May 2020 Issue

Editor’s Spot: Celiac Disease Rising
By Judith Riddle
Today’s Dietitian
Vol. 22, No. 5, P. 4

Celiac Disease Awareness Month is a time for dietitians to learn more about the disease and the latest drug developments. Celiac disease is the most commonly inherited autoimmune disorder that affects the digestive process of the small intestine. When a person with celiac disease consumes gluten, his or her immune system responds by attacking the small intestine, preventing the body from absorbing important nutrients.

The incidence of celiac disease has been surging significantly over the past few decades in several Western countries, according to a recent systematic review and meta-analysis published in The American Journal of Gastroenterology. The researchers found that in the 21st century, the incidence of celiac disease has been higher among women and children compared with men, and evaluation over time shows that these incidence rates have risen on average to the tune of 7.5% per year over the past several decades.

It’s been well established that adhering to a strict gluten-free diet to promote intestinal healing is extremely difficult and not foolproof. Some patients have nonresponsive or refractory celiac disease that doesn’t respond to a gluten-free diet, and others who don’t have the nonresponsive or refractory type, unknowingly, still may be ingesting gluten despite their best efforts not to—putting themselves at risk of progressive intestinal damage, malnutrition, anemia, and even lymphoma. Due to these issues, several drugs have been and are in development in different phases of the clinical trial process. Those in the pipeline are taking a variety of therapeutic approaches to stop the disease in its tracks by reducing an abnormal immune response, inducing immune tolerance, or interrupting immune reactions. The drug larazotide acetate (Innovate), whose goal is to disrupt the effects of gluten on the cells lining the intestine, is starting phase three clinical trials and is the furthest along in the clinical trial process. For more information on the drugs under research, visit

Patients who have success with adhering to a gluten-free diet have many foods and products from which to choose. Added to that list are pulse-based flours for gluten-free baking.

This month’s issue of Today’s Dietitian features “The Ultimate Guide to Pulse Flours,” on page 34, which provides an in-depth discussion (plus two recipes) on the nutritional prowess and versatility of these flours for at-home gluten-free baking.

Also in this issue are articles on the Mediterranean diet, probiotics, and seals and certifications on product packaging.

Please enjoy the issue!

Judith Riddle