The Nuance

How the Western Diet Is Wreaking Havoc on Our Guts

Experts say a range of factors — including how we eat — may explain the rise of IBD and other gut disorders

Markham Heid
Elemental
Published in
5 min readMar 4, 2021

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Illustration by Kieran Blakey for Elemental

Gut health in America is poor and seems to be getting worse. According to a 2020 study led by researchers at the University of North Carolina, roughly one in four U.S. adults regularly experiences diarrhea, constipation, stomach pain, or other symptoms of gastrointestinal dysfunction.

Meanwhile, about the same proportion of Americans — one in four— has gastroesophageal reflux disease (GERD), a condition in which the stomach’s contents migrate up into the throat and food pipe, causing heartburn and other symptoms. GERD used to be relatively rare among people under the age of 50, but a 2018 report from Case Western Reserve University in Ohio found that between 2006 and 2016, the prevalence of GERD rose steadily among younger adults — especially those in their thirties.

Some experts have speculated that these and other discouraging trends in disease prevalence may be partly attributable to “diagnosis creep,” or the steady expansion of diagnostic criteria so that an ever-broader group of people qualify as sick. (A problem that a physician may have once shrugged off as “the runs” or “a little heartburn” may now garner a diagnosis of irritable bowel syndrome or GERD, respectively.)

But no one is downplaying the decades-long rise in inflammatory bowel disease (IBD), a group of conditions — primarily Crohn’s disease and ulcerative colitis — that are associated with immune system hyperactivity. This hyperactivity produces flares of inflammation, and the attendant symptoms include wrenching pain, diarrhea, fatigue, rectal bleeding, and GI damage.

“Following World War II, we’ve seen a rapid rise in IBD incidence throughout the developed world,” says Gilaad Kaplan, MD, a professor and gastroenterologist at the University of Calgary in Canada. While some analyses have found that this rise has plateaued during the first decades of the current century, a 2020 study in the journal Inflammatory Bowel Diseases concluded that between 2007 and 2016, the incidence of IBD in the United States more than doubled among both kids and adults…

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Markham Heid
Elemental

I’m a long-time contributor at TIME and other media orgs. I write mostly about health. I grew up in Michigan, but these days I live in southwest Germany.