May 2010

It is not too often I put out two posts a night. However, I am aware of how many Starbuck fans there are. There is some disheartening news for those of you fans that also have any type of gluten-intolerance. If you are in the habit of ordering the Light Frappuccino, Starbucks has taken out the dairy base and added a base containing gluten. According to the article, New Frappuccino recipe deletes dairy, adds gluten  by Melissa Allison from the Seattle Times, the regular frappuccino does not contain any ingredients with gluten. However it is not listed as gluten-free due to the risk of contamination. “Customers who want a reduced calorie Frappuccino but are sensitive to gluten can request non-fat milk in a regular Frappuccino, the company said.”

Sorry to disappoint those of you who started their day off with this product. Thought I would give you a heads-up!


Whenever I have a new celiac patient see me in my office, one of the first things I order  is a bone mineral density dexa scan.  Reason being, many of us have decreased bone density at the time of diagnosis due to the malabsorption of  nutrients from the food we were ingesting. Well, at least this is what I thought the reason was.  However, while scanning articles on celiac disease , I came across an article that stated in greater than 20% of the cases of osteoporosis in the face of celiac disease, the reason is other than malabsorption. The article is New Link Found Between Osteoporosis And Celiac Disease  in Science Daily October 8, 2009.

 In people without celiac disease, there is a protein called osteoprotegerin which plays a crucial role in maintaining bone health by controlling the rate at which bone tissue is removed. However, some patients with celiac disease  “produce antibodies that attack the OPG protein and stop it  from working properly. This results in rapid bone destruction and severe osteoporosis.” This type of osteoporosis responds poorly to just calcium and vitamin D supplementation. It’s only mode of treatment comes in the form of bisphophonates and other meds to treat osteoporosis.

Because there is no way to tell if a celiac patient’s decreased bone density is due to this “autoimmune”- type process versus a  malabsorptive- type process, erring on the side of caution should prevail and treatment with a medication should ensue with close monitoring of the response.

To read more from the article, go to

There is certainly an abundance of talk, these days, about probiotics. One can hear anything from probiotics can control Inflammatory Bowel Disease to prevention of disease in newborns to overall improvement in health due to a boosted immune system. However, much of it was speculation, until now.

 A study released yesterday in The Journal of Leukocyte Biology concentrated on the link between celiac disease and probiotics. In short, the study tried to simulate the environment of an actively ill celiac patient’s intestine which included certain types of harmful bacteria (ie. gram negative bacteria). Beneficial bacteria (ie probiotics) were then  introduced. In this study, the probiotic used was bifidobacteria. The harmful bacteria, alone, produced a large amount of inflammatory mediators called cytokines. These cytokines, in turn, “revved” up the cells that cause the most inflammation in celiac disease. Once the bifidobacteria was introduced, an extreme anti-inflammatory effect was seen. The authors of the study were so optimistic about the findings, they stated that this “evidence could be the first step toward changing how celiac disease is treated and possibly prevented”.

 This is real concrete evidence in favor of the use of probiotics in celiac patients. There are further theories that probiotics can alleviate symptoms in Irritable Bowel Syndrome and IBD ( both Crohn’s and UC). I will look forward to more studies and more positive findings in the future. But, for the meantime, my suggestion to all celiac patients would be to start a probiotic and help to build up healthy bacteria in the gut. You might find that you feel better.

 To read more about the study, you can visit