Coeliac disease: many suffer from it, but few really know what it is. We talked to Prof. Marchetti on International Coeliac Disease Awareness Day

Coeliac disease is one of the most underestimated diseases in Italy. It is a permanent disease with an auto-immune reaction to gluten (which is the protein component of some cereals). Although it is a common perception of many―especially in recent years―that the incidence figure is on the rise, the official numbers tell us that the average number of those suffering from it in our country is more than 0.4 percent lower than in the rest of the western world.

The Ministry of Health can help us clarify the actual incidence of this problem, from which more and more people claim to suffer. The hypothesis is that despite an increase in diagnoses, not all coeliac patients have yet been identified. It has been ascertained, moreover, that a considerable percentage of people have self-diagnosed the disease, without any specific medical consultation. But there are also several cases that remain silent, even though the health problems resulting from this disease can create disabling situations leading to more serious disease.

For coeliacs, gluten is a real silent killer, and there is no cure for the disease. People must follow a strict diet free of many foods, the best known of which are pasta and bread (but they are certainly not the only ones). This makes the symptoms disappear, but if one goes back to consuming gluten, they reappear unchanged. Statistically, only 3% of the world’s population carry the genetic predisposition that induces this disease, but not everyone who consumes gluten in life actually develops the disease. There are various theories, still being studied by researchers, as to what the triggering factors are. At the moment, however, there is no definitive data that can reveal the full story.

This is also why greater public awareness is needed. The date of 16th May, which is precisely ‘International Coeliac Disease Awareness Day’, is a first response to this need.

Information days like this, aimed at students, could probably help’, says Professor Marco Marchetti, lecturer in Food Merceology and Pharmaceutical Chemistry on the MSc Human Nutrition Sciences programme at UniCamillus University. We tried to shed some light on some of the aspects of this disease and make our contribution to spreading more awareness of it. ‘To take a first step forward, it would be very nice, for example, to make all people aware of the fact that there is no need to use specially prepared food for meals, resulting in separation and distinction. Foods that are already naturally gluten-free can be used, and would allow for greater conviviality, as they are intended for everyone, without distinction. The first example that comes to mind is rice’.

It is true, however, that many people are not adequately informed about the risks that coeliacs run. ‘The main critical issues lie in contamination’, warns the Professor. ‘It is not enough to use products prepared for coeliacs or naturally gluten-free. Careful and strict adherence to preparation standards is also necessary, and often this implies two physically separate and distant locations for the preparation of dishes’.

It also appears from the available data that women are more prone to coeliac disease than men. Whether or not there is a specific reason for this higher incidence, however, remains unclear. ‘Yes, it is true. It is mostly women that are affected, and this is probably because the female immune system appears more aggressive in this respect. Equally true, however, is that the female immune system is readier and performs better not only with regard to coeliac disease but in general, and specifically in anticipation of childbirth. Therefore, there is no clarity as to the reasons for this correlation’. 

Professor Marchetti himself went on to cite another example of a statistical correlation related to coeliac disease, which, however, has not yet found sufficient evidence to formulate a specific theory in this regard: the frequent coexistence of the disease with type 1 diabetes. ‘The existence of a correlation is clear and evident, even in terms of percentages’, the Professor points out. ‘To date, however, there is no unanimous consensus as to the reason behind this. An alteration in the functioning of the immune system seems to play a role, but there is no real proof yet’.