Bejegyzés

The Swedish epidemic of coeliac disease explored using an epidemiological approach—some lessons to be learnt

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.
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Breastfeeding and risk of inflammatory bowel disease: a systematic review with meta-analysis

Eyal Klement, Regev V Cohen, Jonathan Boxman, Aviva Joseph and Shimon Reif
American Journal of Clinical Nutrition, Vol. 80, No. 5, 1342-1352, November 2004

Abstract

Background: It has long been believed that breastfeeding provides protection against ulcerative colitis and Crohn disease. Studies designated to test this hypothesis were conducted without reaching conclusive results.

Objective: The aim of this meta-analysis was to examine the role of breastfeeding in preventing inflammatory bowel disease and to summarize the evidence gathered about this subject.

Design: A meta-analysis was performed on 17 relevant articles that were found by using MEDLINE, EMBASE, the Internet, and articles’ references.
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Human milk oligosaccharides are associated with protection against diarrhea in breast-fed infants

Ardythe L. Morrow, Guillermo M. Ruiz-Palacios, Mekibib Altaye, Xi Jiang, M. Lourdes Guerrero, Jareen K. Meinzen-Derr, Tibor Farkas, Prasoon Chaturvedi, Larry K. Pickering a and David S. Newburg

J Pediatr 145:3;297-303 September 2004

Objective To determine the association between maternal milk levels of 2-linked fucosylated oligosaccharide and prevention of diarrhea as a result of Campylobacter, caliciviruses, and diarrhea of all causes in breast-fed infants.

Study design Data and banked samples were analyzed from 93 breast-feeding mother-infant pairs who were prospectively studied during 1988-1991 from birth to 2 years with infant feeding and diarrhea data collected weekly; diarrhea was diagnosed by a study physician.
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Infant growth and health outcomes associated with 3 compared with 6 mo of exclusive breastfeeding

Michael S Kramer, Tong Guo, Robert W Platt, Zinaida Sevkovskaya, Irina Dzikovich, Jean-Paul Collet, Stanley Shapiro, Beverley Chalmers, Ellen Hodnett, Irina Vanilovich, Irina Mezen, Thierry Ducruet, George Shishko and Natalia Bogdanovich

American Journal of Clinical Nutrition, Vol. 78, No. 2, 291-295, August 2003

Abstract

Background: Opinions and recommendations about the optimal duration of exclusive breastfeeding have been strongly divided, but few published studies have provided direct evidence on the relative risks and benefits of different breastfeeding durations in recipient infants.

Objective: We examined the effects on infant growth and health of 3 compared with 6 mo of exclusive breastfeeding.

Design: We conducted an observational cohort study nested within a large randomized trial in Belarus by comparing 2862 infants exclusively breastfed for 3 mo (with continued mixed breastfeeding through >= 6 mo) with 621 infants who were exclusively breastfed for >= 6 mo.
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Quantifying the Benefits of Breastfeeding: A Summary of the Evidence

Natalia León-Cava, Chessa Lutter, Jay Ross, Luann Martin

The Food and Nutrition Program (HPN)
Pan American Health Organization (PAHO)
The LINKAGES Project
2002 June

This annotated bibliography summarizes the published literature on the following six topics related to the benefits of breastfeeding:

  • Infant morbidity because of diarrhea, acute respiratory infections, otitis media and ear infections, and other infectious diseases
  • Infant mortality because of diarrhea, acute respiratory infection, and all causes
  • Child development
  • Chronic diseases, particularly obesity, diabetes, and cancer
  • Maternal health effects, with special emphasis on breast and ovarian cancers
  • Economic benefits



The work described here attests to the enormous benefits of breastfeeding in terms of infant health, intellectual and motor development, later chronic disease risk, and maternal health.
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Breast-feeding protects against celiac disease

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.
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The Economic Benefits of Breastfeeding: A Review and Analysis

JonWeimer
Food and Rural Economics Division, Economic Research Service, U.S. Department of Agriculture. Food Assistance and Nutrition Research Report No. 13.

Summary

Successfully promoting and supporting breastfeeding in the United States may depend on persuading both mothers and society that breastfeeding is not only nutritionally sound but economically beneficial as well. Current U.S. rates of breastfeeding are 64 percent for mothers in-hospital and 29 percent at 6 months postpartum, below the recommendations of the Surgeon General (75 and 50 percent, respectively). This analysis concludes that a minimum of $3.6 billion would be saved if the prevalence of exclusive breastfeeding increased from current rates to those recommended by the Surgeon General.
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Promotion of Breastfeeding Intervention Trial (PROBIT): A Randomized Trial in the Republic of Belarus

Michael S. Kramer et al.
JAMA. 2001;285:413-420.

Abstract

Context Current evidence that breastfeeding is beneficial for infant and child health is based exclusively on observational studies. Potential sources of bias in such studies have led to doubts about the magnitude of these health benefits in industrialized countries.

Objective To assess the effects of breastfeeding promotion on breastfeeding duration and exclusivity and gastrointestinal and respiratory infection and atopic eczema among infants.

Design The Promotion of Breastfeeding Intervention Trial (PROBIT), a cluster-randomized trial conducted June 1996–December 1997 with a 1-year follow-up.

Setting Thirty-one maternity hospitals and polyclinics in the Republic of Belarus.

Participants A total of 17 046 mother-infant pairs consisting of full-term singleton infants weighing at least 2500 g and their healthy mothers who intended to breastfeed, 16491 (96.7%) of which completed the entire 12 months of follow-up.
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Complementary Feeding and Enteropathies

Jacques Schmitz, MD

PEDIATRICS Vol. 106 No. 5 Supplement November 2000, pp. 1286

Introduction

Since the discovery, in the early 1950s, that gliadin was the component of wheat responsible for celiac disease (CD), and, during the 1960s that cows’ milk proteins could also trigger severe enteropathies, it has been shown that early introduction of many other foreign proteins—from soy, rice, eggs, fish, and chicken—could have the same deleterious effect: a T-cell mediated immune reaction leading to mucosal inflammation with villous atrophy, diarrhea, and failure to thrive.

Research Priorities
1. At what age is the risk of developing a protein-induced enteropathy so low that feeding a foreign protein can be considered safe?
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A Longitudinal Analysis of Infant Morbidity and the Extent of Breastfeeding in the United States

Paula D. Scariati, Laurence M. Grummer-Strawn, Sara Beck Fein
PEDIATRICS Vol. 99 No. 6 June 1997, pp. e5

Abstract

Background. Studies on the health benefits of breastfeeding in developed countries have shown conflicting results. These studies often fail to account for confounding, reverse causality, and dose-response effects. We addressed these issues in analyzing longitudinal data to determine if breastfeeding protects US infants from developing diarrhea and ear infections.

Methods. Mothers participating in a mail panel provided information on their infants at ages 2, 3, 4, 5, 6, and 7 months. Infants were classified as exclusively breastfed; high, middle, or low mixed breast- and formula-fed; or exclusively formula-fed.
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