There is a great misconception that the incidence of celiac disease varies from one ethnic group to another, being highest in the Irish. The truth is the incidence seems to be constant between races, about 1% of the population. In my opinion celiac disease is one manifestation of gluten sensitivity and some professionals believe the incidence for gluten sensitivity is around 1 in 20.
Here is a report that shows the incidence of celiac disease in northern India is near 1%. That means that celiac disease is more common than is recognized in India, and that rates are about the same as in other parts of the world, not lower, as conventional wisdom has held.
More evidence that physicians and health care professionals and the general population need to be more suspicious that health issues may be caused by gluten sensitivity or celiac disease.
Jefferson Adams, over at celiac.com reports:
The research team set out to accurately estimate the prevalence of celiac disease in a specific Indian community. The team gathered data using a structured questionnaire administered via door-to-door visits. The questionnaire provided socio-demographic data and basic screening for features of celiac disease, such as chronic or recurrent diarrhea, and Anemia.
For children, the questionnaire included additional factors, namely short stature (linear height below 5th percentile for age) and failure to thrive/gain weight. All test subjects with positive blood screens and 10% of screen negative individuals were called for anti-tissue transglutaminase antibody blood tests.
All those with positive blood tests were invited to undergo endoscopic biopsy. The team diagnosed celiac disease on the basis of a positive blood screens, the presence of villous atrophy and/or response to gluten free diet.The team contacted 12,573 people in all. A total of 10,488 (83.4%) (50.6% male) agreed to participate. Screening showed 5,622 (53.6%) positive results. Of those who screened positive, 2167 (38.5%) submitted to anti-tissue transglutaminase antibody blood tests. The team also tested 712 (14%) subjects who had tested negative.
The data showed an overall sero-prevalence of celiac disease was 1.44% (95% confidence interval [CI] 1.22 1.69) and the overall prevalence of celiac disease was 1.04% (95% CI 0.85 1.25).
Source:
Read more here at celiac.com
Monday, March 28, 2011
Monday, March 7, 2011
Pneumococcal vaccine indicated if a person is celiac/gluten sensitive
A gluten free diet alone does not seem to change the rate of death in those diagnosed with celiac disease according to a report by UK researchers in the American Journal of Gastroenterology.
In the last ten years there has been an increase in the numbers of people being diagnosed with celiac disease. Intuitively, one would expect this increase in diagnosis to be followed by a decrease in celiac-related deaths. The idea being that earlier diagnosis means earlier treatment with gluten-free diet, and, ideally, less associated conditions and deaths. But according to this study, there has been no change in the mortality rate.
Jeffery Adams of celiac.com reported that researcher Dr. Matthew J. Grainge, of the University of Nottingham, told Reuters Health that his team "found that people with celiac disease have a 37% increase in all-cause mortality compared with the general population."
The study published at Am J Gastroenterol; January 18, 2011.revealed a significantly increased all-cause standardized mortality ratio (SMR) of 1.37. This was higher for men (SMR, 1.86) than for women (SMR, 1.10). Study subjects had higher rates of death from cancer (SMR, 1.61) digestive (SMR, 2.19) and respiratory diseases (SMR, 1.57) compared to the general population. In all, there were 21 deaths from respiratory diseases, 11 of those from pneumonia.
According to the research team, this data supports current guidelines recommending pneumococcal vaccination for people with celiac disease.
In conclusion, the researchers note that the results may offer doctors "an opportunity to reduce mortality following pneumococcal infection by increasing the uptake of vaccination against this pathogen as vaccination rates are currently well below 50%."
I believe the problem lies in thinking that celiac disease is a gastroenterologic disorder more like a food allergy like being allergic to carrots.
In fact celiac/gluten sensitivity is an autoimme connective tissue disorder based on genetics and those with the genetics have tissues that have peptides in their structure that look like wheat. If one becomes allergic to wheat then the antibodies may attack the connective tissues. One is immunocompromised.
I treat people with celiac/gluten sensitivity with a grain free diet and a programme to identify already damaged connective tissues, damaged genetics such as MTHFR, hormone inbalances, infections, heavy metal toxicity and pre-cancers. And treat accordingly.
More research is necessary to determine if pneumococcal vaccination will, in fact lower the death rate.in persons with celiac disease. Other research with Hepatitis B vaccine has shown not all celiacs respond favourably to vaccination.
But in the mean time, it is an option while one works on strengthening the immune system.
In the last ten years there has been an increase in the numbers of people being diagnosed with celiac disease. Intuitively, one would expect this increase in diagnosis to be followed by a decrease in celiac-related deaths. The idea being that earlier diagnosis means earlier treatment with gluten-free diet, and, ideally, less associated conditions and deaths. But according to this study, there has been no change in the mortality rate.
Jeffery Adams of celiac.com reported that researcher Dr. Matthew J. Grainge, of the University of Nottingham, told Reuters Health that his team "found that people with celiac disease have a 37% increase in all-cause mortality compared with the general population."
The study published at Am J Gastroenterol; January 18, 2011.revealed a significantly increased all-cause standardized mortality ratio (SMR) of 1.37. This was higher for men (SMR, 1.86) than for women (SMR, 1.10). Study subjects had higher rates of death from cancer (SMR, 1.61) digestive (SMR, 2.19) and respiratory diseases (SMR, 1.57) compared to the general population. In all, there were 21 deaths from respiratory diseases, 11 of those from pneumonia.
According to the research team, this data supports current guidelines recommending pneumococcal vaccination for people with celiac disease.
In conclusion, the researchers note that the results may offer doctors "an opportunity to reduce mortality following pneumococcal infection by increasing the uptake of vaccination against this pathogen as vaccination rates are currently well below 50%."
I believe the problem lies in thinking that celiac disease is a gastroenterologic disorder more like a food allergy like being allergic to carrots.
In fact celiac/gluten sensitivity is an autoimme connective tissue disorder based on genetics and those with the genetics have tissues that have peptides in their structure that look like wheat. If one becomes allergic to wheat then the antibodies may attack the connective tissues. One is immunocompromised.
I treat people with celiac/gluten sensitivity with a grain free diet and a programme to identify already damaged connective tissues, damaged genetics such as MTHFR, hormone inbalances, infections, heavy metal toxicity and pre-cancers. And treat accordingly.
More research is necessary to determine if pneumococcal vaccination will, in fact lower the death rate.in persons with celiac disease. Other research with Hepatitis B vaccine has shown not all celiacs respond favourably to vaccination.
But in the mean time, it is an option while one works on strengthening the immune system.
Warning Signs of Celiac Disease
Celiac disease and gluten sensitivity can mimic many different diseases and, I have discovered through fifteen years of researching and managing patients, it is best to test everyone. In Japan and Italy they test all children before the age of 6 because they are aware of the high morbidity and mortality that comes with undiagnosed celiac/gluten sensitivity.
On Hartke is online I found an informative article on the warning signs of celiac disease and a video interview of Dr. Peter Jo that's well worth watching. Dr. Peter Jo is a Reston, Virginia based chiropractor and certified nutritionist who is knowlegeable on the subject.
Read more about what he has to say about celiac disease, testing, the in's and out's and more at his blog.
I repeat myself when I say that I use Dr. Kenneth Fine's lab called http://www.enterolab.com/ for testing.
On Hartke is online I found an informative article on the warning signs of celiac disease and a video interview of Dr. Peter Jo that's well worth watching. Dr. Peter Jo is a Reston, Virginia based chiropractor and certified nutritionist who is knowlegeable on the subject.
Read more about what he has to say about celiac disease, testing, the in's and out's and more at his blog.
I repeat myself when I say that I use Dr. Kenneth Fine's lab called http://www.enterolab.com/ for testing.
Tuesday, March 1, 2011
My Favourite Chocolate Cake recipe from Elana's Pantry
Here is my favourite Chocolate Cake recipe from Elana's Pantry called New German Chocolate cake.
The recipe fits the "Specific Carbohydrate diet"," GAPS "diet and the "Paleo" diet. She says it's a little complicated but you can make it in stages: make the cake the day before, make the icing an hour before you plan on serving it as it has to cool and thicken. If you are serving it for dessert at a dinner party, cool the icing just before serving the main course. It should be ready just when you're ready for dessert. I iced the cake infront of everyone after the main course, just before I served it. Everyone needs a little entertainment.
Just a final note: I never use agave because it is almost 100% fructose, instead I use honey and I adjust the amount by using 3/4 of what is asked for in the recipe.
Enjoy!
To your health
Dr. Barbara
The recipe fits the "Specific Carbohydrate diet"," GAPS "diet and the "Paleo" diet. She says it's a little complicated but you can make it in stages: make the cake the day before, make the icing an hour before you plan on serving it as it has to cool and thicken. If you are serving it for dessert at a dinner party, cool the icing just before serving the main course. It should be ready just when you're ready for dessert. I iced the cake infront of everyone after the main course, just before I served it. Everyone needs a little entertainment.
Just a final note: I never use agave because it is almost 100% fructose, instead I use honey and I adjust the amount by using 3/4 of what is asked for in the recipe.
Enjoy!
To your health
Dr. Barbara
Monday, January 31, 2011
Gluten Sensitivity Disease Can Increase Reproductive Problems
Infertility, small for dates babies, miscarriages and unexplained stillbirths are tragic events for a couple trying to conceive. If this should be occurring, I recommend screening for celiac disease or gluten sensitivity because there is a higher incidence of these problems; with small for dates babies, there is a 7.75 times increased incidence according to this study.
This report comes from Jefferson Adams.
Dr. Kumar, of Maulana Azad Medical College & Lok Nayak Hospital in New Delhi, reported in a study published in the World Journal of Gastroenterology that women with latent celiac disease, those who test positive for celiac antibodies but show normal small bowel biopsies, may develop more reproductive problems.
"Women having unexplained infertility, recurrent abortions, stillbirths or intrauterine growth retardation could have subclinical celiac disease, which can be detected by serological screening tests," Dr. Ashok Kumar told Reuters Health by email.
Improved diagnostic tools, and greater access to screening have led to more diagnosis of latent or subclinical celiac disease, says Dr. Kumar.
Doctors know that women with full, biopsy-proven, untreated celiac disease have more reproductive problems if they don't follow a gluten-free diet.
To study the effect of latent celiac disease on reproductive performance, the researchers examined 893 women.
They found that a total of 104 women had undergone idiopathic recurrent abortion, 104 had unexplained stillbirth, 230 had unexplained infertility, and 150 were pregnant, but showed idiopathic intrauterine growth restriction. The remaining 305 women, with normal obstetric histories, and served as control subjects.
Based on IgA tTG antibody titers, latent celiac disease was 5.43 times more common in the group with recurrent spontaneous abortion than in the control group.
Rates of latent celiac disease for the group with stillbirth were 4.61 times greater than the control group.
Rates for the group with intrauterine growth restriction were 7.75 times greater than control subjects, while rates for those with unexplained infertility were 4.51 higher.
The researchers also found that women with positive blood screens showed higher rates of previous early births, low-weight births, and cesarean sections than did seronegative subjects.
Moreover, the researchers note that "the classic presentation of diarrhea and malabsorption is now less common, and atypical and silent presentations are increasing."
As a result of their findings, Dr. Kumar and his colleagues are recommending celiac disease blood screens for women with idiopathic cases of poor reproductive performance.
Source:
Ron Hoggan's response to article about "gluten-free dieting"
Dr. Ron Hoggan, co- author of Cereal Killers and Dangerous Grains, has some interesting things to say in regards to some common myths about gluten-free eating and he emphasizes that gluten sensitivity has been found to be more dangerous than celiac disease.
Recently I have noticed a trend in articles that demonize the gluten-free diet, and imply that there is something unhealthy or even dangerous about it. Here is an example of one that I forwarded to Dr. Ron Hoggan:
http://www.post-gazette.com/pg/11017/1118230-114.stm
and below is his response to its author:
Dear China Millman,
Thank you for your interesting article on gluten-free dieting. I was very pleased to read that you include patients with non-celiac gluten sensitivity among those who should follow a gluten free diet. I assume that you have arrived at your estimate of 20 million who are afflicted with wheat allergy, non-celiac and celiac gluten sensitivity using Dr. Fasano’s estimate that 6 to 7 percent of Americans have what you refer to as this “milder form of gluten intolerance”. There are other estimates. For instance, Dr. Kenneth Fine did random blood draws at a shopping center in Dallas, Texas and found an 11% rate of gluten sensitivity. Congruently, Dr. Marios Hadjivassiliou has reported rates as high as 12% in the United Kingdom and Dr. Rodney Ford reports a prevalence estimate of 10% in New Zealand. Each investigator used different methods to arrive at their estimate, and each method is likely to underestimate the true prevalence of non-celiac gluten sensitivity. For instance, they all rely on a single class of antibody reaction against a single sub-group of proteins found in gluten grains. Thus, Dr. Fasano’s estimate may be unduly conservative as it is substantially lower than others have found in similar populations and the testing used to arrive at Dr. Fasano's estimate also carries all of the other limitations mentioned above.
As for the notion that non-celiac gluten sensitivity is milder than celiac disease, Anderson et al, in their study titled “Malignancy and mortality in a population-based cohort of patients with coeliac disease or ‘gluten sensitivity’ World J Gastroenterol 2007 January 7; 13(1): 146-151, report a higher rate of malignancy and early mortality among those with non-celiac gluten sensitivity than among those with celiac disease. This finding may be the result of the common recommendation that patients ignore test results that show non-celiac gluten sensitivity, as many physicians believe that such results are “non-specific” and do not warrant a gluten free diet. However, it may also reflect that non-celiac gluten sensitivity is a more serious illness than celiac disease. It may also reflect something entirely different than these two interpretations, but it does make a very good case for the need for more research in this very neglected area.
As for the comments by Heather Mangieri and the American Dietetics Association, they might benefit from reading studies such as the one by Dr. Cheng et al titled “Body Mass Index in Celiac Disease Beneficial Effect of a Gluten-free Diet” in the 2009 Journal of Clinical Gastroenterology. They found that, after diagnosis with celiac disease, about half of the overweight and obese patients lost weight. Given the conservative data you report, suggesting that at least 90% of American cases of celiac disease go undiagnosed, there can be little doubt that a large portion of those with undiagnosed celiac disease who are overweight or obese would be likely to lose weight. The number who would lose weight should be greater among those who chose to follow a gluten free diet to lose weight, as some of those who are diagnosed with celiac disease do not comply with the diet. If one accepts the proposition that those with non-celiac gluten sensitivity, IBS, and IBD often have similarly problematic reactions to gluten, the number of Americans who could lose weight and live healthier, and therefore happier, lives (eating a gluten free diet) rises exponentially.
....In the current context of excessive under-diagnosis of celiac disease and limited understandings of the dynamics by which a gluten free diet causes weight loss among celiac patients, and an enormously greater number of Americans who have non-celiac gluten sensitivity, it is difficult to understand why anyone would be cautioned against following a gluten free diet with weight loss as their objective. Whether these individuals are undiagnosed celiac patients, have undiagnosed non-celiac gluten sensitivity, or they find that a gluten free diet is helping them to achieve their body mass objectives, there is little legitimate cause to "warn" people away from a gluten free diet. Overall, your article does raise awareness of gluten as a potential health threat, so its overall impact is positive despite the misinformation that a gluten free diet does not help with weight loss.
Sincerely,
Ron Hoggan, Ed. D.
Tuesday, November 30, 2010
The best diet for celiac/gluten sensitivity is the GAPS diet.
The pathology of gluten sensitivity/celiac disease is in the connective tissues that are structurally and functionally different and the resultant permeable intestine sometimes called a "leaky gut".
To really thrive, the best diet is the GAPS diet or the Gut and Psychology diet developed by Dr. Natasha Campbell-McBride. She updated the specific carbohydrate diet using the newest information we have about foods.The GAPS diet tries to heal the "leaky gut". Supplements are also recommended both to make up for the nutritional deficiencies brought on by the "leaky gut" and because there are higher needs for some vitamens because of genetic (connective tissue) abnormalities.
I don't recommend a gluten free diet because I rarely see gluten sensitive/celiac persons do well on it. (Perhaps 1 out of 10). Autoimmune diseases still continue to present themselves and nutritional deficiencies persist. There are lots of problems with the flour substitutes from contamination, undiagnosed food allergies to high glycemic load. And store bought gluten free products are also made with seed oils which aggravates the omega 3-6-9 ratio. And grains have anti-nutrients in them.
A gluten free (GF) diet does help to some degree, for example we know that cancer rates start to drop from four times higher and by five years on a GF diet the risk of cancer (in a gluten sensitive/celiac person) is at the rate of the general population (RR =1). But is that enough when a person still doesn't feel well?
A GF diet, as apposed to a grain free diet or GAPS diet, rarely heals or stops any inflammatory processes that already exist nor stops the onset of autoimmune diseases (which are 12 times more common in GS/Celiac). Why does the GF diet fail? Because it doesn't heal the "leaky gut".
One of the best GAPS diet blogs is produced by Kat .
To really thrive, the best diet is the GAPS diet or the Gut and Psychology diet developed by Dr. Natasha Campbell-McBride. She updated the specific carbohydrate diet using the newest information we have about foods.The GAPS diet tries to heal the "leaky gut". Supplements are also recommended both to make up for the nutritional deficiencies brought on by the "leaky gut" and because there are higher needs for some vitamens because of genetic (connective tissue) abnormalities.
I don't recommend a gluten free diet because I rarely see gluten sensitive/celiac persons do well on it. (Perhaps 1 out of 10). Autoimmune diseases still continue to present themselves and nutritional deficiencies persist. There are lots of problems with the flour substitutes from contamination, undiagnosed food allergies to high glycemic load. And store bought gluten free products are also made with seed oils which aggravates the omega 3-6-9 ratio. And grains have anti-nutrients in them.
A gluten free (GF) diet does help to some degree, for example we know that cancer rates start to drop from four times higher and by five years on a GF diet the risk of cancer (in a gluten sensitive/celiac person) is at the rate of the general population (RR =1). But is that enough when a person still doesn't feel well?
A GF diet, as apposed to a grain free diet or GAPS diet, rarely heals or stops any inflammatory processes that already exist nor stops the onset of autoimmune diseases (which are 12 times more common in GS/Celiac). Why does the GF diet fail? Because it doesn't heal the "leaky gut".
One of the best GAPS diet blogs is produced by Kat .
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