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Gluten measurement and its relationship to food toxicity for celiac disease patients
Diane R Lester
Plant Methods , 2008, DOI: 10.1186/1746-4811-4-26
Abstract: Celiac disease (CD) is chronic gastrointestinal inflammation caused by an aberrant immune response to dietary gluten [1]. It is treated by life-long adherence to a gluten-free (GF) diet.Speciality GF foods cater for CD patients. ELISA assays have long been used to monitor these foods, but the methods have had limitations which, until recently, have prevented them gaining acceptance as the basis for official GF standards [2,3]. The analysis of gluten is challenging because gluten is a mixture of water-insoluble proteins, derived from wheat, barley or rye grain, which in commercial foods, is within a range of matrices and is modified variously by heat and processing [4].Commercial methods of gluten analysis are based on the ELISA, employing an initial extraction step to solubilise gluten from food samples. The limitations and efficiencies of these methods for the testing of GF foods were reviewed previously [4].New improved gluten ELISAs have since appeared on the market [5,6] and others are in development [7,8]. The commercial R-ELISA [5] has been deemed sufficiently reliable and sensitive to support standards for GF foods based on final gluten content [9]. If the method is to be widely employed, its limitations should be recognised so the method is used correctly.Herein, I critically examine the basis of the R5-ELISA and other recent ELISA methods of gluten analysis.Gluten is a scientifically imprecise term and its definition varies, even when GF foods are concerned. Herein, the current Codex definition of gluten is employed, which is 'a protein fraction from wheat, rye, barley, oats or their crossbred varieties and derivatives thereof, to which some people are intolerant and that is insoluble in water and 0.5 M NaCl' [9]. This definition is similar to that recently proposed by the FDA, 'the proteins that naturally occur in a prohibited grain and that may cause adverse health effects in persons in celiac disease' [10].Alternatively, gluten is sometimes defined by it
Systematic Approach for the Management and Control of Food Safety for the Street/Informal Food Sector in Ghana
Food and Public Health , 2013, DOI: 10.5923/j.fph.20130301.07
Abstract: The street food vending can be considered as one of the fastest growing informal business sectors in Ghana. However, there have been concerns with the safety of the foods sold on our street. In response to this, there have been various project studies and activities, over the last fifteen years all geared towards addressing the issues of safety of these street vended foods. One of such studies was a series of projects involving scientists, development partners, regulators and street-food vendors association from 1999 to 2005, funded by the Department for International Development of the UK government through its crop-post-harvest program. One of the main outputs of these projects was the development of nine modules for the systematic management and control of food safety for the street-food vending sector in Ghana. The nine modules developed by the project were on partnership, training of street food vendors and regulators, improving consumer awareness, improving street food vendor livelihoods, infrastructure requirements, food safety, food inspection, legal requirements and the supply chain management for the street vending sector. Microbiological survey (45 samples) showed that some street foods are intrinsically safer than others. Kenkey and waakye are safe products while most fufu were contaminated. This paper highlights the objectives of each module, the key issues to be considered and the priority actions for implementing the modules. It also considers critical factors that can lead to success as well as critical factors that might lead to failure.
2013 Update on Celiac Disease and Eosinophilic Esophagitis  [PDF]
Rinaldo Pellicano,Claudio De Angelis,Davide Giuseppe Ribaldone,Sharmila Fagoonee,Marco Astegiano
Nutrients , 2013, DOI: 10.3390/nu5093329
Abstract: Celiac disease is a chronic, immune-mediated disorder, characterized by small intestinal inflammation and villous atrophy after the ingestion of gluten by genetically susceptible individuals. Several extraintestinal manifestations have been associated to celiac disease. Eosinophilic esophagitis is a primary disorder of the esophagus characterized by upper gastrointestinal symptoms, absence of gastroesophageal reflux disease and more than 15 eosinophils per high-power field in biopsy specimens. Both celiac disease and eosinophilic esophagitis are caused by aberrant, but distinct, immune responses to ingested antigens and can be responsive to restricted food intake. The aim of this review is to assess whether there is an association between these two pathologies. In the majority of the studies examined, including the studies in pediatric population, the prevalence of eosinophilic esophagitis in subjects with celiac disease was about 10-times that of the general population. We suggest searching for eosinophilic esophagitis in all children undergoing endoscopy for suspicious celiac disease.
Celiac Disease  [PDF]
Nikolaos Fotos,Hero Brokalaki
To Vima tou Asklipiou , 2008,
Abstract: Celiac disease is a small intestine disease caused by the immunological response to gluten, a component of wheat, rye and barley. The worldwide prevalence of celiac disease ranges between 0.2% and 2.2 %. The clinical features of celiac disease includes diarrhea, steatorrhea, flatulence, abdominal pain and weight loss. The asymptomatic type of celiac disease is characterized by soft or normally shaped stool, weakness, lassitude and moderate weight loss. In children, celiac disease usually arises between the first and the third year of age, with diarrhea, flatulence and low weight. The malabsorption in small intestine causes many extaintestinal manifestations, such us anemia, bone abnormalities, hemorrhage and neuropathy. Celiac disease is diagnosed by histological examination of tissue samples taken by duodenum due gastroscopy and by the detection of certain antibodies in blood (anti-GL-IgG, anti-GL-IgA, ΕΜΑ-IgA και anti-tTg-IgA). The only therapeutic approach to celiac disease is a gluten-free diet and, if it is necessary, the administration of iron, folic acid, calcium and vitamins (K, B12). The prognosis of celiac disease is excellent, if there is an early diagnosis and the patient keeps for life a gluten free diet.
Neurological Manifestations of Celiac Disease  [cached]
Ehsan Pishva,Afshin Borhani Haghighi,Soheil Ashkani-Esfahani,Fereshte Bagheri
Galen Medical Journal , 2013,
Abstract: Celiac disease (CD) is a rare malabsorption syndrome mainly occurring in childhood which is now recognized as the most common food intolerance disease in the world. CD is associated with a wide spectrum of extra intestinal manifestations. Neurological involvements of CD were first attributed to malabsorption due to changes in the mucosal architecture of the small intestine. Neurological manifestations were more frequent in middle-aged adults, but were rare in children. The most common central nervous system manifestations include cerebellar malfunctions, seizures, dementia, multiple sclerosis like presentations, motor neuron diseases, headaches, movement disorders, and neuro-psychiatric presentations. On the other hand, the peripheral nervous system involvement includes different types of peripheral neuropathies and muscular involvements. In this study, we embarked on a short review to go through the neurological presentations and problems of CD.
Celiac disease
Wolfgang Holtmeier, Wolfgang F Caspary
Orphanet Journal of Rare Diseases , 2006, DOI: 10.1186/1750-1172-1-3
Abstract: Celiac disease (CD) in children and celiac sprue in adults are probably the same disorder with the same pathogenesis. The synonyms are: Coeliac disease (British spelling) – Celiac sprue – Nontropical sprue-Gluten-sensitive enteropathy – Idiopathic steatorrheaCeliac disease is a chronic intestinal disease mostly associated with malabsorption caused by intolerance to gluten. It is characterized by immune-mediated enteropathy (villous flattening), resulting in maldigestion and malabsorption. Clinical and histological improvement can be obtained after withdrawal of dietary gluten.Celiac disease is characterized by malabsorption and villous atrophy. However, diseases other than CD can cause marked villous flattening and increased intraepithelial lymphocytes (IEL) [1]. Differential diagnosis is of special importance for subjects in whom CD is suspected and who have negative serology. The following diseases, which can have similar features, must be ruled out [1-4]:? Tropical sprue? Collagenous colitis? Whipple's disease? Giardiasis? Viral enteritis? AIDS? Crohn's disease of the small intestine? Small intestinal lymphoma? Carbohydrate intolerance, cow's milk intolerance? Autoimmune enteropathy? Graft-vs-host disease? Radiation damagePrevalence of clinically overt celiac disease varies from 1/270 in Finland to 1/5,000 in North America. However, since celiac disease can be asymptomatic, most subjects are not diagnosed or they can present with atypical symptoms. In epidemiological studies aimed to assess CD prevalence, large cohorts in North America and Europe were screened for highly-sensitive endomysium or tissue transglutaminase antibodies. Besides, they underwent subsequent small intestinal biopsies when antibody testing was positive. The CD prevalence was found to be much higher than expected. Approximately 1/100 to 1/500 were found positive for antibodies and had villous atrophy of the small intestine [5-10]. Thus, up to 1% of a western population tests positive for celi
Celiac disease  [PDF]
Radlovi? Nedeljko
Srpski Arhiv za Celokupno Lekarstvo , 2013, DOI: 10.2298/sarh1302122r
Abstract: Celiac disease is a multysystemic autoimmune disease induced by gluten in wheat, barley and rye. It is characterized by polygenic predisposition, high prevalence (1%), widely heterogeneous expression and frequent association with other autoimmune diseases, selective deficit of IgA and Down, Turner and Williams syndrome. The basis of the disease and the key finding in its diagnostics is symptomatic or asymptomatic inflammation of the small intestinal mucosa which resolves by gluten-free diet. Therefore, the basis of the treatment involves elimination diet, so that the disorder, if timely recognized and adequately treated, also characterizes excellent prognosis.
Food Pricing Strategies, Population Diets, and Non-Communicable Disease: A Systematic Review of Simulation Studies  [PDF]
Helen Eyles ,Cliona Ni Mhurchu,Nhung Nghiem,Tony Blakely
PLOS Medicine , 2012, DOI: 10.1371/journal.pmed.1001353
Abstract: Background Food pricing strategies have been proposed to encourage healthy eating habits, which may in turn help stem global increases in non-communicable diseases. This systematic review of simulation studies investigates the estimated association between food pricing strategies and changes in food purchases or intakes (consumption) (objective 1); Health and disease outcomes (objective 2), and whether there are any differences in these outcomes by socio-economic group (objective 3). Methods and Findings Electronic databases, Internet search engines, and bibliographies of included studies were searched for articles published in English between 1 January 1990 and 24 October 2011 for countries in the Organisation for Economic Co-operation and Development. Where ≥3 studies examined the same pricing strategy and consumption (purchases or intake) or health outcome, results were pooled, and a mean own-price elasticity (own-PE) estimated (the own-PE represents the change in demand with a 1% change in price of that good). Objective 1: pooled estimates were possible for the following: (1) taxes on carbonated soft drinks: own-PE (n = 4 studies), ?0.93 (range, ?0.06, ?2.43), and a modelled ?0.02% (?0.01%, ?0.04%) reduction in energy (calorie) intake for each 1% price increase (n = 3 studies); (2) taxes on saturated fat: ?0.02% (?0.01%, ?0.04%) reduction in energy intake from saturated fat per 1% price increase (n = 5 studies); and (3) subsidies on fruits and vegetables: own-PE (n = 3 studies), ?0.35 (?0.21, ?0.77). Objectives 2 and 3: variability of food pricing strategies and outcomes prevented pooled analyses, although higher quality studies suggested unintended compensatory purchasing that could result in overall effects being counter to health. Eleven of 14 studies evaluating lower socio-economic groups estimated that food pricing strategies would be associated with pro-health outcomes. Food pricing strategies also have the potential to reduce disparities. Conclusions Based on modelling studies, taxes on carbonated drinks and saturated fat and subsidies on fruits and vegetables would be associated with beneficial dietary change, with the potential for improved health. Additional research into possible compensatory purchasing and population health outcomes is needed. Please see later in the article for the Editors' Summary
Recent advances in celiac disease  [cached]
Hugh James Freeman,Angeli Chopra,Michael Tom Clandinin,Alan BR Thomson
World Journal of Gastroenterology , 2011, DOI: 10.3748/wjg.v17.i18.2259
Abstract: Celiac disease now affects about one person in a hundred in Europe and North America. In this review, we consider a number of important and exciting recent developments, such as clinical associations, HLA-DQ2 and HLA-DQ8 predispositions, the concept of potential celiac disease, the use of new imaging/endoscopy techniques, and the development of refractory disease. This review will be of use to all internists, pediatricians and gastroenterologists.
Celiac disease in Iran
Malekzadeh R,Shakeri R
Tehran University Medical Journal , 2007,
Abstract: Background: Until a few decades ago, celiac disease was considered to be essentially a disease of European people and to be very rare in Middle Eastern countries. During the last two decades, having met the criteria for the WHO general screening, the advent and application of novel serological assays used to screen for celiac disease and the use of endoscopic small bowel biopsy have led to increasing numbers of diagnoses of celiac disease in western countries. With this new data, our knowledge on both the clinical pattern and epidemiology of celiac disease has increased, and is now known to be a relatively common autoimmune disorder. Studies performed in different parts of the developing world have shown that the prevalence of celiac disease in this area is similar to or even higher than that in western countries. In fact, celiac disease is known to be the most common form of chronic diarrhea in Iran. However, contrary to common belief, celiac disease is more than a pure digestive alteration. It is a protean systemic disease, and, with a 95 percent genetic predisposition, has a myriad of symptoms including gastrointestinal, dermatological, dental, neurological and behavioral that can occur at a variety of ages. Monosymptomatic, oligosymptomatic, atypical (without gastrointestinal symptoms), silent and latent forms of celiac disease have been identified. In this study we review the epidemiology of celiac disease based on the studies performed in Iran and discuss its pathogenesis, the role of antibodies in the diagnosis of celiac disease and the importance of its diagnosis and treatment in Iran.
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