Category Archives: gluten

Celiac Disease: protecting children from Celiac and Gluten Intolerance

What is Celiac Disease?

Celiac disease is a problem of auto-immunity and exposure to the plant protein gluten.  It can be a rough road, especially for children.  They can’t eat the same things other children eat.  Other kids and even adults may not understand that something that seems so normal to them, like a cupcake or sandwich, can cause serious pain and discomfort for a celiac child.

two children without celiac disease
Two children enjoy a Box lunch at CrossFit Seven in Fort Worth, TX.

Celiac disease is more common in people of European descent and probably has a strong genetic component.  However, there are other factors involved as well.  An individual may be predisposed to developing Celiac disease but not get it unless a combination of other factors line up as well.

Can Celiac Disease be Prevented?

One thing I had written about in an earlier post was the possibility that gut flora (microbial species and ratios of species) might influence the development of Celiac disease.  Intestinal flora in infants will be dependent on whether the infant was born by C-section and on whether he or she was breast fed or bottle fed.  The infant digestive system is not completely developed at birth.  It is suited for breast milk.  New research published this month (October 2012) supports a role for bacterial ecology in Celiac Disease.

Delaying introduction of wheat until the infant reaches 12 months of age appears to reduce risk that a genetically at-risk child will develop the disease.  Children with a genetic predisposition to Celiacs may take longer to develop an intestinal ecology favorable for wheat (and possibly other foods) than other children.  The study was a joint project of the University of Maryland School of Medicine and the Universita` Politecnica delle Marche, in Ancona, Italy.

Should I let my children eat gluten?

The answer to that seems to be yes.  Not exposing your children to gluten may make them more likely to develop celiac disease.A Systematic Review of infant feeding practices and incidence of Celiac (Coelicac) disease has also been published very recently (Szajewska et al. 2012).  The authors suggest that the best time to introduce wheat into an infant’s diet is between 4 and 7 months, and that it should be done while the child is still breastfeeding.   Introducing wheat before a child is under 4 months increases the likelihood that he or she will develop Celiac Disease.  Likewise, delaying introduction until a child is older than seven months may also increase risk of Celiac’s.

Gluten-free diets, such as the Paleo Diet, are very popular right now, especially within the CrossFit community.  If you are wondering “what is CrossFit?” here is a link.  If you are wondering “what is the paleo diet?” try this link.  Do parents who raise their non-celiac children on gluten free diets put them at risk of developing celiac disease? That could be the case.  This website, “Growing Up Gluten Free” is written and maintained by a child with celiac disease.  It helped me understand what life is like for kids like her.

There are lots of unknowns still.  The Szajewska paper does a great job of defining what they are.  

Sellitto M, Bai G, Serena G, Fricke WF, Sturgeon C, Gajer P, White JR, Koenig SS, Sakamoto J, Boothe D, Gicquelais R, Kryszak D, Puppa E, Catassi C, Ravel J, & Fasano A (2012). Proof of concept of microbiome-metabolome analysis and delayed gluten exposure on celiac disease autoimmunity in genetically at-risk infants. PloS one, 7 (3) PMID: 22432018

Szajewska H, Chmielewska A, Pieścik-Lech M, Ivarsson A, Kolacek S, Koletzko S, Mearin ML, Shamir R, Auricchio R, Troncone R, & PREVENTCD Study Group (2012). Systematic review: early infant feeding and the prevention of coeliac disease. Alimentary pharmacology & therapeutics, 36 (7), 607-18 PMID: 22905651

Protecting Children from Celiac Disease and a Child's View the problem.

Protecting children from Celiac Disease:

I’ve written several articles about gluten, microbes and auto-immunity.   All those interactions are interesting to think about.  To me this has been like tinkering with puzzles.  Celiac disease is a problem of auto-immunity and exposure to the plant protein gluten.  It can be a rough road to follow, especially for children.  They can’t eat the same things other kids eat, and other kids and even adults may not understand that something that seems so normal to them, like a cupcake or sandwich, can cause serious pain and discomfort for a celiac child.  This website, “Growing Up Gluten Free” is written and maintained by a child with celiac disease.  It helped me understand what life is like for kids like her. 

Two children enjoy a Box lunch at CrossFit Seven in Fort Worth, TX.

Celiac disease is more common in people of European descent and probably has a strong genetic component.  However, there are other factors involved as well.  An individual may be predisposed to developing Celiac disease but not get it unless a combination of other factors line up as well.  One thing I had written about in an earlier post was the possibility that gut flora (microbial species and ratios of species) might influence the development of Celiac disease.  Intestinal flora in infants will be dependent on whether the infant was born by C-section and on whether he or she was breast fed or bottle fed.  The infant digestive system is not completely developed at birth.  It is suited for breast milk.  New research published this month (October 2012) supports a role for bacterial ecology in Celiac Disease.  Delaying introduction of wheat until the infant reaches 12 months of age appears to reduce risk that a genetically at-risk child will develop the disease.  Children with a genetic predisposition to Celiacs may take longer to develop an intestinal ecology favorable for wheat (and possibly other foods) than other children.  The study was a joint project of the University of Maryland School of Medicine and the Universita` Politecnica delle Marche, in Ancona, Italy.

A Systematic Review of infant feeding practices and incidence of Celiac (Coelicac) disease has also been published very recently (Szajewska et al. 2012).  The authors suggest that the best time to introduce wheat into an infant’s diet is between 4 and 7 months, and that it should be done while the child is still breastfeeding.   Introducing wheat before a child is under 4 months increases the likelihood that he or she will develop Celiac Disease.  Likewise, delaying introduction until a child is older than seven months may also increase risk of Celiac’s.

There are lots of unknowns still.  The Szajewska paper does a great job of defining what they are.  

Sellitto M, Bai G, Serena G, Fricke WF, Sturgeon C, Gajer P, White JR, Koenig SS, Sakamoto J, Boothe D, Gicquelais R, Kryszak D, Puppa E, Catassi C, Ravel J, & Fasano A (2012). Proof of concept of microbiome-metabolome analysis and delayed gluten exposure on celiac disease autoimmunity in genetically at-risk infants. PloS one, 7 (3) PMID: 22432018  

Szajewska H, Chmielewska A, Pieścik-Lech M, Ivarsson A, Kolacek S, Koletzko S, Mearin ML, Shamir R, Auricchio R, Troncone R, & PREVENTCD Study Group (2012). Systematic review: early infant feeding and the prevention of coeliac disease. Alimentary pharmacology & therapeutics, 36 (7), 607-18 PMID: 22905651

CrossFit and Paleo: Why cutting gluten out of your diet may set you up for trouble later: the microbial explaination

CrossFit, Paleo and Gluten

Many CrossFit enthusiasts follow the “paleo diet”.  This diet claims, among other things, that gluten is bad for you.  Is gluten “bad” or are some people not able to tolerate it?  Is toleration genetic or aquired?  So far it looks like exposure to gluten during infancy plays a key role in determining whether or not someone will become gluten intolerant.

The human gut maintains large bacterial populations. In fact they outnumber you by about 10 to 1 on a cell to cell level (as in for each of your cells, there are ten bacteria). Each of us is a walking bus. We are designed to be this way. Our bacterial passengers have always been here. Our good health requires passengers who are not hijakers, jerks or even dead weight. The good ones help us digest food, keep us from getting horrible gas and other forms of intestinal distress, may protect us from obesity, defend against pathogens and degrade harmful substances.

Gut Bacteria and health

The dominant bacterial family present in infants, if they are breast fed, are Bifidobacteriaceae. Bottlefed infants also harbor Bifida sp., but not as much. If a breastfed infant is supplemented with formula he or she will experience a rapid loss of bifida sp. Bifida sp. provide many benefits to their human hosts including protection against pathogens, prevention of diarrhea, maturation of the immune system and reduced risk of developing allergies. Breastfed infants may be better able to handle exposures to environmental chemicals too (Shellor et al. 2012).

The bacteria in your gut will also be dependent on what you eat. A change in diet, for example elimination of gluten by a person who does not have celiac disease, may cause a decline in bacterial populations that help digest gluten (Nistal et al. 2012).

A person eating gluten after a period of abstinence may not be able to digest gluten as well if they eat it again, at least not until bacterial populations re-balance. This may lead some people to get gas, cramps etc. and conclude that they have celiac disease, or that gluten is harmful in itself. It has been brought up by some that the intestinal distress suffered by people following a Paleo-type diet who start eating wheat again is all in their heads (some chat board or other). It probably isn’t. But it’s probably not because gluten is inherently bad either.

Shelor, C., Kirk, A., Dasgupta, P., Kroll, M., Campbell, C., & Choudhary, P. (2012). Breastfed Infants Metabolize Perchlorate Environmental Science & Technology, 46 (9), 5151-5159 DOI: 10.1021/es2042806

Nistal, E., Caminero, A., Herrán, A., Arias, L., Vivas, S., de Morales, J., Calleja, S., de Miera, L., Arroyo, P., & Casqueiro, J. (2012). Differences of small intestinal bacteria populations in adults and children with/without celiac disease: Effect of age, gluten diet, and disease Inflammatory Bowel Diseases, 18 (4), 649-656 DOI: 10.1002/ibd.21830