UCLA Fielding School of Public Health scholar’s work connects celiac disease, diet, and health policy

A groundbreaking work has been published exploring the impact of celiac disease, a serious autoimmune condition that affects approximately three million Americans, or 1 percent of the population, and its connections to diet and public policy in the United States.

Gluten Free for Life: Celiac Disease, Medical Recognition, and the Food Industry, authored by Dr. Emily K. Abel, a prize-winning historian of medicine and public health at UCLA’s Fielding School of Public Health (FSPH), has been published in hardcover and paperback by the New York University Press.

Celiac disease is a chronic, autoimmune digestive disorder that results in inflammation of the small intestine of genetically susceptible individuals when they ingest gluten. Gluten is the compound that gives elasticity to dough and makes bread chewy. The only treatment currently for celiac disease is a gluten-free diet; those strictures – and the reality that those dealing with the disease rarely display obvious symptoms - can lead to serious emotional stress and even social isolation, Abel said.

“People with celiac find it so difficult for others to understand how careful they really have to be about their diet,” said Abel, a professor emeritus at FSPH whose children and grandchildren are dealing with the disease. “There has to be better, truly reliable labeling for gluten-free foods, and there are a lot of people who have celiac but don’t know it, so testing should be much more widespread.”

Symptoms of celiac disease can include abdominal bloating, diarrhea and even constipation. The disease can also cause fatigue, iron deficiency anemia, osteoporosis, weight loss, and malnutrition.

“The only therapy is lifelong adherence to a gluten-free diet, which can lead to very real stresses and strains, especially for children and adolescents – imagine trying to date!” Abel said. “And because many doctors know little about celiac, nearly half of the individuals with the disease remain undiagnosed, and many wait years for the correct diagnosis, but are still living their lives with what amounts to an unseen disability.”

Along with her teaching and research work, Abel is the author of many books, including Sick and Tired - An Intimate History of Fatigue (University of North Carolina Pres, 2021) and Tuberculosis and the Politics of Exclusion: A History of Public Health and Migration to Los Angeles (Rutgers University Press, 2007), which won the Viseltear Prize of the Medical Section of the American Public Health Association for an outstanding book on the history of public health. Abel also received the Genevieve Miller Lifetime Achievement Award from the American Association for the History of Medicine in 2024 for her work; the award is given annually to a scholar with a distinguished record of support for the history of medicine over many years and who has made continuing scholarly contributions of a distinguished nature.

Colleagues said the above sums up Abel’s dedication to her profession, and her work, including her latest book.

“This important book is a rousing call for action – medical, social, and political – to protect people with celiac disease from the gluten proteins that make them sick,” said Dr. Marion Nestle, Paulette Goddard Professor of Nutrition, Food Studies, and Public Health, Emerita, at New York University, and former senior nutrition policy advisor in the U.S. Department of Health and Human Services. “Emily K. Abel’s analysis to the barriers to avoidance, from unaware doctors to food companies’ lobbying against labeling to widespread ignorance of where gluten lurks in food, should convince us all to insist that gluten be labeled and products monitored to ensure they really are gluten free.”