The New Oxford American Dictionary defines a disease as:
a disorder of structure or function in a human, animal, or plant, esp. one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury
For this discussion, the key point is “a disorder of structure or function.” With celiac disease (CD) however, there is a problem: the person does not have “a disorder of structure or function.” Their structure or function would have been just fine before the agricultural revolution. There is nothing wrong with the person; the problem is the invented diet of the agricultural revolution. (Consider it this way: if someone is suffering from chronic mercury exposure, you do not say they have mercury disease, you say they have mercury poisoning.)
Dr. Stefano Guandalini of the University of Chicago Celiac Disease Center, in A Brief History of Celiac Disease, writes:
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. (emphasis added)
According to Guandalini, Aretaeus of Cappadocia, a Greek physician, described celiac “disease” in the first century AD; the name was created from “koelia”, the Greek word for abdomen. Aretaeus' observation:
“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.”
In 19th century, avoidance of “farinaceous food” (starchy foods) was recommended. However, according to Guandalini,“there was still no clue as to what could be causing celiac disease and no hint (in spite of autopsies frequently performed given the high mortality rate) of the damage to the intestinal mucosa.” (emphasis added).
In the mid-20th century, Dutch pediatrician Dicke
“… noticed that during bread shortages in the Netherlands caused by World War II, children with celiac disease improved. He also saw that when Allied planes dropped bread into the Netherlands, they quickly deteriorated.”
In the 1960’s, antibodies to the gluten protein gliadin were discovered and CD began to be viewed as an autoimmune condition. The gut, sensing the foreign protein invader (gluten), mounts a strong immune reaction that if sustained, can eventually destroy the gut. Avoidance of gluten allows many to return to normal, although long-term effects on development, such as short stature, are not reversible in adulthood. Celiac disease represents a strong argument for returning to a modern equivalent of the diet of the Paleolithic era.
The current "treatment" advice is outlined by the National Institute of Diabetes and Digestion and Kidney Diseases. (Please refer to this link if you have, or believe you may have, CD. If affected, your goal is learning how to avoid a toxin, one that was never a significant part of the original human diet.) Part of the Institute's advice includes:
“Plain” meat, fish, rice, fruits, and vegetables do not contain gluten, so people with celiac disease can freely eat these foods. In the past, people with celiac disease were advised not to eat oats. New evidence suggests that most people can safely eat small amounts of oats, as long as the oats are not contaminated with wheat gluten during processing. People with celiac disease should work closely with their health care team when deciding whether to include oats in their diet.
In the celiac as a "disease" model, persons with CD are said to be "genetically predisposed" to the disorder. However, this depends on the point of view. For those supporting the disease model, "genetic predisposition" will be the frame of reference. The opposite point of view is more accurate: those that tolerate gluten have a "genetic protection"; one that, for many, was an evolved trait in view of the loss of persons not adapted to gluten.
In summary, reaction to gluten was mostly a non-issue for human kind during the Paleolithic. The exception may have been occasional exposure to wild grains, most likely during times of relative starvation. Celiac disease is a modern “disease” with it origins at the beginning of the modern era 10,000 years ago. A return to the original human diet, commonly known at the Paleolithic diet, avoids this, for some, toxic stimulus.
John Oró, MD
Revised from initial post 9/12/2011