Influence of infant feeding and gluten intake on coeliac disease

Abstract

Objectives-To study the impact of infant feeding habits and actual gluten intake on gluten induced enteropathy. Methods-A case-referent design, controlling for the HLA alleles conferring increased genetic risk, was used. All 164 siblings of 97 probands were investigated. Eighty five of the siblings, carrying the genes DQA1*0501-DQB1*02 conferring susceptibility for the disease, were investigated by interview, food recording, and taking a small intestinal biopsy sample. Eight cases of silent coeliac disease were found and these were compared with the 73 siblings in whom the diagnosis was excluded. Results-No statistically significant differences were found between cases and referents in terms of duration of breast feeding, age at introduction of cows' milk products, frequency of breast feeding after gluten introduction, and gluten consumption. Conclusions-The studied factors may be of less importance for the development of gluten induced enteropathy.

Genome-wide linkage analysis of Scandinavian affected sib-pairs supports presence of susceptibility loci for celiac disease on chromosomes 5 and 11

“…The risk of a sibling to a CD patient to develop disease is about 20 to 60 times higher than that of the normal population (l s =20 ± 60). 2,3 Moreover, the twin concordance in CD is high. A recent large population based study in Italy using 59 twin couples, claims a proband-wise concordance of 85 ± 95% for monozygotic twins and about 25% for dizygotic twins (Romino et al, personal communication).…”

Effect of Breast-Feeding on Risk of Coeliac Disease: A Systematic Review and Meta-Analysis of Observational Studies

“…Meta-analysis of data of four studies indicated that children being breast fed at the time of gluten introduction had a 52% reduction in risk of developing CD compared with their peers who were not breast feeding at the time of gluten introduction. With the exception of one small study, 6 all the studies included in the review also showed a statistically significant association between increasing duration of breast feeding and reduced risk of CD. The sample size of that study was, however, quite small (see table 1), and there was a risk of a type II error.…”

“…We cannot tell, from the results of the primary studies, whether breast feeding provides a permanent protection against the development of CD or whether the practice only delays the onset of symptoms. All the included studies, except Ascher et al, 6 had used healthy children without symptoms of CD as controls without subjecting them to small intestinal biopsies. CD can be notoriously asymptomatic and the absence of symptoms does not necessarily mean absence of the disease.…”

“…6 Conclusions Breast feeding may offer protection against the development of CD. Breast feeding during the introduction of dietary gluten, and increasing duration of breast feeding were associated with decreased risk of developing CD.…”

“…While these and other observational studies have suggested that breast feeding might reduce the risk of CD, at least one study did not find such an association. 6 In this study, we sought to explore the potential association between breast feeding and reduced risk of CD by conducting a systematic review and meta-analysis. In particular, we looked for the following effects: (1) the effect of breast feeding, compared with no breast feeding; (2) the effect of duration of breast feeding; and (3) the effect of breast feeding at the time of introduction of dietary gluten.…”