title: Tef in the diet of celiac patients in The Netherlands.
abstract: OBJECTIVE
  Celiac disease (CD) is a multifactorial disease with a strong genetic association. It is caused by a T-cell-mediated immune response to wheat gluten. The treatment is a strict gluten-free diet (GFD). The purpose of this study was to investigate whether the naturally gluten-free cereal Eragrostis tef (tef) is associated with health problems when used by CD patients.
  
  
  METHODS
  In March 2006, all 7990 members of the Dutch Celiac Disease Society were invited to complete a questionnaire on tef use and the development of symptoms after tef consumption. Respondents and their family members willing to participate were sent an extended questionnaire on the use of commercially available tef products and on the character of their subsequent symptoms.
  
  
  RESULTS
  Thirty-six percent responded to the first questionnaire of whom 53% consumed tef and 15% reported complaints. For the second questionnaire, out of the 1828 participants willing to complete it, 1545 had biopsy-proven CD (median duration GFD: 6.5 years (range: 0-66.5 years)). Of these, 66% used tef (median duration 1.4 years (range: 0.1-5 years)) and 17% reported symptoms after consumption. The percentage for symptoms was significantly lower than that in patients without tef consumption reporting on their regular GFD (17% versus 61%; p = 0.0001).
  
  
  CONCLUSIONS
  Tef is frequently used by Dutch CD patients and a wide majority can consume tef without experiencing any clinical symptoms. CD patients using tef reported a significant reduction in symptoms, possibly related to a reduction in gluten intake or to an increase in fiber intake. Hence, tef can be a valuable addition to the GFD of CD patients.
authors.affiliation: Department of Dietetics and Nutrition, Leiden University Medical Center, Leiden, The Netherlands. G.D.Hopman@lumc.nl
authors.forename: Erica
authors.initials: E
authors.lastname: Hopman
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Dekking
authors.forename: Marie-Loes
authors.initials: ML
authors.lastname: Blokland
authors.forename: Maud
authors.initials: M
authors.lastname: Wuisman
authors.forename: Walter
authors.initials: W
authors.lastname: Zuijderduin
authors.forename: Frits
authors.initials: F
authors.lastname: Koning
authors.forename: Joachim
authors.initials: J
authors.lastname: Schweizer
mesh_terms: D001706:Biopsy; D002446:Celiac Disease / Q000178:diet therapy* / Q000453:epidemiology / Q000473:pathology; D055050:Diet, Gluten-Free / Q000379:methods*; D031750:Eragrostis; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D018514:Plant Structures; D015995:Prevalence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome