When I was a kid, I was aware that my grandmother was frequently sick as a result of something called “sprue.” It meant she had a weird diet, and was very thin. Sadly, she also had no sense of smell, so the world of food was entirely unremarkable for her. No one else we knew had sprue, an autoimmune disorder, but it made sense because she had other autoimmune stuff going on too.
In 11th grade I went on a trip to what was then the Soviet Union. I made the mistake of eating something from a street vendor. I got very sick, and the sickness lasted through senior year. Regular ol’ tourist bacteria was quickly ruled out, but when the gastroenterologist found out my grandmother had sprue, he got excited: It skips a generation, he said, and might be the cause of my problems. I underwent endless tests and then a biopsy of my small intestine. The results were inconclusive. But a gluten allergy has very specific symptoms—very. Trust me, you don’t want to know what they are, because they’re related to poop, but they are pretty unmistakable and I had them. The doctor diagnosed sprue.
I was put on a gluten-free diet. In high school, that kind of sucks. It’s hard to go to pizza joints and Burger King with all your friends and be so limited. My parents took me to a celiac sprue support group, and I can only tell you that we laughed all the way home. This was 1985, remember, and the delicious! “cornbread” they served to prove that it wasn’t so bad to be gluten-free was not encouraging. The conversation was unintentionally hilarious.
The weird thing was, I got better. My symptoms disappeared. Then, at my high school graduation party, I unthinkingly plucked a piece of macaroni from a bowl of macaroni salad on the sideboard and popped it into my mouth. As soon as I realized it was gluten, I started to cry. What had I done? I told my mom in a panic and she said she thought it was okay. And it was. Gradually, I introduced gluten back into my diet. And you know what? Nothing happened. From that day to this I’ve been eating gluten and never had a problem again.
Nowadays the mysterious sprue is known as gluten allergy and it’s everywhere. It seems half the people I meet are allergic to wheat, and the allergy has spawned an industry of foodstuffs and cookbooks. (For a funny take on this kind of thing, check out the Allergy Pride Parade on the new season of Portlandia.)
Dealing with allergies of any kind can get you down, but when the allergies pertain to something we do every day—something as fundamental as eating—it can truly be a pain in the ass. Now a new study says it’s rather more serious than that for women. From MedPage Today:
In celiac disease, ingested gluten can damage the surface villi and impede nutrient absorption, but 37% of women with the condition met the clinical threshold for depression on the 20-item Center for Disease Studies Depression Scale, according to Joshua M. Smyth, PhD, of Pennsylvania State University in University Park, and colleagues.
Moreover, 22% also met the criteria for disordered eating assessed on a 29-item questionnaire, the researchers reported online in Chronic Illness.
Following a gluten-free diet is the usual recommended treatment for celiac disease, however, because of the near ubiquity of gluten in common foods, many patients with the immune disorder have difficulty keeping to their diet.
And even those who do adhere to the diet can remain symptomatic, which can interfere with normal functioning and lead to psychological difficulties.
Unsurprisingly, women who are forced to focus on food due to the disease can get consumed by the worry, and segue into eating disorders like anorexia and bulimia. Given that eating disorders are frequently about control issues, this makes sense—you have no control over your celiac diet but you exert control otherwise. Also, women who are on the celiac diet have excessive concerns about weight, according to the study. On the other hand, I don’t know one single woman who doesn’t worry about her weight.
Worse celiac symptoms were associated with poorer physical functioning and mental health (P<0.001 for both).
Correlations also were seen between different areas of psychiatric functioning, such as depression and stress (r=0.54, P<0.001), as well as stress and eating concerns (r=0.85, P<0.001).
The average level of depressive symptoms was 14.93, with a cutoff for clinical depression of 16.
The 65 women whose depression scores were at or above the cutoff had worse celiac symptoms (P<0.001), greater stress (P<0.001), lower dietary adherence (P<0.05), and worse quality of life for both physical and emotional domains (P<0.001 for both). ....
The study confirmed that women with celiac disease are at risk for psychiatric distress, implying that screening may be useful and that psychosocial support may be an important aspect to overall care for these patients, they observed.
Lesson to be learned from the study? Women who adhere to the diet and do not obsess about their weight are far less likely to experience depression.