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Celiac.com 07/20/2020 - People with celiac disease can have short stature. A team of researchers recently set out to to assess the global prevalence of celiac disease in patients presenting with short stature, be means of a systematic review and meta‐analysis. The research team included Achintya D Singh, Prashant Singh, Naba Farooqui, Tor Strand, Vineet Ahuja, and Govind K Makharia. They are variously affiliated with the Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA; the Department of Gastroenterology University of Michigan, Ann Arbor, MI, USA; the Department of Global Public Pealth, Innlandet Hospital Trust in Lillehammer, Norway; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences in New Delhi, India. The research team searched Medline and EMBASE databases for the keywords ‘celiac disease, coeliac disease, anti‐gliadin, tissue transglutaminase antibody, anti‐endomysial antibody, short stature and growth retardation.’ They included all studies published from January 1991 to May 2020. The team classified patients with no prior short stature assessment as all‐cause short stature. Patients who had been assessed previously, but received no cause for their short stature, were classified as idiopathic short stature. The team based celiac disease diagnosis on the European Society of Pediatric Gastroenterology, Hepatology and Nutrition guidelines, and used a random‐effects model to pool the study data. The team found and included studies screening a total of 3,759 patients; 1,582 with all‐cause short stature and 2,177 with idiopathic short stature. Based on positive anti‐tissue transglutaminase antibodies, anti‐endomysial antibodies, pooled seroprevalence of celiac disease was 11.2% for all‐cause short stature, and 9.7% for idiopathic short stature. Pooled rates of biopsy‐confirmed celiac disease were 7.4% for all‐cause short stature, and 11.6% for idiopathic short stature. Overall, the pooled results showed a severe risk of selection bias and significant heterogeneity. Biopsy confirmed celiac disease affects about 1 in 14 patients with all‐cause short stature, and 1 in 9 patients with idiopathic short stature. Based on these results, the team feels that all patients with short stature should be screened for celiac disease. Read more in the Journal of Gastroenterology and Hepatology -
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Screening Children of Short Stature for Celiac Disease
Kathleen La Point posted an article in Winter 2008 Issue
Celiac.com 12/20/2007 - Celiac disease is under-diagnosed because many celiac disease patients do not show classic gastrointestinal symptoms. Highly sensitive and specific serological tests have led to the diagnosis of celiac disease in patients for whom short stature may be the only obvious symptom. Researchers from Brazil and Italy have previously reported that celiac disease accounts for 1-5% of short stature in children. Prevalence of celiac disease varies widely according to geographic location. Although epidemiological studies are lacking in India, celiac disease reporting has increased exponentially due to targeted screening and better serological tests. To better understand the relationship between short stature and celiac disease, researchers from the Endocrine Clinic of the Postgraduate Institute of Medical Education and Research in Chandigarh studied children referred for a work-up of short stature from January 2005 to December 2006. Researchers enrolled 176 patients, half male and half female, who fit the criteria for short stature: height ≥ 2.5 standard deviations below the mean for chronological age, growth rate below the fifth percentile for chronological age, and height ≥ 2 standard deviations below mean for chronological age when corrected for mid-parental height. Most patients were 10-15 years old (mean age of 14.5). Researchers took detailed histories and carried out clinical evaluations and screening tests. If they could find no endocrine cause for short stature or if diarrhea had been present for more than 3 months, researchers estimated IgA anti-tissue transglutaminase antibodies (anti-tTG) and performed an endoscopic biopsy. Celiac disease was found in 27 (15.3%) of the patients, making it the single most common cause of short stature. 25 children had pituitary disorder (14%), 24 had hypothyroidism (14%), and constitutional delay of growth and puberty or familial short stature accounted for 18 (11%). Other less common causes of short stature were metabolic bone disease, Turner syndrome, adrenal disorders, diabetes mellitus, and nutritional deficiency. All celiac disease patients were positive for tTG antibodies and had a duodenal biopsy suggestive of celiac disease. All celiac disease patients were symptomatic; the most common symptoms after growth retardation were anemia (88%), weight loss (80%), diarrhea (69%), and delayed puberty (54%). The average time to diagnosis for these patients was 5.5 years (95% cI: = 2.5 to 8.5 years). The celiac disease patients were treated with a gluten-free diet, calcium (500 mg/day), vitamin D (300,000 U cholecalciferol once every 3 months), and iron and multivitamin supplementation including folic acid and vitamin B12. During the 6-9 month follow-up period, growth rate velocity increased significantly from 2.9 cm/year (95% cI = 2.41 to 3.39 cm/year) to 8.9 cm/year (95% cI = 6.7 to 11.1 cm/year). Celiac disease can lead to short stature by causing autoimmune hypothydroidism, resistance to growth hormones, and malabsorption of protein, calcium and vitamin D. Additionally, celiac disease can lead to hypogonadism which inhibits the pubertal growth spurt. Researchers recommend that all short children be screened for celiac disease. Resources Bhadada, S. Bhansali, A., Kochhar, R., Shankar, A., Menon, A., Sinha, S., Dutta, PP., and Nain, C. Does every short stature child need screening for celiac disease? Gastroenterology [OnlineEarly Articles]. doi:10.1111/j.1440-1746.2007.05261.x -
Celiac.com 04/07/2016 - Good braised short ribs are almost sure to draw a crowd, and disappear quickly from the dinner table. This recipe marries beef broth, red wine, garlic and fresh herbs for rich, savory short ribs that are sure to please. Ingredients: 1½ to 2 pounds of meaty short ribs 2 cups red wine 2 cups beef broth 2 tablespoons rendered bacon fat or vegetable oil 1 large shallot, minced 2 carrots, diced 2-3 cloves garlic, peeled and crushed ¼ cup gluten-free soy sauce 2 bay leaves 2 sprigs fresh rosemary 4 2-inch sprigs fresh thyme salt and pepper to taste chives for garnish Directions: Sprinkle the short ribs with salt, and place in the refrigerator. This will ensure that the salt gets all the way to the center of the meat. If you don't have time, just salt the meat before searing. Heat the oven to 350°F (180°C). Heat the bacon fat or vegetable oil over high heat in a large dutch oven or, oven-safe pot. Dry the short ribs well with paper towels and sear the meat on every side in the hot pan. Make sure to get a good, dark brown sear all over the short ribs. Remove the meat to a plate and lower the heat to low. Add the shallots, carrots, and garlic, along with a healthy pinch of salt, to the pot. Cook, stirring occasionally, for about 5 minutes, or until the shallots are translucent. Turn the heat back up to high and add the wine. Scrape up any browned bits at the bottom of the pot, then add the meat back to the pot, along with the bay leaves, rosemary, and thyme. Add the soy sauce and enough beef broth to cover the short ribs. Put the lid on, bring to a boil on the stove, then carefully place the whole pot and its contents into the heated oven. Cook in the oven for 3-5 hours, adjusting the heat as necessary to maintain a steady simmer. The meat is ready when it falls off the bone. Set a colander over a large bowl and pour the contents of the pot into the colander. Set the colander and its contents aside (or refrigerate in an airtight container) while you reduce the sauce. Either chill the braising liquid or let it sit for 30 minutes to an hour, until the fat rises to the surface. Skim off as much fat as you can with a large spoon. If you have time, you can refrigerate the braising liquid overnight and remove the solidified fat in the morning. Once a majority of the fat has been removed from the braising liquid, return it to the pot and set it over medium-high heat. Boil the liquid until it reduced from a broth-like consistency to a thin sauce-like consistency. You should end up with 1½-2 cups of sauce. Lower the heat to medium and add the meat and other contents of the colander to the pot with the sauce to warm up. Serve the ribs hot with sauce, topped with chives, and together with your favorite side dishes.
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Most Gluten-free Products Fall Short on Nutrition
Jefferson Adams posted an article in Additional Concerns
Celiac.com 08/28/2015 - Perhaps unsurprisingly, a study of over 3,200 supermarket products finds gluten-free foods aren't a healthier choice than their non gluten-free counterparts. If you have celiac disease, or gluten sensitivity, gluten-free foods are necessary and beneficial, but the new study suggests that, nutritionally speaking, there's no evidence that they're any healthier than their gluten-containing counterparts. The research looked at 3,200 food products on Australian grocery shelves, and found little or no nutritional difference between regular foods and comparable gluten-free items. Now, that doesn't make gluten-free products unhealthy, just no better than their gluten-containing equivalents. But if you are not celiac or gluten-sensitive, then you're probably spending more money to get the same nutrition, and not getting any health benefits. Strangely, plenty of people seem to believe that sugary treats such as cakes are 'healthier' if they are gluten-free. The study compared supermarket products in 10 categories: bread, breakfast cereal, dry pasta, cereal bars, cakes, sweet biscuits, ice cream, potato chips, processed meats, and candies. The study team assessed foods using the Australian Government's Health Star Rating, which rates food by nutritional value. The rating system awards one star to the foods with the least nutritional value, and five stars to those with the most. Basically, when they crunched the numbers using the Health Star Rating, the team found no significant difference between the ratings of gluten-free foods and their regular alternatives. For me, though, the real takeaway is that there's a good amount of processed food out their, gluten-free or not, and you're likely healthier eating fresh, whole foods than anything processed. Or, alternatively, it takes a bit of effort to maintain a healthy diet, whether you are gluten-free or not. Share your thoughts below. Source: Researchgate.net. -
Celiac.com 08/13/2012 - Research has indicated that giving small amounts of wheat-rich food to people with celiac disease, who are on a gluten-free diet, will trigger interferon (IFN)-γ-secreting T cells in the bloodstream. These T cells react to gluten, and can be easily detected. However, very little is known about how this procedure might be reproduced in the same patient groups that underwent two, or more, gluten challenges. A team of researchers recently set out to assess the reproducability of this short wheat challenge method for detecting immune an response to gluten. The research team included A. Camarca, G. Radano, R. Di Mase, G. Terrone, F. Maurano, S. Auricchio, R. Troncone, L. Greco, C. Gianfrani. They are affiliated with the Institute of Food Sciences-CNR, Avellino Department of Paediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University of Naples, Naples, Italy. They evaluated fourteen celiac patients in remission who consumed wheat bread for 3 days, along with thirteen patients who underwent a second gluten challenge after 3-10 months on a strict gluten-free diet. The team then analyzed the immune reactivity to gluten in peripheral blood by detecting IFN-γ both before and 6 days after patients began a a gluten-inclusive diet. They found that gliadin-specific IFN-γ-secreting CD4(+) T cells increased significantly by day 6 of the first challenge. These cells arose as prevalently human leucocyte antigen (HLA)-DQ restricted and with a phenotype of gut homing, as suggested by the expression of β7-integrin. They also saw a reaction to gliadin after the second wheat consumption, although the responses varied by individual at each challenge. The study showed that a short wheat challenge offers a non-invasive approach to investigate the gluten-related immune response in peripheral blood of people who are sensitive to gluten. Moreover, the study showed that the procedure can be reproduced in the same subjects after a gluten wash-out of at least 3 months. The results of this study mean that we can likely expect this procedure to find its way into clinical practice in the future. Source: Clinical and Experimental Immunology. 2012 Aug;169(2):129-36. doi: 10.1111/j.1365-2249.2012.04597.x. -
The first rule about cooking with wine to only use a bottle you would also be willing to drink. The second is to enjoy a glass while cooking. This is a dish best served on a cold night. It’s actually a fairly simple recipe; most of the cook time is spent in the oven. Amaranth flour substitutes regular flour for the roux. It's nutty and peppery, and makes a great thickener for soups, stews, and gravies. Ingredients: 10-12 bone-in beef short ribs 3 carrots, chopped 2 onions, cut into wedges 2 ribs celery, with leaves, chopped 4-5 cloves garlic 4 fresh bay leaves 1 cup fresh flat-leaf parsley 3 sprigs fresh rosemary, stems picked 4 cups beef stock 1 bottle good red wine 4 tablespoons olive oil, divided 1 teaspoon ground cloves 1 tablespoon smoked paprika 3 tablespoons amaranth flour 3 tablespoons butter Salt and pepper Directions: Preheat over to 350 F. Rinse ribs and pat dry. Season with cloves, paprika, salt and pepper. Heat 2 teaspoons oil in a large Dutch oven over high heat. Working in two batches, brown the ribs on all sides. Remove to a plate as they finish. As the ribs brown, combine garlic, bay leaves, parsley, and rosemary in a food processor until roughly combined. Spoon into a small bowl and set aside. Pour off fat and heat the remaining olive oil. Add onions, celery, and carrots, and a pinch of salt and pepper. Cook for 7-10 minutes and remove to a plate. Add garlic and herb mixture to pot, cook for a few minutes and deglaze with wine. Reduce for 15-20 minutes, add stock and return ribs. Bring to a boil and cook covered in the oven for 2 hours. Add vegetables for the last 30 minutes of cooking time. Just before ribs are ready to serve, melt butter in a small pan and mix with flour to create a roux. Stir in 1 cup rib sauce and then return to pot. Reduce for another 15 minutes and serve with vegetables, mashed potatoes, or polenta.
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