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Summary "Celiac child and cholesterol":
The general tone of the 24 replies was one of healthy doubt regarding the
importance of the cholesterol reading and the doctor's reaction. At least
two parents have had a similar experience in which the doctor has been
blinded by the cholesterol and not immediately realised the danger of an
even more restrictive diet (several suggested seeing a nutritionist).

1. Several posters suggest or state that most cholesterol originates in the
body and does not come directly from ingested food. I have since
corroborated this (less than 20% is assimilated cholesterol) which puts some
doubt on the relevance of a low cholesterol diet.

2. Four people mention the triglyceride-insulin-cholesterol connection
although it seems to underlie several other messages and, in consequence, 5
suggest the reduction of starches and one that of carbohydrates (presumably
"fast" carbs). Three people recommend a high protein low starch diet
including eggs or egg whites.

3. Five posters have heard of evidence that there is a connection between CD
and high cholesterol levels and 3 maintain it is a question of genetic
makeup. I understand these two views to be basically the same. Another,
however, suggests that the connection derives from the celiac's getting most
calories from meat, fat and eggs.

4. On the other hand, two say that the celiac does not absorb fats.

5. Three say that a nutrient deficiency may cause high cholesterol and one
that a low thyroid function produces the same result. Suggestions include
niacin and folic acid as well as early morning vitamin C as a stimulant for
bile cholesterol elimination.

6. It seems that cholesterol is eliminated from the body by the liver in the
form of bile cholesterol incorporated in the stools. Apart from the vitamin
C mentioned above, 4 posters recommend bran (rice bran in the case of
celiacs) as an aid.

Conclusions based on the above and references furnished by posters and other
sources:

1. We should not get over concerned about the high cholesterol level: more
important is the HDL/LDL ratio.

2. Despite some contradictions, the amount of cholesterol ingested is less
relevant than the amount produced and here we should aim at reducing the
production.

3. Nutrients should not be sacrificed to cholesterol and, if the level does
not come down, we should test for nutrient deficiencies or other causes.

4. Although we are dealing in this case with a child who has not yet had
time to develop violent insulin reactions, we should reduce starches and
"fast" carbohydrates.

5. Lean meat, eggs etc. are less of a problem than suggested by the doctor.

Dairy products may have more to do with cholesterol than these. Plenty of
fibre is essential and we should concentrate on natural sources (fruit etc.)
of vitamins and other nutrients and eliminate anything like ice-cream etc.

Thank you all very much. Although somehow we have the feeling more questions
have been raised than answered, we are on the way to doing something
sensible.

Martin Harris