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Celiac Disease

Celiac Disease. Recent Prevalence of Celiac Disease. 1 in 133 people have CD Prevalent, but under diagnosed Those not diagnosed have a higher death rate Mayo Clinic Raise awareness, improve screening Why is Celiac Disease on the rise?. Celiac Disease…. Aka Celiac Sprue

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Celiac Disease

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  1. Celiac Disease

  2. Recent Prevalence of Celiac Disease • 1 in 133 people have CD • Prevalent, but under diagnosed • Those not diagnosed have a higher death rate • Mayo Clinic • Raise awareness, improve screening • Why is Celiac Disease on the rise?

  3. Celiac Disease… • Aka Celiac Sprue • An auto-immune disease that affects the small intestine • No wheat, rye and barley • Attack of the micro-villi! • Malabsorption • Osteoporosis, iron-deficiency anemia, infertility, cancer, other auto-immune diseases, etc • Go gluten-free, intestinal repair

  4. Signs and Symptoms • No classic signs • Bloating, abdominal pain, diarrhea • Less noticeable symptoms • Anemia, joint pain, stomach pain, irritability, dental or bone disorders, weight loss, stunted growth in kids • Can imitate symptoms of other conditions such as irritable bowel • Dermatitis herpetiformis • Silent Celiac Disease • No symptoms, still damage

  5. The Latest Fad • A new diet trend • Gluten only harmful to those with CD • No current evidence to back up gluten-free diet health claims • Wheat flour fortification: B1, B2, B3 and Iron

  6. Diagnosis • 1st: Physical exam and blood testing • 2nd: Duodenal biopsy • 3rd: Implement gluten-free diet http://www.csaceliacs.org/celiac_diagnosis.php

  7. Gluten • Gluten is a protein that gives dough elasticity which allows it to rise without collapsing while trapping the CO2 • Exists within wheat , rye and barley. • Also in wheat derivatives: bulgar, couscous, mataza, seitan, semolina, triticale, spelt, kamut, einkorn, emmer and anything with ‘wheat’ in the title (except buckwheat).

  8. FDA Gluten Free Labeling • Currently, FDA has no current definition for “gluten-free” • Proposed definition of gluten: • proteins that naturally occur in wheat, rye or barley or a hybrids of these. • Voluntary labeling • Proposed in 2007, as of 2009 - still in draft form • Read label ingredients!

  9. Gluten-Free • Naturally gluten-free • Ex: Fresh fruits and vegetables • Commercially gluten-free • Ex: Rice flour bread, Gluten-free cookies

  10. Eating Out and Gluten Free • Gluten-free menus: http://www.glutenfreetravelsite.com/restaurants/ • Menu must be requested • Ask questions! • What’s in the dish, how is it prepared, can I see the label • A severe allergy? • Be skeptical, cross contamination happens

  11. Gluten Free Cooking and Baking • “Safe” grains: corn, rice, buckwheat, wild rice, amaranth, quinoa, teff, millet, sorghum • Other ‘safe’ foods: All vegetables, legumes, fruits, natural meats (not deli meats), fish, shellfish, eggs, natural dairy products and nuts as well as potatoes, tapioca and arrowroot. • Baking is the most difficult-trial and error method of finding tasty recipes • Be aware of gluten-contamination!

  12. Possible Culprits • Hygiene Hypothesis • 21st Century Diet • Modern wheat

  13. Celiac Disease and Obesity • Study states that malnutrition of adults and children is not seen often • After gluten-free diet, percentage of overweight participants doubled • Nutritional imbalance of gluten-free foods • New morbidities, especially in children • Nutritional follow-up needed

  14. Is CD Genetic? • A link between genes and Celiac Disease • 1 in 22 with first degree relatives • Often comes shows up after a bout of trauma such as an infection, injury, stress or pregnancy • Relatives need regular screens for auto-immune disorders

  15. Celiac Disease and Type 1 Diabetes • A link between, T1DM and Celiac Disease • 1 in 20 people with Celiac Disease have Type 1 Diabetes Mellitus • T1DM: the pancreas doesn’t make insulin • T1DM is also an autoimmune disease that is thought to reveal itself in the same manner • Genetic disposition plus an environmental factor

  16. “A New Hope For CD Sufferers?” • New study, no conclusions yet • Pills that break down gluten • Immunotherapy: training the immune system to tolerate gluten through injections + ?

  17. Take Home Message • Be aware of Celiac Disease and the implications it has on those who have it • See a doctor if you have unexplainable symptoms that may be caused by CD or if an immediate family member has CD or another auto-immune disease

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