Celiac disease doesn’t just cause weight loss or gain, diarrhea, bloating and fatigue. It is linked to a variety of diseases and conditions, some of which can be life-threatening.

The good news?

A 100 per cent gluten-free diet will do wonders. Add nutritional support through supplementation, and you’ll be on the road to healing the intestinal damage from celiac disease while dramatically reducing your risk of developing many of the diseases associated with untreated celiac disease.

Here are the top eightdiseases related to celiac disease. If you have celiac, a gluten-free diet will dramatically reduce your risk of all of them. However, for those of you looking to treat celiac disease beyond the gluten-free diet, here is some additional guidance for reducing your risk of developing these diseases.

Dermatitis Herpetiformis (DH) – This is a skin manifestation of celiac disease that results in itchy blistery rashes. The most common sites for this rash are the elbows, knees and buttocks. People with this condition may or may not have digestive celiac symptoms. It can be resolved through a gluten-free diet, the strict use of gluten-free body care products, and specific antibiotics.

Osteoporosis – In untreated celiac disease, excess fat is lost in one’s bowel movements. This fat interferes with Vitamin D and calcium absorption, which in turn causes softening of the bones (osteomalacia) and bone density loss (osteoporosis). Make sure you’re getting plenty of calcium, vitamin D and magnesium through your diet or through supplementation. Adding a regimen of weight-bearing exercise will help as well.

Iron Deficiency Anemia – Caused by malabsorption, this is a common condition that results from celiac disease and can be addressed through improved nutrient absorption via intestinal healing. The gluten-free diet is paramount, but supplementation with things like zinc, glutamine and citrus bioflavonoids initiates and increases the speed at which your gut heals. Short-term iron supplementation may be necessary as well. Consume vitamin C-containing foods with iron-rich foods in order to improve iron absorption.

Depression and Anxiety – The cause of these conditions is not known but may be associated with malnutrition resulting from malabsorption, as well as neurological impacts of untreated celiac disease. Omega 3 fatty acids, B-complex vitamins, exercise and a balanced diet can help. There are also some new theories, and as times goes on, hopefully we’ll continue to see progress on this topic. It sure is a serious one.

Infertility and Recurring Miscarriage – Malabsorption of key nutrients contributes to these challenges. Fertility may be affected in men as well as women. Nutritional imbalances must be corrected, including malabsorption of zinc, selenium, iron, and folate. Supplementing with these nutrients may be necessary while the gut’s absorptive abilities are slowly improved through a gluten-free diet.

Lactose Intolerance – The inability to digest lactose, the sugar in milk products, is very common in celiacs due to intestinal damage. After a while on a gluten-free diet you may be able to digest it again. Anyone with lactose intolerance will benefit from probiotic supplementation, and some may be able to digest lower-lactose foods such as yogurt and hard cheeses in moderation.

Intestinal Cancer – Intestinal lymphoma and bowel cancer are the biggest risks for celiacs, and are most effectively addressed through gluten-free diet compliance. However, eating a diet based around fruits, vegetables and whole grains and containing minimal red meat may help reduce your risk factors. Needless to say, maintaining a healthy lifestyle complete with exercise and stress-reduction helps as well.

Neurological Disorders – From migraines to numbness, celiac patients report all types of neurological disturbance. These are best aided by diet compliance but can also be aided in some cases by vitamin B12 supplementation and prescription medications where necessary.

The number one goal for reducing one’s risk of any of these diseases is total compliance with the gluten-free diet. The second goal is to help the gut gradually heal and restore its ability to absorb nutrients, which can be attained via a balanced diet, probiotics, and supplements designed to help you meet your nutrient needs while you heal.

via Celiac Nutrition and Gluten Free Health Blog.

3 August 2011: One of Africa’s and Asia’s biggest public health problems has had greater light shed on it through a study undertaken by researchers at Wits University and Umea University, Sweden, who have compiled the first global estimates of coeliac disease and associated mortality.

Their findings, published in the journal PLoS ONE, estimates that around 42 000 children may die every year from coeliac disease, mostly from the African and Asian continents.

Coeliac disease is an auto-immune disorder of the small intestine that occurs in genetically predisposed people of all ages from middle infancy onward. It is caused by a reaction to gliadin, a prolamin (gluten protein) found in wheat, and similar proteins found in other common grains such as barley and rye.

In the 1930s, before the discovery of the gluten-free diet as the way to manage coeliac disease, results from Great Ormond Street Hospital in London¹ showed very high mortality among children with coeliac disease. Mostly these days, the disease is well-managed by avoiding gluten. However in poorer settings, particularly where other diarrhoeal diseases are common, questions about gluten intolerance may not be raised, and consequently children may die.

“Coeliac disease may not be one of the world’s biggest killers, but it is a readily preventable cause of death. Much more awareness is needed in the poorer parts of the world – and in particular gluten-bearing food supplements for malnourished children need to be used in the knowledge that they could be harmful to the small proportion suffering from coeliac disease,” says Prof. Peter Byass, research team leader from the Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine at Umeå University.

Coeliac disease has emerged as an increasingly recognised public health problem over the last half-century, and is now seen as a global phenomenon, despite a profound lack of globally representative epidemiological data. Since children with coeliac disease commonly present with chronic diarrhoea and malnutrition, diagnosis is often overlooked, particularly in poorer settings where children often fail to thrive and water-borne infectious diarrhoeas are common. This is the first attempt to make global estimates of the burden of coeliac disease in childhood.

Building a model of childhood coeliac disease, the researchers took into account estimates of population prevalence, probability of non-diagnosis, and likelihood of mortality among the undiagnosed across all countries from 1970 to 2010, based around the few available data.

According to the model, in 2010 there were around 2.2 million children under five years of age living with coeliac disease. Among these children there could be 42 000 deaths related to coeliac disease annually. In 2008, deaths related to coeliac disease probably accounted for approximately 4% of all childhood diarrhoeal mortality.

The researchers found that although coeliac disease may only account for a small proportion of diarrhoeal mortality, these deaths are not preventable by applying normal diarrhoea treatment guidelines, which may even involve gluten-based food supplements. As other causes of diarrhoeal mortality decline, coeliac disease will become a proportionately increasing problem unless consideration is given to trying gluten-free diets for children with chronic diarrhoea and malnutrition.

The authors hope that increased awareness of the consequences of gluten intolerance will lead to better data and the saving of lives in the future.

To read the paper in PLoS one, click here

For further information contact Professor Kathleen Kahn at Kathleen.Kahn@wits.ac.za

Source: http://www.wits.ac.za/newsroom/newsitems/201108/13452/news_item_13452.html

For a single serving, beat together two eggs  and one tablespoon of milk. Add salt and pepper to taste.

Strip the needles from a few sprigs of fresh thyme and add them to the egg mixture.

Heat a little olive oil in a pan over moderate heat and pour in the egg mixture and thyme. Scrape and fold the eggs until just before they are done the way you like it.

Crumble in the feta cheese and give the eggs another scrape and fold. Serve immediately while the cheese is still melting.

Enjoy.

I am also anemia-free, depression-free and most recently, anti-depressant-free.

Yes, it’s true. My psychiatrist has finally pronounced me “cured”, which means for the first time in more than eleven years I no longer have to rely on a drug in order to feel good. Liberating news indeed, and once again, I am astonished at how eliminating this protein composite from my diet has changed my life.

Granted, there are days when the aroma of freshly toasted bread makes my mouth water, and it’s really hard to resist the delicious cakes and other baked goodies provided at our weekly Sunday morning Church teas, but the benefits of just saying no are so monumental, it’s a no-brainer.

I love that I now wake up every morning feeling – awake. No more struggling to get out of bed and then trying to garner the energy required to get through the day. No more having to ingest all sorts of vitamin and energy supplements in attempt to acquire desperately needed get-up-and-go. Now my body does that of its own accord. It’s a completely new experience for me, and it feels wonderful.

Here comes the strange part. Much of my newly acquired energy is being put to use in the kitchen. Me! Cooking? Who woulda thunk it? But it’s true. I have developed a new interest in food preparation and spend a lot of my free time producing all sorts of new dishes. A while ago I even baked a chocolate cake – my first from scratch – and it turned out a success.

Living gluten-free is certainly not without its down sides, but if it means the difference between a significantly improved quality of life and one plagued with chronic anemia, depression and all the associated ailments, then I choose the former. Every time.

What has changed?

Anyone who has been watching Novak’s metamorphosis, must be wondering what on earth changed in his life to permit him to become unstoppable. The commentators at Flushing Meadows and at many of his earlier matches this year, all mentioned that he has made changes to his diet and that these changes together with an improved training programme, have lifted Djokovic from a good player to the dizzying heights of a supremo.

Public deductions

According to the same commentators Novak has a wheat allergy and by simply avoiding wheat, he has written himself into the history books. As a nutritionist, I am of course pleased that nutrition is taking centre court, but I must admit that I am still a bit sceptical. I am also rather worried about the nutritional conclusions the public will arrive at.

It is a well known phenomenon that if sports stars or celebs announce that they are drinking a mixture of chilli and honey to lose weight or like Djokovic that they are avoiding wheat, desperate slimmers and other individuals who may be suffering from a variety of conditions, will follow suit. Wheat and carbohydrates are already the pariahs of the diet world, so the news about Djokovic’s supposed wheat aversion, will probably trigger another anti-carb movement, to the detriment of balanced nutrition.

Coeliac disease?

Intrigued, I did a Google search to see what theories are being put forward to explain Djokovic’s phenomenal performance. As predicted, many members of the public have jumped to the conclusion that Djokovic suffers from coeliac disease.

Now coeliac disease according to a fact sheet on “Food Allergy and Coeliac Disease” published by the Food Standards Agency of the UK Government (2006), is not an allergy, but an “autoimmune disease” (i.e. the body of a patient suffering from coeliac disease produces antibodies that attack its own tissues). The autoimmune reaction is initiated by gluten, a protein that is found in cereals such as wheat, rye, barley, oats, kamut and spelt.

Coeliac disease is diagnosed when a patient had undergone an endoscopy and a biopsy of the intestines has shown clear signs of coeliac disease. According to amost entertaining blog posted by Alex Gazzola (2011), who has published several books on food allergy, intolerance and coeliac disease, there is no evidence that Djokovic has undergone any of these investigations. I am inclined to agree with Alex Gazzola, because patients with coeliac disease have really serious, debilitating symptoms which if untreated for two decades would probably preclude a highly active sports career and have stunted our tennis star’s growth.

It is more likely that the World No 1 tennis player has a more general wheat sensitivity and/or that his general diet has just been fine tuned to exclude foods that contain wheat. This will of course automatically exclude other potential allergens such as colourants, flavourants, preservatives, yeast and other additives, which may, or may not, have been contributing to Djokovic’s previous tendency to run out of steam or go into a dramatic decline at crucial stages of a match. I suspect that he may have a more general allergy to wheat because in the past, he did exhibit symptoms such as breathing difficulties, irritated eyes and low energy levels.

Typical symptoms of coeliac disease

Patients who test positive for coeliac disease usually suffer from the following symptoms:

• nausea
• bloating
• tiredness
• constipation
• reduced or stunted growth
• skin problems

If you suspect that you, or a member of your family, may be suffering from coeliac disease then it is important to be tested because following a strict gluten-free diet (i.e. free of wheat, rye, barley and oats, as well as the lesser known and used cereals, kamut and spelt) is much more difficult and complicated than avoiding wheat alone. Patients with coeliac disease need to be counselled and guided by aregistered dietician so that they do not inadvertently ingest gluten and trigger their debilitating symptoms. In addition, the dietician will have to ensure that young coeliac patients do not develop deficiencies of essential nutrients, which will further retard their growth.

Importance of correct diagnosis

Besides the above mentioned problems, obtaining a correct diagnosis will help to identify those patients you have other digestive problems such as Irritable Bowel Syndrome (IBS), milk and dairy intolerance, or a deficiency of digestive enzymes, which may not require elimination of wheat. Each condition has its specific diet. For example,  patients with milk intolerance need to cut out milk and dairy products, while patients with constipation-linked IBS may need to increase their intake of insoluble dietary fibre which is specifically found in wholewheat products (i.e. these patients generally need to increase their wheat intake!).

In all these cases, patients who cut out food groups at random after self-diagnosis, may expose themselves to deficiencies, which can in turn lead to negative consequences. Anyone who is diagnosed with a milk intolerance or allergy would need to take extra calcium supplements to compensate for the loss of calcium from their diets. Patients who avoid wheat may develop severe constipation because they have eliminated their prime source of insoluble dietary fibre which stimulates peristalsis and ensures regularity.

Consequently it is safer and more sensible if you have the necessary examinations and tests to determine what condition you suffer from and then to consult a registered dietitian to assist you not only to avoid the offending foods, but to compensate for lost nutrients resulting from an avoidance diet.

Coeliac disease and slimming

A Health24 reader recently asked me for a slimming diet that is tailored to the needs of coeliac patients. The basic principles for weight loss in coeliac patients are to reduce total energy intake by eating less or smaller portions of your permitted foods, cutting down on fats and doing regular exercise. Once again I would recommend that coeliac patients should consult their dieticians when they need to lose weight, because many standard slimming aids may contain gluten (e.g. most diet shakes and slimming bars). The dietician will adjust the energy content of your coeliac diet to help you lose weight.

To find a registered dietician in your area, visit the Association for Dietetics in SA (Adsa) website and click on “Find a Dietician”. You can also phone the Adsa Head Office at 011 789 6621 or 011 789 1383, to obtain the contact details of your nearest dietician.

Djokovic does it again!

I watched the exhilarating US Open Men’s Finals match between Djokovic and Raffa Nadal, and Novak did it again! Djokovic won the match beating Nadal with a blistering score of 6-4, 6-2, 6-7, 6-1, to garner his third  Grand Slam title this year – a performance to remember.

If this is what a change in diet can do for a champion, then you too can achieve great goals such as losing weight and improving your health by eating the correct diet. Just keep in mind that you must find out which dietary changes will benefit your condition with the aid of trained experts and not blindly follow the lead of the rich and famous when it comes to diets.

- (Dr IV van Heerden, DietDoc, September 2011)

References

(Gazzola R, 2011. Novak Djokovic: Wimbledon champion, gluten free, probably not a coeliac. Coeliac, Food Allergy and Intolerance Ink. 4 July 2011.http://foodallergyandintolerance.blogspot.com/; Food Standards Agency (2006). Food intolerance and coeliac disease. Food Standards Agency, September 2006 )

 Any questions? Ask DietDoc

 Read more:

Wheat allergy
Allergy, intolerance: which is it?
Coeliac disease

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There is a perception that red meat is associated with negative health consequences, and is considered ‘generally bad’ for your health. But this is not true.

The following is an excerpt from a recent article entitled Eco-eating, published in Longevity magazine (edition 2 2011), by Candice Tehini. I like what it says, not because I’m a lover of red meat, but because I think it makes good sense…

While a plant-based diet has proven health benefits, you cannot totally discount the benefits of meat.

“Vegetables are the easiest and most readily available forms of minerals, vitamins and fibre, and are able to break down into carbohydrates, which is only one of the food groups we need as humans,” says chef and herbalist Barry Farnan. And while fruit and vegetables should make up the bulk of any diet, Farnan believes that in order for humans to function at optimal levels on a vegetarian diet, you would need to constantly graze all day.

“In this modern world, to spend our day eating small snacks is challenging, and meat provides a constant release of more energy,” reveals Farnan.

“Protein is essential to your body. It is the building block for growth and maintenance of muscles, blood, skin and other body structures. Some proteins act as enzymes and others as messengers,” says registered dietician Charne Herbst, from Dieticians at Work. She explains that protein regulates the body’s fluid balance and also regulates the acids within the body fluids.

Anne Till of Anne Till and Associates, in conjunction with SA’s Red Meat Industry Forum, explains: “There is a perception that red meat is associated with negatives health consequences, such as coronary heart disease, high cholesterol, arthritis, cancer, increased weight, and is considered ‘generally bad’ for your health. But this is not true.”

Many of the beliefs are not justified, and were based on incomplete and often limited information, she adds. “As nutritional science has evolved, red meat, including beef, has been shown to be less detrimental than was previously believed.” She adds that red meat, and beef in particular, was branded as “bad for health”, as it contains saturated fat and some cholesterol, two fats that can increase your risk for coronary heart disease. “Saturated fat has also been linked to increased risk of some cancers, insulin resistance and high blood pressure and therefore it is recommended that it should be reduced in one’s diet as far as possible.”

However, she adds, not all meat products have the same amount of saturated fat and cholesterol in them. “Scientific research has shown that lean beef can be effectively incorporated into a balanced eating plan designed to lower blood cholesterol levels and reduce one’s risk of heart disease. In fact, in a research study that compared lean beef and lean chicken as the main source of protein in the diet, it was found that they reduced cholesterol levels equally,” she explains.

Research shows that beef contains saturated, monounsaturated and polyunsaturated fat. “While saturated fat has been proved to be unhealthy, monounsaturated and polyunsaturated fats are important for healthy cell membranes, nerves and brain tissue. Also, about one third of the saturated fat is made up of stearic acid, which does not affect cholesterol, so at least half the fat in red meat is good for you and your heart,” she says.

But, says Farnan, you need to be aware of where your meat is sourced from and make sure that it doesn’t contain growth hormones as, “bovine growth hormone and human growth hormones are very similar. We stop producing growth hormone somewhere around 18 to 20.” He believes that it is unnatural to ingest hormones and chemicals that your body is unable to break down or easily excrete. Retailers, such as Checkers, are even carrying “antibiotic-free” meat.

It’s your choice
While it is perfectly fine to eat meat products, choosing the wrong kind of meat and eating it in excess leads to disease and ailments. The key to staying healthy is “everything in moderation”. Include organic foods if you want to put as little pesticides and toxins in your body as possible.

And make sure your diet is rich in fruit and vegetables, with some lean cuts of free- range (where possible) meat, game, chicken and fish.

The best thing you can do is make lifestyle choices to ensure that you – and your environment – stays as healthy, and sustainable, as possible.

A brief period of healthy euphoria was soon followed by constant headaches, lethargy and a general sense of just not feeling well. More encouraging, however, was the fact that my body was responding well to the high dosage of oral iron supplements my doctor had prescribed – a clear indication that healing was taking place.

But as my body adjusted to the new levels of oxygen in my blood my heart suddenly realised it no longer needed to pump as hard to deliver it thoughout my system. Consequently, my blood pressure slumped to an all-time low.

I felt so awful I was convinced I was suffering from stress-induced depression. To help raise my blood pressure my doctor suggested I ask my psychiatrist to lower my anti-depressant dosage, a risky move as the last thing I needed was a relapse into a full-blown depressive state.

My psychiatrist was agreeable, but understood my hesitation. She suggested prescribing a different anti-depressant that had no effect on blood pressure levels, but could bring on other side-effects.

“No thanks,” was my immediate response. Gluten-free eating was already providing me with more than enough side-effects to deal with. Better the devil you know than the devil you don’t.

Besides, I reasoned, if my depression was originally caused by my Celiac disease and my body was responding positively to the gluten-free diet, then reducing the anti-depressant dosage should work.

“Let’s do it.”

My psychiatrist agreed, on the condition that I contact her immediately if I felt any symptoms of depression. Understood.

I began weaning myself onto the lower dosage the next day. For the first few days everything went well and I felt fine. So far, so good. Eventually I was completely off the higher dosage and only taking the lower amount. Still I felt fine.

Then the dizzy spells started. Initially they only lasted a second or two, but soon my head felt as if it were filled with fog and the dizziness was coming in zaps that made me feel completely disoriented. On the up side, however, my emotional state remained intact.

Okay, so this is just my body adjusting to having to produce its own serotonin instead of relying on a pill, so if I can get through this I’ll be fine.

Gradually over the next few days the fog in my head began to clear and my brain slowly steadied itself. Around two weeks later my head was completely clear and there was no sign of any depression. On the contrary, I had so much energy and there was – what I can only describe as – “a lightness” about me which I had never experienced before. Additionally, my creative juices were flowing so strongly it was like being on an adrenalin high without the downer that follows after the adrenalin wears off. I felt wonderful.

And I still do. If this is the reward of living gluten-free then I say bring it on! It’s truly worth giving up pizza, pasta and cake for.

I’m hoping that when next I see my psychiatrist she will approve me going off my anti-depressants completely. Then I will have my body back to myself again – and that will truly be cause for celebration!

Related articles

• Gluten-Free: A Trend that will Continue to Grow in 2011 (foodservicewarehouse.com)
• How did you get celiac disease (wiki.answers.com)
• #Celiac Disease Just One Form Of #Gluten Sensitivity (trulyglutenfree.co.uk)
• “Gluten-Free” Does Not Always Mean Gluten-Free (projectswole.com)

Not too sure about the leaky gut, but I can definitely relate to the other two pathogenetic factors discussed in the following article by Tina Turbin…

Celiac.com 07/25/2011 – Celiac disease, according to estimates, affects approximately three million Americans and as of yet, 97% haven’t been correctly diagnosed. As staggering as these statistics are, celiac disease remains largely poorly understood by the medical community. It’s no wonder, given its lack of research as compared with other autoimmune disorders. However, there is research being actively conducted in the U.S. and internationally in a quest to understand thepathogenesis, or the cause and development of the disease. With this information, more about celiac disease, diagnosis, prevention, and treatment can come to light.

According to the Canadian Celiac Association (CCA), the pathogenesis of celiac disease consists of three factors: “genetic, environment and immunologic.” With regard to genetics, the CCA points out that more than 97% of celiac patients have the genetic markers HLA DQ2 and/or HLA DQ8. Celiac disease is now known to be a hereditary disease. The Canadian Celiac Association tells us that “first-degree and to a lesser extent second-degree relatives are at higher risk of having unrecognized celiac disease.”

Next, is the environmental “trigger,” as Dr. Alessio Fasano, professor of pediatrics, medicine and physiology at the Center for Celiac Research at the University of Maryland School of Medicine, calls it. This is gluten, a protein found in wheat, barley, and rye. According to the Canadian Celiac Association, sometimes severe physical stressors can also trigger the immunologic reaction to gluten that is characteristic to celiac disease. Such sources of stress include pregnancy, infection, surgery, or even severe emotional stress.

In his article, “Surprises from Celiac Disease,” published in Scientific American, Dr. Fasano describes a different triad of factors involved in the pathogenesis of the disease. The first two factors are the ‘’trigger” of gluten, which sets off the immune response, and the genetic predisposition, as previously described. Fasano proposes that “other genes are likely to be involved as well, but these additional culprits may differ from person to person.”

The third factor, according to Fasano’s research is an “unusuallypermeable gut.” In fact, the author proposes that these three factors also underlie the pathogenesis of other autoimmune diseases, with of course triggers and genetic elements unique to those particular diseases. Fasano tells us that most non-celiacs have “tight junctions [that] ‘glue’ intestinal cells together.” On the other hand, in celiac patients, these links come apart, resulting in a small intestine from which pieces of gluten leak into the tissue and stimulate a response from immune cells. Fasano’s research regarding this third factor of pathogenesis offers hope of new prevention and treatment methods. He says, “Treatments that reduced leakiness could potentially ease not only celiac disease but also other autoimmune disorders involving unusually permeable intestines.”

This research into the leaky gut of celiacs can explain a question that has been perplexing researchers regarding the disease’s pathogenesis: Why do some people not develop celiac disease until later in life? According to Dr. Fasano, this issue could be associated with themicrobes in the digestive tract. The microbicrobial population varies among individuals and groups and even over the course of one’s life.

“Apparently they can also influence which genes in their hosts are active at any given time,” he says. “Hence, a person whose immune system has managed to tolerate gluten for many years might suddenly lose tolerance if the microbiome changes in a way that causes formerly quiet susceptibility genes to become active.” Should this prove true, we may be able to prevent or treat celiac disease with probiotics.

A better understanding of the pathogenesis of celiac disease is certainly needed, but as of yet, researchers seem to be on their way to developing a full picture of what is involved in the origin and onset of the disease. By raising awareness and allocating more funding to celiac pathogenesis research, we may find ourselves with the ability to delay or even prevent the disease or with a new treatment option.