Coeliac Disease has been around for centuries but is it increasing? People’s understanding and awareness of Coeliac Disease seems to be rising slowly, and diagnostic procedures have all advanced. But can these factors account for the increase over the past 4 or 5 decades?
Research is continuing to look at possible treatments like drug trials and vaccines. For folks like me who already have the disease, that’s great news. Finding out what triggers it in the first place, would be even better.
That good old phrase ‘prevention is better than cure’ seems appropriate here. It’s puzzling why people like me, with a low genetic risk, suddenly develop the disease later in life.
What’s good to see, is some research turning towards prevention strategies. One research project called PREVENT-CD is looking into early dietary history and its possible influence. Another study called CELIPREV is looking at genetically at-risk children with HLA genes.
It’s great that research is exploring these but what I’m interested in is what causes the genes that over 30% of people carry, to only be expressed in around 3% of people. What’s in our environment that causes this gene expression and what can we do to prevent it?
is Coeliac Disease increasing around the world?
Coeliac Disease was originally thought of as a mostly Caucasian disease. Today, rates of Coeliac Disease are rising around the globe.
A recent 2018 review of global rates, found that it’s now being reported in many other areas of the world. Just how many people are affected can range from country to country. This could be down to the different ways it can be diagnosed.
Some think rates could be between 1 in 70 in countries such as Australia. In the UK, estimates are around 1 in 100 with similar figures in America. More interestingly, figures like 1 in 100 are now being estimated in some parts of India.
Because there are different ways used in diagnosis, exact rates are still largely unknown. I’ve found that a lot of information on the Internet can be conflicting or out of date. In saying that, new research seems to be appearing and further investigating if Coeliac Disease is increasing.
It also seems hard to measure exact numbers because not everyone with Coeliac Disease has obvious symptoms. Symptoms can vary from person to person. I experienced extremely violent and sudden symptoms. Some people are asymptomatic where they show no obvious symptoms at all.
no longer just a western disease
When I first started researching Coeliac Disease, I was surprised to see the differing rates around the world. To see that certain parts of India were seeing some of the same rates of increase as western countries was equally surprising.
It’s still unclear why rates have doubled every 20 years but it’s suggested it could be from multiple factors. This includes better diagnostic techniques but also environmental factors.
I was reading a lot of medical journal articles and the province of Punjab surfaced again and again. I was also beginning to see some links between general disease rates and the heavy use of herbicides in the Punjab region.
Now, of course, a link doesn’t mean cause so this is still a topic of hot debate. But just because something hasn’t been proven yet, there’s no harm in questioning it right? I mean, if we don’t question why something is happening, we wouldn’t have any advances or changes in, well, anything!
INCREASING SINCE THE 1990S?
Now back to the increasing rates….. Some studies now report a four-fold increase over the past two decades with many individuals remaining undiagnosed.
So why has there been such a sudden increase in Coeliac Disease rates? Some say it’s due to better diagnostic methods but the data just doesn’t appear to stack up.
People have been consuming wheat for centuries and medical journals are stating that Coeliac Disease has been seen since the 1940s. But this doesn’t explain why rates of Coeliac Disease have increased since the 1990s. Women are diagnosed at a higher rate than men and children are 4 times more likely to develop the disease than ever before.
We could probably argue that women are more likely to seek medical advice than men but it doesn’t explain increased rates in children.
What changed in the 1990s to warrant this increase? Maybe it’s down to better technology in diagnosis? But why would children be developing Coeliac Disease at a much higher rate than previously seen before?
HAS IT GOT ANYTHING TO DO WITH FARMING METHODS?
So let’s look at the farming of wheat, barley, rye, and oats. These grains contain the protein gluten. Wheat, in particular, has been farmed, as previously stated for centuries, so how could this relate to the increase in Coeliac Disease since the 1990s?
An article published in the Journal of Agricultural and Food Chemistry in 2013 addressed the issue of wheat breeding and if it was related to the rise in Coeliac Disease. It was concluded in this article that the various varieties of wheat may not be the cause. However, it was suggested that our overall consumption of gluten, has risen significantly over the years.
So whether it has anything to do with farming methods, wheat breeding or the amount of gluten we are consuming these days, it’s still a mystery that needs to be solved. It’s what makes Coeliac Disease so frustrating and complex because there are so many variables at play making it difficult to pinpoint one single cause.
herbicide use?
Another theory, and one of the most hotly debated topics today is the use of herbicides on crops. This can be your more common brands that use the active ingredient Glyphosate, but there are also a lot of organic herbicides that are equally questionable. In 2018, the province of Punjab banned the sale of any formulation containing Glyphosate.
If there’s nothing wrong with these products, then there’s nothing wrong with questioning their use right? If we want the best for the health of every population, I think it’s ‘healthy’ to debate the use of weed killers on crops.
What are the long-term effects on the health of the public? I guess we won’t know unless it’s researched, talked about and examined in a way that really considers what’s best for people’s health! Debate brings about change and that’s a good thing if used in the right way.
Other factors play a part
While these have been researched over the years to try to establish a possible cause, it’s now more accepted that the increase is likely due to other environmental triggers. The problem is, these can have conflicting results in the populations studied.
The quality and the amount of gluten may also play a part in changing the body’s tolerance to gluten into an immune response. So might problems with early nutrition.
Enter the role of the gut microbiome
Coeliac Disease can be triggered at any age. But how levels of gluten tolerance affect the gut microbiome, is an up and coming area of interest.
I had my gut microbiome tested shortly after I was diagnosed. This was because I wasn’t responding to a gluten-free/dairy-free diet. I still had relentless diarrhea and other horrible gastro symptoms.
My report, and the studies I’d been reading shared lots of similarities. I had high levels of some bacteria but was also completely missing a range of important bacteria. My report said these similarities were also seen in people with active Coeliac Disease.
The gut makes up a large part of the immune system so it would be interesting to know just how much it can withstand before breaking. More studies are beginning to focus on how changes to the gut microbiome, may contribute to the disease.
If I’d been aware of my gut health a long time ago, I would’ve made changes to my lifestyle. Although in saying that, it often takes something drastic to make us change the way we live and act right?
Hopefully, advances in understanding how the gut microbiome may play a role in Coeliac Disease might just slow Coeliac Disease from increasing further. Only time, and science will tell.
