12 May 2020

This latest, very small pilot study in children, published in the media on 12 May which links pesticides and household chemicals with the risk of developing coeliac disease, is inconclusive and published with cautionary warnings. To extrapolate the results of the research pilot to make a banner headline is speculative and could result in unnecessary worry, especially as the research doesn’t prove the claim.

Dr Peter Gillett, Consultant Paediatric Gastroenterologist on Coeliac UK’s Health Advisory Council has reviewed the research and says: “We know that the genes associated with coeliac disease can be found in around 40% of the UK population yet only 1% of the UK population is estimated to have coeliac disease. In addition to having the genes associated with coeliac disease and exposure to gluten, there must be other factors, which influence whether a person develops the condition or not.

“An alternative conclusion in this research could actually have been that there was no significant increase in blood chemical levels in coeliac patients compared to non-coeliac patients. Blood concentrations of chemicals in this study did not differ significantly between children with and children without coeliac disease, except in the case of one chemical. This should be viewed with real caution due to the way the data were analysed, and this chemical was not quantified for all children in the study.

“The selection of participants within the study is not fully representative of the coeliac population and leads to bias in the results which can then call into question the conclusions. There is a speculative suggestion that some chemicals found in blood samples increase the risk of developing coeliac disease, but the research does not prove this (bloods were taken at diagnosis, and not before they were diagnosed, so is this cause or effect?). The researchers note that further research is required to better understand the chemicals’ influence on the disease process and to determine true cause and effect.

“This conclusion also does not explain or postulate about the higher numbers of patients we see diagnosed in other industrialised countries like Finland and Sweden (where such chemicals and exposure to coated domestic wares will likely be no different to the study group), nor populations like the Saharwi in Western Sahara (who have a very high prevalence of coeliac disease) who clearly must not be exposed to such chemicals in the same way as other populations.”

Identifying the additional triggers that cause people to develop coeliac disease is important to the coeliac population and within the top ten research priorities set by Coeliac UK’s priority setting partnership.