Awareness of celiac disease and concerns about reactions to gluten and wheat-containing products have increased in recent years. But confusion remains about the causes and differences between celiac disease, gluten intolerances, wheat allergies, and the overall trend in gluten-free product consumption.
Celiac Disease vs Gluten Intolerance
While the symptoms for both conditions are similar, they are two very different medical conditions. Celiac disease is an autoimmune condition where gluten causes an immune response of inflammation in the small intestine.
While gluten sensitivity or gluten intolerance is an asymptomatic reaction after eating gluten where celiac disease is not present. Also called non-celiac gluten sensitivity. The causes of gluten sensitivity are not fully understood.
There is no such thing as a gluten allergy. In fact, typically gluten allergy typically refers to someone with the autoimmune condition of celiac disease.
This should not be confused with a wheat allergy. Wheat allergies are specific to wheat and not all gluten-containing grains. The symptoms are different from celiac and similar to other food allergies. Symptoms occur when a person eats wheat or wheat-containing products or inhales wheat flour.
History of Celiac Disease
The history of celiac disease can be traced back to the original agricultural revolution over 8,000 years ago. As human diets begin to expand from hunter and gather to domesticated livestock and cultivated crops most were able to adapt.
However, those humans who were not able to adapt show the first cases of food intolerances including celiac disease. In fact, a 2008 archeological dig unearthed remains from the 1st century AD which showed, using genetic testing, the presence of the celiac gene HLA-DQ2 along with malnutrition damage typically associated with celiac disease.
An early description of celiac (or coeliac) appears in 50 A.D. which is described as pain in the abdomen. In 1887 the first modern medical description of celiac disease that can be treated by diet is published.
But it isn't until the 1940's that Dr. Willem Dicke hypothesizes that wheat protein may be triggering celiac, and a wheat-free diet is first developed. In the 1950s, Margot Shiner was able to link celiac disease to damage in the small intestine.
In the 1960s the first antibody tests were developed followed by genetic marker identification in the 1970s and 1990s. There are two markers identified, HLA-DQ2 and HLA DQ8.
While clinical trials are underway, there is no known cure for celiac.
Celiac Disease Statistics
Celiac disease (diagnosed) impacts 1% of the population in the United States, about 1 in 133 Americans. (3 and 4)
Celiac disease affects over 3.3 million Americans. (13)
Celiac disease is under-diagnosed with an estimated 15% to 20% of the affected population formally undiagnosed. (3)
Mass screening programs in countries like Italy and Finland show rates of 1.^% and 1.99% of the population respectively. (5)
20% of those with Celiac disease are unaware they are affected. (3)
60% of children diagnosed with Celiac were asymptomatic. (13)
41% of adults diagnosed with Celiac were asymptomatic. (13)
Between 10% to 20% of first-degree relatives of patients with celiac disease have also evidence of the disease. (12)
2.6% of those testing positive for Celiac have a second-degree relative who have celiac. (13)
The average time from symptoms to diagnosis is between 6 and 10 years (5)
There are over 200 signs and symptoms related to Celiac. (13)
While celiac disease affects both men and women, diagnosed cases of celiac disease are 2.2 times higher in women. (9)
Healthy people diagnosed with Celiac disease are 3 times more likely to develop another autoimmune disease. (13)
Gluten Sensitivity Statistics
An estimated 19.8 million Americans (6%) suffer from gluten sensitivity. (5)
Self-reported rates of gluten and wheat sensitivity are as high as 13% of the U.S. population. (11)
Wheat Allergy Statistics
1.3% of children and 0.4% of adults are allergic to wheat. (8) and (3)
65% of children will outgrow their wheat allergy by age 12. (8)
The average time to resolution for adults is 6.5 years. (8)
Gluten-Free Market Statistics
U.S. Gluten-Free Food Market Size in the US is $1.77 Billion. (1)
Global Gluten-Free Food Market Size $5.6 Billion. (1)
The annual growth of the gluten-free food market is 6%. (2)
9% of meals prepared at home in the U.S. contain a labeled gluten-free product (7)
There are over 2,000 gluten-free labeled food products available in the U.S. (13)
Outpatient healthcare costs are on average $3964 higher for individuals with celiac disease (6)
26% of U.S. restaurants contain gluten-free specific items, up 182% over a 4 year period (7)
30% of Americans are attempting to eliminate or reduce gluten in their diets. (10)
27% of Americans reported specifically purchasing a gluten-free product in the last 3 months. (15)
While only 11% of the above 27% were actually gluten sensitive or celiac. (15)
In the U.S. gluten-free labeled foods do not have to be entirely free from gluten, just less than 20 PPM (parts per million). (14)
The global market for gluten-free beer is expected to increase 13.72% between 2019 and 2024 with the largest growth seen in Asia Pacific. (16)
Celiac disease is a genetic autoimmune disorder that causes damage to the small intestine. Having the two identified genetic markers is not a guarantee that the individual will actually develop celiac.
Gluten is a protein found in grains including wheat, rye, and barley. It is also found in triticale, malt, brewer's yeast, and wheat derivatives such as spelt, farro, farina, and wheatberries.
Gluten intolerance or sensitivity is a condition where the person experiences negative symptoms after ingesting gluten. Unlike celiac disease, there is no damage to the small intestine.
- Statista- US Gluten Free Market 2020 to 2025
- Allied Market Research
- Dr. Schar
- Celiac Disease Center Columbia University
- Beyond Celiac
- The Economics of Coeliac Disease: a population based study
- Journal Clinical Immunology
- Am J Gastroenterol April 2020
- Medical News Today
- Department of Medical and Surgical Sciences (DIMEC) and Center for Applied Biomedical Research (CRBA)
- World J Clin Pediatr. 2021 Jul 9; 10(4): 53–71
- The University of Chicago Medicine (Celiac Disease Center)
- The Hartman Group
- Mordor Intelligence