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From:
Dawn Grassick Qld Biochemics Pty Ltd <[log in to unmask]>
Date:
Tue, 24 Nov 1998 01:58:17 -0400
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<<Disclaimer: Verify this information before applying it to your situation.>>

Thank you to everyone who responded.  My question was (23/10/98):

'I've read that coeliacs have trouble digesting fats and that's why they are
often very thin.  Also, they have trouble getting enough of the fat-soluble
vitamins. I can understand this since an impared intestines may not absorb
certain things.  However, I've read in a couple of places that coeliacs
respond well to a diet that is free of gluten and 'high in calories and
protein and LOW IN FAT'.  I don't understand enough about the digestive
process to know why this should be.  Is it just because coeliacs don't
absorb fats very well or is it an enzyme impared thing like those coeliacs
who have problems with milk?'

Generally, the responses fell into two categories:

1.  Once the GF diet has been followed long enough for the gut to repair
itself, the coeliac may start absorbing/breaking down fat like a non-coeliac
and therefore may gain a lot of weight.

2.   Coeliacs may have problems generally in breaking down fats because
while usually (simply put) the liver/gallbladder get commands to make
fat-breaking enzymes from the gut, this doesn't happen so well in a coeliac
so the liver gets 'tired'. (A naturopath I know told me that, if this is the
case, then reducing fat intake puts less strain on an overworked liver)

The responses are below (I didn't put people's names to protect privacy).
Thanks to all, Dawn G (Australia)

************
'I think it's because the medical establishment has bought into the lowfat
eating craze. People on lowcarb, higher protein diets eat plenty of fat
with no problem (whether they are celiac or not!) In their case, it isn't
fat that makes them fat, it's carbohydrates and what they do to insulin (a
fat promoting hormone). Everyone is different, but I wouldn't worry about
a little fat, personally.'

***********
'The only reason why I can think of why someone might have trouble with fats
(perhaps when they first go on the gluten free diet) would be this:  When fats
reach  the upper part of the intestine,  there is a hormone called
cholecystokinin that is produced in the intestinal mucosa and when brought to
the gall bladder by the blood stream, this causes bile to be released and bile
emulsifies fats (or breaks them down into smaller pieces for digestion).  If
this hormone is not released because of a damaged intestine, then fats do not
get emulsified and also do not get absorbed.'

***********
'... my doctor was concerned that I was not getting enough fats, she
recommended that I pour extra virgin olive oil on everything I eat.  The
only time fats are not able to be digested is when I'm under gluten attack....'

***********
'I believe the problem is that the fat is not absorbed [it has been
digested] because of malabsorbtion problems, due to the flattened villi in
the gut.'
***********
'For me, the reason for a low fat diet is simply that once I went on a
gluten free diet - after 42 years of eating gluten - my body went into a
survival mode. That meant that whatever I ate, it made sure to put into
storage just in case I "starved" it again. The wonderful dietician I saw
concluded that in order to keep my weight down, I needed to be very
conscious of how much fat I consumed.'
***********
'When celiacs stop eating gluten completely, the body heals itself
completely. So
what you read could about the low-fat diet could relate to one of two things:
scenario 1: newly diagnosed celiacs' intestines aren't healed yet, and they
benefit from the calories and protein to build up their strength, and from
the low-fat to aide
digestion during the early, not-all-better-yet phase. Dairy is usually
avoided for
the first 3 months too, because the enzymes secreted to digest milk products are
located on the damaged villi - when the villi heal the person can tolerate dairy
again.  scenario 2: because the intestines heal completely, the celiac off
gluten is able to absorb food and nutrients as well as anyone else. (that's
very important to understand). So we gain weight - especially those of us
who over-ate before diagnosis to keep from losing weight. So the low-fat
diet helps there too.'

END

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