I’m often asked if a gluten-free diet is a “fad” of some sort. From an uninformed viewpoint, the question does make sense. It may seem that gluten-free foods and discussions of the ill effects of gluten are suddenly very present in our society.

Those that don’t feel they are affected personally nor have a family member who suffers from gluten intolerance may very well look at the attention begin given to gluten as a fad of some sort.

Celiac Disease Incidence Has Increased 4-Fold

A research article by Dr. Jonas Ludvigsson from Sweden stated that while the current incidence of celiac disease appears to be 1% this may very well be a 4 fold increase over the past 20 or 30 years. The increase was based on old blood samples that showed a dramatically lower incidence than current samples. Such an increase over just a few decades does not fall within normal expectations from a purely genetic standpoint. In other words, there is more affecting this increase than simply genetic change.

Why Did Celiac Disease Change from a “Rare” to a “Common” Disorder?

Dr. Joseph Murray from Mayo Clinic corroborated Dr. Ludvigsson’s findings in his own research comparisons of US citizens today as compared to the 1950s. Dr. Murray stated that in the 1950s celiac incidence would definitely have been put in the “rare” category. He added: “This increase has affected young and old people. It suggests something has happened in a pervasive fashion from the environmental perspective.” [emphasis my own.] What is that “something”?

Dr. Murray states that it’s environmental and I agree with him. He doesn’t commit himself further than that but I’d like to give my opinion on some possible culprits from the perspective that, beyond genetics and the presence of gluten in the diet, the major causes of intestinal damage or a leaky gut are thought to be substances that directly create weaken the immune system of the intestinal tract.

It Seems to Be Environmental

So with that in mind, I suggest that the following changes may be causative in the dramatic increase of celiac disease:

1. Alteration of our grains causing them to be more pro-inflammatory and thereby creating greater damage to the gut wall as well as the immune system. [Recall that there are some studies showing that ancient grains did not have the damaging effects that today’s do.]

2. A diet composed of more chemicals, pesticides, and antibiotics compounded by the ingestion of less organic fruits and vegetables, thereby creating a dysbiosis or unhealthy balance of the important immune-boosting probiotics. [Fruits and vegetables act as pre-biotics or “food” for the probiotics population housed in the gut and are therefore extremely necessary to keep a healthy probiotic population.]

3. Consumption of more NSAIDs (non-steroidal anti-inflammatory drugs) such as Aspirin, Midol, Aleve, Naproxen, etc that are known to create a leaky gut. Please note that Tylenol (Acetominophen), while not an NSAIDs, is also known to create a leaky gut. And the truly insidious aspect of these dangerous drugs is that they are offered over-the-counter, making the population think they are “safe” to consume.

4. Lack of any food education imparting the vital necessity of eating “real food” vs. the chemically laden, over-processed, and over-refined unhealthy products that pass for “food” in our current society.

Mortality Rate Increases if You Have Celiac Disease or Gluten Sensitivity

Dr. Ludvigsson’s team supported the concept of “latent CD” (celiac disease) or “gluten sensitivity” and defined latent CD in the Journal of the American Medical Association as having normal small intestinal mucosa but positive celiac blood tests. They also reported that in any given year, 10 of 1000 individuals with celiac disease will die compared with an expected 7 in 1000 without the disease.

Dr. Ludvigsson made a statement to the United European Gastroenterology Federation that: “Not only is the mortality raised in patients with [CD] but also in those individuals with latent [CD].” This is important as it comes back to diagnosis. Remember that for most gastroenterologists the intestinal biopsy is considered the “gold standard” for diagnosis. But Dr. Ludvigsson clearly states that the cause of death is more prevalent not just in patients with celiac but in those with latent celiac, and the definition of latent celiac is “normal small intestinal mucosa” with positive blood tests. Exactly what I’ve been saying is it not?

He goes on to make another critical statement that, while I have maintained this to be the case for a long time, I haven’t seen it in print before. He says that “In patients with CD who do not become better on a gluten-free diet, the most common reason is probably that the patients do not eat a strictly gluten-free diet.” Exactly! I wholeheartedly agree.

Strict Compliance to the Gluten-free Diet is Often a Problem

Too often researchers and clinicians become “stumped” by seemingly compliant patients who don’t respond at all despite their gluten-free status. The very first step to take is to ensure that they are truly gluten-free.

We frequently see this problem with our patients. Fortunately, the stool test that we use to diagnose pathogenic organisms, imbalance of probiotics, and malabsorption of nutrients have also added a gliadin test such that we can easily see who is being strict or lazy on their diet!

So I think we can conclusively state that gluten is NOT a fad. It’s a very real situation, increasing in prevalence and one that is impacting a very large segment of our population if you include those suffering from gluten sensitivity along with the celiac disease. I hope you find this data helpful and please let me know if I can assist you in any way. We see patients from across the country as well as internationally at our Destination Clinic.