Chances are, however, that the digestive condition you have heard about most frequently is celiac disease, in part because going “gluten-free” has become a popular diet fad among people both with and without the condition. Celiac disease is also attracting attention because, as researchers have recently discovered, some people with the condition don’t exhibit the typical symptoms of diarrhea or weight loss, which makes it even harder to identify and diagnose. One other major symptom of celiac disease, for instance, is a specific type of skin rash; when these patients cut gluten out of their diets, the rash disappears. Many people with celiac disease also develop neurological problems, making it more difficult for them to walk. Some of these people will experience minimal or no digestive issues.

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Once Murray began to spread the news that celiac disease could manifest itself in mysterious ways, and that untreated celiac disease could increase the risks of all sorts of health problems, people started paying a lot more attention to gluten. Slowly, gluten became transformed from a protein most people didn’t know existed to one of the most talked about food ingredients in the country. The hype surrounding gluten doesn’t really apply to the vast majority of people—studies show that celiac disease may affect only approximately 1% of Americans. Other individuals may have GI-related or other symptoms when they consume gluten and experience what has been termed non-celiac gluten sensitivity: a real but poorly understood condition that at present is primarily self-diagnosed. The actual incidence rate is unclear, but a recent study confirmed the condition in fewer than 10% of individuals who reported gluten sensitivity. Thus, many people appear to be avoiding gluten unnecessarily with any perceived benefits coming from heightened awareness of their overall food choices and a lower intake of refined and processed foods. Many of the gluten-free products are processed foods (snacks and baking mixes) that are more expensive and less nutrient-dense than whole foods.

Unfortunately, no one yet knows exactly why the incidence of this immune condition is rising, says Murray, although there are many possibilities. Celiac disease tends to appear more commonly in people with other immune disorders, which suggests that something in the environment may be disrupting people’s immunity. In other words, the rising incidence of celiac disease may be a symptom of a much larger and more pervasive environmental health problem. But the good news is that celiac disease is largely treatable. By avoiding one little protein, people with celiac disease can not only avoid unpleasant stomachaches but also reduce risk of other autoimmune issues and certain cancers. And for the few people with celiac disease, not eating gluten will allow them to better absorb nutrients from their diet and improve their health.

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