Most with celiac disease unaware of it; others go gluten-free without diagnosis

ScienceDaily (July 31, 2012) — Roughly 1.8 million Americans have celiac disease, but around 1.4 million of them are unaware that they have it, a Mayo Clinic-led analysis of the condition's prevalence has found. Meanwhile, 1.6 million people in the United States are on a gluten-free diet even though they haven't been diagnosed with celiac disease, according to the study published July 31 in the American Journal of Gastroenterology.

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Researchers have estimated the rate of diagnosed and undiagnosed celiac disease at similar levels prior to this study, but this is the most definitive study on the issue. "This provides proof that this disease is common in the United States," says co-author Joseph Murray, M.D., a Mayo Clinic gastroenterologist. "If you detect one person for every five or six (who have it), we aren't doing a very good job detecting celiac disease."

Celiac disease is a digestive disorder brought on when genetically susceptible people eat wheat, rye and barley. A gluten-free diet, which excludes the protein gluten, is used to treat celiac disease. Roughly 80 percent of the people on a gluten-free diet do so without a diagnosis of celiac disease.

"There are a lot of people on a gluten-free diet, and it's not clear what the medical need for that is," Dr. Murray says. "It is important if someone thinks they might have celiac disease that they be tested first before they go on the diet."

To determine its prevalence, researchers combined blood tests confirming celiac disease with interviews from a Centers for Disease Control and Prevention (CDC) nationwide population sample survey called National Health and Nutrition Examination Survey. The survey, designed to assess the health and nutrition of U.S. adults and children, is unique in that it combines interviews and physical examinations.

Researchers found that celiac disease is much more common in Caucasians.

"In fact, virtually all the individuals we found were non-Hispanic Caucasians," says co-author Alberto Rubio-Tapia, M.D., a Mayo Clinic gastroenterologist. But previous research in Mexico has shown that celiac disease could be just as common as it is in the U.S.

"So that is something we don't fully understand," Dr. Rubio-Tapia says. The study found the rate of celiac disease in the U.S. is similar to that found in several European countries.

The research was funded in part by the National Institutes of Health and the CDC. Study authors include James Everhart, M.D., from the National Institute of Diabetes and Digestive and Kidney Disease; Jonas Ludvigsson, M.D., Ph.D., from Orebro University Hospital and the Karolinska Institutet; and Tricia Brantner from Mayo Clinic.

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Humans Can Sniff Out Old Age in Others, Study Shows

HealthDay – 4 hrs ago WEDNESDAY, May 30 (HealthDay News) -- How old do you think you smell? A new study suggests that humans possess the ability to judge whether a person has reached their senior years just by sniffing their body odor.

People in the study correctly gauged whether the former wearer of an underarm pad was elderly or not just by sniffing it. And for the record, most didn't think "old-people smell" was off-putting at all.

The finding "shows that there's yet another signal hidden in the body odor that we are somehow able to extract and make use of," said study co-author Johan Lundstrom, an assistant professor at the Monell Chemical Senses Center, in Philadelphia.

As for the notion that "old-people smell" doesn't leave people as disgusted as you might expect, Lundstrom said the odor's power -- or lack thereof -- appears to have a lot to do with whether the elderly are actually physically present. "Lacking a context, the negativity of the body odors disappear," he said.

The study authors launched their research as part of an effort to better understand the chemical signals that people detect in body odor. Previous research had suggested that we can pick up signs of sickness in other people's body odor and even get a sense of whether someone is related to us, Lundstrom said.

Animals appear to be able to detect age through body odor, he said, although it's not clear why it might matter to them. One theory is that the signal could let other animals know that an animal is older and thus more likely to produce offspring because it's managed to stay alive so long, he said.

In the new study, 56 people -- 20 young (20 to 30 years old), 20 middle-aged (45 to 55), and 16 elderly (75 to 95) -- wore clean T-shirts and underarm pads while sleeping. The pads soaked up a sample of each individual's body odor.

The researchers then asked 41 young people to smell the resulting odors -- from pads kept in glass jars -- and try to tell them apart.

Participants were generally able to discriminate between the age groups, but they weren't much better at it than chance, Lundstrom said. However, they were able to do a better job of grouping together body odors from older people and identifying them as coming from the elderly.

"The old-age body odor sticks out," Lundstrom said, but it didn't do so in a negative way. In fact, the subjects tended to think the old age body odors were more pleasant and less intense than those of other age groups.

One factor might explain that: Older men smell more like women, possibly because they've lost testosterone, Lundstrom said.

He also noted that the people who provided their body odor for the study were healthy. That means the older people did not suffer from problems that can occur among seniors that might affect their body odors, such as incontinence.

The "popular prejudice" against the odor of the elderly probably reflects people's distaste for odors in geriatric wards and nursing homes, noted one expert, Tim Jacob, a professor of biosciences at Cardiff University, in England, who studies smell and is familiar with the new study's findings.

"This is obviously an unfair association," he said. "But if people know where the smell originates

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