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?