Celiac Disease or Gluten Intolerance?

When people are experiencing nutritional deficiencies, anemia, weight changes, and/or other symptoms that seem to be of an unknown origin, it’s fairly common practice for doctors to rule out the presence of celiac disease with a small intestinal biopsy. While this is certainly considered the “gold standard” for identifying the pathological changes associated with celiac disease, many experienced physicians are finding that patients can still have a sensitivity to gluten containing grains, making celiac disease and gluten intolerance separate entities altogether.  This led experts at the recent International Celiac Disease Symposium to define the term gluten insensitivity for patients who don’t meet the criteria for celiac disease or wheat allergy, yet improve dramatically when following a gluten-free diet.

The incidence of Celiac disease has doubled since 1974, and gluten sensitivity alone is estimated to be 6 times the prevalence of celiac disease. Fortunately, for patients and doctors who have recognized this phenomenon for quite some time, there is finally a more established definition of gluten sensitivity. Some of the criteria being used to separate gluten sensitivity from wheat allergy and celiac disease include: Negative testing for the presence of IgE antibodies to wheat; Negative endomysial and ttg antibodies (typically present with celiac disease); Negative small intestinal biopsy; Resolution of symptoms following as gluten-free diet. Researchers have concluded that the genetic makeup and immune response of gluten sensitivity patients is unique, and may be more enzyme mediated (like lactose intolerance), rather than immune based.

Since objective testing is still lacking, people who are symptomatic should consider implementing a gluten-free diet. Some of the most common symptoms associated with gluten sensitivity include abdominal pain, rashes, headaches, “brain fog”, fatigue, depression, anemia, and joint pain. If your doctor tells you that celiac testing is negative, don’t give up hope!

 

Eczema and Kids

The discovery that DHA (docosahexaenoic acid) from breast milk promotes healthy brain, eye, and nervous system development was an important step towards understanding why breast milk is a perfect first food for babies. DHA is now commonly added to infant formulas, but it’s not the only fatty acid that is important for developing babies. A new study shows that other fatty acids in breast milk may protect them from allergies.

The sharp rise in allergic diseases like asthma, eczema, food allergies, and hay fever might be explained in part by a shift in the fatty acid balance in our diets. The widespread use of vegetable oils and the comparatively low intake of omega-3 fatty acids (mostly from fish) have tipped the scales in favor of omega-6 fatty acids, which contribute to inflammation in the body.

Does breast milk affect eczema?

As part of the KOALA Birth Cohort Study, scientists investigated the composition of breast milk and its relationship to eczema and allergy development in 310 infant-mother pairs. Based on earlier findings that organic dairy seems to protect against eczema during the first two years, some of the women included led “alternative lifestyles,” meaning that they ate organic foods and breast-fed for an extended period. Researchers were interested to see how the fatty acid composition of their breast milk compared with that of moms who ate a more conventional diet.

Information related to breast-feeding, eczema, and other allergic diseases was gathered from the women while they were pregnant and during the first two years after birth. Blood samples were taken from the babies at one and two years to determine the presence of allergies to things like hen’s eggs, cow’s milk, peanut, tree and grass pollen, dust mites, and cats and dogs.

Babies benefit from fatty acid combo

Compared with the conventional diet group, the breast milk of moms with alternative lifestyles had somewhat higher concentrations of the omega-3 fatty acids EPA (eicosapentaenoic acid), DPA (docosapentaenoic acid), and DHA. The breast milk from this group was also higher in ruminant fatty acids (those derived primarily from dairy fat), including the immune-enhancing fatty acid, CLA (conjugated linoleic acid).

“Differences in fatty acid status between mothers may modify the protective effect of breastfeeding,” said Dr. Carel Thijs, lead author of the study from the Department of Epidemiology at Maastricht University in the Netherlands. “This may explain inconsistencies between studies in different populations with different intakes of fish, ruminant fats, and trans fatty acids from other sources.”

More interesting results:

By age two, 31% of the babies had parent-reported eczema, and 42% of the children with eczema also had allergies as determined by blood tests.

The risk of eczema and allergies at one year was lowest among babies whose mothers’ milk was highest in omega-3 fatty acids.

The risk of eczema and allergies also decreased with increasing concentrations of ruminant fatty acids, independent of the effect of the omega-3 fatty acids.

“Ruminant fatty acids deserve further investigations for their role in early immune development and are potential candidates to explain the protective effects of dairy fat as well as organic dairy and possibly unpasteurized farm milk on the development of atopic (allergic) conditions in early life,” the researchers concluded.

How to protect your baby from eczema

Breast-feed, if you can. For some women breast-feeding isn’t feasible, but it’s worth it for your baby’s health if you’re able to.

Eat more fatty fish. This is important during pregnancy and while breastfeeding. Avoid high-mercury fish including swordfish, shark, albacore tuna, king mackerel, tile fish, grouper, marlin, and orange roughy.

Make it creamy. The latest study adds to a growing body of evidence of the inflammation-fighting potential of full-fat dairy products.

(The study comes from Allergy 2011;66:58-67)