Jump to content
  • Sign Up
  • Join Our Community!

    Get help in our celiac / gluten-free forum.

  • Jefferson Adams
    Jefferson Adams

    Being Poor and Dirty May Help Protect Against Celiac Disease

    Reviewed and edited by a celiac disease expert.

    Celiac.com 04/07/2008 - No, this is not some kind of April Fool’s joke.When I read this report, I just about fell off my chair. New research indicates thatbeing poor and living in squalor might actually provide some benefitagainst the development of celiac disease.

    A team of medicalresearchers recently set out to examine gene-environmental interactionsin the pathogenesis of celiac disease. The research team was made up ofA. Kondrashova, K. Mustalahti, K. Kaukinen, H. Viskari, V. Volodicheva,A. M. Haapala, J. Ilonen, M. Knip, M. Mäki, H. Hyöty, T. E. Group.Finland and nearby Russian Karelia have populations that eat about thesame amounts of the same grains and grain products. The two populationsalso have a high degree of shared genetic ancestry. The only majordifference between the populations of the two areas lies in theirsocioeconomic conditions.

    The region of Russian Karelia ismuch poorer than the neighboring areas in nearby Finland. Thesanitation levels in Russian Karelia are also distinctly inferior thanthey are in Finland. The researchers compared the prevalence of celiacdisease and predisposing human leukocyte antigen (HLA) alleles inpopulations from Russian Karelia and Finland. The team performedscreening for tissue transglutaminase antibodies (tTG) and HLA-DQalleles on 1988 school-age children from Karelia and 3654 children fromFinland. Children with transglutaminase antibodies were encouraged tohave a duodenal biopsy.

    Interestingly, the patients fromRussian Karelia showed tTG antibodies far less often than their Finnishcounterparts (0.6% compared to 1.4%, P = 0.005). The patients fromRussian Karelia also showed Immunoglobulin class G (IgG) antigliadinantibodies far less frequently than their Finnish patients (10.2%compared to 28.3%, P<0.0001).

    The researchers confirmed adiagnosis of celiac disease by duodenal biopsy in four of the eighttransglutaminase antibody-positive Karelian children, for an occurrencerate of 1 in 496 versus 1 in 107 Finnish children.

    In bothgroups, the same HLA-DQ alleles were associated with celiac disease andthe presence of transglutaminase antibodies. The patients from RussianKarelia showed a much lower prevalence of transglutaminase antibodiesand celiac disease than the Finnish children. 

    The poorconditions and inferior hygienic conditions in Russian Karelia mightprovide some kind of protection against the development of celiacdisease. The value of studies like this aren’t to make us wax nostalgicfor poverty, or to encourage people to fend off celiac disease bybecoming poor and living in squalid conditions. The value of a studylike this lies in the idea that there may be more to the development ofceliac disease than simple biological factors. That environmentalconditions might play a key role in both the frequency ofceliac-related antibodies, and in the development of the disease itselfis quite intriguing and clearly warrants further and more comprehensivestudy.

    Ann Med. 2008;40(3):223-31.


    User Feedback

    Recommended Comments



    If being 'poor and dirty' protected against celiac I certainly would have never developed it. Perhaps the poor in Russia have had to live without the bread and the other artificially glutened food ingredients that are rampant here in the US. But being poor in the US means you live off bread and cheap foods many of which should be gluten free but have had the substance added to it.

    This research study leaves a lot of unanswered questions. The idea that here in the US you are less likely to have celiac if you are 'poor and dirty' is so ridiculous it isn't even funny.

    Share this comment


    Link to comment
    Share on other sites

    This is not surprising. In nature, defective genetics are quickly removed from a population. Affluence allows defective genes like celiac to be compensated for, allowing the carriers to pass their defective genes on in the affluent population.

    Share this comment


    Link to comment
    Share on other sites
    Guest Steve Malinowski

    Posted

    There was a study that showed that the exposure to sunlight of the child early on was the Problem. Lack of Sunlight may be bad. If the poorer children got out more

    then investigate the Sun's rays too. Oregon and Washington states large populations are having very low sun because of cloud cover. And I believe they

    are high on the Celiac occurrences too. Also, the Coastal cities of Ireland probably have cloud cover. I also heard that the Jews that went into hiding had little sunlight and were under stress... check it out. Thanks.

    Share this comment


    Link to comment
    Share on other sites

    Krista is right. This is very interesting research but the 'poor and dirty' idea is a guess. The researchers need to look hard at the typical diets of the two groups before they leap into their sanitation - so to speak. When my ancestors were poor and dirty - farm laborers in the north of England in the early 19th C and before - they would have eaten mainly oat cakes, vegetables and a bit of meat. The celiac gene would barely have been tickled awake.

    Share this comment


    Link to comment
    Share on other sites

    Obviously, being poor cannot directly affect the chance of getting celiac, but it is almost equally obvious that being dirty could directly affect the chance of getting celiac. It all has to do with developing immunities. Of course, it could also be that some dirty poor people die from immune problems and the ones who are left (natural selection) to be surveyed are the ones who were born with certain immunities.

    Share this comment


    Link to comment
    Share on other sites

    I am really curious to know what foods comprise the main parts of the diet for each group. I agree with Krista; typically some of the cheapest foods contain wheat, like bread and pasta. In many places rice or potatoes would come first, but I would be curious to know the result of that same test in the US. Here our cheapest foods are basically all wheat-based, or at least, that's what people think to buy first; a loaf of bread, a box of macaroni and cheese, a dollar-menu big Mac, the list continues. My hypothesis for that same study done here in the US would be for it come out opposite from the Russian study.

    Share this comment


    Link to comment
    Share on other sites

    The assumption that poverty and dirt is the 'causal' factor seems a little premature. Perhaps the poor people in Russia spend more time outdoors? Given the slew of recent medical research connecting cholecalciferol (vitamin D) deficiency and higher rates of autoimmune diseases (among other things), MAYBE time in the sunshine is the real difference behind the rates of celiac in these two populations. In any case, 'poverty' implies a lot of lifestyle differences besides 'dirt.'

    Share this comment


    Link to comment
    Share on other sites

    If Celiac comes from being too clean then what's genetic predisposition got to do with it? My whole family (Mother, her siblings) are equally clean, and they don't seem have Celiac, but I do. How could one of us be too clean?

    Share this comment


    Link to comment
    Share on other sites

    I agree with the others that more investigation into the diet and lifestyle differences between the countries is warranted. But I find it a fascinating study and hypothesis. There is a similar 'hygiene hypothesis' in the development of allergies that has been studied a lot more and is really gaining steam.

    Share this comment


    Link to comment
    Share on other sites

    I have a hard time buying the thought of being in poverty will help protect you from developing celiac disease. Kristia is right, here in the U.S. the food that gets donated to food banks and issued by the government is high in gluten. Since this is a gene-related disease, has any one ever thought about inter family marriages as a possible factor, for the richer people to have a higher level of celiac? Back over hundreds of years, there were a lot of rich families marring each other. Just a thought.

    Share this comment


    Link to comment
    Share on other sites

    I agree with Krista, too. I'm 1/2 Finnish and can tell you that I grew up with a fine Finnish baker for a grandmother - and she was 'allergic' to wheat (and had alopecia and arthritis). I also grew up poor and dirty. Wish I could say I grew up in an Asian community ...

    Share this comment


    Link to comment
    Share on other sites

    The results could also be interpreted that those having celiac disease are less likely to thrive & reproduce when born into squalor, compared to celiacs born into better conditions who have more resources and become able to reproduce.

    Share this comment


    Link to comment
    Share on other sites



    Join the conversation

    You are posting as a guest. If you have an account, sign in now to post with your account.
    Note: Your post will require moderator approval before it will be visible.

    Guest
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

×
×
  • Create New...