From the Guidelines
Gluten intolerance, including Non-Celiac Gluten Sensitivity (NCGS) and Celiac Disease (CD), is estimated to affect approximately 1% of the population with CD, while NCGS is more common, affecting around 0.5-13% of the population, according to the most recent evidence 1. The prevalence of gluten intolerance appears to be increasing, possibly due to improved diagnostic techniques, greater awareness, and environmental factors including changes in wheat processing and gut microbiome alterations. Some key points to consider:
- Genetic factors play a significant role, with first-degree relatives of celiac patients having a 7.5% risk of CD, as reported in a recent meta-analysis 1.
- Gluten intolerance is more common in women than men and can develop at any age, though it's often diagnosed in early childhood or between ages 30-50.
- Geographic variations exist, with higher rates in Northern European countries and regions where wheat is a dietary staple.
- If you suspect gluten intolerance, proper medical testing is essential before eliminating gluten from your diet to ensure accurate diagnosis, as symptoms and signs are an important component of every diagnostic effort, and may aid in preliminary problem sorting 1. The most recent guidelines for best practices in monitoring established coeliac disease in adult patients, published in 2024, emphasize the importance of a team-based approach, including a dietician, and recommend a reasonable follow-up schedule of every 12 months 1. Additionally, the guidelines highlight the usefulness of serology in monitoring patients with CD, and the importance of considering novel issues, such as quality of life, in future studies. It is also worth noting that the prevalence of CD is estimated to be around 1% of the population, with a significant proportion of patients remaining undiagnosed, as reported in a systematic review with meta-analysis published in 2022 1.
From the Research
Prevalence of Gluten Intolerance
The prevalence of gluten intolerance, also known as Non-Celiac Gluten Sensitivity (NCGS) or Celiac Disease (CD), is estimated to be around 5% of the global population 2, 3. This estimate includes various gluten-related disorders, such as celiac disease, wheat allergy, and non-celiac gluten sensitivity.
Celiac Disease (CD)
- The prevalence of celiac disease is thought to affect 1% of the population in the USA 4.
- The prevalence increases drastically from 1:133 in patients not-at-risk, to 1:56 in symptomatic patients, to 1:39 in patients with a second-degree relative with the diagnosis, and to 1:22 in patients with a first-degree relative with the diagnosis 4.
Non-Celiac Gluten Sensitivity (NCGS)
- The prevalence of non-celiac gluten sensitivity is highly variable, ranging from 0.63% to 6% 5.
- NCGS is believed to be the most common syndrome of gluten intolerance 6.
- The pathogenesis of NCGS is heterogeneous, with a recognized pivotal role for innate immunity, and many other factors contributing, including low-grade intestinal inflammation, increased intestinal barrier function, and changes in the intestinal microbiota 5.
Gluten-Related Disorders
- Gluten-related disorders, which include celiac disease, wheat allergy, and non-celiac gluten sensitivity, require the exclusion of gluten from the diet 2.
- The incidence of gluten-related disorders is increased, and self-diagnosis is frequent, with many people following a self-prescribed gluten-free diet without first being diagnosed or confirmed as having a gluten disorder 2.