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Coeliac disease on the rise

Coeliac disease rates growing Number of cases doubled every 15 years since 1974

A new US study has found that rates of Coeliac disease have doubled every 15 years since 1974, with older people more at risk.

Coeliac disease is an autoimmune disease of the digestive system, and is triggered by eating gluten, a protein found in bread and other foods made from wheat, barley or rye. If untreated it can develop into a serious health threat due to poor absorption of nutrients.

About the study

Blood samples were taken from over 3,500 adults. By looking for particular markers for coeliac disease, the researchers found that the number of people with these markers grew from one in 501 in 1974 to one in 219 in 1989. Another study from 2003 found that the number of people with coeliac disease in the US was at one in 133.

As the age of the study participants increased, so did the rate of coeliac disease, echoing the results of a Finnish study which found the condition was nearly two and a half times more prevalent in elderly people than in the general population.

This second result is interesting because it challenges the common speculation that the loss of gluten tolerance resulting in the disease usually develops in childhood. As study leader Carlo Catassi pointed out: "You're not necessarily born with coeliac disease - our findings show that some people develop coeliac disease quite late in life."

But so far the process by which a person loses wheat tolerance remains a mystery. "Even if you have these genetic markers, it's not your destiny to develop an autoimmune disease," said co-author Alessio Fasano.

"This shows that environmental factors cause an individual's immune system to lose tolerance to gluten, given the fact that genetics was not a factor in our study since we followed the same individuals over time," he added.

The finding contradicts the common wisdom that nothing can be done to prevent autoimmune disease unless the triggers that cause autoimmunity are identified and removed. Gluten is one of the triggers for coeliac disease. But if individuals can tolerate gluten for many decades before developing coeliac disease, some environmental factor or factors other than gluten must be in play, Dr Fasano noted.

This holds out the promise that by identifying and managing exposure to these environmental factors could result in new treatments for coeliac disease.

The study was carried out at the University of Maryland School of Medicine Center for Celiac Research and is published in the Annals of Medicine.

This article was published on Tue 28 September 2010



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