Source: BBC News | Health

Osteoporosis is a known risk of celiac disease and has been explained by a failure to absorb calcium or vitamin D. But a study in the New England Journal of Medicine suggests celiac patients produce antibodies which attack a key protein that maintains bone health.

They could easily be treated with drugs to prevent bone loss, researchers say.

It also explains why osteoporosis in those with the digestive disorder may not respond to calcium and vitamin D.

Celiac disease is caused by a reaction to gluten, a protein found in wheat, barley, rye and oats which damage the small finger-like villi that line the small intestine and play a key role in digestion. When damaged and inflamed, the villi are unable to absorb food properly, causing diarrhoea and malnutrition.

It affects one in 100 people, and of these a significant proportion may go on to develop osteoporosis – a disease of bone that leads to an increased risk of painful and disabling fractures.

Protein clue

Scientists at the University of Edinburgh say it may be a protein called osteoprotegerin which holds the key to the link between celiac disease and osteoporosis.

In 20% of the celiac patients tested, antibodies were produced which stopped this protein – crucial for maintaining bone strength – from working effectively.

Lead researcher Professor Stuart Ralston from the Institute of Genetics and Molecular Medicine, said: “This is a very exciting step forward. Not only have we discovered a new reason to explain why osteoporosis occurs in celiac disease, but we have also found that it responds very well to drugs that prevent bone tissue removal.

“Testing for these antibodies could make a real and important difference to the lives of people with celiac disease by alerting us to the risk of osteoporosis and helping us find the correct treatment for them.”

Sarah Sleet, head of Coeliac UK said: “Osteoporosis is a damaging complication of celiac disease and our traditional understanding of its cause has left some people with the condition with little hope that their symptoms and quality of life will improve.

“This new breakthrough in understanding and treatment will give renewed hope to our members struggling with their condition.”

Dr Claire Bowring, medical policy officer with the National Osteoporosis Society said: “We already know that celiac disease is a risk factor for osteoporosis and that early diagnosis and treatment of celiac disease gives the best chance of improving bone density.

“A better understanding of the relationship between celiac disease and osteoporosis will enable clinicians to manage both conditions more effectively.

“Although this research is at an early stage it is certainly interesting and we look forward to more extensive work to identify how prevalent this antibody is in people with celiac disease.”Similar Posts:

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Cow’s milk allergy encompasses a wide range of clinical manifestations, from the relatively benign to those that are life threatening. In most cases more than one body system is usually affected-often the skin (50-70%; urticaria or atopic dermatitis), gastrointestinal tract (50-60%; nausea, vomiting, diarrhoea, or colic), and respiratory system (20-30%; rhinoconjunctivitis or wheeze).

Below is a summary some of the features that are suggestive of a diagnosis of cow’s milk allergy (remember, however, that the diagnosis can only be performed by a qualified health professional through the analysis of symptoms, exams and the response to treatment).

• Temporal association between symptoms and the ingestion of milk
• Several body systems affected. Most commonly the skin, gastrointestinal tract, and respiratory system, particularly if symptoms of atopic diseases are present (such as atopic dermatitis or asthma)
  Presence of a family history of atopy
• Exclusion of lactose intolerance, which manifests as explosive watery diarrhoea after ingestion of cow’s milk
• Positive allergy tests or indicators of inflammation
• Failure to respond to other treatments, including consideration of functional causes

The key to management is the elimination of cow’s milk proteins from the patient’s or the mother’s diet (or both). Extensively hydrolysed formulas are the mainstay of such diets, although about 10% of patients are intolerant of these and require amino acid formulas. Other mammalian, soya, or rice milks formulas are not recommended because of high antigenic crossover. Solids must be dairy free. Professional dietetic advice and support are important to ensure provision of adequate nutrients to the growing child and the mother.

On a positive note, a number of studies have shown that cow’s milk allergy usually resolves within the first few years of life, with 60-75% of patients becoming tolerant by the age of 2 years and 84-87% by 3 years. Moreover, strategies to prevent the development of cow’s milk allergy have received considerable interest. Reviews by the American Academy of Pediatrics and the European Academy of Allergology and Clinical Immunology found evidence that exclusive breast feeding, or the use of extensively hydrolysed formulas, alongside avoidance of solids that contain dairy products, for the first four to six months reduces the incidence of the disease in infants at high risk of developing milk allergy (those with a first degree relative with physician diagnosed atopic disease

Sources:
John R Apps, JR & Beattie, RM. 2009. Cow’s milk allergy in children. BMJ 2009 339: b2275.
Host A. Frequency of cow’’s Milk allergy in childhood. Ann Allergy Asthma Immunolol 2002;89:33-37Similar Posts:

• Food Allergies May Be Linked to Obesity
• Anti-transglutaminase antibodies – a marker for celiac disease – can be temporarily elevated in non-celiac children due to infection
• Bones loss in children with celiac disease does not depend on the presence of symptoms
• Fish oil supplementation in pregnancy and food allergy
• Safety of Swine flu medication for allergics and celiacs

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Many cruise lines offer special gluten free, dairy free or food allergen free meals, as well as many other meals for special diets such as kosher, low salt, vegetarian and diabetic. In some cases, the meals offered are in fact not only safe and appropriate for the diet, but also much better than what is usually available in the passenger’s own home town – such as breakfast with gluten free bread and cereal, typical Italian meals especially prepared for celiacs and cakes and sweets for those with dairy, nut and egg allergies. However, it is important to plan ahead, and make sure you follow some procedures that will ensure a well-deserved rest, such as verifying whether the company you chose offers the required dietary options.

Here we describe a series of steps that can make your cruise trip easier, pleasant and safe for your diet.

1 – Choosing the cruise line

Find a travel agent you can trust. Then be clear about your dietary restriction so he/she can offer you choices of packages that are suitable for your condition. Make sure the agent understands this is a serious health condition. At the time of booking, some companies will ask you to fill in an additional form with a detailed description of your food restriction and suggestions of food products that you would like to have during your trip. Even in those cases where the company does not have a form, be clear about your dietary condition and needs already at the time of booking.

2 – Prevention is the key

Having the information about your date of departure, ship and booth number, contact the cruise company to remind them of your dietary needs. If contacted well in advance, most companies will be able to acquire special products for your diet (such as gluten free, dairy free, allergen free cookies, snacks, bread, sweets, pasta, among others). But notice that the time needed to ensure that suppliers can provide special foods can vary (Royal Caribbean for example require a period of 90 days prior to departure), so the earlier you contact them the better. If possible, ask the cruise line to send you a written confirmation of your dietary request (by email or fax), which you can them print out and take with you on board. In some cases you can also ask them to send you the restaurant menus.

4 – Packing up

•  Ask the company if you are allowed to take food products such as cookies, snacks and any other kind of emergency food on board. If possible, take a medical letter with you certifying your dietary condition so you do not have problems with security.
• If your child has a serious food allergy, remember to take allergy identification bracelets.
  Remember also to take with you any necessary medication that is required (antihistamines and Epi-pen, in case of severe food allergies), and a medical certificate justifying the need for medication. Although almost all companies will have drug and emergency procedures to deal with an allergic reaction on board, it is always good to have them handy with you.

5 – Ports of Arrival

Search in SpecialGourmets whether the cities/ports where the ship will stop have food stores with special products, or restaurants where you can eat. In restaurants, it is possible that waiters do not speak your language. So remember to print out some copies of restaurants cards such as those available in SpecialGourmets.

6 – On board

On your first day onboard, before your first meal, contact the Maitre D’ and discuss your meal options. Ask him to make sure your waiter is aware of your needs and condition. Remember that in many ships meals are prepared on large kitchens, so always ask about how your meal will be prepared and the possibility of cross-contamination.

In those cruises with multiple restaurants, ask whether it is necessary to talk with the chef of all restaurants you intend to go, and how long ahead you need to contact each restaurant so they are able to prepare your special meal. Prefer the first meal times, as you’ll be less likely to run into cross-contamination problems (through table cloths, cutlery, furniture, aprons, etc). Avoid all buffets, as in those cases it is very difficult to prevent cross-contamination.

7 – Activities for the kids

If your children have any dietary restriction or allergy, remember to make the children monitors and staff responsible for the kids’ activities on the ship aware of their condition, ensuring that inappropriate snacks, pastries and cookies are not served (and that they have alternatives to offer).

8 – Enjoy your trip and comment your cruise experience here!

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Ingredients

2 carrots (grated)
1 cup corn oil
3 eggs
2 cups sugar
1 cup soy flour
1 cup rice flour
1 tea spoon salt
2 (full) spoons baking powder
Margarine and rice flour to grease the mold

Topping

4-5 spoons soy milk
4 spoons cocoa powder
1-2 spoons sugar
1 spoon margarine

Preparation
Mix the carrot with the oil, eggs and sugar in a blender until obtaining a homogeneous batter. Then in a medium bowl combine the batter with the soy and rice flour, the salt and baking powder. Fill the molds (coated with margarine and rice flour) with the batter and bake in a preheated 400 oF (200 oC) oven for approximately 35 minutes.

Topping
In a saucepan over a medium heat melt the margarine together with the soy milk, cocoa powder and sugar. Mix well until obtaining and homogeneous mixture. Pour over the hot cake and enjoy!Similar Posts:

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Ingredients

350 g dark chocolate
3/4 cup sugar
1/2 cup margarine
4 eggs
1 spoon hot water de água quente
1 fullspoon potato starch

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Preparation

Pre-heat the oven. In a bowl suspended over a saucepan of simmering water (bain marie), melt the dark chocolate, the margarine and water until obtaining a homogeneous and shiny mixture. Beat the egg yolks with the sugar, and when fluffy add the molten chocolate mixture. Sprinkle the potato starch with the help of a sieve over the batter. Beat the egg whites in a separate bow, and when firm gently mix the beaten egg whites with the batter.

Bake in a mold with a loose bottom, greased with a bit of margarine and some potato starch sprinkled over it. Bake for approximately 40-50min, until the center of the cake is still wet, but the surface is already crusty. Before taking the cake out of the oven, leave the over door slightly opened, so the cake can cool down slowly. As the cake has no baking powder, it will reduce slightly in size while cooling down. You can add the topping of your choice!Similar Posts:

• Gluten free Molten Chocolate Cake!
• Gluten-free, dairy-free nut cake
• Gluten-free, dairy-free carrot cake
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• Allergen-free crepes!