The Godfather of Gluten-Free
In the battle of physician versus maladaptive protein, physician perseveres and recharges through pursuits befitting his Italian heritage.
Gluten-Free by the Numbers
- In 1996 gluten-free foods were a $100 million business.
- In 2012, gluten-free foods grew to a $4.2 billion industry.
- 27 million people consume gluten-free foods to lose weight.
- 9 million go gluten-free because of Gastro-intestinal symptoms.
- 7 million claim going gluten-free helps clear their headaches and foggy mind.
- 320,000 Americans have a Celiac disease diagnosis.
Alessio Fasano, MD, has been known to break into song in appreciation of a fine meal. For the Italian native, food is a passion. And the ingredient he is most passionate about has fueled both his professional career and a national dietary fervor: gluten.
When Fasano, a pediatric gastroenterologist, first arrived in the United States from Salerno, Italy, in 1993, he intended to develop a vaccine for cholera. But he also saw patients suffering with other disorders and was surprised to learn how few diagnoses of celiac disease—an autoimmune reaction to wheat’s main protein, gluten—existed in the United States. He had a dual track of action ahead of him then: uncover the mechanism by which a wheat allergy develops and educate the public that such a disease even exists. Thanks in part to his efforts, gluten has become the nutrient du jour, and the number of patients identified with celiac disease has soared from 45,000 in 2003 to 320,000 in 2013. And Fasano believes it is still largely underdiagnosed.
While there is a certain genetic component to celiac disease, people are not born with it, he says. They are born with a predisposition to it and need a trigger to set it off. That trigger can be as simple as a change in the gut’s flora from “friendly neighbors,” as Fasano says, to “belligerent ones,” possibly set off by a course of antibiotics or an illness. Then when the body detects gluten, it no longer moves it along, but attacks. Now that the underlying mechanism for the autoimmune response is understood, Fasano and his researchers are seeking biomarkers that could help create a definitive test. “If we have better diagnostic tests, we can gain a greater understanding of the genetic component of celiac disease, and eventually find alternative treatments to the gluten-free diet.”
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