14 Facts About Celiac Disease

iStock.com/fcafotodigital
iStock.com/fcafotodigital

Going gluten-free may be a modern diet trend, but people have been suffering from celiac disease—a chronic condition characterized by gluten intolerance—for centuries. Patients with celiac are ill-equipped to digest products made from certain grains containing gluten; wheat is the most common. In the short-term this can cause gastrointestinal distress, and in the long-term it can foster symptoms associated with early death.

Celiac diagnoses are more common than ever, which also means awareness of how to live with the condition is at an all-time high. Here are some things you might not know about celiac disease symptoms and treatments.

1. Celiac an autoimmune disease.

The bodies of people with celiac have a hostile reaction to gluten. When the protein moves through the digestive tract, the immune system responds by attacking the small intestine, causing inflammation that damages the lining of the organ. As this continues over time, the small intestine has trouble absorbing nutrients from other foods, which can lead to additional complications like anemia and osteoporosis.

2. You can get celiac disease from your parents.

Nearly all cases of celiac disease arise from certain variants of the genes HLA-DQA1 and HLA-DQB1. These genes help produce proteins in the body that allow the immune system to identify potentially dangerous foreign substances. Normally the immune system wouldn't label gliadin, a segment of the gluten protein, a threat, but due to mutations in these genes, the bodies of people with celiac treat gliadin as a hostile invader.

Because it's a genetic disorder, people with a first-degree relative (a sibling, parent, or child) with celiac have a 4 to 15 percent chance of having it themselves. And while almost all patients with celiac have these specific HLA-DQA1 and HLA-DQB1 variations, not everyone with the mutations will develop celiac. About 30 percent of the population has these gene variants, and only 3 percent of that group goes on to develop celiac disease.

3. Makeup might contribute to celiac disease symptoms.

People with celiac disease can’t properly process gluten, the protein naturally found in the grains like wheat, rye, and barley. Patients have to follow strict dietary guidelines and avoid most bread, pasta, and cereal, in order to manage their symptoms. But gluten isn’t limited to food products: It can also be found in some cosmetics. While makeup containing gluten causes no issues for many people with celiac, it can provoke rashes in others or lead to more problems if ingested. For those folks, gluten-free makeup is an option.

4. The name comes from 1st-century Greece.

A 1st-century Greek physician named Aretaeus of Cappadocia may have been the first person to describe celiac disease symptoms in writing [PDF]. He named it koiliakos after the Greek word koelia for abdomen, and he referred to people with the condition as coeliacs. In his description he wrote, “If the stomach be irretentive of the food and if it pass through undigested and crude, and nothing ascends into the body, we call such persons coeliacs.”

5. There are nearly 300 celiac disease symptoms.

Celiac disease may start in the gut, but it can be felt throughout the whole body. In children, the condition usually manifests as bloating, diarrhea, and abdominal discomfort, but as patients get older they start to experience more “non-classical” symptoms like anemia, arthritis, and fatigue. There are at least 281 symptoms associated with celiac disease, many of which overlap with other conditions and make celiac hard to diagnose. Other common symptoms of the disease include tooth discoloration, anxiety and depression, loss of fertility, and liver disorders. Celiac patients also have a greater chance of developing an additional autoimmune disorder, with the risk increasing the later in life the initial condition is diagnosed.

6. Some patients show no symptoms at all.

It’s not uncommon for celiac disease to be wrecking a patient’s digestive tract while showing no apparent symptoms. This form of the condition, sometimes called asymptomatic or “silent celiac disease,” likely contributes to part of the large number of people with celiac who are undiagnosed. People who are at high risk for the disease (the children of celiac sufferers, for example), or who have related conditions like type 1 diabetes and Down syndrome (both conditions that put patients at a greater risk for developing new autoimmune diseases) are encouraged to get tested for it even if they aren’t showing any signs.

7. It’s not the same as wheat sensitivity.

Celiac is often confused with wheat sensitivity, a separate condition that shares many symptoms with celiac, including gastrointestinal issues, depression, and fatigue. It’s often called gluten sensitivity or gluten intolerance, but because doctors still aren’t sure if gluten is the cause, many refer to it as non-celiac wheat sensitivity. There’s no test for it, but patients are often treated with the same gluten-free diet that’s prescribed to celiac patients.

8. It's not a wheat allergy either.

Celiac disease is often associated with wheat because it's one of the more common products containing gluten. While it's true that people with celiac can't eat wheat, the condition isn't a wheat allergy. Rather than reacting to the wheat, patients react to a specific protein that's found in the grain as well as others.

9. It can develop at any age.

Just because you don’t have celiac now doesn’t mean you’re in the clear for life: The disease can develop at any age, even in people who have tested negative for it previously. There are, however, two stages of life when symptoms are most likely to appear: early childhood (8 to 12 months) and middle adulthood (ages 40 to 60). People already genetically predisposed to celiac become more susceptible to it when the composition of their intestinal bacteria changes as they get older, either as a result of infection, surgery, antibiotics, or stress.

10. Not all grains are off-limits.

A gluten-free diet isn’t necessarily a grain-free diet. While it’s true that the popular grains wheat, barley, and rye contain gluten, there are plenty of grains and seeds that don’t and are safe for people with celiac to eat. These include quinoa, millet, amaranth, buckwheat, sorghum, and rice. Oats are also naturally gluten-free, but they're often contaminated with gluten during processing, so consumers with celiac should be cautious when buying them.

11. Celiac disease can be detected with a blood test.

Screenings for celiac disease used to be an involved process, with doctors monitoring patients’ reactions to their gluten-free diet over time. Today all it takes is a simple test to determine whether someone has celiac. People with the condition will have anti-tissue transglutaminase antibodies in their bloodstream. If a blood test confirms the presence of these proteins in a patient, doctors will then take a biopsy of their intestine to confirm the root cause.

12. The gluten-free diet doesn’t work for all patients.

Avoiding gluten is the most effective way to manage celiac disease, but the treatment doesn’t work 100 percent of the time. In up to a fifth of patients, the damaged intestinal lining does not recover even a year after switching to a gluten-free diet. Most cases of non-responsive celiac disease can be explained by people not following the diet closely enough, or by having other conditions like irritable bowel syndrome, lactose intolerance, or small intestine bacterial overgrowth that impede recovery. Just a small fraction of celiac disease sufferers don’t respond to a strict gluten-free diet and have no related conditions. These patients are usually prescribed steroids and immunosuppressants as alternative treatments.

13. If you don’t have celiac, gluten probably won’t hurt you.

The gluten-free diet trend has exploded in popularity in recent years, and most people who follow it have no medical reason to do so. Going gluten-free has been purported to do everything from help you lose weight to treat autism—but according to doctors, there’s no science behind these claims. Avoiding gluten may help some people feel better and more energetic because it forces them to cut heavily processed junk foods out of their diet. In such cases it’s the sugar and carbs that are making people feel sluggish—not the gluten protein. If you don’t have celiac or a gluten sensitivity, most experts recommend saving yourself the trouble by eating healthier in general rather than abstaining from gluten.

14. The numbers are growing.

A 2009 study found that four times as many people have celiac today than in the 1950s, and the spike can’t be explained by increased awareness alone. Researchers tested blood collected at the Warren Air Force Base between 1948 and 1954 and compared them to fresh samples from candidates living in one Minnesota county. The results supported the theory that celiac has become more prevalent in the last half-century. While experts aren’t exactly sure why the condition is more common today, it may have something to do with changes in how wheat is handled or the spread of gluten into medications and processed foods.

Keep Your Cat Busy With a Board Game That Doubles as a Scratch Pad

Cheerble
Cheerble

No matter how much you love playing with your cat, waving a feather toy in front of its face can get monotonous after a while (for the both of you). To shake up playtime, the Cheerble three-in-one board game looks to provide your feline housemate with hours of hands-free entertainment.

Cheerble's board game, which is currently raising money on Kickstarter, is designed to keep even the most restless cats stimulated. The first component of the game is the electronic Cheerble ball, which rolls on its own when your cat touches it with their paw or nose—no remote control required. And on days when your cat is especially energetic, you can adjust the ball's settings to roll and bounce in a way that matches their stamina.

Cheerable cat toy on Kickstarter.
Cheerble

The Cheerble balls are meant to pair with the Cheerble game board, which consists of a box that has plenty of room for balls to roll around. The board is also covered on one side with a platform that has holes big enough for your cat to fit their paws through, so they can hunt the balls like a game of Whack-a-Mole. And if your cat ever loses interest in chasing the ball, the board also includes a built-in scratch pad and fluffy wand toy to slap around. A simplified version of the board game includes the scratch pad without the wand or hole maze, so you can tailor your purchase for your cat's interests.

Cheerble cat board game.
Cheerble

Since launching its campaign on Kickstarter on April 23, Cheerble has raised over $128,000, already blowing past its initial goal of $6416. You can back the Kickstarter today to claim a Cheerble product, with $32 getting you a ball and $58 getting you the board game. You can make your pledge here, with shipping estimated for July 2020.

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The 15 Best Netflix Original Series

Tim Robinson stars in I Think You Should Leave with Tim Robinson.
Tim Robinson stars in I Think You Should Leave with Tim Robinson.
Netflix

Netflix is a cultural Rorschach test. In addition to being a revolution of the way we watch movies and television, it's a prestige factory that's helping to bring Oscar-quality entertainment to your home. And it's massive enough to be whatever you need it to be at whatever time you need it.

Seven years after House of Cards changed our perceptions of what streaming content could look like, Netflix has amassed a library of more than 100 original series (and that's only counting the English language stuff). Here are 15 of the best of them.

1. Russian Doll (2019- )

Nadia (Natasha Lyonne, who also co-created the series) is a game developer stuck in a time loop that keeps killing her and depositing her back at her own birthday party. If you roll your eyes at Groundhog Day situations, roll them back, because this incredibly inventive take from Lyonne, Leslye Headland, and Amy Poehler is deeply funny, strange, sad, and celebratory all at once. One woman's existential crisis is our binge-worthy content. As a bonus, Harry Nilsson's "Gotta Get Up" will be permanently stuck in your brain.

2. Dear White People (2017- )

Based on his (also excellent) 2014 feature, Justin Simien takes us back to prestigious Winchester University, where social justice bard Samantha White (Logan Browning) navigates the growing pains of collegiate romance and friendship while trying to make her classmates recognize the social divisions at their school. Through three seasons (with a fourth coming in 2020), the show has faithfully delivered outrageous humor with its singular blend of satire and soap opera.

3. GLOW (2017- )

Anchored by Alison Brie, Betty Gilpin, and a stellar ensemble cast, GLOW follows a group of women who launch a wrestling show backed by a trust fund kid and a cranky cult horror director (brilliantly played by Marc Maron). It scored laughs from how awkward everything was early on, but the show really sailed when Brie and her cohorts began to fully own the weird, wonderful spandex assault they were creating. Now it's about keeping that show, their group, and their personal lives intact.

4. I Think You Should Leave with Tim Robinson (2019- )

Tim Robinson is a Saturday Night Live alum whose sketch show couldn't be further from that mainstay's sensibilities. Where SNL is the McDonald's of comedy, I Think You Should Leave is the hole-in-the-wall place only you and your friends love because it keeps changing the menu with new dishes you can't get anywhere else. It's fair to call the show outlandish, but its comic brilliance stems from the simplicity of its setups and the deranged lengths that the characters go to in order to stick with that premise. Learn nothing else and dive in.

5. BoJack Horseman (2014-2020)

It's the silly cartoon show here to make you think about death and get sad and stuff. Like emo music for grownups, Raphael Bob-Waksberg and Lisa Hanawalt's brilliant series focuses on the addiction, self-loathing, and career envy of its titular anti-hero as he attempts to crawl out of the cheesy '80s sitcom stardom of his past and into something more respected. No other show can get away with this many animal puns while exploring the depths of despair that result from trying to fill a bottomless pit in your soul.

6. Master of None (2015- )

Allora! Although it has dipped its toe into experimentation, Aziz Ansari and Alan Yang's relationship comedy works largely because of the likability of Dev Shah (its main character, played by Ansari). It's buoyant and feels like you're hanging out with friends but, fair warning, it will make you deliriously hungry for pasta.

7. Sex Education (2019- )

Plenty of high school comedies have focused on how awkward sex and romance is for high schoolers, but this fantastic show from Laurie Nunn wanted to raise the stakes by making the young, sexually ambivalent main character's mom a sex therapist. In another ingenious move, they hired Gillian Anderson to play that sex therapist mom, and she delivers all the frank, embarrassing talk you could possibly ask for. So what happens when the insecure son of a sex therapist starts his own sex therapy side hustle to help his high school friends? An excellent, empathetic series that uses its laughs as a release.

8. Sense8 (2015-2018)

Eight strangers living all over the world discover they are emotionally connected to each other. They can feel what others in their cluster are feeling and can communicate with each other despite physical separation. Teaming with comic book and screenwriter J. Michael Straczynski, the Wachowskis have pulled another big-think, sci-fi rabbit out of their hats with this globetrotting thriller that's never met a third-rail issue it didn't want to explore. When they're not running from a mysterious entity bent on their destruction, the fascinatingly diverse crew of connected characters break down everything you're not supposed to talk about at the dinner table. So maybe we should be talking about them around the dinner table?

9. Orange is the New Black (2013-2019)

One of Netflix's original originals is still one of its best. Jenji Kohan found a perfect follow-up to Weeds with this adaptation of Piper Kerman's memoir about a young suburban woman going to a minimum-security prison. The fish-out-of-water comedy, drama, and horror only lasts as long as it takes for the show to blossom into a gorgeous, emotional roller coaster that shines the spotlight on all of its women—from the surly cook Red (Kate Mulgrew) to the sweet/troubled Crazy Eyes (Uzo Aduba)—to humanize them beyond the personas they adopt to survive. The show is a hilarious self-peeling onion, tears and all.

10. Astronomy Club (2019- )

Within the first two minutes of Astronomy Club, a talking garlic bulb shoots a gun at Dracula and shouts "Tryin' get this money in 2020, baby!" Fortunately, it gets weirder. This sketch show from some Upright Citizens Brigade alums is framed around a fake reality show that wisely lets us get to know these new performers while mocking every Real World descendant and the cast themselves. The comedy ranges from self-aware and absurdist to straightforward and even socially-conscious, and it all blends together smoothly. A one-of-a-kind winner.

11. The Crown (2016- )

Peter Morgan's historical drama has taken advantage of the new format and the lengthy reign of Queen Elizabeth II to craft a charming, devilish exploration of the scandals and triumphs of her adult life. As The Crown has covered decades and decades, it has shifted from Claire Foy playing the young queen (post-WWII) to Olivia Colman playing her through middle age (Winston Churchill's death and Soviet espionage intrigue) and will eventually star Imelda Staunton as the older queen closing out the show in the early 2000s (the years, not her age). It's an anglophile's delight with keen dramatic instincts and a huge list of world events to tackle.

12. Mindhunter (2017- )

Based on Mindhunter: Inside the FBI's Elite Serial Crime Unit, the series—created by Joe Penhall and executive produced by David Fincher—uncovers our earliest understanding of serial killers and the pioneering research conducted by letting FBI agents interview the country's most notorious murderers about their crimes. The fictionalized team played by Jonathan Groff, Holt McCallany, and Anna Torv battle bureaucracy and old paradigms in order to get their fledgling, vital program to succeed in using the criminal mind to help solve future cases. It's a delicate, gorgeous show exploring our worst impulses, and, chillingly, uses real serial killers' own words to describe their acts.

13. Stranger Things (2016- )

If there were an Audience Choice Award winner for this list, this nostalgia-bomb from the Duffer Brothers would score it. An absolute phenomenon that stuffs Steven Spielberg, The X-Men, and D&D into a blender and pours the results into a Trapper Keeper, the adventures of the psychokinetic Eleven and her band of merry young men are wondrously creepy fun. Perfect PG-13 horror where puberty and a Cthulhu-esque behemoth from a different dimension are equally strong villains.

14. The OA (2016-2019)

After being missing for seven years, a blind woman named Prairie Johnson (Brit Marling) resurfaces with the ability to see and calling herself the Original Angel. The series is a stunning blend of sci-fi and fantasy that explores past trauma and near-death experiences with the backdrop of dimension-hopping adventure. It's an epic, intimate story that's truly unlike anything else, and diving into the magnetic first episode comes with the risk of getting addicted to a series that (for now) ends on a cliffhanger.

15. American Vandal (2017-2018)

American Scandal is undoubtedly the best show ever made about misdemeanor penis drawings. What might have been a crass, surface-level parody of our obsession with true crime stories is elevated to the highest of comedic heights due to the unwavering dedication to taking its juvenile crimes seriously. The first season focuses on a high school slacker who swears he's innocent of drawing the aforementioned phalluses on dozens of cars in the school parking lot while the second uncovers the truth about who spiked cafeteria lemonade with a laxative to cause an event known as "The Brownout." Imbued with all the twists and obsessively granular details of Serial, it's a miracle that they filmed any of it with a straight face.