The Effect of Early Feeding on the Onset of Symptoms in Celiac Disease

Greco, Luigi; Mayer, M; Grimaldi, M.; Follo, Daniela; Ritis, G De; Auricchio, Salvatore

doi:10.1097/00005176-198502000-00010

Cited by 56 publications

(28 citation statements)

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“…Using the age of 5–6 months as a reference when estimating hazard ratios for future CD, Welander et al [39 ]showed that there was no difference in the risk of CD in infants aged 3–4 months or 7–8 months at gluten introduction. Other studies confirm the lack of an association between timing of gluten introduction and later CD [42,43,44,46,48]. …”

Section: Timing Of Gluten Introductionmentioning

confidence: 85%

“…To summarize, most studies point toward a protective effect of breastfeeding against CD, but it is unclear if this protective effect is persistent or only represents a delay in the diagnosis of CD [48]. One of the mechanisms potentially explaining an inverse relationship between breastfeeding and CD is that continuing breastfeeding could reduce the amount of gluten given [18].…”

Section: Breastfeedingmentioning

confidence: 99%

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Timing of Introduction of Gluten and Celiac Disease Risk

Ludvigsson¹,

Fasano²

2012

Ann Nutr Metab

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Breast milk is the natural nutrition for infants, but in the second half of the first year of life, complementary feeding is needed. Many complementary foods contain gluten, but gluten exposure is associated with the risk of developing celiac disease (CD). CD is a disease with considerable morbidity and mortality. Although CD is associated with certain genetic features, carrying the human leukocyte antigen haplotypes DQ2 or DQ8 (a prerequisite for CD development) cannot fully explain who will or who will not develop CD. Potential risk factors for CD include perinatal events and infant feeding practice. With the exception that children who are breastfed at and beyond gluten introduction into the diet probably may be at a lower risk of developing CD, and that heavy gluten load early in life may increase the risk of future CD, data on the impact of infant feeding are inconsistent.

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Section: Timing Of Gluten Introductionmentioning

confidence: 85%

Section: Breastfeedingmentioning

confidence: 99%

Timing of Introduction of Gluten and Celiac Disease Risk

Ludvigsson¹,

Fasano²

2012

Ann Nutr Metab

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“…[13][14][15] Four studies were excluded because they were retrospective studies of children with CD without control groups. [16][17][18][19] The paper by Challacombe et al was excluded because it only investigated the relations between changing infant feeding practices and the incidence of CD. 20 A ninth study was excluded because it was a short letter with insufficient information provided on study methodology.…”

Section: Resultsmentioning

confidence: 99%

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

Ak¹,

Ramanan²,

Basude³

2005

Journal of Pediatric Gastroenterology and Nutrition

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Background: Coeliac disease (CD) is a disorder that may depend on genetic, immunological, and environmental factors. Recent observational studies suggest that breast feeding may prevent the development of CD. Aim: To evaluate articles that compared effects of breast feeding on risk of CD. Methods: Systematic review and meta-analysis of observational studies published between 1966 and June 2004 that examined the association between breast feeding and the development of CD. Results: Six case-control studies met the inclusion criteria. With the exception of one small study, all the included studies found an association between increasing duration of breast feeding and decreased risk of developing CD. Meta-analysis showed that the risk of CD was significantly reduced in infants who were breast feeding at the time of gluten introduction (pooled odds ratio 0.48, 95% CI 0.40 to 0.59) compared with infants who were not breast feeding during this period. 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 reduced risk of developing CD. It is, however, not clear from the primary studies whether breast feeding delays the onset of symptoms or provides a permanent protection against the disease. Long term prospective cohort studies are required to investigate further the relation between breast feeding and CD.

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“…Previous observational studies in unselected populations suggested that concomitant gluten introduction and breastfeeding should protect at least from early début of CD (Auricchio 1983, Greco 1985. More recent randomized studies in high-risk infants have questioned those results (Vriezinga 2014, Andrén-Aronsson 2014, Lionetti 2014, Szajewska 2015.…”

Section: CD Breastfeeding and Gluten Introductionmentioning

confidence: 99%

Demographics, clinical features and treatment of pediatric celiac disease

Tapsas¹

2015

Linköping University Medical Dissertations

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Celiac disease (CD) is a chronic small intestinal immune-mediated enteropathy triggered by ingestion of gluten-containing food in genetically predisposed subjects. The enteropathy is presented with a wide variety of clinical manifestations, which can occur even outside the gastrointestinal tract. In the majority of cases, the diagnosis of CD is based on a small intestinal biopsy showing mucosal alterations, i.e. intraepithelial lymphocytosis, crypt hyperplasia, and villous atrophy. The treatment, gluten-free diet (GFD), has recently been revised with the addition of gluten-free oats. Oats give a more diversified nutrition and increase the fibre content. The use of oats in CD is though still debated in some reports. A strict life-long adherence to the GFD can be problematic, especially for pediatric CD patients. Sweden reported of one of the highest observed CD prevalences worldwide, i.e. 3%, among 12-year-olds born during what has been described as "the Swedish celiac epidemic", 1984−1996.The aims of this thesis were to elucidate how pediatric CD has changed during a 41-year period in Sweden, i.e. 1973Sweden, i.e. −2013, in terms of clinical presentation, disease severity, incidence, and demographics. We also wanted to adress the compliance to the GFD, the use of oats in the GFD and the safety of oats inclusion in the diet by measuring urinary nitric oxide (NO) metabolites.Filed information provided data about 2856 pediatric patients investigated for suspected CD between 1973 and 2013; of which 1030 patients were diagnosed with CD. After the data analyses the mean age of CD patients was shown to increase after the celiac epidemic period.Currently, CD shows a less severe picture in terms of symptoms and intestinal pathology.Younger children suffer primarily from gastrointestinal symptoms and growth failure, whereas extra-intestinal manifestations are more often displayed among adolescents. viWe also reported an unusually high pediatric CD incidence rate and cumulative incidence, likely the highest reported worldwide. We hypothesised that the introduction of new antibody tests would affect the diagnostic activity and accuracy in performing small intestinal biopsies for CD investigation. However, the outcome of diagnostic activity and accuracy could not clearly be attributed to the use of antibody tests due to changes occurring in parallel during the 41-year study period, e.g. a different pattern of symptoms at presentation and improved knowledge of the disease among parents and health professionals.In a questionnaire-based study our patient group reported a high compliance to the GFD.Long duration of the GFD may, however, influence compliance negatively. Oats have been included to the GFD of our study population in most of the cases without reporting major complications related to their well-being.The urinary measurements of NO metabolites revealed two patient groups, one with high and one with low levels. The two populations did not differ regarding sex, age, compliance to the GFD or oats consumption. Fa...

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The Effect of Early Feeding on the Onset of Symptoms in Celiac Disease

Cited by 56 publications

References 0 publications

Timing of Introduction of Gluten and Celiac Disease Risk

Timing of Introduction of Gluten and Celiac Disease Risk

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

Demographics, clinical features and treatment of pediatric celiac disease

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