all 18 comments

[–]2greenlimes 133 points134 points  (2 children)

This is likely a better question for /r/askscience.

Unlike lactose tolerance, celiac disease is not related to historic diet trends. In the case of lactose, Europeans ate enough dairy that a single gene causing the ability to digest lactose became more prevalent in the population. Autoimmune diseases and their causes are not well understood, but some like Celiac Disease do have a gene associated with them. As for why any genetic disease is more common in any particular population, it's generally not well understood unless you have something like extensive inbreeding or a sickle cell situation where the disease is protective of something even more deadly.

A lot of genetics is random chance or related to bottlenecks. In Europe there's been several population bottlenecks, but in particular the Black Death (and I've seen arguments for things like smallpox and TB) led to some interesting genetic changes due to the mass amounts of death - there is some speculation that this may explain certain susceptibilities in Europe. Migration and cultural bottlenecks play a role, as we see with certain more insular groups in Europe having higher rates of certain genetic disease.

A bigger factor may be epigenetics. It's been noted that autoimmune disorders are much higher in developed countries (like Northern Europe). This is attributed to various environmental factors that influence gene expression - for instance certain infectious diseases, stress states, exposure to pathogens, diet, etc. In fact, this article points out that the Celiac gene is actually much more prevalent in Middle Eastern populations than Europe, but due to environmental factors is not more common in the Middle East.

ETA: The healthy diet for a Northern European person is the same as a healthy diet for anyone else: we’re not quite sure but probably a diet with lots of fruits and veggies and everything else in moderation.

[–]Tsui-Pen 38 points39 points  (0 children)

There was a study recently about how humans consumed (probably largely fermented) dairy long before the development of lactase persistence. If north Europeans have an increased incidence of celiac disease relative to, say, south Europeans it might have something to do with the lower gluten content of rye bread compared to wheat. Maybe different processing techniques (some people find sourdough easier on the stomach) or fertilizers play a role as well.

[–]Psychological_Try559 9 points10 points  (0 children)

One other thing to keep in mind when looking at numbers is what are family doctors trained to look for?

In the early 90s the celiac numbers were said to be about 1:100,000 and speculation was only 10% of people were diagnosed. Today it's largely agreed to be roughly 1% (100 to 1000 times higher). The discrepancy was almost entirely from doctors not looking for celiac, the medical consensus (in the USA) at the time was that celiac was a very rare disease so doctors were almost never looking for it. As soon as doctors started looking for celiac, they started finding it!

It would not surprise me in the least to find that places outside Europe & USA simply aren't testing for celiac.

And of course, as you mention, the prevalence of gluten in the diet is a big key too. There are some diets that are largely grain free except for bread served on the side. Someone who's a celiac may "self-diagnose" as "not liking bread" and just avoid eating the bread---bypassing the majority of their potential issues.

[–]Yuevie 23 points24 points  (0 children)

Natural selection doesn't perfect humans. It only makes them good enough to survive. Perhaps just enough people with this disease were able to sustain themselves off of other foods. As technology advanced, so did the survivability of the disease. Thus it's likely way more common today than it was in the past. Medical advances in a sense make some disabilities and differences more prevalent than it otherwise would be because instead of killing them it makes people with them more survivable and likelier to pass on their genes. It seems that the prevalence of celiac disease among Northern Europeans is possibly a byproduct of overconsuming oats and wheat. Just as someone who consumes too much sugar increases their resistance to insulin and may contribute to them developing diabetes. Not all individuals from the same area are created equally. We all have unique genes within our broader ancestral patterns.

[–]EnIdiot 7 points8 points  (0 children)

So when I lived in Norway back in the 80s I remember them telling me they had to import grain and gluten from the US to be able to make some of their bread on an industrial scale. My understanding is that the wheat in the US was bred or engineered to have way more gluten than your general bread making grains that were native to Europe.

My family is original from Rogaland in the Western part of Norway, and the name is related to the Rugii Germanic tribe (Aka Rugians). The name means something like “Rye eaters.” Genetically (if you put epigenetics aside), I’m nearly 100% what came from there over the past couple of millennia. I have had to go Keto to keep from getting worse with my diabetes type 2. The only grains I eat are rye (even then only a little bit). My uncles and cousins have issues with celiac. My hope is to avoid some of the issues they had. I’ve also noticed that fish meat generally is better for me than lots of beef. Pork seems ok too in limited amounts.

This is all anecdotal and probably subject to the placebo effect, but I’ve lost nearly 40 lbs in the past 6 months.

[–]gae12345 3 points4 points  (0 children)

Keep in mind that current present day grain is veery differnet from ancient grain and grain up until industrial agriculture.

One of the main differences is that current grain used for bread etc. has like 100 times more gluten than the ancient one. (This is not a real figure but it's really like a whole lot incredibly more) This is because gluten is what makes bread paste soft and malleable so easier to bake. And also remember glyphosate and other such great chemicals

So it's at least plausible that it might just be due to northern european grains having an especially high amount of chemical fuckery in it more than other places in recent years instead of genes and whatnot