In his opening talk at the 2017 International Celiac Disease Symposium, celiac expert Dr. Abul Abbas of UC San Francisco said, “We are drowning in data, but thirsting for information.” Though there is still much debate around celiac disease and non-celiac gluten sensitivity (even among global experts), the featured ICDS speakers sifted through the numbers to help practitioners interpret what the latest studies can tell us about the negative effects of gluten and how celiac disease presents in populations all over the world.
Today the globetrotting Gluten Free RN is coming to us from Thailand, after attending the International Celiac Disease Symposium in New Delhi, India. Armed with the latest information from the ICDS clinical forum, Nadine covers talks given by Dr. Abbas on gluten and the immunological system, and Dr. Alessio Fasano on the spectrum of gluten-related disorders. She relays information regarding the barriers researchers face in studying autoimmune disease as well as gluten’s negative impact on body tissue, including that of our brain.
Nadine also shares the most up-to-date statistics around the big business that is celiac disease and the increasing prevalence of gluten intolerance in the US and Asia. She discusses the importance of celiac testing in patients with other autoimmune and neurological disorders and the need for a global education campaign. Listen as Nadine educates you about what gluten is, where it hides, what you can do to avoid it, and how to undo the damage and get healthy again!
What’s Discussed:
The challenge of eating gluten-free in India
- Conference food wasn’t entirely gluten-free
- Nima sensor helped identify unsafe meals
- Travel with stash of safe food
- Carry Gluten Free Passport Allergy Cards to communicate dietary needs
The highlights of Dr. Abul Abbas’ talk on the immunological system
- Celiac disease as autoimmune issue
- ‘Drowning in data, but thirsting for info’
The importance of the thymus gland
- T cells manufactured there
Why the ‘mouse model’ doesn’t work well in the study of celiac disease
The impossibility of in vivo experiments for celiac research
The significance of epithelial barriers in a functioning immune system
- First line of defense against microorganisms
- Produce local antibodies
The difficulty of studying the dendritic cells
- Inside tissues
How the immune system recognizes double-stranded RNA (viruses)
- Can’t escape autoimmune response
- Should not recognize own single-stranded as ‘invader’
Dr. Terry Wahls’ work around the mitochondria
- Cured MS with Paleo diet
Dr. Alessio Fasano’s presentation
- ‘Spectrum of Gluten-Related Disorders’
- Controversy re: who should go gluten-free
- Gluten affects every tissue in body (even brain)
- Celiac cases double every 15 years in US
- 1:2 in US will try gluten-free diet this year
The big business of celiac disease
- $17.6B industry at end of 2017
- Largest untapped market in world
Who is affected by the gluten protein
- Gluten can’t be digested by human body (long chain amino acid)
- Triggers autoimmune response, especially in HLA-DQ2/HLA-DQ8 gene carriers
- Patients without genetic predisposition can present with villous atrophy
- In absence of celiac diagnosis, may still have non-celiac gluten sensitivity
- AGA-positive patients at risk for developing neurological issues
How infants exposed to gluten are at an increased risk for developing celiac disease
- Includes exposure in utero, breast milk
- No downside to eliminating gluten from baby’s diet
The value of avoiding gluten exposure for infants
- Emotionally stable
- Grow, develop appropriately
The latest statistics regarding the prevalence of celiac disease
- Increased to 3% in US (not 1% consistently reported)
- 30-50% of world population has genetic predisposition
- Global prevalence of 1.37%
Celiac disease in the Asian population
- Used to say could not develop celiac disease
- At increased risk of developing neurological disorders
- 6-8M people in east, south Asia
- 50 countries make up 60% of world population
- 35B people in China have celiac disease
- 22B people in India have celiac disease
- 19% of Chinese 16-25 tested positive for celiac disease in study
How the Chinese diet has evolved over time
- Older Chinese ate much less wheat
- Fast food has become common in recent years
- Despite rice-based diet, many products contain wheat (soy sauce, cashews)
Other disorders that may indicate undiagnosed celiac disease
- Anemia
- Osteoporosis
- Elevated liver enzymes
- Eating disorders
- Type 1 diabetes
- Autoimmune thyroiditis
Why patients should be tested for celiac disease annually
- Can seroconvert at anytime
- Develops at any age with any/no symptoms
The new information about a potential connection between Wilson’s and celiac disease
- 3% of Wilson’s patients tested positive
What celiac experts agreed on at ICDS 2017
- Poor support, understanding of celiac disease
- Need to increase knowledge base (general practitioners, food manufacturers, public)
- Important to find where gluten hides
- Must take education campaign to non-traditional settings
Resources:
Gluten Free RN Travel Podcast EP036
Gluten Free Passport Allergy Cards
Connect with Nadine:
‘Your Skin on Gluten’ on YouTube
Books by Nadine:
Dough Nation: A Nurse’s Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism
