In the 1930s, before the discovery of the gluten-free diet as the way to manage coeliac disease, results from Great Ormond Street Hospital in London1 showed very high mortality among children with coeliac disease.
Mostly these days, the disease is wellmanaged by avoiding gluten. However in poorer settings, particularly where other diarrhoeal diseases are common, questions about gluten intolerance may not be raised, and consequently children may go on to die.
Prof. Peter Byass, who led the research, said “Coeliac disease may not be one of the world’s biggest killers, but it is a readily preventable cause of death. Much more awareness is needed in the poorer parts of the world – and in particular gluten-bearing food supplements for malnourished children need to be used in the knowledge that they could be harmful to the small proportion suffering from coeliac disease.”
The research is based on many estimates and assumptions, because there is a huge lack of reliable data on a global basis, and these limitations are discussed in the paper. The authors hope that increased awareness of the consequences of gluten intolerance will lead to better data and saved lives in the future.