Celiac Disease

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
(No Transcript)
5
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

6
(No Transcript)
7
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

8
Diagnosis

• 1st Physical exam and blood testing
• 2nd Duodenal biopsy
• 3rd Implement gluten-free diet

http//www.csaceliacs.org/celiac_diagnosis.php
9
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).

10
(No Transcript)
11
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!

12
Gluten-Free

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

13
Eating Out and Gluten Free

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

14
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!

15
Possible Culprits

• Hygiene Hypothesis
• 21st Century Diet
• Modern wheat

16
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

17
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

18
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 doesnt make insulin
• T1DM is also an autoimmune disease that is
  thought to reveal itself in the same manner
• Genetic disposition plus an environmental factor

19
(No Transcript)
20
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

?
21
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