As May is Celiac Awareness Month, we’d like to shed some light about Celiac Disease. A gluten-free diet is not a choice for people who have celiac disease. While the rates of this condition have been increasing globally, there simply isn’t enough awareness to bring about more facilities for testing and diagnosing, especially in certain regions.
What is Celiac Disease?
Celiac disease is a genetic, autoimmune condition that is triggered with the ingestion of gluten. When people with celiac disease consume gluten-containing foods, an immune response occurs. Their bodies see gluten as a toxin and cannot digest it, releasing a cascade of immune reactions. The immune system responds by producing antibodies to attack and over time this can also damage healthy cells and organs. A main part of the damage happens in the lining of the small intestine which contains villi, fingerlike projections that are important for absorbing nutrients from food. When villi are damaged, nutrients cannot be absorbed properly. Continued activation of the immune response also leads to inflammation, which can affect overall health.
Testing for Celiac Disease involves two types of tests: antibody blood tests and biopsies from the small intestine. These tests give a definite diagnosis by identifying positive celiac disease antibodies and changes to the small intestine. Celiac disease can also be developed later on in life, even in those who have been tested negative before. This can be due to a change in the intestinal bacteria composition, or simply due to a weakened immune system with age.
Currently there is no cure for celiac disease, and the only treatment is adhering to a life-long gluten-free diet.
Read more about gluten and the symptoms associated with gluten consumption in our blog post here.
The History of Celiac Disease
It is believed that celiac disease first occurred at the start of the agricultural revolution. As humans began to incorporate more grains and cultivated crops in the diet, some might not have been able to adapt well, leading to various food allergies, sensitivities, and intolerances.
While there have been some discoveries of symptoms typical of celiac disease – like malnutrition in the early First Century, it was only in 1887 when celiac disease was properly defined in the modern world. Doctors tried multiple ways to treat this, from going on a rice-heavy diet to a diet high in bananas and removing starches. All of these diets were unintentionally gluten-free and seemed to work. It took another 65 years to discover that the trigger to this disease was actually gluten found in wheat, barley, and rye. In the early 1990s, celiac disease was finally classified as an autoimmune disease associated with a specific gene.
Celiac Disease Today
Today, around 1 in 140 people worldwide have been diagnosed with celiac disease. While it used to be a condition concentrated in the European region, it’s now spread across globally. Here are the statistics around the world:
- Europe, USA, and Oceania: 0.8-1.0% diagnosed
- Asia: 0.6% diagnosed
- Africa: 0.5% diagnosed
The numbers are slowly increasing. In the USA alone, the prevalence of celiac disease increased by 5-fold between the years 1975 and 2000. However, lack of awareness and facilities in Asian and African regions can mean that there are still many that remain undiagnosed.
The prevalence of celiac disease also differs within populations:
- Females have a higher prevalence than males (0.6% vs 0.4%)
- Children have a higher prevalence than adults (0.9% vs 0.5%)
The Gluten Sensitivity Spectrum
While we are able to quantify the prevalence of celiac disease, researchers are now finding that there is a spectrum when it comes to gluten sensitivity. This is also termed as non-celiac gluten sensitivity (NGCS), which is a separate and distinct condition. Gluten sensitivity is a digestive disorder where an individual gets adverse digestive reactions when consuming gluten – such as bloating, gas or diarrhea.
Gluten affects most people at some level and can present with varying symptoms both mild and severe. Currently there is no accepted test for gluten sensitivity, and it is harder to diagnose than celiac disease. The experts in the field estimate between 0.6% (6 in 1000 people) and 6% (6 in 100 people) of the population are gluten sensitive.
Here at The Whole Kitchen, we hope to be able to continue to support the celiac and gluten sensitive community here in Singapore. Hearing our customers say they feel much better when they include our products in their diet motivates us to do better and do more. We also want to push for more awareness of these conditions and encourage curiosity when it comes to our own health and bodies.
If you are interested in a more in-depth understanding of celiac disease, check out these local and global online resources we used:
- Gluten Free SG: https://glutenfree.sg/medical-info-celiac-disease/
- Beyond Celiac: https://www.beyondceliac.org/celiac-disease/celiac-history/
- Health Coach Elika’s https://thewholekitchen.com.sg/blogs/news-2/gluten-free-guide
- Everyday Health: https://www.everydayhealth.com/news/developing-celiac-later-life-can-you-become-gluten-intolerant/
- Very Well Health: https://www.verywellhealth.com/how-many-people-have-gluten-sensitivity-562965