Devon Geary CAS137H Dr.

Raman October 30, 2013 Celiac Disease In recent years, the words celiac and gluten have made headlines and have been brought to the forefront of health and wellness. Gluten-free food has broken through the market. This phenomenon can be attributed to rates of celiac disease, an allergic reaction to gluten, increasing across the globe. A change in the way food has been processed throughout the years has created a spike in the amount of people who suffer from this disease. Although this is true, going gluten free has become popular among those who dont suffer from celiac. W ith the emergence of health trends and diet fads, people have found that going gluten free is an avenue they want to try, regardless of if they have the disease or not. As time goes on and knowledge of the gluten free world expands, so does the amount of people choosing a g-free diet. When did the desire to cut out gluten start and why? In examining the breakthrough of this phenomenon it is first important to start at celiac disease and what it is. From there, it will be easier to understand why a diet that was once needed for a medical condition has shifted and evolved into a trendy fad. Celiac Disease is an intestinal reaction to eating gluten, a protein found in wheat, barely, and rye. For those with the disease, eating gluten triggers a response in the small intestine causing stomach pain and irritation. The intestinal damage may result in weight loss, bloating,

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and diarrhea. Leaving the disease untreated will cause fatigue and mental fogginess. Originally the disease was characterized by stomach pain and irritable bowels but after further research, more serious and concerning issues have arisen. Eventually, the brain, nervous system, bones, liver, and other organs may be deprived of vital nourishment. In less common cases, dermatitis herpitformis, an itchy, blistering, skin reaction will occur. Complications due to celiac include osteoporosis, impaired splenic function, infertility, and neurologic disorders. The origin of celiac disease lies in the Neolithic era, when the agricultural revolution began. However, it wasn't until the 20th century that rudimentary causative factors were identified (Celiac Sprue Associati on, 2013). A Dutch pediatrician by the name of Willem Karel Dicke was the first individual to link the ingestion of wheat to the symptoms of celiac. Ever since, the only treatment has been a gluten-free diet. The life style of an individual with celiac disease is significantly different from those without the disease. A gluten free diet is a must, however, gluten contamination is difficult to avoid. According to the New England Journal of Medicine, the minimum amount of gluten a celiac needs to digest to have a reaction, (the gluten threshold) is 10 to 50 mg per day (Fasano, 2012). A slice of bread contains almost 20 times that amount. However cutting out gluten for a celiac means revitalizing the intestine and allowing it to absorb the nutrients needed for healthy function. Often times celiacs who cut out gluten gain weight, which is a positive sign of nourishment. Instances of celiac disease can be found all across the globe. Celiac disease is prevalent in almost 1% of the population world-wide, making it four times more common now than it was 50 years ago (CBS News, 2012). Although this is true, instances of gluten intolerance are even more prominent. Gluten intolerance is when an individual will have all the signs and symptoms of

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celiac disease, but all of their diagnostic tests come back negative. One in ten Americans will suffer from gluten intolerance. A reason for this large number of diagnoses world-wide may be attributed to westernization of the diet, changes in wheat production and preparation, increased awareness of the disease, or a combination of these factors (Fasano, 2012). Diverse nations across the world such as North Africa and the Middle East have begun to adopt westernized diets. Such diets are characterized by red meats, sugary desserts, and refined grains. Celiac disease is also extremely prevalent in areas such as northern India, where wheat is a staple food. Not only is the diet expanding but so is the style of living. For example, in decades past, people would make their own bread in their own homes. During this process bread had a long leavening period, allowing the gluten proteins to break up. Today, a fast pace society and impatient style of living doesnt allow for homemade bread. Bread is mass produced, processed, and placed on the shelves, creating a larger chance for gluten intolerance. Dr. Neal Barnard, founder and president of the Physicians Committee for Responsible Medicine (PCRM) has studied gluten and its effects his entire career. His research states that there are more than 25,000 hybrids of wheat being developed and sold to consumers. This copious amount of wheat being sold is correlated to the advancements in technology, the increasing number of factories producing gluten filled products, and a higher demand for processed food. Other technological advancements that have influenced diagnosis are those in the field of medicine. For example, a major development came in the mid- 20th century with breakthroughs in serological testing. Serology is the scientific study of plasma and other bodily fluids. Serological tests are performed to help diagnose patients with immune deficiencies, such as celiac. Serological scans are one of the primary means of diagnosis of celiac

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disease. With food trends and cultural expansion, reports of celiac disease have increased, causing awareness to increase as well. Other technological advances responsible for increased diagnosis of the disease lie in television and internet. With the emergence of daytime talk shows, figures like Dr. Oz and Ellen DeGeneres have been able to spread awareness and encourage individuals to do their research. Dr. Barnard was recently on the Dr. Oz television show and he gave a thorough yet simple analysis of the disease and told the audience what to look for and how to classify gluten intolerance. Therein lies a focus on people self-diagnosing and believing they have gluten intolerance, which may be a causative factor in the rise of a gluten free market. TV personality Elizabeth Hasslebeck, who has celiac disease herself, has written a best-selling book about going gluten free. When people see their favorite celebrities giving them information, they are bound to listen. Another avenue to consider when looking at the increased awareness of this disease is something called detection bias. The more aware and concerned the health community is about any given health condition, the more they tend to look for it and therefore, the more often they are going to find it (Katz, 2011). With increased awareness and diagnoses world-wide, the demand for gluten free food has increased. For example in 2008 a Denver Caf owner by the name of Udi Baron met baker Chad White. White specialized in baking good-tasting gluten free foods and together the two created Udis Healthy Foods packaged good subsidiaries. After Udi hired White, Udis gained retail distribution of their gluten free breads and other baked goods reaching $60 million in sales (Gross, 2013). Last year Udis sold their business to Smart Balance for $125 million. Udis is one of the top selling gluten free brands and continues to expand. Other companies such as Glutino and Three Bakers are not far behind Udis and the competition for best brand has

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become intense. Although the explosion of gluten free food is convenient for those with celiac and gluten intolerance, there has also been an interest from those who are not affected by the disease. Recently, it has become popular to go gluten free. 1.6 million people in the U.S. are on a gluten-free diet even though they haven't been diagnosed with celiac disease (CBS News, 2012). In todays society, losing weight is not just limited to exercise and healthy foods, but cutting out those unhealthy foods altogether. One hundred and fifty years ago, when William Banting invented the low-carb diet, he sparked an obsession with fad diets and quick fixes. Ever since, Americans have spent between $1 and $2 billion dollars a year on diet and exercise programs (Novak, 2013).There is also a concern with the up and coming generations and the longing for children to live a healthy lifestyle. In 2009, more than one-third of adults and almost %17 of youth were obese (NCHS Data Base, 2012). First Lady Michelle Obama has created an entire campaign towards eliminating childhood obesity, and parents are trying to make examples for their children by following a healthy lifestyle. With the attention on health trends and a need for a healthy future in America, gluten free has become an effective vessel for healthy living. With easy to read food labels, more gluten free products, and an increased awareness, the diet has become fairly manageable. The benefits of a gluten free diet include weight loss, higher energy levels, and improved cardiovascular health. Even celebrities such as Miley Cyrus and Lady Gaga have hopped on the gluten free bandwagon, and are strong advocates for the diet. Therein lies another example of celebrity influence on peoples ideas and actions. But is gluten free just a fad that glamorous stars and health nuts are interested in, or is it here to stay?

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According to Udi Baron, the gluten free trend is not a fad that will go the way of low carb or fat free in a matter of years: it is a health trend, not a diet trend (Gross, 2013). More people are being diagnosed therefore more people are cognizant of the disease. Awareness then leads to a more thorough understanding of what gluten free is among those without the disease. Those without the disease will in turn pick up on the health trends and become part of the world where gluten is an object of the past. Gluten free food in todays society is becoming more and more important and not only those with celiac are reaping the rewards. With the abundant information on the disease and a popularity to go gluten free increasing, the food industry is experiencing a boom. Neither doctors nor pharmaceutical companies can do anything to treat gluten intolerance, so people are turning to food. Last year alone, Americans spent approximately $6 billion going gluten free (Dr. Oz, 2013). Celiac disease will never go away and neither will people aspiring for health. These trends will continue. Although it is here to stay, some critics argue that eliminating gluten is not as healthy as everyone believes. Those who go gluten free by choice must be wary. Although individuals with celiac gain nourishment by cutting out the gluten, those who go gluten free by choice tend to lack essential nutrients such as iron, calcium, and foliate which are all found in wheat. Wheat contains vitamins that are important to maintaining health. Gluten free dieters must ensure they are getting the proper amounts of fruits and vegetables to compensate for what they are losing, and in doing so, will most definitely improve their health. Going gluten free the right way will only reinforce its benefits and its credibility within the health world. When looking at the big picture, it is easy to see why there has been an increase in gluten free food production and marketing. There is simply a need for it. Whether it is because more people are being diagnosed with gluten related diseases or more people want to be healthy, the

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G-free diet is here to stay. Not only is it here to stay but it is beneficial to the overall health of America and even the world. Gluten free manufacturers are going to continue to thrive as long as wheat and processed food exists. Across the span of 60 years or so, there has been a transition from eating g-free because its necessary, to going g-free because its trendy. This is due in large part to the heightened sense of awareness and knowledge about the subject and its health benefits as well as technological advancements and an enlightened understanding of what being healthy means. With a world that is becoming more gluten friendly by the day, celiacs and non-celiacs alike are able to maintain healthy and happy lives.

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References Gross, D. (2013, June 25). Pivoting, Consumer Products Style. Forbes. Retrieved October 30, 2013, from http://www.forbes.com/sites/groupthink/2013/06/25/pivoting-consumerproducts-style/

Novak, S. (n.d.). Discovery Health. Discovery Fit and Health. Retrieved October 25, 2013, from http://health.howstuffworks.com/wellness/diet-fitness/diets/150-years-of-fad-dietingwhat-have-we-learned.htm

Adult Obesity Facts. (2013, August 16). Centers for Disease Control and Prevention. Retrieved October 23, 2013, from http://www.cdc.gov/obesity/data/adult.html

Celiac Disease Research. (n.d.). Celiac Disease Research. Retrieved October 25, 2013, from http://www.csaceliacs.info/celiac_disease_research.jsp

Fasano, A., & Catassi, C. (2012, December 20). Celiac Disease. Proquest. Retrieved October 27, 2013, from http://search.proquest.com.ezaccess.libraries.psu.edu/docview/1264397963

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Hasselbeck, E. (2009). The G-free diet: a gluten-free survival guide. New York: Center Street.

Gluten-free diet fad: Are celiac disease rates actually rising?. (2012, July 31). CBSNews. Retrieved October 30, 2013, from http://www.cbsnews.com/8301-504763_162-5748378910391704/gluten-free-diet-fad-are-celiac-diseaserates-actually-rising/

M.D., D. K. (2011, July 25). Is Gluten-Free Just A Fad?. The Huffington Post. Retrieved October 29, 2013, from http://www.huffingtonpost.com/david-katz-md/gluten-freediet_b_907027.html?