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Celiac disease numbers keep going up — yet due to lack of funding, researchers still aren’t sure why

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2 years ago

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A few decades ago, the initialism “GF” on a menu could have easily been mistaken for “good food.” Nowadays, it is common knowledge that it stands for “gluten-free” — and now, the shorthand adorns restaurant menu items nationwide. This shift in understanding is partly due to the rise in celiac disease, an immune reaction to gluten that causes inflammation and atrophy in the intestines. Coupled with increased awareness and internet access, gluten-free living is no longer just for the health-conscious; rather, celiac disease is an exceedingly common condition whose numbers keep going up every year.

According to Dr. Peter Green, Director of the Celiac Disease Center at Columbia University, celiac disease has increased fivefold over the past 50 years, with the majority of that occurring in the 1990s. A meta-analysis study published in the American Journal of Gastroenterology in 2020 supports this claim, finding that celiac disease has been on the rise throughout the Western world, with higher incidence rates in females and children.

The reason for this increase in celiac disease continues to vex scientists. Yet there are some compelling theories as to what could be causing it.

“We don’t know why it increased,” Green said. “But there is evidence that it’s leveling off,” he said, pointing to some research from Finland.

Despite a common misconception, celiac disease isn’t a gastrointestinal disease, but an autoimmune one. People who have celiac disease have developed an immune reaction to gluten, which is a protein found in wheat, rye, barley and triticale.

Green said it is not a “typical” allergy, so to speak, because the response can be delayed.

“There’s a period of time in which an individual tolerates gluten and then for some reason, they develop this immune reaction which causes inflammation, the development of the antibodies, the inflammation in the intestine which causes atrophy,” Green said.

Notably, doctors say many people with celiac disease aren’t diagnosed properly. One issue is that physicians often don’t think about the diagnosis, partly because symptoms can vary. Indeed they include bloating, chronic diarrhea, constipation, gas, lactose intolerance, nausea, vomiting, or pain in the abdomen. A flare-up can physically manifest itself as an itchy rash on a person’s skin that can appear as clusters of bumps or blisters.

Green said that “failure of physicians” to think about the diagnosis, and a lack of knowledge of the testing and how a diagnosis should be made, is the primary cause of people not being diagnosed.

“There’s actually less gluten ingested by the public now than 100 years ago.”

“We often hear stories, people say, ‘I’ve been going to a doctor for a long time and then the doctor had a new person come into the practice and a new person diagnosed me,’ or ‘I’ve been seeing doctors and then I had to go to the emergency room for some reason and the doctor in the emergency room diagnosed by celiac disease,'” Green said. “We often see people who are told they have celiac disease based on very spurious information.”

However, with so many unknowns surrounding celiac disease — like how many people have it, and what’s causing the rise — misinformation follows. A search on Instagram with the hashtag #glutenfree yields over 41 million posts. Between holistic healers peddling untested remedies and pseudoscience around the effects of gluten, it can be hard to sift through the noise. Yet some in the medical and scientific community have been actively researching the possible reasons for this dramatic rise in autoimmune issues with ingesting wheat.

“One of the common myths out there is ‘we have genetically modified wheat,’ but there is no genetically modified wheat in the U.S.””

An oft-seen, unfounded rumor as to the cause of celiac disease has to do with industrial manipulation of grains.

“One of the common myths out there is ‘we have genetically modified wheat,'” Dr. Amy Burkhart, a physician and registered dietitian, told Salon. “But there is no genetically modified wheat in the U.S.”

Yet some patients insist something is different about American wheat. Both doctors said they’ve heard from patients with gluten sensitivities who reported that they have visited another country — say in Europe where food safety standards are more stringent — where they ate food with gluten didn’t have symptoms.

“I’ve heard this, and it’s a really interesting kind of phenomenon, but it’s important to say that this is people with gluten sensitivity — not with celiac disease. People with celiac disease should never go to Europe assuming that they can eat the gluten foods,” Burkhart said.

She noted that that those with a gluten sensitivity have a spectrum of gluten they can tolerate.

“People think maybe because the gluten content of wheat in Europe is lower — maybe it’s because the growing conditions are different and the climate that the wheat is grown in can affect how much gluten is in that food.”

Burkhart said there are more additives in food in America than in Europe, which could be part of the phenomenon. Green said he suspects that high-fructose corn syrup could be part of why people with gluten sensitivities feel better eating abroad.

“I have many patients who go to Europe and say ‘my stomach feels right,’ but we don’t know what that’s due to,” Green said. “Food is different in the United States, but part of that is always high fructose corn syrup that people add to food in the United States, as a replacement for sugar.”

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But Green emphasized that wheat in America is almost certainly not the cause of the rise of celiac disease. He pointed to the fact that celiac disease is rising in countries like Australia and Canada, too. He said that theories that suggest grain has been altered or that gluten has changed over the last hundred years aren’t true either.

Celiac disease “has not received a large amount of research” monies, Green said. “It has been under-investigated.”

“There’s actually less gluten ingested by the public now than 100 years ago,” Green said. “Celiac disease has increased, and we don’t know why, but autoimmune diseases and allergies have also increased and we don’t know why.”

Burkhart said she does believe that an increase in public awareness of celiac disease has understandably played a role in the rise of celiac disease, in addition to an increase in testing and the rise of the internet as a forum for medical discussion.

“People talk, information is shared, and symptoms are discussed; this quickly spreads awareness of information, including information regarding celiac disease,” Burkhart said. “Patients began asking for testing and recommending it to friends; some of these patients, of course, have been diagnosed with celiac disease and they might not have otherwise thought of celiac disease or asked for testing if they hadn’t read about someone with similar symptoms.”

Despite the mystery surrounding celiac disease, Green said researchers struggle with a lack of funding that might help them get answers.

Celiac disease “has not received a large amount of research” monies, Green said. “It has been under-investigated… there are only a few individuals actually, all around the world who have demonstrated the mechanism of celiac disease.”

Hence, a few researchers are doing a lot of the legwork, Green said. “We understand how the gluten fragment interacts with the immune system and results in inflammation in the intestine… we have a very great amount of knowledge now, and that’s been developed by just a few people.”

 

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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1 week ago

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October 31, 2024

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.
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Here is how to prepare your online accounts for when you die

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2 weeks ago

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October 24, 2024

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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October 23, 2024

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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