The Anonymous Widower

Coeliac Disease: Can We Avert The Impending Epidemic In India?

The title of this post, is the same as that of this article on the Indian Journal Of Research Medicine.

With the high levels of COVID-19 in Leicester and an Indian population who make up 28.3 % of the population of the city, I was searching the internet to see if there was any connection between those of Indian heritage and coeliac disease.

I know you should not try to prove a theory. But as a coeliac, I’m very interested to see how the millions of diagnosed coeliacs on a gluten-free diet like me, are faring in this pandemic.

These are some extracts from the article.

Prevalence Of Coeliac Disease In Northern India

Coeliac disease was recognized in northern India, primarily in children, since the 1960s. A community-based study in Ludhiana that involved a step-wise approach to case detection and diagnosis estimated that celiac disease prevalence in this city was at least 1 in 310 individuals. Hospital-based studies examining a general paediatric patient population suggest a prevalence of 1 per cent.

One per cent is a high figure.

Diet And Coeliac Disease

The other variable is that cereal consumption patterns are very different between north and south India, although there has been a recent change in these patterns particularly in urban areas. In south India, rice is the primary cereal consumed in the diet. In the Indian sub-continent, wheat consumption is high in Pakistan and in the States of north India, which also constitute the coeliac belt of India.

It’s fascinating how two parts of the same country can be so different.

Introducing Babies To Gluten

The time of first exposure to wheat influences the development of celiac disease. In countries such as Finland, Estonia, and Denmark, characterized by low gluten consumption in infancy, celiac disease prevalence is much lower than in Sweden where gluten consumption is high in infancy. A natural experiment occurred in Sweden about two decades ago when national recommendations were made to introduce wheat into the diet after cessation of breast feeding at six months. This change was coupled with increased wheat gluten consumption through infant feeds. Together these measures resulted in a two-fold increase in incidence of celiac disease in Sweden, which was attributed to introduction of wheat into the diet after cessation of breast feeding. In 1996 this recommendation was changed to introduce gluten in gradually increasing amounts while the infant was still being breast fed. This led to a dramatic decrease in celiac disease incidence.

We used a Baby Mouli with our three and they all got what we ate, through a sieve.

All Wheats Are Not Equal

The other dimension to this problem is that not all wheat is alike when it comes to inducing celiac disease. The ancient or diploid wheats (e.g. Triticum monococcum) are poorly antigenic, while the modern hexaploid wheats e.g. Triticum aestivum) have highly antigenic glutens, more capable of inducing celiac disease in India, for centuries, grew diploid and later tetraploid wheat which is less antigenic, while hexaploid wheat used in making bread is recently introduced. Thus a change back to older varieties of wheat may have public health consequences.

I’ve read somewhere before that high-gluten wheats could have been the reason that bubonic plague came back.

Public Health Recommendations

Public health authorities may well want to examine both these avenues, i.e. infant feeding recommendations and wheat varieties cultivated in the country, for opportunities to avert the epidemic of celiac disease which is impending in our country.

I’ll agree with that! And the recommendations should be carried forward in the UK.

Conclusion

I have found this medical paper fascinating.

I can’t resist looking up the rates of confirmed cases in the countries mentioned.

  • Denmark 12751 – 6.80 million – 187.5
  • Estonia – 1947 – 1.32 million – 147.3
  • Finland – 7190 – 5.52 million – 130.2
  • Sweden – 65137 – 10.3 million – 632.4
  • United Kingdom – 311965 – 66.5 million – 469.1
  • United States – 2593169 – 326.7 million – 793

Note.

  1. The first figure is the number of lab confirmed cases from Wikipedia
  2. The second figure is the population.
  3. The third figure is the rate of lab-confirmed cases per 100.000 of the population

I have left India out as their numbers of tests seem extremely low.

Note how the three countries, that have fed their children on a low-gluten diet are top of the table, with the lowest rates of lab-confirmed cases.

I have said it before and I’ll say it until I’m blue in the face. Undiagnosed coeliac disease may have something to do with this pandemic and someone should investigate it properly.

Thoughts On The Outbreak In Leicester

I have heard reports that those found positive in Leicester live in a poor area and they tend to be younger.

Could it be that in their new country, they were introduced to gluten too early, because it’s easier to give gluten than proper food? Especially, where some roads in this country, are lined with scores of fast food shops selling gluten-rich junk food.

What do I know? I’m just an engineer and a coeliac who has a good nose for problems!

But please someone! Research the connection between undiagnosed coeliac disease and COVID-19!

My son; George was an undiagnosed coeliac with a gluten-rich and smokey lifestyle. He died at just 37 from pancreatic cancer.

Did he have a poor immune system, which meant he couldn’t fight the cancer? One expert on cancer said, “Yes!”

June 29, 2020 - Posted by | Health, World | ,

6 Comments »

  1. The problem may go deeper than you think. I too was an engineer and Quality specialist. I today visited our local Morrisons store. The lack of training and quality control is astonishing. They sell Topside which is Brisket, Brisket which is Skirt or Shin. The Butchers have no idea what cut they are selling, or the correct way to cut and prepare for sale. I have taken an interest in making craft bread, and as I have no flour, looked for some in Morrisons. No bread flour on the shelves, so, I approached the bread counter to ask if they had some to spare. The assistants said that other people had asked for bread flour, but they had none. I asked what they made bread from. Ordinary flour, was the answer. Their bread is horrible to eat, soft, under baked and under proofed. So is this another cause of intestinal illnesses when large food chains have no idea what they are selling to the public? Is covid-19 a cover up for something much bigger? I remember large numbers of Indian people were poisoned with toxic pesticides some years ago, Bhopal, and the Indian government pushed pesticides on poor rural villages at the same time. Are we now seeing the long term results of these chemicals?

    Comment by jagracer | June 29, 2020 | Reply

    • Commercially produced bread quality in influenced by 3 main factors
      1/ The “Chorleywood” bread making process (1950’s?) which uses heavy mechanical mixing and accelerated proving (yeasts, flour improvers, and heat) to enable softer domestic wheat to be used to make soft aerated bread. Allegedly Margaret Thatcher was professionally involved in the development of this before entering politics full time. Prior to this the best bread was made with harder wheats imported from North America especially Canada. Not sure how soft vs hard wheat aligns to diploid/triploid/hex wheat varieties. One improver that I sometimes use for my home baked is Vit. C (crush a couple of high strength tablets into the flour).

      2/ Increasing augmentation of commercial flours with ground soybean flour for reasons of cost and shelf life. USA is major producer with Asia only recently regaining no1 in tonnage. Also used in animal feeds. Personally I dislike this, and avoid except for occaisional takeaway sandwich (where I have not bought my own).

      3/ Steam baking for soft crusts (optional part of Chorleywood, but can also be done at home if desired, with a tray of ice cubes in bottom of oven when bread is put in).

      I have been having reasonable luck in getting strong wheat flour (generally white only) in my grocery orders from Sainsbury and Ocado in North London, more for pizza bases (maturing dough in fridge for 7 days) than bread, and some artisan bakery/pastry shops will sell flour and fresh yeast to increase their trade worth asking locally.

      Comment by MilesT | June 30, 2020 | Reply

      • Thank you for your analysis. I knew there were changes when Red Turkey wheat was imported to europe, but did not know they now add soya dust. I did an OU course where the fors and againsts of Soya production were discussed. Apparently there is heavy use of pesticides in its production, which is now showing third generation mutation in animals fed on soya feed. The raw beans are also toxic until cooked. Where do the public go from here? I have no access in my area to alternative supplies of bread flour. I believe Amazon sells in quantity, but I have no means of keeping large quantites dry and vermin free.

        Comment by jagracer | June 30, 2020

  2. I do think that coeliac disease could be a positive mutation of the genes to protect for some virus or bacteria. After all, coeliacs on a gluten-free diet are less likely to get cancer. What other disease gives you protection?

    Comment by AnonW | June 29, 2020 | Reply

  3. As an aside here about soya. A very senior hospital pharmacist friend once told me, that they were seeing young children with an allergy to soya, because their mothers were feeding them on soya milk!

    Comment by AnonW | June 30, 2020 | Reply

    • soya is now a very common additive to packaged foods, either as flour or as base for emulsifiers.

      Comment by MilesT | July 1, 2020 | Reply


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