The link between celiac disease and asthma has been as difficult to prove as finding the reason celiac disease exists. However some tangible evidence (statistical relationships) have been found.

The majority of articles suggest there is no link between celiac disease and asthma, while anecdotal evidence from celiacs suggests that their asthma increases dramatically after the ingestion of any gluten foods.

For instance, an article by Dr Pradeep Bhandari (Ref 1) says that “Celiac disease and Asthma tend to run in families and the tendency to get these diseases is inherited genetically. However, they are not inter-linked. The tendency to get celiac disease is inherited genetically. It mostly affects people of European descent. It is also more common in families with Diabetes or rheumatoid Arthritis. Something in the environment is necessary to trigger the celiac disease in those who are susceptible. Asthma tends to run in families. A person with a parent who has Asthma is three to six times more likely to develop Asthma than someone who doesn’t have a parent with Asthma. But no single gene is responsible for Asthma. Instead, you may inherit a general predisposition to Asthma” Ref 1

However a 2005 study was performed on a population of 86 persons residing in the Maltese Islands in the Mediterranean Sea does suggest some correlation:

MALTESE RESEARCH 2005 (Ref 2: Ellul P, Vassallo M, Montefort S)

“Patients previously diagnosed to have CD (based on serological tests and duodenal biopsy) and attending a medical out-patient clinic answered a questionnaire designed to determine whether they had previously been diagnosed to have asthma or allergic rhinitis.” Ref 2

“All 86 patients (age range 16-69 [median 43] years; 65 female) answered the questionnaire about CD and asthma. They constituted 21% of the 409 patients with CD in the Maltese islands included in a register kept for controlling free prescription of gluten-free foods.” Ref 2

Of 86 respondents, 24 (27.8%; 21 female) had asthma, including 22 with known asthma and 2 with previously undiagnosed asthma; the frequency of asthma in CD patients was higher than that reported in the general Maltese population (11.1%; p<0.00005).[7] In addition, four non-asthmatic patients (one smoker, two ex-smokers, one non-smoker) reported wheezing in the absence of respiratory tract infection in the past; they however had normal pulmonary function tests.

In 16 patients, asthma preceded CD by 3 months to 39 years (median 20 years). Among these patients, gluten-free diet had led to improvement in asthma in 6 patients, possible improvement in 2 patients, and no change in 8 patients. In the remaining 8 patients, asthma followed CD by 2 to 14 years (median 8). Thirty-one of 86 patients with CD and 11 of 24 patients with CD and asthma gave family history of asthma among first-degree relatives.

Eighty-two patients (62 female) answered the questionnaire about allergic rhinitis. Of these, 36 (44%) suffered from allergic rhinitis; this frequency was higher than that reported in the general Maltese population (32.3 %; p<0.05). They conclude that their findings suggest that asthma and allergic rhinitis are more common in CD patients than in the general population in Malta. In patients with atopic diseases, index of suspicion for CD should be high.

FINNISH study in 2001 (Ref 3: Journal of Allergy and Clinical Immunology)

This study tested the postulate of whether TH1 and TH2 cells could co-exist. A correlation between these would suggest a correlation between celiac disease and asthma.

“Background: Asthma is generally regarded as a disease with strong TH2-type cytokine expression, whereas in autoimmune disorders, such as celiac disease (CD), insulin-dependent diabetes mellitus (IDDM), and rheumatoid arthritis (RA), TH1-type expression is seen. According to the cross-regulatory properties of TH1 and TH2 cells, one would assume that these diseases exist in different patient populations.” Ref 3

“Objective: We sought to test the hypothesis that asthma could exist in children with TH1-type diseases, such as CD, IDDM, and RA. Methods: Comparison was made of the cumulative incidence of asthma in children with CD, IDDM, or RA by linking Finnish Medical Birth Register data on the whole 1987 birth cohort (n = 60,254 births) with the data of several national health registers to obtain information on the incidences of these diseases during the first 7 years of life.” Ref 3

“Results: The cumulative incidence of asthma in children with CD (24.6%) or RA (10.0%) was significantly higher than in children without CD (3.4%) or RA (3.4%; P < .001 and P = .016, respectively). Asthma tended to be more common in children with IDDM than in children without IDDM. Conclusion: These data indicate that the TH1 and TH2 diseases can coexist, indicating a common environmental denominator behind the disease processes.”

IMPLICATIONS

While these two studies do not show a causal relationship (proof that one disease causes another), they do suggest that there is a strong correlation between the diseases. That means that if you have celiac disease there is a greater likelihood that you will have asthma. The main ‘take home’ point from this is that for people who are celiac, or gluten intolerant, and have asthma, that the removal of gluten from their diet is likely to decreases the incidence and severity of their asthma.

 

is difficult to follow the gluten free diet but at the same time it should be noted that if you are suffering with gluten intolerance then you have no other options to survive than to just make yourself habituated to these gluten free products in your own special way. It depends on you how you consume so that you do not remain half starve. It is true that gluten free diet is not tasty as other normal diet but unfortunately you have to follow that gluten free diet because you are sick. Now removing foods that contain gluten out of your diet is not so simple and easy as it sounds. Simply checking the ingredients of everything you buy and do not consume those food product that says gluten may be easy but unfortunately it is not so every time since gluten comes in many forms, and there are almost endless ways it can be described on an ingredients list. You have to know those forms and ways gluten comes. The only easy way to learn if a product holds gluten is to look for the ‘gluten-free’ sign, or call up the manufacturer. Here are a few of the ways that has been mentioned to show you how gluten can be described on a list of ingredients on the package of the food products.

As we know that wheat is the most common form of gluten so avoiding foods that contain wheat is a good way to start eliminating gluten from your diet but sometimes you will find that wheat is not mentioned instead in the ingredients and your logic says that it is a gluten free product. Watch out for the ingredient includes durum, bulgur, dinkel, kamut and spelt because these words mean wheat. Semolina and Couscous are common wheat containing substances. Also avoid those substances such as starch, bran, hydrolyzed vegetable protein or dextrimaltose in a food product if you are unsure that these are derived from a gluten free source.

Difficulties also arise from the word flour because the word flour on its own in a list of ingredients. There are different kinds of flour but the safe forms are rice flour, potato flour, buckwheat flour, chestnut flour and corn flour. Flour that are described as plain flour, self-raising flour, stoneground flour, wheatgerm flour, malted wheatgrain flour and wholemeal four should not be consumed as they are made from wheat from wheat flour.

Barley and Rye are the two most common gluten containing substances besides wheat and there are a number of derivatives that you may not even realize containing gluten and these include caramel coloring and malt, which can be in the form of a flavoring or vinegar. As you realize that there are myriad terms used to illustrate foods that hold gluten, and derivatives of these substances, so getting hold of an up to date list of all the terms that may mean gluten, or wheat is required to memorize to avoid those foods with hidden gluten. Also manufacturers should specify whether the food is gluten free or not to make the work of the consumer a little easy.

Its very hard for the celiacs (people with celiac disease) to swallow the fact that they need to adhere to gluten-free diet for their life. Many of them lack mental strength to accept this reality. Also, such dietary plans create many deficiencies in the body. It all starts showing up in the form of depression. However, with some simple techniques you can beat this depression for a healthy and enjoyable life!

People having celiac disease are often subjected to severe depression attacks. These may be because of three reasons. Firstly, they are not aware that they are suffering from celiac disease and so they inadvertently consume a big dose of gluten from their daily intake. Simple things like breads, pizzas and other wheat products contain huge quantity of gluten. This in turn affects their villi (lining of your small intestine) and their capacity to absorb essential nutrients is substantially reduced. This results in mal-nutrition and gives rise to several disorders in brain. This can be simply termed as ‘glutenated depression’

Secondly, on realizing that they have celiac disease, they have to accept a bitter truth that they have to take gluten-free diet for lifetime. They are told to change drastically their eating habits and lifestyle, with complete exclusion of wheat. So they will be banned from eating all sorts of breads, pizzas, they cannot drink beer and they will be cutting most of the deserts from their diet. Its very hard to accept these realities easily. Their mind and body will resist. It becomes very hard for them to say “no” to all ‘glutenated’ foods every now and then, even if they are told by their doctor that these things can harm them. Gluten is very nasty nutrient. It will immediately show up.

Starting from diarrhea and stomach upsets, it will make the person sick mentally and physically. So it will lead to glutenated depression.

Thirdly, even if a person follows a strict gluten-free diet, he/she may not be aware of the deficiencies, which such diet creates in the body. So he/she strictly adheres to gluten-free diet, but may not take in essential vitamins and nutrients, wich would have been otherwise part of his/her normal diet. So it will affect his body (mainly brains) and within a short period of time he will start feeling empty and depressed. This is the third cause of glutenated depression.

Symptoms of glutenated depression

Depression, whether glutenated or otherwise, starts showing up quickly. Continuous sad / empty feeling, loss of interest in general, fatigue and depleted energy, sleeping problems and headaches and body aches are the normal symptoms. In many cases, overdose of alcohol or drugs are some of the consequences. So the shadow of depression is cast over the entire life ahead.

How to get rid of glutenated depression

With appropriate medicines and correct strategies, you can get rid of glutenated depression. If you are tested positive for the celiac disease, then you should not waste time. In consultation with your doctor, you can work out a suitable dietary plan. This includes intake of certain vitamins and minerals which you may be missing out due to wheat restrictions.

Other ‘physical’ strategies include improvements in eating habits, taking ‘translation’ foods (like high carb snacks) and increasing physical activity, mainly exercise. There are some ‘precautionary’ strategies like postponing important decisions, setting realistic goals and diverting your attention to something else. Then there are some recreational strategies like trying to stay social and joining a support group.

Note: This article is for informational purposes only and is not intended to be a substitute for professional medical advice. Please consult with your physician on any matters regarding your health.

When analysing gluten free markets, the main question that people with celiac disease will ask is “what’s in it for me”? Having an understanding of markets such as Australia and America is fundamental to understanding how many more suppliers are likely to enter the market and so drive competition and choice. If you are celiac or a gluten free supplier, these are two words that you hold dear to your heart: choice and low price. To understand how close we are to a mature market (when maximum competition drives prices down) it is useful to compare several countries and communities within these.

This analysis is based on Google search terms (for the month of Dec 08) used in the gluten free market. As Google usually has a large market share in most countries and also has specific country domains, this provides a perfect baseline to compare gluten free markets across the world.

This article is set out in the following format:



Identification Of the Four Gluten Free Market Tiers

Introduction Comparison Of Communities By Their Market Tiers



The following are available in the full article on our website



FULL ANALYSIS PER COMMUNITY

Statistic Tables for each community



GFP MATRIX: Identification Of the Four Gluten Free Market Tiers

So far four market levels (TIERS) have been identified.

A fully matured gluten free market has not been reached yet due to the low diagnosis of celiac disease even in developed countries. So far, analysis has shown that the most developed gf markets are those in Australia, the US and Canada. Characteristics of the e-demand side of these are a high number of search terms and high search volumes.

Of the search terms used in tier 1 communities, they are typically dominated by generic gluten free terms where the first 2 to 3 terms represent over 55% of the top 50 searches. This is the case in Australia, US (English speaking) and Canada (English). It is speculated that in these countries there are a significant number of celiacs who have been diagnosed for a few years. They originally searched for information on the disease and diets required and now prefer to spend more time searching for generic gluten free terms. By doing so they have found that on the supply side of things products have been amassed in the one place. This means that by searching on generic terms they can easily find large gluten free sites that contain many gluten free products on which they can search internally for specific terms. While generic searches are large, searches on the celiac group are still the second highest and account for over 15% of the top 50 searches. Within this group two terms ‘celiac’ and ‘celiac disease’ typically account for over 85% of all searches.

The next level of market maturity (tier 2) is shown by communities like US Spanish speaking and Canadian French speaking communities. These communities are often smaller than the dominant communities (often English) in their countries but they have first world affluence available to them. They often have under 100 total search terms over a twelve month average. In this example, US Spanish has 17 search terms and Canadian French have 30. The relatively high level of affluence within these communities increases the individual’s chances of being diagnosed and pursuing a often more difficult and costly gluten free diet (as compared with tier 4 markets. These ‘second tier’ communities also have a high search proportion devoted to generic gluten free terms but there is also a higher proportion of searches (than found in tier 1 markets) devoted to finding information on celiac disease such as through celiac diet and/or wheat allergy searches.

The third market maturity (tier 3) is shown by communities such as Mexican English speaking (101 searches) and Brazilian English speaking (100 searches) communities. These communities are much smaller proportions of the country population than tier 2 markets. They are often much more affluent than the main population ethnicity (through education/ employment) or having come from more affluent countries such as America. They tend to not search so much for generic gluten free terms (less than 45%) but have an increase in searches for celiac diet searches and specific food groups. This pattern is indicative of newly diagnosed people (having access to good medical attention). The other main trait of this market is that it includes people who have had the disease for a while and are now seeking specialist gluten free products such as ‘gluten free restaurants’ or ‘desserts’ – rather than staple gluten free foods such as flour or breads.

The lowest developed market (tier 4) is reflected by searches in Mexico (Spanish Speaking) 24 total searches and Brazil (Portuguese speaking) 23 searches. The communities also tend to have very low searches per head of population and may not have access to good medical facilities – often a large rural population. These people have a relatively small proportion of generic searches and a much higher number of ‘wheat free’ and ‘celiac’ searches. While they also have higher search volumes for specialty gluten free foods, rather than bread searches (main specialty in refined markets) or desserts, they tend to search for even more fundamental food staples such as flour and oatmeal. Counter intuitively they also tend to search for cakes and cookies. This is not necessarily related to the countries affluence but is more likely a social phenomenon where providing good food spreads for parties and extended family gatherings account for a large part of their social interaction.

INTRODUCTION 

Higher choice and lower prices will likely occur in tier 1 market countries as more celiacs are diagnosed and search for and buy more products. The development will reach maturity once the growth of the market goes through a point of inflexion in its growth and begins to plateau. Only long term monitoring of this demand can assess where that level of maturity approaches saturation.

The development of the market level definitions (tier structure) will be refined as more countries are analysed.

A practical application of this analysis for celiacs is to see what other celiacs are searching for and how developed the gluten free market is in their own countries. This article attempts to answer the question “what are the characteristics of a mature gluten free market”.

This research and analysis was undertaken to see if there is a correlation between gluten free search profiles of developed nations and how this may differ from countries in close proximity to the US.

A previous article on www.glutenfreepages.com.au showed a very strong correlation between gluten free search profiles of Australia and the US. In the article you are now reading, analysis was refined to include the affect of languages, internet usage, Google market share etc. Where countries use several languages, analysis was performed on English searches and the other local language.

This research was undertaken for the month of December 2008 Google search volumes for Gluten free products and uses monthly averages over a year in countries where search volatility is high and/or search volumes low. The analysis again shows a very strong correlation between the Australian and US Gluten free markets.

One of the first indictors or market maturity is considered to be the number of ‘gluten free’ related internet searches per ‘population divided by 100′. This takes into consideration that approximately 1 in 100 people (diagnosed and undiagnosed) may be celiac.

TABLE: A table showing the number of monthly searches per celiac for each community is shown in the full article.

The Adjusted GF Searches per month per celiac column takes into consideration internet usage, Google market share. The values are most accurate for the first three countries, ‘developed’ nations. These countries have a long established internet usage and Google was able to provide search terms up to its self imposed limit of 200 terms. The search values for Mexico and Brazil English speaking are likely to be inflated due to sparse information on the penetration of English language in these countries and Google’s translation abilities.

The most important concept in this research is the gluten free grouping profiles. As explained below, all gluten free terms were assigned to one of seven groups. The top 50 search terms were sorted into these groups and groups were analysed for number of terms, proportion of the top 50 and the specific terms within each group. While the following pages go into the details of each country a summary of the analysis is:

GRAPH: “Guten Free Product Search Term Group Proportions of TOP 50 terms” is shown in the full article.

Group Composition

The following shows some of the representative terms in each group.

Generic GF Product: This group of search terms all involve the word gluten and are generic in nature, such a gluten, gluten free, gluten free products, gluten free meals.

Gluten Diet: These are terms that are related to the specifics of gluten free diets such as: gluten free diets, celiac diet.

Gluten Free recipe: Terms such as gluten free recipes, gluten recipe, gluten free baking, wheat free baking

Celiac related: These are terms related to information on the disease such as: celiac disease, gluten intolerance, gluten allergies

Wheat free: Terms such as: wheat free, wheat gluten, wheat allergy

Locations: gluten free stores, gluten free shopping, gluten free restaurant

GF Specific Foods: gluten free bread, gluten free pizza, gluten free cakes, gluten free muffins

COMPARISON of Communities by their Market Tiers

Australia, US English, Canada English.

Australian, US English speaking and Canadian English groups had very similar profiles. Each country had the ‘generic gluten free’ group as its main group with the following volume proportions: AUS 65%, US Eng 64%, Canadian Eng 63%. In each case the same ‘gluten and gluten free’ generic terms rated as the top two overall searched terms by volume.

The celiac group was the second largest volume searched by all three countries: AUS (18%), US Eng (21%), Canada Eng (21%). Each category was dominated by over 85% by the terms ‘celiac’ and ‘celiac disease’. Dual spellings in Australia.

US Spanish, Canadian French

The graphs show that these communities are similar to the three above, at least in the proportion of the generic ‘gluten free products’ group.

One of the main things that affects the distribution profile of these communities is that US Spanish searches only comprised a total of 19 terms compared to US English that was capped by Google at 200. Per population of the American English V Spanish community, the English speaking community performed 4.2 times as many gluten free product searches as US Spanish speaking people on Google.

For the US Spanish community, the ‘celiac’ group was the highest volume proportion of any of the countries analysed. While the US and Australia searched for generic ‘celiac’ terms in this group the US Spanish search for ‘celiac allergies’. This suggests a possible different approach to the way each country views celiac disease.

Compared to the US English, these communities also have a stronger interest in wheat issues. While the US English searched for 3 terms in this group it only made up 4% of volumes. The US Spanish searched for only one term: ‘wheat intolerance’ and it made up 18% of total search volumes. These factors suggest the US Spanish searchers are new to celiac disease and the market is immature compared to the first three countries.

The Canadian French speaking community had a similar profile to Canadian English but a much higher interest in the ‘gluten diet’ group and slightly higher interest in GF specific foods. These terms are accounted for by them looking at the specifics of what they can eat, and specific foods of gluten free ‘oatmeal’ and ‘quinoa’. The higher interest in the diet group suggests that they are either more specialised in their searches than their English counterparts or are earlier in the disease diagnosis stage.

Mexican English / Brazilian English

In each community English is a very small minority of the population but is massively over represented in search volumes. As Google has country specific domains in each countries main language this statistic suggest that these English communities are more aware of gluten issues, are more affluent, and potentially represent a more mature search market.

There is a strong similarity between the Mexican English and Brazil English speaking group profiles. Both communities have a significantly reduced generic search focus but a similar increases in GF specific foods and Gluten Diet information. Quite a few of the English speaking people in these countries are believed to either be affluent locals or foreigners (ex pat US).

In the Mexican English speaking community, the highest searched group is ‘gf locations’ and the highest volume terms are related to gluten free restaurants. The second highest group ‘celiac’ is dominated by several equally search volume terms that use three and four word search strings. The third group ‘gf specific foods’ is dominated by searches for desserts. This suggests a split in focus between people newly diagnosed and those who are affluent enough to regularly search for gluten free restaurants and desserts.

In the ‘Brazil English’ community there was an even stronger fascination with gluten free desserts taking up three individual search terms – the first two accounting for 9% of all searches. Coelaic (UK spelling) was the second most searched group and it contained only one term which accounted for 24% of search volumes. The highest specific food searches were for cakes and muffins, whereas in US English and Australia top specific searches were for breads.

Mexican Spanish, Brazil Portuguese.

The profiles for these communities were the most unlike the US English and Australian. The table at the beginning of this article also shows that in raw terms they had one tenth the searches per head.

Mexican Spanish differs from market 1 profiles as much by its large reduction in generic searches as its large increase in searches on wheat issues. In fact three of the top ‘wheat free’ searches accounted for 44% of top 50 volumes. This suggests a community in early stages of diagnosis and discovery. The two highest specific gf food searches were for ‘oatmeal’ and ‘flour’. These non luxury items, low search volumes and focus on wheat free issues suggests a non affluent community searching for fixes to staple food groups.

Brazil Portuguese has a very large population but low search volumes. In fact it has nine times the population of Australia, but less than half the searches on gluten free products. While generic gluten searches were the main search group at 44% (20% less than US and AUS), its first two terms were still the same generic terms. Of most interest is that this community has the highest specific food group volume proportion of all countries. And rather than an interest in food staples, they focus on gluten free cakes (18% of top 50 searches), and cookies 10%. They also search for gluten free flour (3%) and oatmeal (2%).

With the third highest group being ‘wheat free’ and gluten allergies Brazil’s market resembles the split shown in Mexico (English) between learning about celiac disease and enjoying treats. However rather than searching on restaurants, the Brazilian Portuguese interest in cakes may be seen as a cultural choice (socialising and providing family spreads) rather than an opulent choice.

GRAPH: A graph on our website shows the relationship between a tier 1 community (place that is nearing market maturity) AND a high proportion that its top two searches take up of the top 50 searches AND a high number of searches per (population / 100).

MORE INFORMATION:

The development of the GFP MATRIX and market level definitions (tier structure) will be refined as more countries are analysed. The above information is a summary of the full article that can be found at www.glutenfreepages.com.au To find this article, look under the menu tab ‘Articles’, then ‘GFP Original articles’. The full report analyses each community in detail and shows graphs and statistic tables associated with each community.  

Dining together on the table with having the same food really makes the fun of breakfast or lunch or dinner or whatever it is twice. Just the opposite happens when different food is arranged for someone who cannot follow the normal diet as the other. Yes, I am talking about those who are suffering from food intolerance. Gluten intolerance is becoming a very common problem nowadays all around the world.

Talking about gluten intolerance much of this kind responses from a variety of sources like citrus fruits or other acidic foods and even it may be due to the presence of some kind of chemicals such as some preservatives used in food or natural compounds like caffeine and, of course, lactose. Some times it is difficult to distinguish food allergy from food intolerance as their symptoms are quite similar but biologically they are absolutely different in bodily responses. In true sense food intolerance is a problem of digestive system whereas food allergy is an abnormal response to food that is generated by a specific reaction in the immune system. Whatever it may be food allergy or food intolerance both affects nearly everyone at some point.

Food intolerance is an abnormal response to food and is far more prevalent, that occurs in a variety of diseases, and is activated by several different mechanisms that are different from the immunological reaction responsible for food allergy. If you experience symptoms like headaches, gastrointestinal problems, like gas, bloating, constipation, or diarrhea, or if you experience runny nose, hives, or difficulty breathing or if you find yourself gaining weight then be sure that all these symptoms indicating of gluten intolerance. Gluten intolerance is very common food intolerance and is also called celiac disease in its most serious form, has been linked to behavioral problems, weight gain, and even autism. It is an incurable condition that causes the immune system to attack a person’s own body and causes all of the symptoms of food intolerance. In addition to it, such disease also affects the growth and skin conditions. And if left abandoned, in due course it can even cause bone disease, anemia, and even cancer. Now you can realize that how dangerous is this disease.

Gluten is protein and is found in all wheat products, and even in some products made from barley, rye, and oats. And unfortunately most of the food that is included in our normal diet contains gluten and people with gluten intolerance need to avoid those foods. It is recommended that if suspect gluten intolerance then you must speak to your doctor as soon as you can so that you can get the dietary guidelines to follow. This is important because what happens actually is that when you attempt to cut out those food groups that are creating health problems completely then you start suffering from malnourishment. There are many gluten-free products available in the market today but a product is gluten-free does not necessarily mean every time it is safe for people with gluten intolerance. Therefore it becomes important that people who are suffering from gluten intolerance must educate themselves with proper knowledge so that they become very good label readers.