“National Picture of Celiac Disease in Greece ” Eleftheria Roma Professor of Paediatric Gastroenterology of Athens University

COELIAC DISEASE IN GREECE Incidence: unknown (1:135 children from recent pilot study, unpublished) Under-diagnosed National cover of the cost for GF products Need for: collaboration of health professionals registry of patients more dieticians Need for education about the disease of: Patients Food producers and restaurants Schools and other services Health care professionals with regard to the detection and management of CD

Greek National task force Composed from 8 members: 4 Paediatric and an adult gastroenterologist, dietician, a coeliac patient member of the council of the HCS, and a representative of the Ministry of Health (dietician) The plans: Training and dissemination at national level all about CD Effort to register all diagnosed coeliacs (children and adults ) Better follow up (especially adults) Providing gluten-free menus in restaurants, schools Arrangement for the proper cost of GF products provided by the Government Effort for detection of asymptomatic or atypical CD

Building National Task Forces : which are the plans State of the art in the training and dissemination at national level Information about CD by the media, local societies, schools Work with Institution and Professional Societies Communication with Hellenic : Gastroenterology associations (Adult & Paediatric) Paediatric Association College of Paediatricians Internal medicine association Information and sensitization of medical students about CD Dissemination tailored to the General Practitioners Distribution by the government information about CD to GPs over the country Seminars about CD

GREEK COELIAC SOCIETY Members (children and adults): about 1300 Established in 1987 Activities Annual meeting ( participants) Annual participation of council members to AOECDS meeting Annually updated pamphlet with local and manufactured GF products Site for information Forum (chat between members) Support information by members Youth meetings (2-3/year, participants years old) Summer camp

Greek coeliac society General information Administration council AOECS The Association of European Coeliac Societies (AOECS) was founded in AOECS is the umbrella organisation of European Coeliac Societies and is an independent non-profit association. AOECS reviews problems of international importance, coordinates international activities and matters of common interest of the members and favours the exchange of information among the members for the benefit of Europeans affected by the coeliac condition or dermatitis herpetiformis. Greek coeliac society is also a member of AOECS and CYE.

The Greek Mediterranean diet and naturally gluten free foods

The key components of the Greek Mediterranean diet The key components of the Greek Mediterranean diet includes many naturally gluten free foods such as fruits, vegetables, protein rich legumes-beans, fish and sources of monounsaturated fatty acids (olive oil) and polyunsaturated fatty acids (such as omega-3 fatty acids)

Greek vegetable dishes Naturally gluten free Greek vegetable dishes are rich in fiber, vitamins and antioxidants.

Traditional Greek bean & lentil soups rich in soluble fiber & vegetable protein

Traditional stuffed vegetable dish called gemista Traditional stuffed vegetable dish made with several different vegetables(tomatoes), rice, parsley, mint and olive oil. Vine leaves stuffed with rice & parsley (dolmadakia)

Greek fast food-souvlaki and homemade french-fries

Traditional Greek deserts are naturally gluten free Rice pudding Yogurt, walnuts & honey

Greek desert made of honey and sesame seeds are naturally gluten free used by ancient Greek civilizations

The Diagnostic Guidelines actually working in the reality of our country How they are applicable in the country T-TG, EMA, (AGA occasionally) Biopsy HLA typing (especially in atypical cases ) not in all centers The status of contribution to the retrospective study Available data concerning the above tests

Training and dissemination in your country Medical students General practitioners Work with all institution and professional societies Information by the media

Starting a pilot study in the field far from reference centers A stratified study funded by the Hellenic SPGHAN concerning detection of CD by whole blood quick test is on the way Pilot data exist.

CONCLUSION Coeliac disease remains undiagnosed in the high proportion Need for intervention: education about the disease screening the high risk groups availability of GF products outside home follow up for improvement of compliance to GFD

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