Celiac disease: When you really need to stay gluten-free

Kate Williams
11 February 2014

Image © istockphoto.com/jwblinn

In 2012, TIME magazine published a list of the top 10 food trends in the United States. Coming in at number 2 was “Gluten-Free Everything”. Why are people so desperate to cut gluten from their diet? After all, for most people, gluten is harmless and easily digested. However, for many people, eating food that contains gluten leads to a range of gastrointestinal problems. The most severe problems are caused by a condition called celiac disease.

Did You Know? The word “celiac” comes from the Greek word “koiliakos”, which refers to “suffering in the bowel”.

What is gluten?

Gluten is made up of two different proteins found in wheat, barley, and rye. These proteins are called gliadin and glutenin. When mixed with water, they combine to form gluten. The structure of gluten makes it very elastic. This helps to keep bread dough flexible when rising.

But many people have trouble digesting gluten. The types of gluten-related disorders can go from mild sensitivity to all-out celiac disease. If you have mild sensitivity, you’ll feel okay as long as you only eat small amounts of gluten. If you have celiac disease, though, any amount of gluten will make you sick.

What is celiac disease?

Celiac disease is a genetic autoimmune disorder. The word “autoimmune” literally means “immunity against yourself”. When your immune system works properly, it protects you from disease. It does this by recognizing and attacking foreign substances such as bacteria and viruses. However, if your immune system starts attacking harmless substances in your body, it causes damage to your own healthy cells and tissues.

If you suffer from celiac disease, gluten entering your small intestine triggers an autoimmune response in the villi. Villi are small, finger-like projections that line the inside of your small intestine. They help increase the surface area of your intestine to improve absorption of vitamins, minerals, fats, and other nutrients.

In people with celiac disease, the autoimmune response triggered by gluten damages the villi. This reduces the ability of the villi to absorb nutrients. This means people with celiac disease can struggle with malnutrition and weight loss.

Did You Know? A person’s small intestine is normally between 5 and 7 metres long. The villi lining the small intestine give it a surface area similar to that of a tennis court!

Unfortunately, there is no cure for celiac disease. A sufferer’s immune system will always detect gluten as a harmful substance. However, sufferers who stop eating gluten can prevent any future damage from the immune response. In fact, over time, a gluten-free diet can actually reverse damage done to the villi.

Going gluten-free

Following a gluten-free diet can be difficult. But thanks to greater awareness and wide media coverage of celiac disease, it’s getting easier. Many restaurants and grocery stores now offer lots of gluten-free options. For example, the number of gluten-free options available in top Canadian restaurants increased by 36% in 2012!

Estimates suggest that less than 1% of North Americans suffer from celiac disease. However, as many as 30% of the population are following a gluten-reduced or gluten-free diet! Why? Some people may have symptoms similar to a celiac sufferer. But these symptoms may actually be due to a wheat allergy (a non-celiac gluten sensitivity). Or they may be due to an autoimmune response to a different protein in wheat. If these people stop eating gluten, their symptoms usually stop, too.

Did You Know? Celiac disease and other gluten-related disorders were rare 50 years ago. Researchers think the increase may be related to a general increase in wheat consumption.

However, this increased awareness of gluten-related disorders has caused many people to see wheat as a “bad” food. Some of these people don’t even experience gluten-related symptoms! As a result, many people now either eat less wheat, or no wheat at all. Extensive media coverage has even made going gluten-free trendy. This is especially true when there are celebrities endorsing these diets!

Doctors fear that this trend has led to a large number of people diagnosing themselves with celiac disease, rather than seeking professional medical advice. Remember: it’s important to get your health information from a medical professional, not the latest headlines in the entertainment section!

This article was updated by Let's Talk Science staff on 2016-10-12 to improve readability by reducing the reading grade level.


General information

About Celiac Disease (Canadian Celiac Association)
Celiac Disease (National Digestive Diseases Information Clearinghouse, US National Institutes of Health)
Gluten (Bake Info, Baking Industry Research Trust)
Gluten Sensitivity Exists On Spectrum With Celiac Disease, Researchers Say (Elizabeth Nolan Brown, Blilsstree.com)
Gluten-Free Trend has Significant Impact on Canadian Restaurant Industry (NPD Group)
History of Celiac Disease (Celiac Support Association)
Is genetically modified wheat causing increases in gluten issues? (Jane Anderson, About.com)
Is Gluten-Free Eating a Trend Worth Noting? (NPD Group)
The dangers of going gluten-free (Cathy Gulli, Maclean’s)
Top 10 Food Trends of 2012 (Josh Ozersky, TIME)

Scholarly publications and textbooks

Pietzak, M. 2012. Celiac Disease, Wheat Allergy, and Gluten Sensitivity: When Gluten Free Is Not a Fad. Journal of Parenteral & Enteral Nutrition. Rubio-Tapia A, et al. 2012. The prevalence of celiac disease in the United States. American Journal of Gastroenterology. 107:1538–1544. Starr C, et al. 2010. Biology: Concepts and Applications. Cengage Learning.

Kate Williams

Kate Williams is currently working on her PhD in Neuroscience at McMaster University.  Her research focuses on how the brain changes during development and aging.  In her spare time she enjoys traveling, reading, running, and playing softball.

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