility can point to hidden celiac disease. Source: Journal of Clinical Gastroenterology. doi: 10.1097/MCG.0000000000000285
  20. Celiac.com 03/16/2015 - Researchers don't really have too much data on celiac disease in patients with cryptogenic cirrhosis or idiopathic noncirrhotic intrahepatic portal hypertension (NCIPH). In India, a research team recently set out to look for celiac disease in patients with portal hypertension. The research team included Rakhi Maiwall, Ashish Goel, Anna B. Pulimood, Sudhir Babji, J. Sophia, Chaya Prasad, K. A. Balasubramanian, Banumathi Ramakrishna, Susy Kurian, G. and John Fletcher. For their study, the team enrolled 61 consecutive patients with portal hypertension having cryptogenic chronic liver disease, including 14 with NCIPH, along with 59 patients with hepatitis B- or C-related cirrhosis as control subjects. They looked at tissue transglutaminase (tTG) antibody and duodenal histology in study patients. They found six cases of celiac disease, including two NCIPH patients, while they found none in control subjects. Duodenal biopsies for a significant percentage of the remaining study subjects showed villous atrophy, crypt hyperplasia, and lamina propria inflammation, not accompanied by raised intraepithelial lymphocytes (IELs), far more commonly than in controls. Study subjects with portal hypertension having cryptogenic chronic liver disease showed an unexpectedly high rate of tTG antibody positivity (66%), as compared to 29% in controls (p-value < 0.001), which could indicate false-positive test result. This study showed that 10% of patients with unexplained portal hypertension (cryptogenic chronic liver disease) had associated celiac disease. In addition, an unexplained enteropathy was seen in a significant proportion of study patients, more so in patients with cryptogenic chronic liver disease. This finding warrants further investigation. Source: Indian Journal of Gastroenterology. November 2014, Volume 33, Issue 6, pp 517-523
  21. Celiac.com 01/14/2015 - Recent epidemiological studies show that celiac disease rates are still underestimated, both in Europe and in Mediterranean regions. But how is better testing impacting higher celiac numbers in Europe? To get a clearer picture, a team of researchers recently set out to review the latest data on celiac rates and incidence in the European Union (EU) as of September 2014. The research team included E. Altobelli, R. Paduano, R. Petrocelli, and F. Di Orio. They are variously affiliated with the Department of Life, Health and Environmental Sciences at the University of L'Aquila in L'Aquila, Italy, and with ASREM in Molise, Italy. They assessed the celiac disease rates and cases by conducting a search of PubMed for papers in English using the key words "celiac disease", "celiac disease plus prevalence" (limits: 1990-2014), "incidence" (limits: 1970-2014), and "frequency", plus "in Europe". They conducted additional searches using the same key words plus the name of each European country. The team included only prevalence data obtained by serology using anti-gliadin antibodies (AGA), EMA test, tTG test, and/or duodenal biopsy, and only studies that were retrospective and prospective, such as population-based, cross-sectional, case-control and cohort studies. They found that the overall undiagnosed celiac population in EU is 0.5-1%, whereas the highest estimate reported in population-based studies is approximately 1%. Considering data from different periods, incidence seems to range from 0.1 to 3.7/1000 live births in the child population and from 1.3 to 39/100,000/year in the adult population. Interestingly, though perhaps unsurprisingly, the data show clear geographical variation in both cases and rates of celiac disease in various European countries. They note a rising occurrence of celiac disease in recent decades in European countries, due partly to the advent of improved serological testing (tTG + EMA) and partly to increased awareness of its clinical presentation. Source: Ann Ig. 2014 Nov-Dec;26(6):485-98. doi: 10.7416/ai.2014.2007.
  22. Celiac.com 09/01/2014 - At present, the number of reported celiac disease cases in China is extremely low, and celiac disease is considered to be rare in that country. To determine the accuracy of this perspective, a team of researchers recently set out to compile an accurate estimate of rates of celiac disease in China. The research team included Juanli Yuan, Jinyan Gao, Xin Li, Fahui Liu, Cisca Wijmenga, Hongbing Chen, and Luud J. W. J. Gilissen. They are variously affiliated with the State Key Laboratory of Food Science and Technology, the College of Pharmaceutical Sciences, and the School of Life Sciences and Food Engineering, at Nanchang University in Nanchang, China, the Department of Genetics at the University Medical Centre Groningen of University of Groningen in Groningen, The Netherlands, with the Sino-German Joint Research Institute, Nanchang University, Nanchang, Jiangxi, China, and with the Plant Research International at Wageningen University & Research Centre in Wageningen, The Netherlands. The team reviewed the literature for certain and possible cases of celiac disease, the predisposing HLA allele frequencies, and information on gluten exposure in China. For the review, the team used the MEDLINE database, Chinese full-text databases CNKI, CBM, VIP and WANFANG, and two HLA allele frequency net databases, along with the Chinese Statistics Yearbook databases. They performed meta-analysis by analyzing DQ2, DQ8 and DQB1*0201 gene frequencies, and heterogeneity, in populations from different geographic regions and ethnicities in China. They found that frequencies of the HLA-DQ2.5 and HLA-DQ8 haplotypes were 3.4% (95% confidence interval 1.3–5.5%) and 2.1% (0.1–4.1%), respectively. HLA-DQ2 and HLA-DQ8 antigen frequencies were 18.4% (15.0–21.7%) and 8.0% (4.5–11.4%), respectively. The frequency of the DQB1*0201 allele was 10.5% (9.3–11.6%), and the allele was more common in the northern Chinese than in the southern Chinese individuals. HLA haplotype data, in conjunction with increasing wheat consumption, strongly suggest that rates of celiac disease are far higher in China than currently reported. The researchers suggest that the Chinese government, medical and agricultural research institutions, and food industries work together to increase awareness about celiac disease to prevent it from growing into a medical and societal burden. Source: PLOS ONE DOI: 10.1371/journal.pone.0081151
  23. Celiac.com 07/16/2014 - Information about the number of cases and and overall rates of celiac disease and dermatitis herpetiformis in the UK have not been well studied over time, either by region or by age. Yet, this type of information is essential for determining potential causes and quantifying the impact of these diseases. To provide this information, a team of researchers recently conducted a population-based study to assess incidence and prevalence of celiac disease and dermatitis herpetiformis in the UK over two decades. The researchers included J. West, K.M. Fleming, L.J. Tata, T.R. Card, and C.J. Crooks. They are variously affiliated with the Division of Epidemiology and Public Health, City Hospital Campus, The University of Nottingham, the NIHR Biomedical Research Unit in Gastrointestinal and Liver Disease at Nottingham University Hospitals NHS Trust, and the Division of Epidemiology and Public Health at the City Hospital Campus of The University of Nottingham in Nottingham, UK. They used the Clinical Practice Research Datalink to identify patients with celiac disease or dermatitis herpetiformis between 1990 and 2011, and calculated incidence rates and prevalence by age, sex, year, and region of residence. They found a total of 9,087 incident cases of celiac disease and 809 incident cases of dermititis herpetiformis. From 1990 to 2011, the incidence rate of celiac disease rose from 5.2 per 100,000 (95% confidence interval (CI), 3.8-6.8) to 19.1 per 100,000 person-years (95% CI, 17.8-20.5; IRR, 3.6; 95% CI, 2.7-4.8). During that same period, incidence of dermatitis herpetiformis decreased from 1.8 per 100,000 to 0.8 per 100,000 person-years (average annual IRR, 0.96; 95% CI, 0.94-0.97). The absolute incidence of celiac disease per 100,000 person-years ranged from 22.3 in Northern Ireland to 10 in London. Celiac disease showed large regional variations in prevalence, while dermatitis herpetiformis did not. The team found a fourfold increase in the incidence of celiac disease in the United Kingdom over 22 years, with large regional variations in prevalence. This contrasted with a 4% annual decrease in the incidence of dermatitis herpetiformis, with minimal regional variations in prevalence. These contrasts could reflect differences in diagnosis between celiac disease (serological diagnosis and case finding) and dermatitis herpetiformis (symptomatic presentation) or the possibility that diagnosing and treating celiac disease prevents the development of dermatitis herpetiformis. Source: Am J Gastroenterol. 2014 May;109(5):757-68. doi: 10.1038/ajg.2014.55. Epub 2014 Mar 25.
  24. Celiac.com 03/27/2013 - Increased rates of celiac disease over the last fifty years are not linked to wheat breeding for higher gluten content, but are more likely a result of increased per capita consumption of wheat flour and vital glutens, says a scientist working with the US Department of Agriculture (USDA). The researcher, Donald D. Kasarda is affiliated with the Western Regional Research Center of the U.S. Department of Agriculture's Agricultural Research Service. Kasarda recently looked into one prominent theory that says that increased rates of celiac disease have been fueled by wheat breeding that has created higher gluten content in wheat varieties. His research article on the topic appears in the Journal of Agricultural and Food Chemistry. Kasarda says that, while increased consumption of wheat flour and vital wheat gluten may have contributed to the rise in celiac disease over the last decades, "wheat breeding for higher gluten content does not seem to be the basis." He notes that vital gluten is a wheat flour fraction used as an additive to improve characteristics like texture, and commonly featured in numerous and increasingly popular whole wheat products. However, he says that there is a lack of suitable data on the incidence of celiac disease by year to test this hypothesis. Part of his article features statistics on wheat flour consumption throughout the two centuries. He notes wheat flour consumption from all types of wheat hit an all-time high of 220 pounds per person (100kg) in 1900, declined steadily to a low of around 110 pounds per person (50kg) in 1970, then gradually rose to about 146 pounds per person (66kg) in 2000, and then decreased to about 134 pounds per person (61kg) in 2008. He goes on to point out that, even though consumption of wheat flour "seems to be decreasing slightly in recent years, there was an increase in the yearly consumption of wheat flour of about 35 lb (15.9kg) per person in the period from 1970 to 2000, which would correspond to an additional 2.9 lb (1.3kg) of gluten per person from that extra flour intake." Kasarda suggests that 'crude estimates' indicate that consumption of vital gluten has tripled since 1977. He finds this fact very interesting, because, he says, "it is in the time frame that fits with the predictions of an increase in celiac disease." However, he says that attributing an increase in the consumption of vital gluten directly to the rise of celiac disease remains challenging, partly because consumption of wheat flour increased far more significantly in the same time frame. Additionally, Kasarda says that there is no evidence that farmers have been breeding wheat to ensure higher protein and gluten content over the years. He points out that numerous studies have compared the protein contents of wheat varieties from the early part of the 20th century with those of recent varieties. These studies have all shown that, "when grown under comparable conditions, there was no difference in the protein contents," he said. One factor that remains unanswered is the relationship between higher rates of celiac disease and higher rates of diagnosis. That is, are more people developing celiac disease, or are more people simply with celiac disease getting diagnosed than in the past? It's likely that more and more people with celiac disease are being diagnosed, but it's unclear whether celiac disease rates are rising. There is just not enough evidence yet to provide a solid answer, although studies in the US and in Finland suggest that rates of celiac disease may be on the rise. Kasarda's article points out how much more research needs to be done. We need to determine if there is, in fact, a genuine rise in celiac disease rates and, if so, how such a rise might relate to gluten consumption. For now, though, there just isn't any solid evidence that wheat has any higher gluten levels than in the past, or that gluten consumption is driving an increase in celiac disease levels. What do you think? Have you heard this theory about modern wheat having higher gluten levels, or being substantially different than wheat in the past? Have you heard that such a difference may be driving higher rates of celiac disease? Please share your comments below. Source: J. Agric. Food Chem., 2013, 61 (6), pp 1155–1159. DOI: 10.1021/jf305122s
  25. 06/04/2014 - A Swedish research team study of nearly four decades of population-based data shows that rates of celiac disease are rising in most age groups of children. The research team included Fredinah Namatovu, Olof Sandström, Cecilia Olsson, Marie Lindkvist, and Anneli Ivarsson. They are variously affiliated with the Department of Public Health and Clinical Medicine, Epidemiology and Global Health, the Department of Clinical Sciences, Paediatrics, and the Department of Food and Nutrition, all at Umeå University, in Umeå, Sweden. In order to assess variations by age, sex and birth cohort, and to determine the clinical impact of these changes, their research team recently looked at rates of biopsy-proven celiac disease in children in Sweden over a 36-year period. The team used the National Swedish Childhood Celiac Disease Register to identify 9,107 children under 15 years of age who were diagnosed with celiac disease from 1973 to 2009. From 1973 to 1990 the register covered 15% of the the Swedish population, increasing to 40% during 1991–1997, and then to 100% from 1998 onwards. The research team estimated annual celiac rates, cumulative incidence and clinical impact by age groups, calendar month and birth cohorts. Their results show that celiac disease rates are increasing in children aged 2–14.9 years. One encouraging piece of data revealed that celiac rates in children 1.9 years and under decreased sharply in the most recent years. Average age for celiac diagnosis rose from 1.0 year in the 1970s to 6.8 years by 2009. The average number of new cases rose from about 200 during 1973–1983 to about 600 during 2004–2009. In the birth cohorts of 2000–2002 the cumulative incidence even exceeded that of the epidemic cohorts at comparable ages. The highest overall rates were seen in those born between 1985–1995 and 2000–2002. Celiac disease risk varies between birth cohorts, which indicates environmental and/or lifestyle risk factors may be at play in triggering celiac disease. Finding new prevention strategies will require further research. Source: BMC Gastroenterology 2014, 14:59. doi:10.1186/1471-230X-14-59