Gluten Free Tips

Long, long ago, man was a simple hunter/gatherer and he enjoyed this. His diet  consisted of fruits, nuts, perhaps tubers and the occasional feast of meat. But eventually, he learned to cultivate plants, and the agricultural revolution began. Soon, the hunter/gatherer way of life was replaced by domestication of crops and animals which had implications for our diet.

As habits changed, some unanticipated problems arose. The human gut had developed, over more than 2 million years, into a sophisticated organ that could tolerate food antigens that were staples of the human diet over hundreds of thousands of years. But how would it react to new antigens, suddenly appearing in the diet? He may like the food but would it like him? The agricultural revolution of the Neolithic period generated a whole battery of food antigens previously unknown to man, including  protein from cow, goat, and donkey milk, as well as birds’ eggs and cereals. Most individuals were able to adapt. Among those who could not, food intolerances appeared and celiac disease was born.

Some 8,000 years after its onset, celiac disease was identifed and named. This was the begining of better understanding.  A clever Greek physician named Aretaeus of Cappadocia, living in the frst century AD, wrote about The Coeliac Affection.” In fact, he named it “koiliakos” after the Greek word “koelia” (abdomen). His description: “If the stomach be irretentive of the food and if it pass through undigested and crude, and nothing ascends into the body, we call such persons coeliacs.

During the 1980’s it became increasingly clear that Celiac Disease could be associated with other conditions, mostly autoimmune disorders such as type 1 diabetes, but also some syndromes such as Down. It was also apparent that Celiac Disease was changing patterns of presentation, becoming less an intestinal disorder, and more a variety of extra-intestinal symptoms and signs.

In the late 80’s, a large multicenter Italian study that I conducted demonstrated that by relying on strict clinical and laboratoristic criteria, a correct diagnosis of Celiac Disease could be reached in 95% of cases by limiting to the one initial biopsy, and new diagnostic guidelines were published in 1990 by ESPGHAN, guidelines that stand to this day. After 1990,Celiac Disease  was increasingly accepted as an example of an autoimmune disease, associated with a specifc gene (either DQ2 or DQ8) and the missing autoantigen was fnally identifed in the enzyme tissue transglutaminase. At long last, there was universal acceptance that celiac disease is an autoimmune condition whose trigger (gluten) and autoantigen (tissue transglutaminase) are known.