By all accounts, both celiac disease and gluten intolerance are being diagnosed much more widely these days. A recent study by Joseph Murray, MD, of the Mayo Clinic, tested blood samples taken fifty years ago and compared the incidence of celiac disease with blood samples taken today. The study found that the incidence of celiac disease today is four times what it was fifty years ago.
There’s much ongoing debate about why celiac and gluten sensitivity diagnoses are increasing, which includes both research and conjecture.
Here are a few controversial theories we’ve heard about why celiac disease and gluten intolerance are being diagnosed more frequently than before.
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Celiac disease is not becoming more common. Doctors are simply more aware of it and are testing for it and diagnosing it more accurately.
This theory sees the increase in celiac diagnoses as simply the result of doctors becoming more educated about celiac disease and being more likely to test for it. It used to be that children with failure to thrive or adults with severe gastrointestinal distress plus bone density issues were the only people tested for celiac disease. Now more and more doctors know that overweight people are just as likely as underweight people to have celiac disease, and that it’s worth testing for in anyone presented with ongoing symptoms (ranging from diarrhea to neurological issues). It’s equally as worth testing in those who have other autoimmune conditions and/or who have relatives with celiac disease.
Newer and more sensitive tests help accurately diagnose cases that would have been negative before. Naturally, because we are testing more, we are getting more positive test results. A recent study shows that in the United States, 1 in 147 people have celiac disease – and this number is closer to 1 in 100 for non-Hispanic whites. This theory does not account for the results of the Murray study mentioned above, which found a dramatic difference in celiac disease incidence in blood samples from the 1950s compared to blood samples from today, but it may explain some of the increase in diagnosis.
All autoimmune diseases are rising in their prevalence, possibly due to environmental, dietary, and societal factors.
Autoimmune disease has become much more common than in previous generations. Lupus, for example, is three times as common as it was just forty years ago. The reasons for this spike in autoimmune diseases are not yet clear. What we know is that they are more prevalent in Western societies, and that there are several theories about why. One is the “hygiene hypothesis” which posits that our modern living environment is so clean that the immune system doesn’t have enough “invaders” to attack (parasites, microbes, etc.) and therefore attacks itself.
The contemporary American diet is another possible culprit. Our diets include many of the highly processed foods that were not in existence 50 years ago. This, and the hybridization and genetic modification of wheat, may put the immune system at further risk of malfunctioning.
We are also exposed to a higher level of toxins than ever in history, which can potentially damage the body’s normal immune function. While celiac disease has a genetic component, some kind of “trigger” has to activate the gene to make a person develop active celiac disease, and any number of environmental factors may be to blame for this.
Wheat has been genetically engineered and bred to be higher in gluten, and is processed differently.
Today’s wheat is not yesterday’s wheat. It is highly hybridized, so that the wheat we are eating is far removed from traditional wheat as our ancestors knew it. It is hybridized in such a way that the gluten level is far higher than it ever was before. It is possible that our bodies have not evolved to be able to process this type of wheat with its high level of gluten and more people are producing anti-gliadin antibodies in response to their body being bombarded by high levels of gluten.
American wheat is nearly all hybridized high-gluten wheat, but in some other countries more traditional wheat is used, with lower gluten levels. This may help explain why some people with milder gluten intolerances report fewer symptoms when eating wheat in Europe or other areas. Genetic modification of wheat may also pose problems for the human body that haven’t yet been identified. More research is required in this area.
Regardless of why celiac disease is on the rise, all evidence points to increasing diagnoses. As the gluten-free population grows, so does awareness about celiac disease as well as the demand for quality, healthful, tasty gluten-free foods. This can only benefit people with celiac disease and gluten intolerance, who will see an increasing variety of foods available and more knowledgeable and sympathetic friends, families, restaurants, and healthcare providers.
Which theory do you think explains this upward trend in the number of people with celiac disease?
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