Some of the most common misconceptions about gluten sensitivity is that suddenly this modern society is more complaining and "allergic to everything". That this problem didn't exist 50 years ago. Or that it's just a fashion and a fad, a dietary choice.

There is no doubt that some people do choose to be gluten-free, perhaps as a healthier diet choice, or because they experience bloating and discomfort when eating bread and gluten products. These are all very valid reasons for following a gluten-free diet, and it is also a massive help in making gluten-free products much more widely available. However, some individuals don't have a choice whether to eat gluten or not, and their immune systems make that choice for them when coeliac disease is diagnosed.

But even the numbers of diagnosed coeliac patients has increased dramatically in the last 20 years. Below, I discuss three possible reasons for increased gluten sensitivity nowadays.

1) Improvements in testing and diagnosis

Not that long ago it was common to take many years and thousands of pounds to be assessed for, and diagnosed as, coeliac. This would take many medical appointments with specialists and expensive endoscopies/biopsies as the only medical option for assessment.

Endoscopy and biopsy remains the gold standard for final diagnosis, however, the introduction of a blood-test, that nowadays costs as little as £20, provides the ability to now screen mass numbers for coeliac. Meaning 1st degree relatives of a newly diagnosed coeliac can be screened (the condition has a genetic risk). It also means likely cases of coeliac can be detected much earlier in the GP surgery, with a simple quick and cheap blood test.

2) Modern wheat varieties have changed

Many modern wheat varieties have been bred to have higher gluten levels - this effectively makes "stronger" bread flour, which has more stretch and rises more, giving more palatable bread as desired by modern baking and consumer demands.

Although this increased gluten content makes the bread texture better, it also has an impact on the permeability of the gut lining. For any individual, whether they have a gluten sensitivity or not, gluten has an effect on the chemicals that control "tight junctions" in the gut wall. So, increased gluten intake will likely increase gut permeability, making the possibility of immune reactions to foods entering our gut more likely.

3) Lectins in genetically-modified (GM) foods

Often GM foods are more resistant to insects and pests, which is one of their big benefits to enable higher yields. This is often achieved by increasing something called Lectin (different to lecithin), which is a natural chemical in a plant, particularly found in grains and seeds (e.g. wheat or in seeds in fruit such as strawberries).

Lectin is a plant's natural defence against being eaten by insects/animals. Lectins cause immune reactions and digestive irritation. This means that an animal will learn not to eat too much of that plant because they'll feel ill each time they do, making them less likely to eat it and increase the survival rate of the grain/seed to grow into a plant.

So, by increasing the natural lectin levels of a plant it becomes more of a problem to insects eating the plant. However, more pest resistant GM grains/seeds with higher lectin content (such as wheat or corn grain) can also cause more digestive and immune reactions in humans too!

Since the 2nd World War there has also been an increase in antibiotics and chemical usage in farming and food production, which can influence gut bacteria and immune reactions. Creating ever increasing challenges for digestive and immune health.

In conclusion

It's not all in the imagination, there are probably more diagnosed coeliac's nowadays, and probably more people with gluten sensitivity, but some of this is because the problem is better recognised. With some of due to improving laboratory testing and perhaps changing food manufacturing and farming practices.