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Celiac Disease Increases Sharply

Celiac disease, an immune system disorder that causes people to react to gluten in their diet, has increased dramatically in the past half-century, according to new research.

Gluten is a protein found in wheat, rye and barley. People with Celiac disease get severe abdominal pain, diarrhea, vomiting, constipation and other symptoms when they consume gluten. They are also prone to a host of health problems later in life. Originally thought to be a rare childhood syndrome, Celiac disease is now known to be more common. Perhaps as many as 2 million people in the United States may have the disease.

Joseph Murray of the Mayo Clinic and colleagues tested 9,133 blood samples that were gathered at Warren Air Force Base in Wyoming between 1948 and 1954 for the antibody that people with Celiac disease produce in reaction to gluten. They compared the blood tests with those from two recently collected 12,768 sets of blood collected in Olmsted County in Minnesota. One set matched the ages of those from 1948 to 1954 at the time the blood was drawn while the other matched their birth years.

The researchers found that young people today are 4.5 times more likely to have Celiac disease compared to young people in the 1950s, while those whose birth years matched the Warren Air Force Base subjects were about 4 times as likely, the researchers reported in the journal Gastroenterology.

The reason for the increase remains unknown. But the researchers said the most likely explanation probably has something to do with changes in the way wheat and bread are processed. Another possibility is the "hygiene hypothesis" which argues that increase in a variety of allergies and immune system disorders are the result of growing up in environments that are too clean.

To read more about that trend, see this story.

By Rob Stein  |  July 9, 2009; 7:00 AM ET
Categories:  Family Health , General Health  
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Wait a minute -- how can we extrapolate national trends from studies of two different populations in two different places? I don't know about the AFB, but rural Minnesota is fairly genetically non-diverse (although Rochester may be a little more diverse than some of the surrounding areas). Maybe Scandinavians have a higher propensity for autoimmune diseases? Maybe the diets were different (which could imply that the difference is due to presence or absence of trigger foods, vs. "becoming more prevalent over time")? Then again, maybe not -- but they should at least evaluate those possibilities.

Don't get me wrong -- I do think there's significant evidence that these kinds of autoimmune diseases are increasing over time. But I think it is irresponsible to jump to causation without at least accounting for potentially significant differences in the study populaces -- especially in light of the current scientific thinking that genetic components play a large part in autoimmune diseases.

Posted by: laura33 | July 9, 2009 8:19 AM | Report abuse

It's my impression that celiac disease is more common in white people of northern european origin.

Native Americans are the other ethnic group in that area, so you'd hope they were eliminated from this study.

It seems likely that blood samples would have been taken at the Air Force Base as new recruits were processed. So were they to be non-natives then the samples could be compariable.

Posted by: RedBird27 | July 9, 2009 10:14 AM | Report abuse

Posted by: RedBird27 | July 9, 2009 10:21 AM | Report abuse

Actually, RedBird, I'm thinking that the AFB samples may not be comparable for that same reason. Yes, both areas are in the Northern Plains, with fairly small minority populations. However, Southern MN is very Scandinavian. I know the Wyoming is mostly white, but don't know whether it is as specifically Scandinavian. In addition, the military tends to move people around, so the AF samples may be somewhat more representative of the American populace than the local populace would be. So I suspect the MN samples are weighted much more heavily toward the Scandinavian side than the AFB samples. And if, in fact, Celiac disease is more prominent in folks of Northern European origin, well, then, you'd expect to see it more in a heavily Scandinavian populace.

Does any of this make a difference? Who knows, since they seemingly didn't bother to evaluate that. Maybe the Scandinavian bloodline would explain a little of the increase, but not all of it (increasing by a factor of 4-5 is pretty big). Or maybe the overall "northern European" populace was similar in both places, and Scandinavians have the same incidence of Celiac disease as other northern Europeans. But it just really, really bugs me when scientists -- especially people from highly-respected places like the Mayo Clinic!! -- leap right to causation without even mentioning that there could be other variables at play, much less evaluating their impact. Look at the video linked to in the blog post above -- the guy repeatedly says, over and over, that this study clearly shows that Celiac disease has increased 4-5x over time. Unless you have considered those confounding factors, you simply can't say that.

Posted by: laura33 | July 9, 2009 10:52 AM | Report abuse

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Posted by: jensolley | July 9, 2009 11:09 AM | Report abuse

Luckily, there are so many more gluten free options today then even 2 years ago when I was diagnosed. Jules Shepard has a great book for newly diagnosed (First Year Celiac Disease and Living Gluten Free) and using her all purpose flour I can actually eat food that tastes good. So if you're new to celiac disease, don't worry it is totally manageable with a little information and advice.

Posted by: candrews2 | July 9, 2009 11:51 AM | Report abuse

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