Times of India
16 March 2011
By Durgesh Nandan Jha
New Delhi, India

Wheat allergy, once considered a disease of the West, has been termed an ‘impending epidemic in India’ in an article published in a recent issue of Indian Journal of Medical Research (IJMR). The disease is not just affecting paediatric patients but adults too.

According to the report, celiac disease, commonly known as wheat allergy, is seen more in north India as compared to south India due to high consumption of wheat products that contain gluten – a protein which causes this allergy – in this part of the country.
A change in the variety of wheat grown – from ancient or diploid wheat to the modern hexaploid wheat – has also been cited as a reason for an increase in the number of cases. Hexaploid wheat is more antigenic – a substance which stimulates the production of an antibody when introduced in the body. The modern hexaploid wheat has highly antigenic glutens, which are more capable of inducing celiac disease.

The article states that for centuries, diploid, and later tetraploid, wheat was grown in India. These varieties were less antigenic in comparison to hexaploid wheat, which has recently been introduced. Thus switching over to older varieties of wheat may be better for public health.

The IJMR article – which has been written by B S Ramakrishna, a professor of gastroenterology at Christian Medical College, Vellore – adds that public authorities should examine infant feeding recommendations and wheat varieties cultivated in the country for finding ways to avert the epidemic of celiac disease. In addition to breast feeding, infants are often fed rye, barley and other wheat products after a certain age, mostly when they are six months to one year old.

The prevalence of celiac disease is much lower in countries like Finland, Estonia and Denmark, which are characterized by low gluten consumption in infancy, than in Sweden, where gluten consumption is high in infancy, the article states.

According to experts, the classical symptoms of celiac disease are related to the gastrointestinal tract – diarrhoea, weight loss, failure to thrive, abdominal pain, anorexia, vomiting and constipation. These may account for only a portion of the cases.

"Celiac disease is actually a multi–system disorder, which is highly variable in its clinical expression. It may occur at any age, and may have a variety of manifestations, including iron deficiency, anaemia, osteoporosis, vitamin deficiencies and fatigue.

It may manifest in the form of delayed puberty, infertility or recurrent foetal loss or as dental enamel hypolapsia," said the expert. He added that celiac disease is also associated with neuropsychiatric conditions like depression, anxiety and epilepsy.

Said Dr Pankaj Vohra, paediatric gastroenterologist at Max Healthcare, "I have seen more than 350 cases of celiac disease in the past few years. A three–yearold child came to us recently with a bloated stomach, sticklike limbs and passed several heavy stools daily. Her parents could not understand why she refused to grow." He said that a change in the diet chart of the patient and certain medicines can help.

Dr Ishi Khosla, who heads the Celiac Society for Delhi, added, "One should consume foods that require minimum processing to prevent allergy caused by gluten. It’s a good idea to have fresh fruits, fruit juices, nuts and south Indian food items."