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It’s Celiac Disease Awareness Month. And as James Hamblin aptly points out in an article for The Atlantic, it “…might seem unnecessary, if the superfluity of ‘gluten free’ labels and advertisements were any indication of people’s awareness of the disease.”

Indeed, “gluten free” is everywhere—to the point of annoyance for many. Comedians are all over it. Movies, TV shows and commercials exploit it in farcical ways. Memes poke fun at the idea in messages that range from silly to sarcastic. Skeptics view it as greenwashing gone wild.

For those with celiac disease, gluten-free is no laughing matter. Patients in advanced stages of the disease are cautioned that any exposure to gluten could have life-threatening consequences. Here are some statistics to consider:

  • The Celiac Disease Program at UCLA reports that celiac disease is one of the most common autoimmune conditions.
  • Approximately 1 percent of the population has this condition, affecting approximately 1 in 133 people.
  • Currently, about 80 percent of people with the disease remain undiagnosed, which aligns with research by Joseph M. Murray, MD and professor of medicine and gastroenterologist at the Mayo Clinic. He found a dramatic increase in undiagnosed celiac in the U.S. over the past 50 years.
  • Over the same period, the U.S. has seen a four-fold increase in celiac-related deaths.
  • In a Time magazine article entitled “The Rise of Celiac Still Stumps Scientists,” Murray states that he considers celiac disease a “public health issue.”

Although celiac has a strong genetic component, this has proven to provide little insight as to why some people get it and some people do not. It is more common among Caucasians, but from there, it’s hard to spot patterns. You could eat wheat for decades without incident and experience some type of event, stressor or change that triggers celiac. One thing is clear—the increased prevalence of celiac disease is not due to a rise in wheat consumption according to USDA statistics.

Time mentions some of the theories on why it is becoming more common. C-sections. Overuse of antibiotics. Hygiene hypothesis. But none of these has gained much traction.

After conducting an inconclusive study about breast feeding and the timing of gluten introduction, Dr. Alessio Fasano, MD, director of the Center for Celiac Research and chief of pediatric gastroenterology and nutrition at Mass General Hospital for Children, came to the realization that there is something other than glutenalonethat can eventually move gluten-tolerant people toward developing celiac disease.

Without an obvious culprit, many are starting to suspect the modern, hyper-processed diet—and its impact on gut bacteria—to be the root cause. In the Time article Fasano states, “These bacteria eat whatever we eat. We’ve been radically changing our lifestyle, particularly the way we eat, too fast for our genes to adapt.”

If you suspect you may have issues with gluten, think about getting tested to determine if celiac disease, non-celiac gluten sensitivity, or a wheat allergy is present. These are three different conditions. Consult a resource like the Celiac Disease Foundation to learn more.