Celiac Disease

Discussing the latest advances in celiac disease

August 22nd, 2014 · Leave a Comment

Bone Density and Celiac Disease

By Margaret Shepard

Raul Ruiz Esponda, M. D., discusses the connection between bone density and celiac disease.

 

Celiac disease and bone health is a very important topic. Bone loss is important because it may lead to osteoporosis and fractures. Fractures can lead to morbidity and in some cases, mortality. It is important to detect boss loss and make sure celiac disease patients are taking care of their bone health.

There are several reason why someone with celiac disease may have bone loss. Malabsorption and inflammation are two of the main reasons for bone loss for celiac disease patients. Malabsorption of calcium leads to secondary hypoparathyriodism. When calcium levels are detected as low in the blood, parathyroid hormone (PTH) is secreted. In situations like celiac disease where malabsorption is occurring, the parathyroid hormone plays an important role in bone reabsorption in order to receive calcium within normal limits leading to decreased bone density or bone wasting.

Some studies have shown that in patients with celiac disease the higher the level PTH, the lower the level of bone density at the hip and the spine. This correlation explains and ties together how patients lose bone density when they have celiac disease.

Another important factor is inflammation. This interferes with bone reabsorption. Other less known factors include lower levels of physical activity, lower body mass indexes, early menopause, and decreased levels of growth hormone. All of these are factors for bone loss.

Bone density is used as a surrogate marker for fractures. Studies that have compared celiac disease patients with healthy controls have shown celiac disease patients at diagnosis have lower bone densities at the hip and spine. Similar studies have also shown bone density correlates with damage at the gastrointestinal level. This means the more malabsorption, the lower the bone density. Pulling the reports together, 50-70% of patients with celiac disease will have some type of low bone density.

Studies examining fractures have shown celiac disease patients are at a 30% higher risk of having a fracture. So what can we do about this? A gluten-free diet has shown to increase bone density by 8% in the first year. After being on a gluten-free diet for one year, physicians may consider putting patients on medication for osteoporosis. The number of vitamin D and calcium supplements a celiac disease patient needs a day varies from patient to patient.

For more information about celiac disease, visit mayoclinic.org/celiacdisease.

Tags: bone density, celiac disease, Raul Ruiz Esponda

August 15th, 2014 · Leave a Comment

New FDA Rules for Gluten-Free Labeling

By Margaret Shepard

Joseph Murray, M.D., discusses the new Food and Drug Administration (FDA) rules for gluten-free labeling.

 

Almost ten years ago congress passed a law legislating food labeling. However, part of that law required the FDA to formulate regulations defining what gluten-free is. Up until now, there was not a set definition of gluten-free in the United States.

The FDA conducted a careful study over several years analyzing all the known literature about gluten and its affect on patients with celiac disease. The goal of the study was to come up an estimation of what is a safe threshold where food is not likely to cause a problem for patients with celiac disease. The FDA came up with a level of 20-parts per million. This is a small amount and also a level possible to detect gluten.

What does this mean for patients? This means that if a food is labeled gluten-free, it has to contain less than 20-parts per million. For a great majority of patients, this means the food should not present a problem. Labeling is voluntary. If a company chooses to put a gluten-free label on its food, it'll have to meet this standard.

This is good news for patients with celiac disease as it sets standards for safety going forward.

For more information about celiac disease, visit mayoclinic.org/celiacdisease.

Dr. Murray is a gastroenterologist and celiac disease expert at Mayo Clinic.

Tags: FDA, gluten free, gluten-free labeling, Joseph Murray

August 8th, 2014 · Leave a Comment

Gluten-Free Recipe: Vegetable Salsa

By Margaret Shepard

Is your garden overflowing with fresh vegetables this summer? Here's a gluten-free, fresh recipe for vegetable salsa that makes a great side dish or appetizer.

Ingredients

1 cup diced zucchini
1 cup chopped red onion
2 red bell peppers, seeded and diced (about 2 cups)
2 green bell peppers, seeded and diced (about 2 cups)
4 tomatoes, diced (about 2 cups)
2 garlic cloves, minced
1/2 cup chopped fresh cilantro
1 teaspoon ground black pepper
2 teaspoons sugar
1/4 cup lime juice
1/2 teaspoon salt
Directions

Wash vegetables and prepare as directed. In a large bowl, combine all the ingredients. Toss gently to mix. Cover and refrigerate for at least 30 minutes to allow the flavors to blend.

Originally posted on mayoclinic.org.

For more information about celiac disease, visit mayoclinic.org/celiacdisease.

Tags: gluten free recipe, healthy living, recipe

August 1st, 2014 · Leave a Comment

Motivations for Avoiding Wheat Consumption

By Margaret Shepard

The public has a great interest in avoiding gluten. Joseph Murray, M.D., discusses a recently published article in Public Health and Nutrition about the reasoning behind why people are avoiding gluten.

 

The study took place in Australia, where a lot of people are avoiding gluten. A survey was sent out to adults in Australia and over 1,000 responded. More women than men responded. The survey asked people if they were avoiding gluten and if so, why, and had they experienced symptoms from eating gluten.

The researchers found that a significant proportion of adults in Australia are avoiding gluten because it seemed to make them feel better and most of them didn't have celiac disease.

Recent research, also from Australia, suggests that many people are feeling better because they avoid, not gluten, but perhaps other components of wheat such as fructans or FODMAPs. It may be that going on a gluten-free diets leads to less FODMAPs. Researchers also know that avoiding gluten leads to less consumption of fast food, junk food, and maybe even less food in general.

Read the full article online here.

For more information about celiac disease, visit mayoclinic.org/celiacdisease.

Dr. Murray is a gastroenterologist and celiac disease expert at Mayo Clinic.

Tags: celiac disease, gluten, Joseph Murray, Public Health and Nutrition, wheat consumption

July 24th, 2014 · Leave a Comment

Gluten-Free Recipe: Grilled Pineapple

By Margaret Shepard

Take advantage of a hot grill and grill up some dessert! This recipe for grilled pineapple is a good source of vitamin C as well as gluten-free.

Ingredients

For the marinade

1 tablespoon olive oil
1/4 teaspoon ground cloves
1 teaspoon ground cinnamon
2 tablespoons dark honey
1 tablespoon fresh lime juice
1 firm yet ripe pineapple
1 tablespoon dark rum (optional)
1 tablespoon grated lime zest

Directions

Prepare a hot fire in a charcoal grill or heat a gas grill or broiler (grill).

To make the marinade, in a large bowl, combine the olive oil, cloves, cinnamon, honey and lime juice and whisk to blend. Set aside.

Cut off the crown of leaves and the base of the pineapple. Stand the pineapple upright and, using a large, sharp knife, pare off the skin, cutting downward just below the surface in long, vertical strips. Cut off any remaining small brown "eyes" on the fruit. Stand the peeled pineapple upright and cut it in half lengthwise. Place each pineapple half cut-side down and cut it lengthwise into four long wedges; slice away the core.

Place the pineapple in the bowl with the marinade and stir to coat the pineapple.

Place on the grill and cook about 3 to 4 minutes, basting once or twice with the remaining marinade. Turn the fruit and move it to a cooler part of the grill or reduce the heat. Baste again with the marinade. Grill until the pineapple is tender and golden, about 3 more minutes.

Remove the pineapple from the grill and place on a platter or individual serving plates. Brush with the rum, if using, and sprinkle with the lime zest. Serve hot or warm.

Recipe originally posted on mayoclinic.org

Tags: Friday recipe, gluten free, gluten free diet, gluten free recipe, healthy living

July 17th, 2014 · Leave a Comment

A Pill for Celiac Disease?

By Margaret Shepard

Joseph Murray, M.D., discusses a recently published article in Gastroenterology about a pill for the treatment of celiac disease.

 

For decades, celiac disease has been treated solely by a gluten-free diet. This proof-of-concept paper shows that a digestive enzyme engineered to specifically break down gluten proteins seems to be effective at preventing damage of the intestine.

Normally, patients with celiac disease on a gluten-free diet are challenged with gluten. The challenge induces inflammation or irritation of the intestine and symptoms. This study from Finland uses a novel preparation of two, custom designed enzymes that break down the particular damaging parts of the gluten proteins. The two enzymes combine in a way to increase the maximum efficiency of breaking down the parts of gluten that drive the disease.

In this clinical study, patients with well-treated celiac disease on gluten-free diet and healed intestines were challenged with gluten at a dose that would induce injury. In the group that received the placebo, there was significant injury seen. The patients that received the drug were protected from this damage to a significant degree.

What does this mean for people with celiac disease? This is an experimental agent being studied in a large international study, including North America, in patients with symptomatic celiac disease. The hope is that it can improve the damage or inflammation to the intestine while also improving symptoms. There are many challenges before this drug, or other drugs, can reach the marketplace. There are more studies underway with other agents and it's an exciting time to be involved with celiac disease.

Read the full study online here.

For more information on celiac disease, visit mayoclinic.org/celiacdisease.

Dr. Murray is a gastroenterologist and celiac disease expert at Mayo Clinic.

Tags: AGA, celiac disease, enzyme, Gastroenterology, gluten free diet, Joseph Murray, pill

July 10th, 2014 · Leave a Comment

Celiac Disease and Brain Fog

By Margaret Shepard

Joseph Murray, M.D., discusses a recently published article in Alimentary Pharmacology & Therapeutics about brain fog and celiac disease.

 

For people with celiac disease, brain fog implies significant cognitive impairment. Brain fog indicates problems with thinking, memory, recall, and computation. Brain fog can lead to significant mental fatigue.

This recent study took place in Australia and closely followed a small group of patients with celiac disease. The researchers tested their mental ability with multiple tests at the time of diagnosis and at 12 and 52 weeks later. They also followed their symptoms with blood tests and biopsies. At 12 weeks, patients showed significant improvement in all of the measures, especially antibody tests and biopsies. Most interestedly, the patients showed a significant improvement in cognitive ability over time. This suggests that not only does celiac disease impair cognitive function but a gluten-free diet improves it.

More information and studies needs to be done on this subject of brain fog and how celiac disease impairs brain function. There's hope for patients with celiac disease that their cognitive function will improve once they are appropriately treated.

Read the full study online here.

For more information on celiac disease, visit mayoclinic.org/celiacdisease.

Dr. Murray is a gastroenterologist and celiac disease expert at Mayo Clinic.

Tags: brain fog, celiac disease, cognitive impairment, Joseph Murray

July 1st, 2014 · Leave a Comment

Gluten-Free Recipe: Grilled Chicken Salad with Olives and Oranges

By Margaret Shepard

Heading to a 4th of July picnic this week? Bring this grilled chicken salad with olives and oranges to share! The garlic-rubbed grilled chicken is a nice complement to the tangy dressing.

Ingredients

For the dressing

1/2 cup red wine vinegar
4 garlic cloves, minced
1 tablespoon extra-virgin olive oil
1 tablespoon finely chopped red onion
1 tablespoon finely chopped celery
Cracked black pepper, to taste
4 boneless, skinless chicken breasts, each 4 ounces
2 garlic cloves
8 cups leaf lettuce, washed and dried
16 large ripe (black) olives
2 navel oranges, peeled and sliced

Directions

To make the dressing, in a small bowl combine the vinegar, garlic, olive oil, onion, celery and pepper. Stir to mix evenly. Cover and refrigerate until needed.

Prepare a hot fire in a charcoal grill or heat a gas grill or broiler. Away from the heat source, lightly coat the grill rack or broiler pan with cooking spray. Position the cooking rack 4 to 6 inches from the heat source.

Rub the chicken breasts with garlic, then discard the cloves. Grill or broil the chicken until browned and just cooked through, about 5 minutes each side. Transfer the chicken to a cutting board and let rest 5 minutes before slicing into strips.

Arrange 2 cups lettuce, 4 olives and 1/4 of the sliced oranges onto 4 plates. Top with 1/4 of the chicken strips and drizzle with dressing. Serve immediately.

Originally posted on mayoclinic.org.

For more information on celiac disease, visit mayoclinic.org/celiacdisease.

Tags: gluten free, gluten free recipe, healthy living, recipe, salad

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