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!

 

Dairy Officially Deemed Unhealthy

The Harvard School of Public Health sent a strong message to the United States Department of Agriculture (USDA) and nutrition experts everywhere with the recent release of its “Healthy Eating Plate” food guide.  The university was responding to the USDA’s new MyPlate guide for healthy eating, which replaced the outdated and misguided food pyramid.

Harvard’s nutrition experts did not pull punches, declaring that the university’s food guide was based on sound nutrition research. The greatest evidence of its research focus is the absence of dairy products from the “Healthy Eating Plate” based on Harvard’s assessment that “…high intake can increase the risk of prostate cancer and possibly ovarian cancer.”  The Harvard experts also referred to the high levels of saturated fat in most dairy products and suggested that collards, bok choy, fortified soy milk, and baked beans are safer choices than dairy for obtaining calcium, as are high quality supplements.

In my practice, I try to emphasize to people how “duped” we’ve been by the dairy industry, and that dairy products aren’t indeed the most nutritious source of calcium, as we’ve been brainwashed to believe in our society. Of course, this report doesn’t mean that you should avoid dairy entirely, especially when you can acquire local or non-commercial organic sources. Mainly, the take-away message here is that both past and present food recommendations from the government have emphasized dairy as a requirement, and this is clearly not the case!

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)

Food Allergies-More Common Than You Think!

A study published in the October issue of the Journal of Allergy and Clinical Immunology estimated that nearly 2.5 percent of Americans have at least one food allergy. The study, which is believed to be the largest food allergy study to date, showed that the allergies were more common in children 5 years old or younger. 


“This study is comprehensive in its scope and is the first to use specific blood serum levels and look at food allergies across the whole life spectrum,” says study senior investigator Darryl Zeldin, M.D., acting clinical director at the National Institute of Environmental Health Sciences (NIEHS). 

In the study, children under the age of 5 were more than twice as likely as those older than 20 to have a food allergy and black people were three times as likely as white people to have one, while men were nearly 1.9 times more likely than women to be affected. Black boys were more than four times as likely as white women over 20 to have a food allergy. 

The findings also show that food allergies were more common in those with asthma. While the researchers did not study cause and effect between food allergies and asthma, having a food allergy appeared to compound the risk for asthma and vice versa. 

Those with asthma had nearly four times the risk of having a food allergy than those without it. Overall, people with food allergies were nearly seven times more likely than those without them to have required ER treatment for their asthma in the 12 months leading up to the study. 

“Our findings confirm a long-suspected interplay between food allergies and asthma, and that people with one of the conditions are at higher risk for the other,” says investigator Robert Wood, M.D., director of Allergy and Immunology at Hopkins Children’s. 

Wood notes that many children experience an “allergic march,” developing a food allergy first and getting asthma and hay fever later. 

While people with food allergies were somewhat more likely to be diagnosed with hay fever, the link between the two was not particularly strong, and they did not appear to have higher risk for eczema, the investigators found. 


If you or your child are suffering from asthma or other allergy-related conditions, you should definitely consider pursuing food allergy testing from a licensed naturopathic physician.

Gluten and the Nervous System

This is something my colleagues and I have been familiar with for quite some time, but a new report published in the Lancet Neurology demonstrates further proof that an intolerance to gluten containing foods can cause much more than just digestive symptoms.

Sensitivities beyond celiac

“Celiac disease is only one
aspect of a range of possible manifestations of gluten sensitivity. In
some individuals, gluten sensitivity is shown to manifest solely with
neurological dysfunction,” the authors of the new report explain.

Neurological
disorders that might be tied to a gluten sensitivity include a lack of
muscle coordination leading to instability (ataxia), tingling and
numbness (neuropathies), and migraine-like headaches (encephalopathy).
The authors go on to say that the tests that help to establish a
diagnosis of celiac disease may not reliably show if a person has a
gluten sensitivity that affects only their nervous system. For this
reason, they suggest other tests that may help uncover a hidden gluten
sensitivity in people suffering from certain neurological disorders.

The
report’s authors recommend, “To improve diagnosis rates, the perception
of physicians that gluten sensitivity is solely a disease of the gut
must be changed.”

If you think you have a gluten sensitivity


Get medical support. Identifying and treating a gluten
sensitivity can help you avoid serious complications.

Be
proactive
. Ask your naturopathic doctor if he or she is familiar with the tests
that are useful for identifying different types of gluten sensitivities,
or if he or she can refer you to someone who is.

Pay
attention
. If you think your symptoms might be related to gluten,
consider a six-week gluten-free diet trial. If you’re going in for lab
work, though, eat your normal diet so your test will gauge your regular
reactions.

Living with a gluten sensitivity

Gluten
sensitivity is in the spotlight, so there’s never been an easier time to
go gluten-free. New food packaging requirements mandate that
gluten-free foods be accurately labeled, and gluten-free cookbooks
abound on bookstore shelves. Ask your grocer whether they can recommend
books, recipes, and other resources to help.

(Lancet Neurol
2010;9:318-30)