High Risk Of Coeliac Disease In Punjabis. Epidemiological Study In The South Asian And European Populations Of Leicestershire
The title of this post, is the same as that of this peer-reviewed paper on PubMed.gov.
This is the abstract of the paper.
The purpose of this study was to measure the incidence of coeliac disease in different ethnic communities and investigate the hypothesis that the incidence is decreasing in most European countries and the role incomplete retrieval of data may play. In a retrospective study of histologically confirmed cases of coeliac disease between 1975 and 1989 in the City of Leicester, 106 patients with coeliac disease were identified. Of these 86 were European and 20 Asian. The overall incidence of coeliac disease in Europeans was 2.5/10(5)/year (95% CI 2-3.2), in Gujaratis 0.9/10(5)/year (95% CI 0.4-1.8), and in Punjabis 6.9 (95% CI 3.2-12.3). These differences were independent of religious belief. The relative risk to Punjabis compared with Europeans is 2.9 (95% CI 1.5-5.3; chi 2 = 12.5, p < 0.01) and to Gujaratis 8.1 (95% CI 3-22.4; chi 2 = 25; p < 0.001). Gujaratis were at 0.4 risk of Europeans (90% CI 0.2-0.8; chi 2 = 6.7; p < 0.01). The incidence in the urban populations of Leicester was 6/10(5)/year (95% CI 1.3-1.9) which was significantly lower than the 3.2/10(5)/year (95% CI 2.7-3.8; chi 2 = 5.6; p < 0.001) in surrounding rural areas. This study shows that the incidence of coeliac disease in Punjabis (Sikhs, Hindus and Muslims) is 8 times higher than in Gujaratis (Hindus and Muslims) and 4 times higher than in Europeans in Leicester.
I find the last sentence in particular very significant.
I’m no medic, but I think it is reasonable to assume, that in a particular community for every diagnosed coeliac, there will be several undiagnosed coeliacs out there.
In this overview of coeliac disease on the NHS web site, this is said about the incidence of coeliac disease.
Coeliac disease is a condition that affects at least 1 in every 100 people in the UK.
But some experts think this may be underestimated because milder cases may go undiagnosed or be misdiagnosed as other digestive conditions, such as irritable bowel syndrome (IBS).
Reported cases of coeliac disease are around 3 times higher in women than men.
The one-in-100 figure is often used in web pages in European countries or Australia, Canada and the United States, so I’ll go along with that.
So does that mean that Punjabis living in Leicester, have a one-in-twenty-five likelihood of being coeliac?
Whether you have been diagnosed though, is a matter of pure luck.
I had been having gut problems for years and then one Autumn, I didn’t see my GP, but a very elderly locum, who as I had recently had my fiftieth birthday, gave me a present of my first blood test.
It turned out my B12 levels were very low and after several months of B12 injections, which made little difference to my B12, my GP decided to send me to a consultant at Addenbrooke’s Hospital in Cambridge.
My appointment was on a Monday morning and consultant took about ten minutes to ask a few questions, after which he said they would take a few bloods.
On the Wednesday morning, I received a letter that said, that I was probably suffering from coeliac disease and this would be confirmed by endoscopy.
Was I diagnosed solely by analysis of my blood? This was in 1997, which is after the date of the Leicester study.
Two endoscopies without sedative or anaesthetic were performed and I was confirmed as coeliac.
The first was performed by Dr. Richard Hardwick and the second by Dr. Rebecca Fitzgerald.
Both doctors feature in this story on the Cambridge University Hospitals web site, which is entitled Familial Gastric Cancer – Case Study.
My problems have been minor compared to the two sisters in the story.
My luck had been good and I recommend that everyone who feels they could be coeliac should get themselves tested.
Cases Of Covid-19 In Leicestershire
This article on the Leicester Mercury is entitled 11 Areas Of Leicestershire Have Among Worst Infection Rates in the UK.
In Coeliac Disease: Can We Avert The Impending Epidemic In India?, I started like this.
The title of this post, is the same as that of this article on the Indian Journal Of Research Medicine.
With the high levels of COVID-19 in Leicester and an Indian population who make up 28.3 % of the population of the city, I was searching the internet to see if there was any connection between those of Indian heritage and coeliac disease.
I know you should not try to prove a theory. But as a coeliac, I’m very interested to see how the millions of diagnosed coeliacs on a gluten-free diet like me, are faring in this pandemic.
I then talk about some extracts from the Indian research.
In a section entitled, which is entitled All Wheats Are Not Equal, I say this.
The other dimension to this problem is that not all wheat is alike when it comes to inducing celiac disease. The ancient or diploid wheats (e.g. Triticum monococcum) are poorly antigenic, while the modern hexaploid wheats e.g. Triticum aestivum) have highly antigenic glutens, more capable of inducing celiac disease in India, for centuries, grew diploid and later tetraploid wheat which is less antigenic, while hexaploid wheat used in making bread is recently introduced. Thus a change back to older varieties of wheat may have public health consequences.
So did all these factors come together to create the high levels of Covid-19 in Leicestershire?
Conclusion
I am getting bored with saying this. More research needs to be done!
Why A Lucky Few May Help The Rest Of Us Beat Disease
The title of this post, is the same as that of this article in The Times.
This is the sub-title.
A British biotech firm believes patients who defy odds could hold the key in their blood.
These three paragraphs introduce the article.
Patient 82 should be dead. At the age of 63 he was diagnosed with pancreatic cancer. In most cases, he would not have lasted a year. But seven years on, patient 82 is alive. Not merely alive — thriving.
He enjoys gardening. He likes seeing his grandchildren. He enjoys life.
How? The answer, a British biotech company believes, could lie in his blood. Now, with the help of dozens of other anonymous patients, all of whom have defied their cancer prognoses, they hope to find it.
Note, that the company is Alchemab Therapeutics.
The article got me thinking about myself.
I belong to a group of people, who are twenty-five percent less likely to suffer from cancer according to peer-reviewed research at Nottingham University.
I am coeliac and adhere to a strict gluten-free diet.
There may be other benefits too!
I have not had a serious dose of the covids, although I may have had a very mild case at the beginning of 2020 after I shared a train with a large number of exuberant Chinese students, who had recently arrived at Manchester Airport and were going to their new University across the Pennines.
I have also since found at least another seventy coeliacs, who have avoided serious doses of the covids.
Research From The University Of Padua
This paper on the US National Library of Medicine, which is from the University of Padua in Italy.
The University followed a group of 138 patients with coeliac disease, who had been on a gluten-free diet for at least six years, through the first wave of the Covid-19 pandemic in Padua.
This sentence, sums up the study.
In this analysis we report a real life “snapshot” of a cohort of CeD patients during the SARS-CoV-2 outbreak in Italy, all followed in one tertiary centre in a red area of Northern Italy. Our data show, in accordance with Emmi et al., the absolute absence of COVID-19 diagnosis in our population, although 18 subjects experienced flu-like symptoms with only one having undergone naso-pharyngeal swab.
It says that no test subject caught Covid-19, in an admittedly smallish number of patients.
But it reinforces my call for more research into whether if you are a diagnosed coeliac on a long-term gluten-free diet, you have an immune system, that gives you a degree of protection from the Covids.
The Times article mentions the immune system.
I believe my immune system to be strong after the reaction I had to the Astra Zeneca vaccine. I didn’t feel well to say the least after my Astra Zeneca vaccine and my GP and other doctors felt that it could be due to my immune system, thinking that the chimpanzee virus-based vaccine was a danger and attacking it.
Significantly, I had no reaction to the second dose. So had my immune system recognised the vaccine as a friend not a foe?
My son, who my late wife was sure was an undiagnosed coeliac, died of pancreatic cancer at just 37.
How did my late wife know? Don’t question her intuition and also she felt that my son and myself felt the same to her touch.
It should be noted that my son’s daughter was born with a Congenital hernia of the Diaphragm. Congenital defects can happen to people, who have a coeliac father.
At the age of 20, my granddaughter is fine now, after heroic surgery at the Royal London Hospital, at just a few days old.
Why Don’t I Feel The Cold?
It’s been cold today in London, but I didn’t really feel it.
100,000 Newborn Babies Set To Have Their DNA Fully Decoded
The title of this post, is the same as that of this article on the FT.
This sub-heading gives a few more details.
Genomics England programme aims to extend the number of treatable conditions detected to about 200.
I am coeliac and I do wish, I had been diagnosed at birth.
But more importantly, my youngest son, who would have been fifty this year, might still be here.
He was probably coeliac and worked as a sound engineer in the music business.
He lived the rock-and-roll lifestyle on a diet of ciggies, Subways and high strength cannabis.
He probably had an immune system, with all the strength of a plastic colander.
Consequently, he died at 37 of pancreatic cancer.
My First Christmas Snack Supper Of 2022
I saw the first of Marks & Spencer’s gluten-free Turkey Feast Christmas sandwiches in their Finsbury Pavement store today.
Note.
- The only allergens in the sandwich are egg and mustard.
- The cranberry sauce is real, but there appear ti be not enough cranberries to affect my Warfarin-controlled INR.
- Although the Adnams Ghost Ship 0.5 % is labelled as containing gluten, it seems to have no adverse effect on my body.
- I have discussed this with the brewer and they have told me, that there is so little barley in each bottle, that some might find the beer appears to be gluten-free.
I do think it the best humble sandwich, I’ve ever tasted.
Battersea Power Station – 14th October 2022
I went to Battersea Power Station today and took these pictures.
Note.
- The picture of my jacket was taken in the toilet. All male toilets should have a hook for jackets.
- The crane is still in place.
- There are a number of shops still to open.
- There was no food store, although a Marks and Spencer’s food store is coming soon.
- The only place to have a coffee and cake and sit down was Starbucks. But I never eat in an American cafe or eat American food, as I don’t trust their gluten labelling.
One guy I met described it as Dubai without the sand.
I have some thoughts.
Getting There
There are two main routes.
- Northern Line to Battersea Power Station station.
- Thames Clipper to Battersea Power Station pier.
I went by the Northern line, changing both ways at Tottenham Court Road station to and from the Elizabeth Line.
- This interchange is a short walk and step-free, if you use the lift.
- There are no trains to Battersea Power Station on the Bank branch of the Northern Line.
- There are five trains per hour (tph) to Battersea Power Station, with an extra two tph in the Peak.
- There are no Night Tube trains to Battersea Power Station.
I can see this service being improved.
Arriving At Battersea Power Station By Underground
Punters were certainly arriving.
Gluten-Free Food
There was absolutely none, that I could find.
At least though a Gordon Ramsay restaurant is opening soon.
Signage
It wasn’t good. But then I have found several modern shopping centres work on this principle.
Conclusion
Canary Wharf is better.
- Partly because the shops are more useful and to my taste.
- But mainly because it is on the Elizabeth and Jubilee Lines, and the DLR.
- All rail lines go through Canary Wharf rather than terminate there.
Battersea Power Station might be better, when the Northern Line is extended to Clapham Junction station.
One Of The Three Best Pastas That I’ve Ever Eaten!
I like pasta and regularly cook myself a quick pasta dish, like this one in Serial Cooking – Pasta With Yogurt Sauce For One.
I was staying in the Premier Inn by Chester railway station last night, so I popped in to the Modern Italian Restaurant next door called The Yard.
It was one of the three best pasta dishes, that I’d ever eaten and the others had been in Michelin-starred restaurants in Italy.
The chef had one pasta dish on the main menu, but it wasn’t gluten-free.
So he happily modified it for me.
Coeliacs On A Gluten-Free Diet And The AstraZeneca COVID-19 Vaccine
I am coeliac and I am on a strict gluten-free diet.
I have not had a serious dose of Covid-19, but I may have had a very mild dose, after a meeting with about twenty Chinese students, that I described in Did I Have A Close Brush With Covid-19?
That would not be possible to check now, but I did have a bad reaction after my AstraZeneca vaccine, which I wrote about in July 2021 in Hay Fever, Coeliac Disease And The AstraZeneca Covid-19 Vaccine. I also told my GP about it and he said he’d heard similar tales.
I had no reaction to my second AstraZeneca vaccine.
This year my hay fever was even worse. Is this due to my immune system being boosted by the vaccines?
Yesterday, at a funeral, I met an old friend, who is on a strict gluten-free diet and she had not had a serious dose of Covid-19. But like me, she did have a serious reaction to her first dose of the AstraZeneca vaccine.
I’d like to hear any experiences of coeliacs on a gluten-free diet during the pandemic.
Coeliac Disease And Atrial Fibrillation
I am 75 and coeliac and I had or have atrial fibrillation. Cardiologists tell me that, the atrial fibrillation led to my stroke in 2011.
I should also say, that my father was an undiagnosed coeliac and he died from a stroke younger than I am now.
I typed the title of this post into Doctor Google.
I found this paper on Cureus, which is entitled Celiac Disease and Risk of Atrial Fibrillation: A Meta-Analysis and Systematic Review.
I will show two paragraphs from the Abstract,
This is the Introduction.
Several studies have found celiac disease may be associated with a variety of cardiac manifestations. Atrial fibrillation (AF) is one of the most common arrhythmias that can cause significant morbidity. However, the risk of atrial fibrillation in patients with celiac disease according to epidemiological studies remains unclear. The aim of this meta-analysis study is to assess the risk of atrial fibrillation in patients diagnosed with celiac disease compared to controls.
And this is the Conclusion.
A significant association between celiac disease and risk of atrial fibrillation was reported in this study. There is a 38% increased risk of atrial fibrillation. Additional studies are needed to clarify the mechanistic link between atrial fibrillation and celiac disease. Some of the limitations of this study are that all were observational studies, some were medical registry-based and there was high heterogeneity between studies.
One of the paper’s conclusions is more research needs to be done.
I know that I have a supercharged immune system, in that it seems to protect me from flu and the dreaded covids and it gave the AstraZeneca vaccine a good kicking. Research from Nottingham University has also shown, that coeliacs on a gluten-free diet have a 25 % lower risk of cancer compared to the general population.
So I asked Doctor Google if there was any link between the immune system and atrial fibrillation.
I found this paper on PubMed, which is entitled The Role Of Immune Cells In Atrial Fibrillation.
This was the Abstract.
Atrial fibrillation (AF) is the most common sustained arrhythmia, but its mechanisms are poorly understood. Recently, accumulating evidence indicates a link between immune response and AF, but the precise mechanism remains unclear. It should be noticed that the relationship between immune response and AF is complex. Whether immune response is a cause or a result of AF is unclear. As the functional unit of the immune system, immune cells may play a vital role in the immunological pathogenesis of AF. In this review, we briefly highlight the evidence on relationships between immune cells and AF, and discuss their potential roles in AF pathogenesis. We hope this review could provide new orientation and enlightenment for further research on AF mechanism.
One of the paper’s conclusions is more research needs to be done.
Conclusion
I feel a lot of research concerning coeliacs, their immune systems and atrial fibrillation should be done and this could lead to a better understanding of atrial fibrillation.
Ease Up IPA Goes Gluten Free!
The title of this post, is the same as that of this page on the Adnams web site.
I am now 75 and I have been drinking Adnams beer, almost exclusively since I was thirteen.
My father introduced me to halves of Adnams bitter, whilst playing snooker at Felixstowe Conservative Club.
Part of his logic behind doing this was to teach me to drink alcohol responsibly, like he did and to prevent me ending up like his father, who was a drunk, who died before the age of forty.
The other thing, that my father’s teaching did was give me a preference for good real ale. And especially Adnams!
As I write this, I’m drinking a bottle of their 0.5 % Ghost Ship.
I drink it for three reasons.
- Obviously, I like the taste.
- It is low-alcohol, so it doesn’t affect the action of the Warfarin, that stops me having another stroke.
- I also find, that because the beer is made with low amounts of barley to keep the alcohol low, it doesn’t affect my gut, despite the fact that I’m a coeliac.
I have yet to find a low-alcohol beer, that has had an adverse effect on my body.
But Will Ease Up Be Safe For A Coeliac To Drink?
These paragraphs describe how Ease Up is brewed and the testing of the product.
When producing Ease Up, we now use an enzyme called Clarex® which breaks down gluten-type proteins, reducing gluten content to below 20 parts per million (ppm). Only foods that contain 20ppm or less can be labelled as ‘gluten-free.’ According to Coeliac UK, research shows people diagnosed as coeliac can consume products with gluten present at or less than this level, but customers are advised to consider their own individual tolerances.
Clarex® is added in the fermentation vessel, where it mixes well during a normal, vigorous fermentation. Our beer is tested at the end of fermentation and then, after packaging, it is put on hold while it undergoes a thorough external validation process before it is confirmed gluten free and released. Just look out for the new, updated branding.
Note the phrase about individual tolerances.
Conclusion
It looks like Adnams have produced the ideal real ale to have in your pub, club or house, if you have some coeliac customers, family or friends.
Never did I think, I would ever write about disruptive innovation in the brewing industry.
The Anonymous Widower 