Â Â by Joseph Murray, MD
Until the last few years, celiac disease was an obscure, little-known condition and people who had it were extremely limited in terms of what they could eat or even where to turn for help managing their condition. That has changed dramatically with new studies on celiac disease, abundant online information and support, and a generous selection of gluten-free products, including bread, cookies, cereal and the like in specialty markets. In fact, gluten-free food is one of the fastest-growing categories in todayâs supermarket.
Â This is one time food marketers were ahead of the curve. Though it has been recognized that celiac disease (an autoimmune response triggered by gluten, the protein in wheat, rye and barley) is on the rise, the extent came as a surprise to researchers from the Mayo Clinic, who discovered that young people today are more than four times as likely to have celiac disease than was the case 60 years ago.
Â The study looked for the antibody triggered by celiac in blood samples taken between 1948 and 1954 and compared findings with recent blood tests on two groups of residents of Olmstead County, Minnesota. One group was the same age as those tested in the original study… the other group consisted of people born in the same years as those tested in the original study.
Â Joseph Murray, MD, professor of medicine and immunology at Mayo Clinic, was the lead author of the study. He told me that this increase undoubtedly is due to environmental causes. One possible factor relates to the fact that wheat has been genetically altered to heighten gluten content. Another might be the huge increase of gluten-containing food products. Gluten is used extensively today because it reduces manufacturing and processing costs of foods.
Â Even Worse…
Â But there was a second startling finding of the study — people with so-called “silent” celiac have four times greater mortality than people without celiac. To explain… the majority of people with celiac are not diagnosed or treated, so they continue to consume gluten — perhaps with symptoms, and perhaps without. Although the disease can cause severe digestive distress, it also can lead to other conditions that seem unrelated, such as infertility, headaches, osteoporosis (especially early onset) and anemia, or it might cause no apparent problems at all. But even without symptoms, Dr. Murray says that celiac is damaging the intestines and weakening the body, and also may be increasing vulnerability to other diseases, including cancer.Â
Â What to Do
Â It is possible to develop celiac at any age. Dr. Murray says to consult your doctor about the possibility of celiac in the event of digestive problems, including diarrhea, excess gas and bloating, anemia or accelerated osteoporosis — especially if you have a family history of celiac or if you notice a problem when you eat foods containing wheat, rye or barley. Do not eliminate gluten from your diet before being tested, as this may decrease the accuracy of the tests.
Â Even in the complete absence of symptoms, some experts advise avoiding wheat, rye and barley in all forms — including such things as soy sauce and many canned soups — entirely to see whether it makes a difference in how you feel. I have done this, in fact, and felt so much better that Iâm rarely eating wheat at all these days… and Iâm not missing it either.
Joseph Murray, MD, professor of medicine and immunology, department of gastroenterology and hepatology, Mayo Clinic, Rochester, Minnesota.