Celiac disease, also known as gluten-sensitive enteropathy, non-tropical sprue, and celiac sprue, is an autoimmune reaction causing damage to the small intestine, potentially leading to malnutrition and related deficiency diseases. This disorder is induced in certain genetically-disposed people by eating gluten, a protein found in many grains including wheat, rye and barley. As the number of people diagnosed with celiac disease continues to rise, so does the market for gluten-free foods.

An estimated one in 4,700 Americans have been diagnosed with celiac disease. However, according to Celiac.com, as many as one in 133 Americans may suffer from the disorder. Furthermore, celiac disease occurs more prevalently in populations that are genetically predisposed, and incidence rises to one in 22 among those closely related to someone with celiac disease. Celiac disease may be under-diagnosed in the United States because many doctors lack current knowledge about the disease and may attribute its symptoms to other problems. Celiac disease is difficult to diagnose because a biopsy must be taken from the intestinal wall, and many patients would rather live with mild symptoms than undergo this procedure.

When people with celiac disease eat gluten, it causes an immune system reaction. The immune system responds to gluten in the intestinal tract by trying to neutralize it and prevent it from entering the bloodstream. Through this process, the tiny villi that line the intestinal wall and help to break down and absorb nutrients are damaged and destroyed. Without villi, a persons body cant absorb vitamins and nutrients from food.

The onset of celiac disease varies; some people develop symptoms as children, while others do not exhibit signs until adulthood. The older a person is, the harder diagnosis generally becomes. There is also a wide range of symptoms. While one person may have diarrhea and abdominal pain, another may be irritable or depressed. Symptoms include constipation, diarrhea, constant fatigue, weight loss, abdominal distention from bloating, tooth discoloration and bone pain. In children, stunted growth, behavioral disorders and anemia are also common symptoms.

For people with celiac disease, eating any gluten can damage the intestine. The best treatment for celiac disease is to adhere to a strict gluten-free diet, which is a lifetime commitment. For most people, following a gluten-free diet will stop symptoms, heal existing intestinal damage and prevent further damage. Removing gluten-containing foods from the diet generally relieves symptoms within days, and within months damage to the small intestine heals, allowing villi to function properly.

It is important for people who suffer from celiac disease to be educated about the foods that contain gluten ingredients. Following a gluten-free diet means avoiding all foods that contain wheat as well as many less obvious gluten-containing grains including spelt, triticale, kamut, rye, barley, and possibly oats. Common glutencontaining foods include baked goods, pastas and cereals. However, many unexpected items can contain hidden gluten ingredients, such as sour cream, gravies, meat patties, canned baked beans, pickles and even potato chips.

Despite dietary restrictions, people with celiac disease can eat a well-balanced diet with a variety of foods. Following a gluten-free diet does require a different approach to eating, but there are a growing number of food options available. Many foods are inherently glutenfree such as meat, fish, rice, fruit and vegetables. In recent years, gluten-free breads, pastas, cereals and other products have become more readily available, and the quality and variety of gluten-free foods has significantly improved. Many people who do not require a glutenfree diet purchase gluten-free products simply because they enjoy the taste and variation these items provide.

While some items are clearly labeled as gluten-free, others may state that gluten ingredients have not been added. For celiac sufferers, there is a big difference between these two statements, because items that state anything other than gluten-free may have been produced in a facility that also processes gluten-containing grains. Many celiacs must even avoid these products. Although many foods are now labeled as gluten-free, there is no law regulating the labeling of gluten-free products. The Food and Drug Administration (FDA) is developing a gluten-free labeling program, which promises to enforce strict guidelines that companies must follow when labeling their products as gluten-free.

The availability of gluten-free foods, as tracked by SPINS, has increased significantly. In natural and conventional supermarkets, sales of items labeled as gluten-free grew 17 percent in 2006 and have increased by 33 percent since 2004. Although consumers have historically looked to natural retailers for gluten-free options, conventional markets now account for 63 percent of gluten-free products purchased in supermarkets. Annual sales of the nearly 2,000 gluten-free items available have surpassed $740 million. In 2006, the number of active gluten-free items in creased to over 2,400 in natural supermarkets, and to over 1,400 in conventional supermarkets. In addition to the greater availability of products in retail stores, gluten-free options are beginning to appear in restaurant menus, airline in-flight food carts and school lunch programs.

Beyond adhering to a gluten-free lifestyle, multivitamin and mineral supplementation can also play an important role in maintaining a healthy and symptom-free lifestyle. The malabsorption that occurs in celiac disease can lead to multiple nutritional deficiencies. The most common nutritional problems in people with celiac disease include deficiencies of essential fatty acids (EFAs), calcium, magnesium, folic acid, iron, vitamin K and vitamin D. Anyone diagnosed with celiac disease should be assessed for nutritional deficiencies by a health care practitioner.

There is some evidence that thymus extract, quercetin, digestive enzymes, probiotics and betaine HCL may alleviate some of the symptoms caused by food allergies, such as celiac disease. These ingredients, as both single products and primary ingredients in combination formulas, are segmented by SPINS into a Food Allergy Health Condition. Cross-channel sales of food allergy items grew by 16 percent in 2006. This increase in sales suggests people with food allergies, such as celiac disease, are seeking out natural therapies. Though more research is needed to solidify the clinical use and preliminary science surrounding products with these ingredients, item sales growth infers that consumers are seeking a solution.

As the awareness of celiac disease grows among the general population and medical community, more people will be diagnosed. Lifestyle changes are imperative in treating the symptoms of celiac disease and its overall impact on the bodys digestive system. The opportunities for companies to develop products that enhance the quality of life for gluten-intolerant individuals are vast. Gluten-free food choices and supplement formulas, which help to correct nutrient deficiencies and support digestive integrity and immunity, will continue to grow in their demand. The natural products industry is a trailblazer in offering products that help those with celiac disease maintain a healthy and enjoyable life and it will continue to be a leader in addressing the special needs of this growing population. 

Kerrin Rourke is natural products expert, and Alison Tirone a marketing consultant with Schaumburg, Ill.-based SPINS, a market research firm. SPINS is a leading provider of industry reporting and consulting services for the natural products sector. SPINS comprehensive offering includes retail measurement services, content-based reporting, consumer information and consulting services. Learn more at www.spins.com, or contact the company at (847) 908-1200.