Celiac and the Sahara
The Saharawi People
Highest Percentage of Celiac Disease
What population has the highest rate of celiac disease? People thought for a long time it had to be in Europe. Not at all - we see the most celiac disease in the Sahrawi or Saharawi, a traditionally tribal people in the Western Sahara.
It took until the 1950s to realise that celiac disease is caused by gluten but it took even longer to realise that celiac disease is global. Most cases were found in Northern Europe and so it was assumed to be unique to this region. Even up to 2003, researchers and doctors assumed not only that celiac disease was extremely rare in North America but it only affected children (Fasano 14).
The higher frequency of diagnosis in North Europeans was taken as evidence that it didn't exist anywhere else. Today we know that celiac disease occurs all over the world.
Who are the Saharawi?
The Saharawi people live in the Western Sahara region of Africa, south of Morocco and north of Mauritania, an area that used to be under Spanish colonial rule. When Spain withdrew, they left out the nomadic tribes of the Sahara who attempted to declare themselves an independent state in 1976. Mauritania and Morocco declared a war, and despite a cease-fire in 1991, large populations of Saharawi have since lived as refugees (Holt). Wheat is a staple of refugee camps and most of these refugees were exposed to wheat for the first time. Several studies have shown that the rate of celiac disease is 5-6% among Saharawi people, as opposed to 1% in Europeans, a significantly higher rate.
Why do some populations have higher CD rates?
One of the theories as to why certain populations have much higher rates goes back to when gluten first entered our diets 10,000 years ago. Those with the celiac disease genes didn't survive to pass them on, dropping the amount of those individuals in a population down. In places where wheat wasn't introduced until later, or at least not into large amounts, those with celiac disease survive unawares. However, this theory is far from definitive and evidence points to a paradox at the heart of this history of celiac disease.
Another theory is that some populations (around 1 billion people by some counts) strongly prefer consanguineous marriage, or marriage between second cousins or closer (Hamamy). The more closely related two partners are, the higher the chances that recessive genes in their children will become dominant. There is no definitive answer for more information on this topic
Title Image Credit: By Western Sahara (Exhibicion de camellos Uploaded by ecemaml) [CC BY-SA 2.0 (http://creativecommons.org/licenses/by-sa/2.0)], via Wikimedia Commons
Fasano, Alessio, and Susie Flaherty. Gluten freedom: the nation's leading expert offers the essential guide to a healthy, gluten-free lifestyle. NY, NY: Wiley, 2014. Print. p10-12; 14
Fasano, Alessio, Riccardo Troncone, and D. Branski. Frontiers in celiac disease. Basel: Karger, 2008. Print. p23-30
Hamamy, Hanan. “Consanguineous Marriages: Preconception Consultation in Primary Health Care Settings.” Journal of Community Genetics 3.3 (2012): 185–192. PMC. Web. 6 Mar. 2017.
Holt, Bella. Sahara, Sahrawi Arab Democratic Republic - Protracted Sahrawi Displacement and Camping. Abobo Abidjan: Dany Beck Paper Shop, 2017. Print.