Prevalence of Celiac Disease in Italy
For decades, celiac disease was considered rare, but research shows a clear increase in prevalence, with Italy having one of the highest rates in Europe. A recent multicenter study conducted between 2017 and 2020 among school-age Italian children found an overall celiac disease prevalence of 1.65%, almost double the rate from 25 years prior. The Italian Celiac Association (AIC) estimates that approximately 1% of the total Italian population is affected by celiac disease, which translates to over 600,000 people, although many remain undiagnosed.
This high prevalence is partly attributed to increased awareness among both the public and medical professionals, alongside advanced screening and diagnostic methods. Interestingly, the prevalence is higher in Southern Italy (1.93%) compared to Central (1.36%) and Northern (1.62%) regions, potentially linked to higher wheat consumption in the south.
The Rise of Non-Celiac Gluten Sensitivity
Beyond medical diagnoses, the percentage of Italians avoiding gluten is further inflated by those with non-celiac gluten sensitivity (NCGS). While defining and diagnosing NCGS remains a challenge due to a lack of specific biomarkers, estimates suggest it is far more prevalent than celiac disease. A 2014 Italian survey found that the ratio of suspected NCGS to new celiac disease diagnoses was 1.15 to 1, suggesting that for every new celiac diagnosis, there is a person reporting NCGS. This subgroup experiences similar gastrointestinal and extra-intestinal symptoms to celiac patients but lacks the autoimmune response and intestinal damage associated with the condition. This population, along with health-conscious individuals, makes up a large portion of the gluten-free market.
Lifestyle and Wellness Trends Drive Gluten-Free Popularity
In addition to medical reasons, a growing number of Italians are choosing a gluten-free diet for perceived health and wellness benefits, including improved digestion, reduced bloating, and weight management. The market has capitalized on this trend, with significant investment in developing high-quality gluten-free alternatives that mimic the taste and texture of traditional Italian products like pasta and pizza. This shift is supported by increasing access to products in supermarkets, specialty stores, and online platforms. For many, the gluten-free diet has transitioned from a medical necessity to a mainstream, health-conscious lifestyle choice.
Government Support and Societal Response
Italy's government and the Italian Celiac Association (AIC) play a crucial role in supporting the gluten-free community. Here's how:
- Financial Assistance: The government provides monthly vouchers (up to €140) to help diagnosed individuals offset the higher cost of gluten-free foods.
- Product Regulation and Certification: The AIC certifies safe dining establishments and food products, which is particularly vital in a country with a high risk of cross-contamination in traditional kitchens.
- Mandatory Screening: As of 2025, Italy became the first country to pass a law requiring mandatory celiac disease screening for all children under 18, which is expected to significantly increase diagnoses and awareness.
Comparison of Gluten-Free Motivations in Italy
To understand the full picture, it's helpful to break down the primary drivers for a gluten-free diet in Italy.
| Feature | Celiac Disease Diagnoses | Non-Celiac Gluten Sensitivity | Wellness and Lifestyle Choice |
|---|---|---|---|
| Prevalence | Approximately 1-1.6% of the population | Estimated to be more prevalent than celiac disease | Significant and growing portion of the market |
| Underlying Cause | Autoimmune response to gluten | Symptoms triggered by gluten; not an autoimmune reaction | Perceived health benefits, digestive wellness, weight management |
| Diagnosis | Requires blood tests and intestinal biopsy (or biopsy-sparing criteria) | Diagnosis of exclusion; no definitive biomarker | No formal medical diagnosis required |
| Government Support | Financial subsidies and product registry | No direct government support | No direct government support |
| Required Strictness | Lifelong, strict adherence to avoid complications | Varies by individual sensitivity | Personal choice; adherence can be flexible |
Conclusion
While a precise single percentage of Italians following a gluten-free diet is challenging to pinpoint, the number is clearly on the rise and higher than the official celiac disease prevalence. The most conservative estimate places the number of diagnosed celiacs at over 600,000, or about 1% of the population. However, accounting for undiagnosed celiacs, those with NCGS, and individuals pursuing a gluten-free lifestyle for perceived health benefits, the true percentage of Italians consciously avoiding gluten is likely much higher. The gluten-free market in Italy is growing at a rapid pace (over 10% CAGR forecasted for 2025-2035) and is driven by medical needs, a cultural shift towards wellness, and strong government support. This blend of medical necessity and lifestyle choice has transformed Italy into a global leader in gluten-free awareness and accessibility.
Sources
- Italian Celiac Association (AIC): A non-profit network dedicated to supporting celiac patients and promoting awareness throughout Italy.
What Percent of Italians are Gluten-Free?
- Celiac disease affects approximately 1-1.6% of Italians: Recent multi-center studies show a prevalence of 1.65% among children, confirming Italy as having one of Europe's highest celiac rates.
- NCGS is more prevalent than celiac disease: Estimates suggest that the percentage of Italians with non-celiac gluten sensitivity is higher than those with celiac disease, adding significantly to the gluten-free population.
- Over 6 million Italians may avoid gluten: Some estimates, based on older data, suggest millions follow a gluten-free diet without a celiac diagnosis, though this figure likely includes those with NCGS and wellness adherents.
- Lifestyle choices increase the total: A rising trend of adopting gluten-free eating for health and wellness reasons further expands the total number of Italians avoiding gluten, even without a medical need.
- The true percentage is higher than diagnosis rates: When factoring in diagnosed celiacs, undiagnosed celiacs, non-celiac gluten sensitive individuals, and wellness-driven consumers, the total percentage of Italians who are gluten-free is a much larger figure than official prevalence statistics suggest.
