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Dear All,

I've not really got every piece of information in on this
yet but I'm now fairly clear that there really is very
little.  Most of the papers I have read are poor
scientifically and dose data (the amount of gluten you can
eat without risk to health) is pretty much non-existant.
For example THE study everyone quotes for lymphoma and
coeliac is by Holmes et al (Gut 1989; 30:333-8).

This is the study that Joe Murray pointed me to when I
contacted him.  There are a number of questions that can be
asked about what is claimed for this study but let's look
at the "dose data" first.

The authors grouped their subjects into 3 groups.

1       "Gluten-free diet"
2       "Low-gluten diet"
3       "Normal diet"

None of these are clearly defined.  The "GF diet" may or
may not include people eating purified wheat starch.  This
group had a similar level of lymphoma to normal people.
The "low-gluten" group were people who "cheated on their
diet".  They could vary from "GF diet" to "normal diet"
depending how much they cheated and how honest they and the
members of the other groups were.  They had similar
significantly higher lymphoma levels to those on a "normal
diet".

As you can see there's not a lot of certainty in any of
this.  Other papers which I have read abstracts have
similarly vague definitions in them.  One very interesting
one shows how the level of lymphoma in newly diagnosed
coeliacs falls to normal after they have gone onto a
GF diet.  Once again there is no definition of what this
is.  Since BOTH of these papers originate here in the UK
this may well mean that purified starch IS OK from the
point of view of lymphoma - but I can't PROVE that.

Finally the statistical meaning of these papers has been
overstated by the medical profession.  It is PRUDENT to
assume that there is a link between coeliacs eating too
much gluten but these papers do NOT PROVE it.  They show
what is known as an association.  This means that the one
MAY cause the other BUT IT MIGHT NOT.  Unfortunately this
has not been recognised and clearly stated.

I'm now waiting for a friend and colleague to come back
from a round of holidays and conferences.  He's an expert
on a very similar disease to coeliac in pigs, caused by
soya husk.  I intend to see what he has in terms of
similarities and differences and how the dose of soya husk
affects these pigs.  It MIGHT be a good model for coeliac
(it might not too).  Of course he's a vet........

Regards

David

David J Walland
University of Bristol Radiation Protection Adviser
[log in to unmask]
Tel +44 (0)117 928 8323
Fax +44 (0)117 929 1209

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