Research Roundup: December/January 2019

Woman at restaurant
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The latest medical news for people with allergies and food sensitivities.

‘Gluten-Free’ Restaurant Food

About a third of restaurant foods labeled gluten-free contain detectable amounts of gluten, according to a new study by the Celiac Disease Center at Columbia University Medical Center in New York City. Some foods are risker than others; pizza and pasta dishes are the most likely to be contaminated, the study found.

Using portable gluten sensors, over 800 investigators assessed the gluten content (over 20 ppm) of items listed as gluten-free on restaurant menus. Based on over 5,600 gluten tests over 18 months, they found that about 27 percent of gluten-free breakfast items contained gluten and 34 percent of gluten-free dinner items.

The research was presented at the American College of Gastroenterology 2018 Annual Scientific Meeting.

Gluten & Epilepsy

Researchers at the National Institute for Health Sheffield Biomedical Research Centre in Sheffield, UK, examined the prevalence of epilepsy in those with celiac disease and gluten sensitivity. They found that epilepsy is 1.8 times more prevalent in people with celiac disease and celiac disease is over 2 times more prevalent in those with epilepsy compared to the general population.

Certain presentations of epilepsy have a stronger association, including temporal lobe epilepsy with hippocampal sclerosis, as well as a syndrome of celiac disease, epilepsy and cerebral calcification. The gluten-free diet is effective in managing epilepsy in 53 percent of cases, either reducing seizure frequency, enabling reduced drug doses or eliminating the need for anti-epileptic medications altogether.

“It is important that epilepsy is more broadly recognized within the spectrum of gluten-related disorders,” the researchers concluded. Notably, they recommended further study of the prevalence of TG6 antibodies in people with epilepsy to identify whether that could be used to identify those at risk of epilepsy due to gluten sensitivity.

The study was published in the Journal of Neurology.

Epinephrine Nasal Spray

Standard treatment of anaphylaxis is auto-injected epinephrine. Now INSYS Therapeutics, a specialty pharmaceutical company, is developing an epinephrine nasal spray as a potential easy-to-use treatment that is non-invasive and needle-free.

Preliminary results involving 60 people with seasonal allergies demonstrated rapid drug absorption with this epinephrine nasal spray, similar to that of intramuscular injection with EpiPen, according to an INSYS press release. The epinephrine nasal spray has been granted a “fast track” designation by the FDA.

Steve Sherman, senior vice president of regulatory affairs for INSYS Therapeutics, said the company looks forward to working with the FDA to make the epinephrine nasal spray available “as soon as possible.”

Over 200,000 cases of anaphylaxis occur every year in the United States, according to the Mayo Clinic.

Arsenic in Rice

Many people on a gluten-free diet eat a lot of rice and rice is a common ingredient in gluten-free processed products. A recent study out of Dartmouth College found that rice and rice-containing products have significantly higher levels of arsenic than foods made with other grains; brown rice was higher in arsenic due to the fact that arsenic accumulates in the outer bran layers. The team also found that rice is lower overall in nutrients, particularly selenium and iron, than wheat and other non-gluten-containing grains.

Researchers cautioned against over-consuming rice products as a substitution for wheat, recommending that those on a gluten-free diet eat a well-balanced variety of gluten-free grains.

The study was published in the journal Food Chemistry.

Editor’s note: For more about alternative gluten-free grains (ancient grains), see here.

Sticking to a Gluten-Free Diet

What factors influence people with celiac disease to successfully adhere to a gluten-free diet? Researchers wanted to know. They surveyed over 5,300 people with celiac disease in Australia and New Zealand and found that 61 percent had very good or excellent adherence to the gluten-free diet. Predictors of this strong adherence were older age, being male, symptoms after gluten ingestion, better food knowledge and lower levels of psychological distress. Not surprisingly, dietary adherence was associated with better quality of life.

Poor knowledge of the gluten-free diet and poor psychological wellbeing were linked to inadequate adherence to the diet. Celiac patients struggling to stick to a gluten-free diet would benefit from working with a dietitian. In the presence of psychological distress, involvement of both a dietitian and a mental health care professional should improve dietary adherence and health outcomes, the researchers said.

The study was published in Alimentary Pharmacology & Therapeutics.

Wheat Sensitivity Linked to Chronic Fatigue Syndrome Symptoms

Research conducted by Columbia University Medical Center in New York City reveals that a significant subset of people with chronic fatigue syndrome has blood markers associated with non-celiac wheat sensitivity. Chronic fatigue syndrome is marked by extreme fatigue that does not improve with rest. Many with the condition show immune system abnormalities and report gastrointestinal issues.

More studies are needed to examine the clinical and therapeutic relevance of food sensitivity, particularly non-celiac wheat sensitivity, in the context of chronic fatigue syndrome, researchers said.

The research was reported in Gut.

baby eating food
© Getty Images Plus/ IStock/ Oksana Zahray

Feeding High-Risk Infants

Emerging evidence that early peanut ingestion can help prevent peanut allergy in high-risk children prompted the National Institute of Allergy and Infectious Diseases to alter its guidelines in early 2017. Current allergy guidelines support the early introduction of allergenic foods to ward off food allergy, particularly for kids with a family history of allergies. Allergy-prone babies are to be introduced to pureed peanuts, for example, when they’re as young as 4 to 6 months old.

Now a recent Canadian study suggests that most pediatricians and family doctors don’t follow the guidelines. Researchers surveyed pediatricians, family doctors and allergy specialists in Canada, asking about their approach to managing babies who are at high risk of developing food allergies. High-risk babies are those with severe eczema or egg allergy or both. The survey revealed that many primary care doctors recommend delaying the introduction of allergenic foods to between 6 months and 1 year. In contrast, most allergists in the survey correctly said that milk, egg and pureed peanuts (or peanut powder) be introduced between the ages of 4 and 6 months. In addition, allergists were almost ten times more likely than pediatricians and family practitioners to recommend allergy testing.

The study was published in the Journal of Allergy and Clinical Immunology: In Practice.

Editor’s note: Always consult with your pediatrician about introducing solid foods
to your baby.