How Genetic Predispositions Influence the Development and Management of…
How Genetic Predispositions Influence the Development and Management of Gluten Intolerance
Celiac Disease Development
There is a myth that this disease mainly affects Caucasian people from Europe. However, there is strong evidence that it actually is most predominant in people from Punjabi ancestry in the United States.
Celiac disease would impact overweight or obese individuals to a higher extent in Western countries (including the United States). Since Indian immigrants from the United States have the highest rate of this disease, and obesity is also a factor, there may be a connection between Indian American Obese individuals and celiac disease.
Around 15-31% of individuals with celiac disease are overweight at diagnosis, and 6.8-13% are obese.
This is due to the fact that BMI tends to increase on a gluten-free diet (GFD) because it is more difficult to adhere to strict GFD diets, as processed gluten-free foods can be higher in calories and fat than natural alternatives.
22% of patients diagnosed at a normal or high BMI at diagnosis notice an increase by around 2 points.
There is a global percentage of 3.08% and 1.8% of celiac disease in India and from those of Indian origin; while it is 0.2-0.8% for the majority of Europe.
There are genetic factors that may make certain individuals more susceptible to gluten-related conditions. Individuals with specific genetic markers are at a higher risk of developing gluten sensitivity and celiac disease when exposed to gluten-containing foods.
In a study done on people with Celiac Disease in England, 40% of patients respondents acknowledged purposefully consuming gluten over the previous six months.
30% also reported accidentally coming into contact with gluten during that time.
This is because eliminating all dietary gluten may be a difficult aim to accomplish since the "gluten free" title possess 20 parts per million of gluten in food.
Socioeconomic Impact of Gluten Sensitivity on Low-Income Communities
can analyze the economic burden of gluten sensitivity on low-income individuals, considering factors like access to gluten-free foods, healthcare, and lost work productivity.
A total of 872 patients with biopsy-proven celiac disease were studied.
They were categorized based on the presence or absence of diarrhea and any gastrointestinal symptoms at diagnosis.
Univariate and multivariate analyses were used to assess the association between socioeconomic status and symptoms.
Results showed that patients without diarrhea and any gastrointestinal symptoms had higher mean per capita incomes compared to those with these symptoms.
On multivariable analysis adjusting for various factors, per capita income remained a significant predictor of diagnosis without gastrointestinal symptoms.
It showed a trend towards significance in diagnosis without diarrhea.
The conclusion drawn was that patients with nonclassical symptoms of celiac disease, particularly those of lower socioeconomic status, are less likely to be diagnosed.
This may be due to socioeconomic factors like lower rates of health-seeking behavior and limited access to healthcare.
Malabsorption of nutrients can lead to nutrient deficiencies.
Diets low in vitamins and minerals can result in inadequate nutritional intake.
In untreated celiac disease, malabsorption of nutrients like iron, vitamin D, and zinc is common.
Celiac disease can affect not only the upper part (duodenum) but also the entire small bowel.
Deficiency in Vitamin B12, absorbed in the lower part of the small intestine, is often seen in celiac disease.
Following a balanced, gluten-free diet can help correct low vitamin and mineral levels.
It might be necessary to take gluten-free vitamin and mineral supplements.
Consult your doctor or dietitians for personalized advice on your nutrient and supplement requirements.
Micronutrient deficiencies may not be detectable in patients on long-term gluten-free diets with good compliance (LTGFDWGC).
A research strategy was employed on PubMed using defined keywords: celiac disease, vitamin B12, iron, folic acid, and vitamin D.
The review included 73 studies.
Studies on LTGFD patients (over 2 years with good compliance) showed deficiencies in:
Vitamin B12 (30% of subjects) - DSA: 1000 mcg/day until normal, then 500 mcg
Iron (40%) - 325 mg/day
Folic acid (20%) - 1 mg/day for 3 months, followed by 400–800 mcg/day
Vitamin D (25%) - 1000 UI/day or more if level <20 ng/mL
Zinc (40%) - 25–40 mg/day
Calcium (3.6% of children) - 1000–1500 mg/day
Magnesium (20%) - 200–300 mg/day; no data available for adults.
If diet integration is insufficient, starting supplements might be necessary.
Initial blood levels should be evaluated to determine the right dosage of supplementation.