Is One Sex Spared?

Is gluten the enemy to more women than men?

At celiac disease support groups, it's perfume, pumps, and purses that tend to dominate the room.  The various celiac books and blogs out there sound decidedly feminine with names like "Gluten-free Girl" and "CeliacChicks."  And the scant few celiac celebrities are all women:  CNN's Heidi Collins, the View's Elisabeth Hasselbeck, and former Massachusetts Lieutenant Governor, Jane Swift.  So, it begs the question, are celiac men simply less interested in participating in support groups and penning books about celiac, or are there just fewer of them?  Is celiac disease really a predominately female condition?

The research seems to suggest as much.  Two studies, one from Italy and the other from Spain, retrospectively examined hospital records of patients diagnosed with celiac and found that it was diagnosed two and four times as often in women, respectively (1, 3).  Dr. Peter Green of the Columbia Celiac Disease Center reports a similar figure from his research, finding that more women have celiac at a rate of about three to one (2).  This estimate is consistent with other autoimmune diseases like type-1 diabetes, thyroiditis, lupus, and rheumatoid arthritis, which when averaged together, tend to affect women more often than men roughly three times to one (2). 

But, that said, men don't necessarily have it easy.  According to Dr. Green, men with celiac may have more severe manifestations of the disease.  He found that at diagnosis, men may experience worse malabsorption than women, evidenced by their slightly lower cholesterol levels and lower bone density (2).

So while more women may suffer from celiac, men may actuall suffer more.  But for both the sexes with celiac, gluten is a formidable enemy.

Bardella, MT, Fredella C., Saladino V., Trovato C., Cesana BM, Quatrinin M., Prampolini L. Gluten intolerance: gender-and age-related differences in symptoms. Scand J Gastroenterol. 2005 Jan;40(1):15-9

Green, Peter HR. Celiac Disease: A Hidden Epidemic. New York: Harper Collins 2006.

Llorente-Alonso MJ, Fernández-Acenero MJ, Sebastián M. Gluten intolerance: sex and age-related features. Can J Gastroenterol. 2006 Nov;20(11):719-22