Bejegyzés

ABSTRACT

BACKGROUND: Celiac disease is defined as a ‘chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals’. Sweden has experienced an “epidemic” of celiac disease in children below two years of age. Celiac disease etiology is considered multifactorial; however, little is known regarding potential risk- or protecting factors. We present data on the possible association between early infectious episodes and celiac disease, including their possible contribution to the Swedish celiac disease epidemic.

METHODS: A population-based incident case-referent study (475 cases, 950 referents) with exposure information obtained via a questionnaire (including family characteristics, infant feeding, and the child’s general health) was performed.
-> Olvasd el a teljes cikket. <-

Scientific Advisory Committee on Nutrition (SACN) and the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) Join Statement, March 2011

Background
In 2010, the Department of Health and Food Standards Agency asked the Scientific Advisory Committee on Nutrition (SACN) and the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) to assess the evidence on timing of introduction of gluten into the infant diet and subsequent risk of developing coeliac disease or type 1 diabetes mellitus (T1DM). The request was made in response to the publication of a European Food Safety Authority (EFSA) Panel on Dietetic Products, Nutrition and Allergies (NDA) Scientific Opinion on the appropriate age for the introduction of complementary food into infant diets in the EU; this included conclusions that were inconsistent with UK infant feeding advice.
-> Olvasd el a teljes cikket. <-

Háttér

Az elmúlt hónapokban az egészségügyi dolgozók (gyermekorvosok, védőnők) körében elter­jedt az a nézet, hogy a gluténtartalmú élelmiszereket 4 hónapos korban be kell vezetni a csecsemők étrendjébe, mert a glutén későbbi bevezetése fokozza a cöliákia kialakulásának kockázatát. Ez a javaslat a kutatási eredmények félreértelmezésén alapul, ellentmond az Egészségügyi Világszervezet és az európai egészségügyi szervezetek ajánlásának, és – a szilárd táplálékok túl korai bevezetése miatt – egészségügyi kockázatokat hordoz mind a szoptató anyákra, mind a szoptatott csecsemőkre nézve.

Az ESPGHAN ajánlása

Az Európai Gyermek Gasztroenterológiai, Hepatológiai és Táplálkozástudományi Társaság (ESPGHAN) 2008-ban kiadott állásfoglalásában (1) úgy fogalmaz, hogy az Egészségügyi Világszervezet által javasolt 6 hónapos korig tartó kizárólagos szoptatás kívánatos cél, vala­mint, hogy a kiegészítő táplálás semmiképpen se kezdődjön 17 hetes kor előtt és ne halasztód­jon 26 hetes kor utánra.
-> Olvasd el a teljes cikket. <-

Smith JP, Harvey PJ.
Public Health Nutr. 2010 Jul 13:1-11.

Abstract

OBJECTIVE: To assess the public health significance of premature weaning of infants from breast milk on later-life risk of chronic illness.

DESIGN: A review and summary of recent meta-analyses of studies linking premature weaning from breast milk with later-life chronic disease risk is presented followed by an estimation of the approximate exposure in a developed Western country, based on historical breast-feeding prevalence data for Australia since 1927. The population-attributable proportion of chronic disease associated with current patterns of artificial feeding in infancy is estimated.

RESULTS: After adjustment for major confounding variables, current research suggests that the risks of chronic disease are 30-200 % higher in those who were not breast-fed compared to those who were breast-fed in infancy.
-> Olvasd el a teljes cikket. <-

A K Akobeng, A V Ramanan, I Buchan and R F Heller

Archives of Disease in Childhood 2006;91:39-43

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.
-> Olvasd el a teljes cikket. <-

Ivarsson A.

Best Pract Res Clin Gastroenterol. 2005 Jun;19(3):425-40.

Sweden has experienced an epidemic of symptomatic coeliac disease that has no likeness anywhere else in the world. This is quite unique for a disease that is genetically dependent, immune-mediated and chronic, and suggests an abrupt increase and decrease, respectively, of one or a few causal factors influencing a large proportion of Swedish infants during the period in question.

We have shown that half of the epidemic was explained by an increase in the proportion of infants introduced to gluten in comparatively large amounts after breast-feeding had been ended. This was partly an effect of societal changes in national dietary recommendations and the food content of industrially produced infant foods.
-> Olvasd el a teljes cikket. <-

Anneli Ivarsson, Olle Hernell, Hans Stenlund and Lars Åke Persson
American Journal of Clinical Nutrition, Vol. 75, No. 5, 914-921, May 2002

Abstract

Background: Celiac disease, or permanent gluten-sensitive enteropathy, is an immunologic disease strictly dependent on exposure to wheat gluten or related proteins in rye and barley.

Objective: The aim of this study was to explore whether breast-feeding and the mode of introducing dietary gluten influence the risk of celiac disease in childhood.

Design: A population-based incident case-referent study of Swedish children, 627 cases with celiac disease and 1254 referents, was conducted; 78% of the matched sets were included in the final analyses.
-> Olvasd el a teljes cikket. <-