Culture November 23, 2016
It’s ten o’clock and I’m sitting inside a small café, drinking coffee and watching tourists walk along San Diego’s busy streets. The waiter quickly returns with my menu – it’s an off-hour, after all. Scanning the menu, asterisks on the side of certain dishes immediately catch my eye. “Can be prepared gluten-free.”
According to Beyond Celiac, one out of 133 Americans has celiac disease, an autoimmune condition in which ingesting gluten damages the intestine. I am one of them. I am also one of the people whose chronic illness has been erased, or at the very least, hidden by the gluten-free fad taking over our favorite restaurants, Hollywood celebrities and soccer moms.
It’s time to raise the curtain. Here are the facts, stats and stories about celiac disease and the gluten-free fad that you need to know.
What is Celiac Disease Anyway?
As already mentioned, celiac disease is an autoimmune disease in which one’s intestines cannot properly digest gluten. However, as the National Institute of Diabetes and Digestive Kidney Diseases explains, celiac disease is more complicated than that.
For one thing, no one knows what causes celiac disease. It can be genetic but the odds of developing celiac disease increase if the gene becomes active. For example, my father has the celiac gene but it has never become active while my own celiac gene activated when I was a senior in high school. Possible triggers of celiac disease include surgery, pregnancy, childbirth, infection or extreme emotional distress.
READ MORE: Is Gluten Intolerance Really a Thing?
The symptoms of celiac disease can include gas and bloating, constipation, vomiting, weight loss, fatigue, delayed growth, behavioral problems and a variety of other issues. To diagnosis the disease, doctors test the blood of possible celiacs, checking for certain antibodies. In addition, doctors often require patients to have an endoscopy in order to send a biopsy for lab tests and check for intestinal damage. Most Americans with celiac disease, however, remain undiagnosed.
A Brief History
Celiac disease has existed nearly as long as humans and wheat. According to a “Glutinous History” timeline by Proto Magazine, Aretaeus of Cappadocia coined the term “celiac” to describe patients in the second century AD. What happened in the years since then?
1888: Samuel Gee states that diet is the key to treating celiac disease.
1952: Willem Karel Dicke isolates the ingestion of gluten as the cause of celiac disease and the gluten-free diet becomes the typical treatment.
1956: Gastroenterologist Margot Shiner pioneers a new way to diagnose celiac disease – doctors test a biopsy of intestinal villi damaged by gluten in celiacs.
1989: Ludvig Sollid and others determine that two versions of the HLA molecule are the main genetic risks for celiac disease.
2000: Alessio Fasano finds zonulin, a molecule thought to increases one’s risk for celiac disease.
2010: Several non-dietary therapies for celiac disease are ongoing clinical trials.
A Woman’s Disease?
Celiac disease can be considered a woman’s disease in that women are diagnosed with celiac disease two to three times more often than men. In fact, women make up 60 to 70 percent of currently diagnosed celiacs.
Why should you care? For many women, the inability to get pregnant is the main symptom of undiagnosed celiac disease. While research is conflicting, some studies suggest that four to eight percent of women with unexplained infertility are undiagnosed celiacs. More importantly, as an article in Women’s Health states, celiac disease is an “underappreciated issue in women’s health.” Besides affecting a woman’s chances to have children, undiagnosed celiac disease can also cause complications during pregnancy (including miscarriage and low birth weight) and increase a woman’s risk of low bone mass density.
No one seems to know the definitive reason why celiac disease affects women more than men. Several experts posits that the higher rates in women are due to the fact that there are more women than men in the U.S. and women tend to visit the doctor more often. However, the study in Women’s Health calls for greater celiac testing especially in women with correlative factors such as infertility or low bone mass density.
Reality of Celiac Disease
Now it’s time to step out of the research books and glance into a celiac’s real world. What does living with celiac disease really entail? In my experience, it means:
The Gluten Free Diet’s Rise to Trendiness
A report by Mintel values America’s gluten-free market at around nine billion dollars. Although difficult to pinpoint the start of the “gluten free fad diet,” BBC News Magazine offers several possibilities. For instance, an analysis of Google trends shows jumps in “gluten-free” searches when Gwyneth Paltrow launched her gluten-free cookbook, Miley Cyrus reported a gluten “allergy,” William Davis published his book, “Wheat Belly” and tennis player Novak Djokovic revealed he follows a gluten-free diet. Nothing sells food, it seems, like the promise of becoming more like your favorite celebrity.
As more people learn about the gluten-free diet, more people try it. Some people experienced real benefits (due to undiagnosed celiac disease, for instance) and others enjoyed a placebo effect. BBC News Magazine points out that this isn’t the first time in history that gluten-free diets have become popular. In the 1920s, doctors often treated celiac disease with a prescription of bananas and milk. By the 1930s, this weight loss diet dominated America. Considering that Mintel projects the gluten-free industry to value at a whopping 14.2 billion dollars by 2017, it doesn’t seem like this trend will be ending anytime soon.
Is the Gluten Free Trend Good or Bad?
What do celiacs think of the gluten-free trend? Some see the gluten-free fad diet as a blessing in disguise. As a relatively recently diagnosed celiac, I felt lucky to be able to walk in the grocery store after my diagnosis and find foods – pasta noodles, crackers, tortillas and more – that fit my dietary requirements. I feel even luckier when I hear stories about celiacs diagnosed 20 or 30 years ago. At that time, gluten-free products were uncommon – and rarely tasty. For some, the gluten-free fad also helps alleviate the social awkwardness of celiac disease. As celiac Molly Lewis says in an NPR article, “Having access to replacement foods helps you feel more included in events, parties and holidays.”
At the same time, the Wall Street Journal’s article “The Celiac’s (Gluten Free) Lament” points out that fad dieters have made the gluten-free diet a “pariah” that reduces restaurants’ attention to cross-contamination (which is dangerous for celiacs), and makes “gluten-free” seem like a preference instead of a medical necessity. Why should restaurants take these orders seriously when many diners order a wheat-filled beer along with their “gluten-free” lunch?
However, the gluten-free trend could be hurting more than celiacs. According to Consumer Reports, a gluten-free diet can actually be less nutritious than its wheat-filled counterpart. When companies remove gluten from products, they must replace it with something else, usually sugar, fat or calories. People who follow a gluten-free diet are also often exposed to more arsenic (due to a higher rice intake) and miss nutrients like folic acid and iron, which are found in fortified wheat products but rarely in gluten-free foods.
The truth is that unless you’re one of the Americans diagnosed with celiac disease, avoiding gluten probably won’t make you any healthier. And that is perhaps the biggest secret hiding behind the curtain of the gluten-free trend.
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