Celiac PEI - What's new
celiacpei


What's New

“What's New With Food and Celiac Disease" Carolanne is an Assistant Professor in the Dept of Family and Nutritional Sciences, UPEI and was diagnosed with celiac disease in 2006.   In addition to teaching medical nutrition courses at UPEI, Carolanne is a nutrition researcher exploring the health benefits of native Maritime crops such as rosehips, blueberries and seaweed.   Following are the points covered in her presentation.

Introduction to Celiac disease Damage to intestinal mucosa due to exposure to gluten
-  Genetic and autoimmune
-  Occurs when alpha-gliadin from wheat, rye, malt, barley, and oats are eaten

Introduction - Celiac disease - pathophysiology
-  Damage to intestinal villi: reduced height, flattened
-  Decreased enzyme function and surface area
-  Maldigestion and malabsorption
-  Associated with other autoimmune disorders • Dermatitis herpetaformis, Type I Diabetes Mellitus, rheumatoid arthritis, thyroid disorders

Symptoms • Celiac disease - clinical manifestations
- Diarrhea, abdominal pain, cramping, bloating, gas
-  Bone and joint pain
-  Muscle cramping, fatigue
-  Peripheral neuropathy, seizures
-  Skin rash
-  Mouth ulcerations
-  Higher risk for lymphoma (?) and osteoporosis • BUT - Can have no symptoms • OR - Can have unusual symptoms
-  Iron deficiency
-  History of IBS
-  Very low cholesterol levels
-  Early onset osteoporosis Epidemiology • The ‘old’ celiac disease epidemiology:
-  Rare disorder typically seen in infants
-  Incidence varies from 1/400 (Ireland), to 1/10000 in Denmark
-  A disease of European origin Why are more being diagnosed? • Blood tests are very accurate • Realized that ‘typical’ symptoms weren't so typical
-  Found large numbers of people with CD who were anemic, chronic fatigue, short stature
-  Also found in large numbers of people with Down’s syndrome, osteoporosis, infertility
Prevalence of CD amongst relatives •      Amongst first degree relatives:     15-20%
•  First degree family members should be tested, every 5 years for adults, every 2 years for children
Celiac Disease: a European Disorder? • In the Western Sahara, the incidence of CD is 1:18
• In Iran, the incidence is 1:166
Hunger initiatives to 3rd world countries is feared to be causing an epidemic of CD that is impossible to diagnose

Celiac Disease - Nutrition Intervention  Symptomatic - low-fibre, low-fat, lactose-free, gluten-free diet
Asymptomatic
•  Regular gluten-free diet
•   Gluten restriction for LIFE
•  Oats controversial - limit to 1/4 cup/day
•    Identify hidden sources of gluten
•    Investigate specialty products

Nutrient Intake of People with CD
• British study (2007)     Completed dietary records on 49 people with CD and found
• Protein intakes were too high
•Inadequate intake of: Fibre - Vitamin D - Calcium

Nutrition Issues on Gluten-free Diet

  •  Difficult to get sufficient fibre - fibre critical for health of the intestine -Suggestions: Use more nutritious flours such as amaranth, bean flours        
    Rice bran (can be used like wheat bran); ground flaxseeds and psyllium. Above can be added to meatloaf, muffins, loaves, homemade bread, cookies, peanut butter. Meet your daily requirement for fruits and vegetables. Include more beans in your diet
  • Chili, molasses and beans (read labels, some contain flour)

    • Fibre content of GF flours
  • White rice flour (1/4 c)
  • 1 gm
  • Brown rice flour (1/4 c)
  • 1 gm
  • Almond flour (1/4 c)
  • 3 gm
  • Flaxseed (2 Tbsp)
  • 4 gm
  • Amaranth flour (1/4 c)
  • 3 gm
  • Quinoa flour (1/4 c)
  • 4 gm
  • Potato flour (3 Tbsp)
  • 2 gm
  • White Bean flour (1/4 c)
  • 8 gm
    Issues
  • Increase in weight and cholesterol levels as you begin to feel better Due to improved absorption of fats and nutrients as the intestine heals Follow a heart-healthy, gluten-free diet Limit intake of hydrogenated fats (trans fats) and saturated fats (whole milk, butter, cheeses, high fat baked goods)


    • Osteoporosis and Celiac Disease

  • Bone density Make sure you have adequate intake of calcium and Vitamin D Best source for absorption is cow’s milk. No vitamin D in cheese and not in most yogurtsIf you are over 50 yrs of age, Canada’s Food Guide recommends everyone take a supplement of Vitamin D of 400 IU/d

    • Quinoa
    •      ‘mother of all grains’
    •      From S. America - Rich in protein, amino acids, fibre, phosphorous, magnesium, iron -Beginning to be used as a meat analogue
    •      Comes as: - Flakes: nice alternative to oatmeal
    -      seeds Sorghum

  • Typically used as an agricultural feed crop Has undergone extensive testing for tolerance and safety with humans with Celiac Disease and was found to be safe
  • Related to corn family and contains no gluten

    Marigot's Aquamin complex
  • Extracted from a red seaweed Rich in calcium and magnesium Shown to improve the texture of gluten-free bread

    Gluten-free ‘fad’ Last year, gluten-free products were deemed to be one of the top 10 food trends
  • There was an 86% increase in the number of gluten-free products launched in the Europe and N American markets

    Gluten-free market
  • According to a report published last year by Packaged Facts, the market for gluten-free foods and beverages in the US currently stands at almost $700M, and is due to reach around $1.7Bn by 2010.   This market has increased 27% since 2001 and is expected to continue to do so in the ongoing future
  • Alternate Flours

    Scientists in the US have found that a flour made from rice and sweet potatoes is a "superior substitute" to wheat in pancakes, suggesting a possible alternative for products targeting Celiac sufferers.
  • Alternate Treatment for CD? Prolyl endopeptidases (PEPs) can digest gluten
  • Oral administration of this enzyme in a pill form might allow limited consumption of gluten without side effects
    • •      Extracts can be made to be food grade
    •      Clinical trials expected to start soon
Alternate Treatment #2
  • Exposure to gluten in a person with CD results in increased intestinal permeability AT-1001 is an inhibitor of intestinal cell permeability People with CD given AT-1001 and an acute gluten challenge had no response to the gluten
  • Those with CD who did not receive the medication had a 70% increase in intestinal permeability

 

 
Events