Going Gluten-FreeAugust 31, 2011

More of Us Are Getting Celiac Disease. Why?

It’s documented by recent studies that the number of people in the United States with celiac disease has increased notably since the 1950s. This increase is way beyond what can be explained by heightened awareness and better screening tools. Interestingly, it tracks the upward trend in prevalence rates of other autoimmune conditions, such as diabetes and food allergies, as well as childhood disorders like asthma, autism and ADHD.

What’s going on?

Researchers are delving into the problem and experts speculate on multi-factored causes, likely a mysterious combination of environment and genetics.

Theories behind environmental contributors include the “hygiene hypothesis” (industrialized society has become so sanitized that it’s prompting our immune systems to misfire), as well as multiple chemical toxins, timing of gluten introduction in infancy and even the dropping rates of breastfeeding.

I interviewed celiac expert and researcher Alessio Fasano, MD, director of the Center for Celiac Research at the University of Maryland, about this and other issues related to gluten sensitivity (non-celiac gluten intolerance), a couple months ago. Here’s a snippet of that conversation [click here for the full interview]

Up to 20 million Americans may have gluten sensitivity. That’s in addition to 3 million who have celiac disease and 400,000 to 600,000 with wheat allergy. Humans have consumed wheat as a staple for generations. What’s going on?

Dr. Fasano: Although we’ve been eating wheat for thousands of years, we are not engineered to digest gluten. We are able to completely digest every protein we put in our mouth with the exception of one—and that’s gluten. Gluten is a weird protein. We don’t have the enzymes to dismantle it completely, leaving undigested peptides that can be harmful. The immune system may perceive them as an enemy and mount an immune response. 

It seems like we’re seeing an explosion of gluten-related health problems.

Dr. Fasano: Two components are coming together to create this perfect storm. First, the grains we’re eating have changed dramatically. In our great-grandparents era, wheat contained very low amounts of gluten and it was harvested once a year. Now we’ve engineered our grain to substantially increase yields and contain characteristics, like more elasticity, that we like. We’re susceptible to the consequences of these extremely rich, gluten-containing grains. Second, and this applies to the prevalence of celiac disease that’s increased 4-fold in the last 40 years, is the upward trend we’re seeing in all autoimmune diseases. We’re changing our environment faster than our bodies can adapt to it.

Dr. Fasano elaborated on these thoughts in the keynote address he delivered at the Celiac Disease Foundation’s annual conference on May 14th. I’ve excerpted some of his comments:

 “….Perhaps the most important aspect [as to why certain people suddenly develop celiac disease in their senior years] is the change of that “parallel civilization” that lives with us for our entire life, i.e., the bugs that live in our guts.… The composition of that village was changed and [these patients] switched from [gluten] tolerance to the immune response. At the Center for Celiac Research in Maryland, we are really looking into this aspect of the story to see if, indeed, this is true.” (CDF Newsletter, Summer 2011)

Could it be as simple (and complex) as unbalanced pathogenic gut flora? Maybe it comes down, at least in part, to our multi-generational overuse of antibiotics combined with our national bad eating habits and their effect on the bacterial balance in our guts. Maybe the future of celiac research includes examining how to foster the healthiest possible environment for growing and maintaining the most vibrant village of good microbes and bacteria in our intestines.

Hurray for probiotics? Just a thought. What do you think?

Comments (10)

Its time something is done about our food supply. New diseases and ailments popping up gastro related, and upswing in e-coli cases the only thing that has really changed is that monsanto has genetically altered seed for which they now corner the market on producing upwards to 90% of the seed used by farmers look it up and the timetable im more than sure there is a direct correaltion

Posted by: cjp6811@gmail.com | September 6, 2011 8:06 AM    Report this comment

I was diagnosed with celiac disease 12 years ago after suffering and being very ill for 12 years and going to many drs. who did not have a clue what was wrong and did many tests. I do not understand what this DNA test is that Rosa posted. I would say that if your blood test and biopsy came back positive for celiac disease that you have celiac disease. I have a wonderful dr. that I love. Her name is Dr. Iqbal and she is located in Longmont. She knows a lot about celiac disease and has a wealth of information. Mary Lorenz

Posted by: MLorenz | September 1, 2011 11:04 PM    Report this comment

hi my name is pat and I have noticed a lot has changed in the food industry in the last five years, bieng a celiec I have had to make my own bread and cake because I cant eat foods with wheat, glutin and dairy, also have to watch that there is no preservatives. or artiftial sweetener. and stuff like nuts apples oranges lemons capsicums and spices of any kind. Most of the time I eat well, but somtimes for no reason my stomach goes nuts, but I am living with it can be hard at times,if anybody nows of some new treatment for this condition let me know, use my email account ok thanks pat, ps if you want any recipes let me know I am willing to help when and if I can.

Posted by: patmouse | September 1, 2011 10:52 PM    Report this comment

@Carrie S - you're not crazy and your doctor is very poorly informed. Tell him to read Dr. Fasano's articles! :)

Posted by: Regina M | September 1, 2011 8:03 PM    Report this comment

I very much believe that antibiotics and too many vaccinations have destroyed the flora and health in my 20 yr. old daughter's gut. She cannot eat gluten, diary, or eggs. When she was little I got her off milk because even though I didn't know the cause, she seemed to get stomach aches when consuming any milk products the same was true of eggs with the yolk so she always ate only egg whites, by the time she was 18 she had been on a leadership program where she consumed mass amounts of gluten because pasta and bread is an easy thing to fix when living in the wilderness. She had just had her last and 3rd gardisil vaccination prior to leaving for the program and came home with all kinds of gut issues. We are still trying to get her system straightened out! We have gone to clean eating but because her gut is so messed up she cannot absorb the nutrients to keep her system healthy, she is under weight and her hormones are completely non functioning. We have not eaten at a restaurant in months because though they may say some of the items are GF there is no way without serious interrogation on how they handle everything in the kitchen to know if there has been no cross contamination. A very difficult situation caused by our society: policy makers and food manufacturers and the medical profession! I hope things will begin to change and more people will become aware of all the ills that have been created!

Posted by: Ann S | September 1, 2011 5:08 PM    Report this comment

The comments above are probably all right on point. Exposure undoubtedly has a great deal to do with the problem. There is another problem, too: the use of soy products has beome quite widespread, and unfermented soy products can also cause autoimmune disease. They have many of the toxins present in nightshades, but in much greater abundance and also with very strong resistance to neutralization by cooking.

I have found that I have airborne allergies to many of the grasses that are members of the Poaceae family to which the gluten grasses belong. As a result, I have allergic symptoms when I use them as alternative grains. Examples include wild rice, sorghum, teff. As I have eliminated soy products and the additional grains to which I am sensitive, my autoimmune symptoms have gone into remission and require no further medication. I had been diagnosed with SLE back in the 1980s and used many medications (including inhalers and thyroid replacement hormone since the late 1980s). Now I require none of them.

I understand "molecular mimicry" is an issue with both gluten and soy, although I am only beginning to understand it.

For additional info on soy, see "The Whole Soy Story: The Dark Side of Soy" by K. Daniels. The book is informative and humorous, but there may be other good ones. I initially got well after going gluten-free, but then autoimmune disease returned. The only thing that had changed in my diet was that I'd begun using a good deal of soy, which is presented as a great health food. I zeroed in on it and began searching for information. Then the autoimmune disease symptoms disappeared again after I eliminated it from my diet. I still use a little (very little) wheat-free, fermented soy sauce for flavoring, though.

Posted by: Sally E | September 1, 2011 3:19 PM    Report this comment

I am so lost now that my genetic test came back negative for Celiac disease when the biopsy and blood tests were positive for Celiac disease. Somebody have had something like this happened?

Posted by: Rosa Rodriguez | September 1, 2011 3:12 PM    Report this comment

I recently had the dna test done to find out if I had celiac or gluten sensitivity because my gastro doc kept putting me thru test after test. Yes I do have crohns, but I have been gluten free now for 2 months and feeling better everyday. However, I took the dna test to the gastro doc and he told me there was not such test to find out and that I wasted my money and wants to put me on a drug that you have to have blood tests every week and very bad side affects. I told him no. I have spent a lot of money on all the tests he has put me thru but the dna test proved to be the best test I had. I don't know who to turn to now, I would like a 2nd opinion but don't know who to go to. My doc feels that if you were not born in a certain part of the world you can't possibly have it. I really need someone to tell me that I am not crazy I guess.

Posted by: Carrie S | September 1, 2011 2:25 PM    Report this comment

It's our FOOD! Saw an episode on "The Doctors." It's disgusting what chemicals and pesticides are in our foods. They know that certain dyes have a direct effect on hyperactivity and other issues in children, yet it's still in their foods. Babies are born with a large amount of chemicals in their systems already.

Wheat used to have much less gluten in it. But with all the changes made to it to increase production and make it disease and insect resistant, it has 70 or 80% (can't remember exact %) more gluten in it now.

When will this change? Obviously not in the near future....

Posted by: CAROL D | September 1, 2011 1:04 PM    Report this comment

I believe that people completely underestimate or are unaware of the huge changes in our food supply that have taken place within the last 50 years. Farming practices have dramatically altered. Food genetics have been manipulated for highest profitability not highest nutrition or food safety. Food imports have changed food manufacturing practices world-wide.

Food supplement companies and pharmaceuticals source materials world-wide with minimal quality control. Food chemistry has maximized utilization of every aspect of gluten grains to the point where it is nearly impossible to limit exposure to glutens. Glutens are in processed foods, medications, supplements, packaging, clothes, cleaning supplies. Since exposure plays a significant role in triggering immune reactions it's not surprising that there has been a big upswing in numbers of affected individuals at earlier and earlier ages. Older people have had at least had some years of lower exposure. Today's children have never lived in a world where gluten wasn't in practically every food they might eat.

It's popular to blame 'bad eating habits' for a host of illnesses. However, I believe that the huge rise in numbers of celiacs, gluten intolerance cases, ADHD and other autoimmune disorders has more to do the the fundamental changes in the food supply. I never had 'bad eating habits' yet I became gluten intolerant as a senior. Why? Because if you have the genes and gluten exposure is unavoidable, then eventually the intolerance will be triggered.

I think that the percentage of people who carry the genes for celiac/gluten intolerance has remained about 30% of the population. Consequently the 4 fold increase in the last 40 years is most likely due to an increase in exposure. The increase also coincides with the rise in use of genetically modified grains in the 1970's, the big changes in farming and food industry. It's not a matter of 'bad eating habit's if the food that is available to us is making us sick.

Posted by: Jean S | September 1, 2011 11:14 AM    Report this comment

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