Celiac Disease is an uncommon occurrence, and it affects less than 1% of people world-wide. Those who have it, suffer from diarrhea, bloating, and pain in abdomen. Their intestines do-not absorb nutrients as well, and so they often develop anemia, iron and vitamin deficiencies. Weakened bones, and dysfunctional nerves also take their toll. If it begins in childhood, growth gets slower. In adults weight declines, and so do energy levels. All this is due to overactive immune system, triggered by “gluten” a wheat protein.
Gluten is a wheat protein
We crush wheat seeds to produce flour, a key ingredient in various kinds of breads. Wheat seeds also contain gluten, a protein that allows plant to germinate and grow. While wheat is being consumed for centuries, it was only in 1745 that an Italian scientist Jacopo Becarri extracted gluten from it. It is also present in other food grains such as rye and barley. Gluten is also used as an additive and today it is also present in many processed foods such as sauces (soybean, tomato, mustard, mayonnaise), cheeses (pecorino, parmesan), preserved foods (capers, olives, tuna, and other foods containing vinegar) and even chocolate.
Some individuals who are sensitive to gluten, and mount an immune response when their bodies encounter this protein. More wheat we will consume, greater will be exposure to gluten. This itself will make gluten sensitive individuals more sick with celiac disease.
There has been a tremendous growth in both production as well as consumption of wheat worldwide. Annual global per-capita wheat consumption has also surged from around 55 Kg in 1960 to close to 70Kg in 2023. Consumption was already high in Europe in 1960s (more than 130 kg per person per year), which still is above the global average. Having enough food to protect against hunger has been an achievement of the 20th century.
Recognition of Celiac Disease
Celiac disease is ancient, as allergies to certain foods were described by the ancient Greeks. First modern description came in early 1800s by British pathologist Matthew Baillie. He described abdominal symptoms that responded to rice diet. In 1888 Samuel Gee a Pediatrician described its symptoms in detail, and attributed these to diet. He along with an American scientist, Dr Christian Herter, described the condition as Gee-Herter syndrome. Yet, exact cause eluded them.
During Second World War a Dutch physician, Dr Willem Dicke noticed that celiac disease symptoms reduced during the famine, when bread and flour became scarce. By 1950s, scientists narrowed down the problem to the gluten component of wheat, barley and rye. Later Dr John Paulley and his team discovered that patients with celiac disease have flattened intestinal villi. By 1960 Australian scientist Dr Charlotte Anderson could show that this was caused by gluten in wheat. Over next two decades we knew that disease is autoimmune. Blood based tests such as anti-endomysium tissue transglutaminase antibodies were discovered in 1984 and 1997 respectively. Hence recognition of celiac disease is quite new.
A food producers malady
Human beings were hunter-gatherers, and civilization made them food producers. Gluten was always there, but exposure to it was limited. In 20th century we transitioned from food-grain paucity to excess, and it is believed that this unmasked role of gluten in populations. The genetic predisposition to celiac disease is seen across all populations, but what is different is environmental exposure. Increasing medical awareness, has brought many mild variants of celiac disease, and hence the overall burden of disease is debatable.
Unfortunately, gluten free foods have sprung as an industry. They have little use, except in those few who have gluten sensitivity or celiac disease. In-fact gluten free may not always be healthy, as such food may have more emulsified fats so as to make them palatable. Regardless attention to gluten is on the rise, and maybe a moderation of food-grains in our diets is the way to go.