The earliest description of celiac disease was recorded in the second century A.D. In 1888 Samuel Gee published a monograph on celiac disease that “to regulate the food is the main part of treatment … The allowance of farinaceous foods must be small … but if the patient can be cured at all, it must be by means of diet.”
In the early 1900’s a carbohydrate restricted diet was advocated where the only carbohydrates allowed were ripe bananas and rice. Then in the 1950’s Dr. W. K. Dicke published work reporting that celiac children improved dramatically during World War II when wheat, rye and oats flour were scarce and therefore excluded from the diet. When these grains were reintroduced as a dietary mainstay after World War II the negative affect on celiac children was also noted. These observations were confirmed by other researchers who also demonstrated that “gluten” was the harmful component in wheat flour. Thus the gluten-free diet was born.
In 2002, Shan et al. demonstrated that the gluten-free diet model was valid. These researchers identified a 33-mer peptide (a chain of amino acids) as the primary initiator of the inflammatory immune response to gluten in celiac disease. They also identified tissue transglutaminase as the major autoantigen in celiac disease. Tissue transglutaminase was first identified by the late Dr. Elizabeth Ferguson of Glasgow, Scotland. This identification resulted in a more sensitive and specific serum antibody test which can be used to screen for celiac disease or to track individual response to gluten exposure.
Despite the advances in celiac disease, the inclusion of oats in a gluten-free diet remains controversial. Clinical studies suggest that some people with celiac disease tolerate uncontaminated oats. Other researchers have reported an inflammatory gastrointestinal immune response to oats. At this time there is no method to identify which people with celiac disease will tolerate uncontaminated oats and those who will not. The addition of oats is not a risk free choice for those on a gluten-free diet.1
1. Guest JE. Gluten-Free Diet Self Management Three Step Process. Celiac Sprue Association USA. PO Box 31700, Omaha, NE, 68131-0700. http://www.csaceliacs.org