Celiac Disease

Do you know the difference between Food Sensitivities, Intolerances, and Allergies?

May is Celiac Awareness Month. Gluten sensitivity enteropathy is an autoimmune inflammatory condition that refers to a group of different types of gluten sensitivity. Gluten is a protein found in wheat, rye, barley, and other foods derived from these grains. The most extreme subgroup is celiac disease, a genetic autoimmune condition. One percent of Americans are estimated to have celiac disease. When individuals with celiac disease consume gluten, their bodies have an immune response that results in damage to the intestinal villi. Some individuals who experience distress when eating gluten-containing products and show improvement after following a gluten-free diet may have non-celiac gluten intolerance, instead of celiac disease. More common than celiac disease, research suggests 10-15% of Americans suffer from non-celiac gluten intolerance. Intolerances generally worsen over time but, unlike celiac disease, there may be no damage to the small intestine. To summarize the gluten spectrum: any individual who experiences some type of reaction to gluten is gluten sensitive. Those people that are gluten sensitive and also have the genetic markers for celiac disease are gluten-intolerant, but not all gluten-intolerant individuals have celiac disease.

Wikipedia® defines food sensitivity as a negative reaction to foods that may or may not be related to the immune system or to food poisoning. It is a delayed hypersensitivity and can be caused by the absence of specific chemicals or enzymes needed to digest a food substance, or to the body's responses to certain food components both natural and artificial. In comparison, a food allergy is an immediate hypersensitive immunologic response to a food protein. It is estimated that up to 12 million Americans have food allergies of one type or another. Approximately 90 percent of all IgE-mediated food allergies are caused by the "Big 8" food sources of allergens: peanuts, tree nuts, milk, eggs, soybean, fish, crustacea, and wheat.

Symptoms of food sensitivity vary greatly, and can be mistaken for the symptoms of an allergy. While true allergies are associated with fast-acting immunoglobulin IgE responses (requiring the participation of antibodies), it can be difficult to determine the offending food causing a sensitivity because if the immune system is involved, the response is likely to be IgG mediated (a cellular reaction that requires the participation of T lymphocytes, a type of white blood cell that helps the body fight infection) and takes place over a prolonged period of time. Thus the causative agent and the response are separated in time, and may not be obviously related. A deficiency in digestive enzymes can also cause some types of food intolerances. Lactose intolerance is a result of the body not producing enough lactase used to break down the lactose in milk. Salicylate sensitivity is an intolerance to food chemicals such as salicylates or salicylate sensitivity. Salicylates are chemicals that can occur naturally in many foods. Salicylate sensitivity causes many symptoms, the most common of which are: hives, stomach pain, headaches, mouth ulcers, and it has even been linked to ADD and ADHD.

Symptoms of food sensitivities include gas, intermittent diarrhea, constipation, irritable bowel syndrome, skin rashes, migraine headaches, and an unproductive cough. Common symptoms of food allergy include skin irritations such as rashes, hives, and eczema, and gastrointestinal symptoms such as nausea, diarrhea, and vomiting. The American College of Gastroenterology estimates that 95 million Americans have gastrointestinal problems. If 12 million of the 95 million experience true food allergies, then 83 million, or approximately one out three Americans, are experiencing true food sensitivities and intolerances. Quite literally, the food we eat is making us sick. Currently, there is no cure for food allergies, sensitivities or intolerances. The only way to manage these conditions is strict avoidance of the offending food or food component.

It is not easy eliminating common foods from your daily diet, but eating a whole foods diet based on fresh (organic when possible) vegetables, fruits, nuts and seeds; wild fish, grass fed animal protein, and healthy fats (like those found in coconut oil) will reduce inflammatory reactions in most people. If you are experiencing any symptoms of food sensitivity or allergies, we recommend eliminating the common allergens from your diet that you suspect might be culprit for two months. Think carefully, do you get bloated or inflamed after eating pasta or a bagel? You may have gluten intolerance. Do you experience diarrhea after eating ice cream? You may be lactose intolerant. Keep a diary of what you eat and how you feel after each meal. After two months of eliminating a certain food, add the food back into your diet and note any physical and mental changes you experience. If you noticed a decrease in physical discomfort and inflammation, and feel in better health when you eliminated the food, you probably have sensitivity to that food. Nourish yourself and practice preventive medicine- don't eat food that makes you sick. After all, we are what we eat so FEED YOUR BODY ROYALLY!

Hail Merry's desserts and snacks are free of GMO's, peanuts, milk, eggs, soybean, fish, crustacea, and wheat. All the products are certified gluten-free at less than 5 ppm for gluten. Only the Chocolate Macaroons are free of tree nuts.

Vitamin D is a fat-soluble vitamin that is naturally present in very few foods but essential for optimum health.  Vitamin D deficiency has been linked to autoimmune diseases and some cancers. Do you suffer from muscle aches and weakness, bone pain or frequent bone fractures, low energy and chronic fatigue, depression or lack of sun exposure? You may need to eat more foods rich in Vitamin D and get out in the sun.

Last week we asked, “What can we eat to reduce autoimmune disease symptoms associated with chronic inflammation?” The answer: consume a diet rich in anti-inflammatory foods, omega 3 fatty acids, Vitamin D and probiotics. We offered recipes and ideas about eating anti-inflammatory foods, Red & Green Kale Spa Salad Recipe, and Arugula Salad with Pears and Seeds Recipe,

Today, we focus on Vitamin D. Vitamin D is a fat soluble steroid hormone that functions at the cell level to promote calcium absorption and bone health; protect against inflammation and cancer; support immune function; and when converted to calcitriol, Vitamin D repairs cell damage. Our body can synthesize Vitamin D (in the form of D3) when exposed to adequate amounts of sunshine. (Many vitamin supplements are D2, which are not as potent in raising and maintaining Vitamin D levels as D3.)

Vitamin D deficiencies has been associated with many health conditions and autoimmune diseases including: heart disease, diabetes, osteoporosis, muscle and nerve pain, muscle weakness, MS, rheumatoid arthritis and cancer of the breast, prostate, colon and pancreas. It appears that Vitamin D deficiency can be an environmental trigger for the development of many autoimmune diseases in genetically susceptible people, just as gluten is a trigger for people with celiac disease.

How much Vitamin D do you need for disease prevention? The current recommended daily allowance is 400-600 IU (international units) per day. Many experts believe 1000-2000 IU of the vitamin may be optimal for preventing disease. It is important to note that Vitamin D supplements have varying levels of efficacy. Therefore it is important to have Vitamin D levels checked yearly by a blood test to make sure any supplements you are taking are increasing the D level in your body. The research on Vitamin D is still inconclusive and new so do your research carefully from reputable Internet sources.

What are Sources of Vitamin D?

1. Sunshine is the best and most effective source of Vitamin D. Vitamin D3 is created through exposure of your skin to the sun, but due to most of us working indoors, recommendations to avoid the sun and use of sun block, over 75% of the US population have deficiencies. Through 15 to 20 minutes of summer sun exposure, the body creates 10,000 to 20,000 IUs of Vitamin D3- less in the winter.  For latitudes and vitamin D production in the skin see this map.

2. Fatty fish species, such as:

Catfish 85 g (3 oz)= 425 IU

Salmon 100 g (3.5 oz)= 360 IU

Mackerel 100 g (3.5 oz)= 345 IU

Sardines, canned in oil, drained, 50 g (1.75 oz)= 250 IU

Tuna 100 g (3.5 oz)= 235 IU (2.35 IU/g)

Eel, 100 g (3.5 oz)= 200 IU (2.00 IU/g)

3. Egg Yolk= 20-40 IU

4. Cod Liver Oil= 1360 IU per tablespoon

5. VEGAN Sources:

UV-irradiated portabella mushrooms, 100 g =130-1000 IU

Wild chanterelles & morels, 100 g=100-500 IU

6. Fortified Foods such as nutritional yeast and orange juice (variable)

The bottom line: if you are vegan get outside for 15-20 minutes per day and eat UV-irradiated or wild mushrooms and fortified foods.  If you are not vegan, get outside for 15-20 minutes per day and consume fatty fish and eggs several times per week. Plus have your Vitamin D levels checked yearly.

What can you eat to reduce autoimmune disease symptoms?

Women experience autoimmune diseases 3X the rate of men- some like lupus effect women 9X the rate. Autoimmune diseases are disorders in which the body’s tissues are attacked by its own immune system and they are on the rise affecting every system of the body. What is going on and what can we do to protect ourselves and reduce the symptoms of autoimmune diseases? Eating an anti-inflammatory gluten-free diet is key.

Celiac disease, a digestive autoimmune condition triggered by the consumption of gluten (the protein found in wheat, rye and barley) is 400% more prevalent today than 40 years ago. Rheumatoid arthritis, a chronic autoimmune disease that causes inflammation and deformity of joints, is on the rise among women after decades of decline. The list goes on: type-1 diabetes, lupus, Hashimoto’s thyroiditis and ulcerative colitis. A growing body of evidence suggests that virtually the same trio of factors underpins most, and perhaps all, autoimmune diseases: an environmental substance that is presented to the body (in the case of celiac disease the trigger is gluten), a genetically based tendency of the immune system to overreact to the substance, and an unusually permeable gut.  Celiac disease is the only autoimmune disease with a known trigger (gluten) and a known cure (a gluten-free diet).

What is a leaky gut?

When you ingest something your immune system does not like or perceives as undesirable, it attacks by means of inflammation. When inflammation occurs, chemicals from the body’s white blood cells are released into the blood or affected tissues in an attempt to rid the body of foreign substances. This release of toxic chemicals increases blood flow to the gut and may result in irritation, redness and swelling (think arthritis) of the epidermal cells of the intestinal wall. The common thread in all autoimmune conditions is an unusually permeable gut caused by chronic inflammation in the small intestine as a response to the food and drugs we consume- most of us eat a lot of wheat, sugar and acid forming foods like refined polyunsaturated oils and beef; and we pop a lot of over-the-counter drugs. With a leaky gut, undigested food proteins, bacteria, viruses, and yeast (Candida is a problem for many with Autism) can escape into our blood system thru the inflamed cell walls of the small intestine. The body recognizes these proteins as foreign invaders and our immune system attempts to fight them off causing more inflammation in various systems of the body which sets the stage for various chronic and autoimmune disorders including IBD, Crohn’s Disease, Rheumatoid Arthritis, allergies, migraines, and Hashimotos Disease.

Once diagnosed with an autoimmune disease, it is important to eat a gluten-free anti-inflammatory diet, so that your gut can heal. An anti-inflammatory diet is one based on whole fresh vegetables, fruits, nuts, seeds, healthy fats, wild sustainable fish and grass fed protein.

What Can You Eat to Reduce Autoimmune Disease Symptoms?

1. Anti-inflammatory Foods
2. Omega-3 Fatty Acids
3. Vitamin D
4. Probiotics

This week we will discuss how to incorporate all 4 of these foods and substances into your daily diet. We encourage your feedback and experiences in reducing your chronic inflammation and autoimmune disease symptoms.

For information on anti-inflammatory foods and recipes, check out the Hail Merry blog.

Gluten-free diets are “hot” but for those with celiac disease, gluten-free diets are a necessity that will not go away. What is celiac disease? Where can you go for more information? See below for the top 5 Celiac Research Centers.

Many of our favorite foods- a slice of pizza, a chocolate chip cookie, a flaky biscuit—were unknown to our ancestors. All of these comfort foods contain wheat, a grain not grown by man until "recently"—about 7000 years ago. Of course, you have to take into consideration that Homo Sapiens, our nearest ancestors, have been on the planet about 100,000 years, 90,000 of which they ate only what they could find. This is the equivalent of a 45 year old man making wheat a part of his diet for the first time at the age of 42.

Interestingly enough, today wheat has become part of a growing controversy about carbohydrates. Just how much bread, pasta, cake, and pizza can we eat without getting fat? Do these carbo-loaded foods make us sluggish? Are they good for our blood type? The questions are endless. Unfortunately, so are the answers. But one thing is for sure. Wheat can make many of us sick. For people with celiac disease, the concerns are far more serious than whether wheat will make them fat.

Celiac is a genetic intolerance to gluten, a protein found in wheat, rye, and barley. When people with celiac disease eat foods containing gluten, it triggers their immune system to attack the lining of their small intestine. This reaction causes inflammation and interferes with the digestion of vitamins, minerals and other vital nutrients. Currently, the only effective treatment for celiac disease is a lifelong gluten-free diet.

Celiac is thought to be the most common genetic disease in the United States and Europe. It has also been identified in people from South America, the Near East, India, Pakistan, Cuba and North Africa. Recent studies indicate that as many as 1 in 100 Americans of European descent may have the disease, although the actual diagnosis rate is 1 in 4000. It is estimated that there are two million people in the United States with undiagnosed celiac. Perhaps even more alarming, it is the most misdiagnosed disease in America. Symptoms can be severe, mild or non-existent; close to 25% of newly diagnosed cases exhibit no obvious symptoms. Those with symptoms are often told they have other intestinal, digestive, emotional, and dermatological problems (including Irritable Bowel Syndrome, Crohn's Disease, Diverticulitis, depression and arthritis). Many doctors not only fail to correctly screen for celiac, they fail to consider it in the first place. The average time for correct diagnosis in the United States is over six years!

Symptoms include: chronic diarrhea, constipation, bloating, stomach pain, severe gastroesophageal reflux, skin rash, tooth enamel discoloration, joint and muscle pain, diabetes, thyroid disease (and any other autoimmune syndrome of which there is an almost end-less number including rheumatoid arthritis, multiple sclerosis, lupus, dermatomyositis, psoriasis, alopecia areata, hepatitis, etc.), Hepatitis C, asthma, chronic liver disease, osteoporosis, iron deficiency anemia, chronic fatigue, short stature in children, female infertility, ADD, ADHD, and other learning problems, peripheral neuropathy, seizures, and other neurologic syndromes, depression and other psychiatric syndromes. In addition, Autism is emerging as a syndrome that may improve with a gluten-free diet.

Why are so many people sensitive to gluten?

Early man hunted for meat and fish and gathered fruits, seeds, herbs, tubers, and roots. As civilization progressed, plant crops of complex carbohydrates were cultivated for the purpose of stabilizing food supplies. Rice was the cultivated species in Asia, sorghum and millet in Africa, and in America, maize was the major crop. Wheat and barley containing very low gluten content were grown only in Southwest Asia. As time went on, farming of wheat and barley spread into Europe. But our ancestors never ate bread, as we know it today.

The industrial and agricultural revolution of the past 200 years has changed our diet faster than we can change genetically. Today our wheat crops have a high gluten content (50% higher in some cases) for the purpose of improved bread baking, and with it, we see a rise in the prevalence of gluten intolerance, 400% in the past 40 years. Just as humans are predisposed to store excess calories as fat, the same genetic makeup that tolerated wheat with low gluten levels, cannot "stomach" modern foods with high gluten levels.

Unfortunately, we Americans have come to rely on wheat to fill our bellies. Instead of dining on the fruits, vegetables, meats and fish eaten by our ancestors, today our diets are loaded with wheat (and gluten) based foods: breads, pastas, pizza, cookies, muffins and bagels. Gluten is also the second largest additive for all packaged foods (sugar is the largest).  The average American eats 800 calories of grains per day, mostly in the form of wheat.

What does this mean for me?

It means that if you or a family member has any of the symptoms listed above, you should insist on celiac testing. Be especially insistent if you experience non-typical symptoms such as ADD or ADHD, learning problems, depression, thyroid disease, seizures or infertility problems. But be aware, you may have to argue for testing even if you have more typical symptoms such as stomach pains or irritable bowel syndrome. Do not take "no" for an answer from your doctor. Remember, the current average time to get a correct diagnosis for celiac in the United States is more than five years. Doctors routinely refuse to consider the removal of gluten as the cure for many of their patient's ailments. It is easier for them to prescribe medicine. Don't let it happen to you. For more information about celiac disease go to:

http://www.celiacdisease.net/factsheets

http://www.mayoclinic.org/celiac-disease/

The above article was written by Annalise Roberts and Dr. Claudia Pillow:

The Gluten-Free Good Health Cookbook  http://www.foodphilosopher.com/

All of Hail Merry Snacks are Certified Gluten-Free

Celiac Disease Research Centers:

1. University of Maryland Centers for Celiac Research: http://celiaccenter.org/

Led by Dr. Alessio Fasano, the Center for Celiac Research includes a multidisciplinary team of gastroenterologists, pediatricians, dieticians and nurses who work together to develop individualized treatment plans for people with Celiac Disease. Celiac patients and their families also receive life-style counseling and dietary support to help them avoid foods containing gluten.

2. Columbia University Celiac Disease Center NYC: http://www.celiacdiseasecenter.columbia.edu

Under the guidance of Peter Green, M.D, a recognized expert on celiac disease in the country, the CDCC is one of the leading centers for celiac disease in the United States. Patient care is the main aim of the Center. Individualized patient care is managed by the Center and may include referrals to specialists in fields such as pediatric gastroenterology, hematology, dermatology, infertility, nutrition, metabolic bone disease, neurology, oncology and endocrinology.

3. University of Chicago Celiac Disease Center Research Program: http://www.celiacdisease.net/research-and-education

The University of Chicago Celiac Disease Center Research Program, led by Dr. Bana Jabri, is focused on making new discoveries in the pathogenesis of celiac disease that will impact on the treatment, follow-up and diagnosis of celiac disease. The University of Chicago Celiac Disease Center Research Team contributes to many multi-center studies and collaborates with some of the best research teams in the world.  It is the only center in the nation to offer in-depth training for doctors and other medical professionals regarding celiac disease.

4. WM Warren Medical Research Center for Celiac Disease University of California: http://celiaccenter.ucsd.edu/

Led by Dr. Martin Kagnoff, and a $2.5 million research grant from the Oklahoma-based William K. Warren Foundation, researchers at the University of California, San Diego (UCSD) School of Medicine have joined in the fight against Celiac Disease. The mission of the Center is to advance the knowledge of Celiac Disease pathogenesis and to develop novel diagnostic and therapeutic advances. Community activities include increasing the medical and local community's knowledge about Celiac Disease. The Center clinics at UCSD aim to provide state-of-the-art clinical care and education to adults and children with celiac disease.

5. Beth Israel Deaconess Medical Center Boston http://www.bidmc.org/celiaccenter

Led by Dr. Thomas Lamont, The BIDMC Celiac Center is the only multidisciplinary center in New England specializing in the care of patients with celiac disease and other gluten sensitive disorders. Internationally recognized experts —gastroenterologists, nutritionists and experts in allergy, bone health and endocrinology — have extensive experience in managing all aspects of celiac disease including treatment of refractory sprue.