The Gluten-Free Link: ADHD, Autism, Celiac Disease and Non-Celiac Gluten Sensitivity Brought to you by Crunchmaster www.CeliacCentral.org Restoring Health … Reclaiming Lives. National Foundation for Celiac Awareness 2012. All rights reserved. Two Important Reminders! ①  A recording of each webinar will be posted along with the webinar slides within 72 hours after the live Webinar ends. To download recorded webinars and slides, visit the Archived Webinars page: CeliacCentral.org/webinars/archive/ ②  Continuing Education Credit: •  Registered Dietitians (RD) and Dietetic Technicians, Registered (DTR) are able to participate in this live 60-minute webinar to obtain continuing education credits regardless of this program's approval status as long as the webinar is professional in nature. NFCA will provide a certificate as proof of participation for each webinar. Attendees must complete the program evaluation/follow-up survey in order to access this certificate. Program participants will receive a link to complete the program evaluation/follow-up survey 24 hours after the close of the webinar through an email from GoToWebinar. •  Please note that RDs and DTRs are not permitted to claim credits by viewing archived webinars. Only those who register and attend live webinars will receive the opportunity to obtain continuing education credits. www.CeliacCentral.org Restoring Health … Reclaiming Lives. National Foundation for Celiac Awareness 2012. All rights reserved. Watch and Win ! One lucky winner will receive: A mixed case of 12 boxes/bags of Crunchmaster Crackers (a $50 retail value) *Winner will be contacted within 72 hours after the close of the Webinar www.Crunchmaster.com www.CeliacCentral.org Restoring Health … Reclaiming Lives. National Foundation for Celiac Awareness 2012. All rights reserved. NFCA Welcomes You! Marie-Nathalie Beaudoin, PhD •  Training Director, Bay Area Family Therapy & Training Associates, Cupertino, CA • Child and family therapist in private practice •  Coauthor of 2011 article: • “ A medical issue affecting the diagnosis of mood, attention and autistic disorders: a closer look at celiac disease and gluten sensitivity” • Author of “The Skill-ionaire in every child: Boosting children’s socio-emotional skills using the latest in brain research” •  Both she and her son are diagnosed with celiac disease www.CeliacCentral.org Restoring Health … Reclaiming Lives. National Foundation for Celiac Awareness 2012. All rights reserved. Tonight’s Agenda ①  Review important definitions of key topics, including the link between diet and psychological problems. ②  Provide a summary of recent key research on the connections between the autism spectrum disorder, ADHD, celiac disease and non-celiac gluten sensitivity. ③  Share client stories relevant to the webinar’s topic, helping to bridge the gap between research and real-life applicability. ④  Teach the audience how to accurately understand the research that is presented in today’s news mediums. ⑤  You ask, we answer: Questions from the audience! * Bonus! Dr. Beaudoin will share a simple checklist that webinar participants can reference when navigating academic research on their own. www.CeliacCentral.org Restoring Health … Reclaiming Lives. National Foundation for Celiac Awareness 2012. All rights reserved. Setting the Stage: Definitions “In the last few years, research has shown an increasing number of evidence for the existence of two categories of gluten-related problems: celiac disease and gluten sensitivity.” Sapone et al, 2011 “The literature suggests a lack of consensus on the use of terms related to celiac disease and gluten.” Ludviggson et al, 2012 Gluten-Related Disorders: All conditions related to gluten, including gluten ataxia, non- celiac gluten sensitivity and celiac disease. Celiac Disease: •  A chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals. •  A blood test indicating presence of specific antibodies EMA, tTG and/or DGP strongly supports the diagnosis, but a small intestinal biopsy is necessary to confirm a diagnosis. Volta, Oral presentation at ICDS 2011 Sapone et al, 2011 Sapone et al, 2012 Ludvigsson et al, 2012 www.CeliacCentral.org Restoring Health … Reclaiming Lives. National Foundation for Celiac Awareness 2012. All rights reserved. Setting the Stage: Definitions   Non-Celiac Gluten Sensitivity (NCGS): • A non-specific innate immune response. • Not accompanied by “the enteropathy, elevations in tissue-transglutaminase, endomysium or deamidated gliadin antibodies, and increased intestinal intestinal permeability that are characteristic of celiac disease.” (Ludvigsson et al, 2012) • Causes possible but minimal intestinal damage that recedes with a gluten-free diet. • Does not appear to be genetically based. • Although early research indicates a possible prevalence of anti-gliadin antibodies (AGA), no laboratory or histological tests can currently diagnose NCGS, making the diagnosis a process of exclusion. Celiac disease and wheat allergy must be ruled out. Volta, Oral presentation at ICDS 2011 Sapone et al, 2011 Sapone et al, 2012 Ludvigsson et al, 2012 www.CeliacCentral.org Restoring Health … Reclaiming Lives. National Foundation for Celiac Awareness 2012. All rights reserved. Side By Side Celiac Disease Non-Celiac Gluten Sensitivity   Onset of symptoms can be weeks to   Onset of symptoms is generally hours to years days   6% of the population, or 18 million   1% of the population, or 3 million Americans Americans   Diagnostic rate?   95% are undiagnosed •  In NCGS, there is some overlap of symptoms with celiac disease such as abdominal pain, fatigue, headaches, tingling/numbness, “foggy brain,” but often non-intestinal symptoms prevail. •  Both treated by the gluten-free diet! Sapone et al, 2011 Sapone et al, 2012   www.CeliacCentral.org      Restoring  Health  …  Reclaiming  Lives.     National  Foundation  for  Celiac  Awareness  2011.  All  rights  reserved. The Link: How can a food we eat change behavior? Gut-Brain Connection •  Malnutrition •  Leaky Gut •  Inflammation Did you know? Gluten is poorly digested in the human intestine, with or without celiac disease. (Ludvigsson et al, 2012) www.CeliacCentral.org Restoring Health … Reclaiming Lives. National Foundation for Celiac Awareness 2012. All rights reserved. Understanding The Link: Malnutrition •  Damaged gut is unable to assimilate certain nutrients essential to proper functioning of a number of organs •  Damaged villi cannot properly process and assimilate a number of nutrients, particularly: •  Vitamin B, such as B6, B12, & Folate •  Iron •  Vitamin D, K •  Calcium Hallert, C., Grant, C., Grehn, S., Granno, C., Hultén, S., Midhagen, G., Ström, M., Svensson, H. & Valdimarsson, T.(2002). Evidence of poor vitamin status in celiac patients on a gluten-free diet for 10 years. Alimentary Pharmacology & Therapeutics, 16, 1333-1339. Bhadada, S., Bhansali, A., Kochhar, R., Menon, A.S., Kant Sinha, S., Dutta, P., Kanwal Nain, C. (2008).  Does every short stature child need screening for celiac disease? Journal of Gastroenterology and Hepatology, 23, 253-256. Mora, Barera, Beccio,Proverbio,Weber,Bianchi,Chiumello (1999). Bone density and bone metabolism are normal after long-term gluten free diet in young celiac patients. The American Journal of Gastroenterology, 94(2), 398-403. www.CeliacCentral.org Restoring Health … Reclaiming Lives. National Foundation for Celiac Awareness 2012. All rights reserved.