This is the second part of a series on the history of celiac disease in America, based on Emily Abel’s article “The Rise and Fall of Celiac Disease in the United States,” which was published in the Journal of the History of Medicine and Allied Sciences in January 2010.  The first part of the series is here.

In the 1920s, a doctor named Sidney Haas came up with a diet for celiac disease sufferers that worked, and it had a novel twist: along with milk products and meat, the patient ate bananas.  A lot of bananas.  Four to six bananas a day, or up to sixteen bananas in 24 hours’ time.

Haas had been influenced by the United Fruit Company, the dominant importer of bananas in America.  In the early 20th century the company based much of its advertising on the idea that bananas were healthy and nutritious.  Haas’s new diet became popular, both because it worked and because United Fruit Company promoted it like crazy (look at how healthy bananas are!  Here’s a disease where people are kept alive almost solely by bananas!).  In doing so, the company also promoted awareness of celiac disease—between the 1920s and the 1950s, it was a relatively well-known disease among Americans.  During World War II, for example, when many imported foods were almost impossible to find, the United Fruit Company’s PR department cranked out news stories about frantic mothers searching in vain for bananas for their celiac children, who were then helped by local police (who searched grocery stores) or friendly airlines (who flew shipments of bananas to celiac sufferers).

The ability for banana producers to profit from the disease was limited, though.  In 1951 Dutch researchers published an article showing that gluten was the culprit behind celiac disease, and the only real treatment was a gluten-free diet.  Sufferers were free to eat whatever they wanted so long as it didn’t contain gluten, which meant that, in this new context, bananas were not particularly special—no fruits contain gluten.  Haas, though, had staked his professional reputation on his banana diet, and more than a decade later was still promoting it.  Gluten might be a cause, he admitted, but he knew the banana diet worked, so why change?

And here a strange thing happened: celiac disease began to fade away in America.  It was still routinely diagnosed in Europe and Australia (by 1970 one in 890 people was diagnosed with it in Switzerland), but it seemed to disappear from America.  In her article, Emily Abel points out that this could have been because American researchers had never done much research on the disease, and therefore it was probably not talked about much among doctors.  It’s not that not many people had the disease, but it’s more likely that it just wasn’t diagnosed as often as it should because doctors didn’t know how to read the symptoms.

Today, though, the disease (and other food allergies) are becoming well known again.  Wheat is commonly listed on labels in foods that contain it (that is, it’s specifically listed as something people are potentially allergic to at the bottom of food labels).  There are web sites that discuss celiac disease, and doctors are routinely diagnosing it.  And, in a parallel to the fruit companies’ promotion of celiac disease in the middle of the 20th century, food companies are essentially promoting awareness of it by producing products that are specifically labeled as gluten free.  Hopefully, this time awareness of the problem will continue rather than just fade away.