Thursday, July 02, 2009

Study Finds Celiac Disease Increasing in U.S.

And GFNYC Wonders Whether Breastfeeding is a Factor

A recent Mayo Clinic/University of Minnesota study, "Increased Prevalence and Mortality in Undiagnosed Celiac Disease" (Gastroenterology, July 2009), concludes that "During 45 years of follow-up, undiagnosed CD was associated with a nearly 4-fold increased risk of death. The prevalence of undiagnosed CD seems to have increased dramatically in the United States during the past 50 years."

Reports Josephine Marcotty in the article "Study confirms increase in wheat gluten disorder (Minneapolis Star Tribune, July 1, 2009):
The findings contradict the prevailing belief that a sharp increase in diagnoses of wheat gluten intolerance has come about because of greater awareness and detection, and raises questions about whether dramatic changes in the American diet have played a role.

"It's become much more common," said Dr. Joseph Murray, the Mayo Clinic gastroenterologist who led the study. No one knows why, he said, but one reason might be rapid changes in eating habits and food processing over the last half century.

"Fifty years is way too fast for human genetics to have changed," Murray said. "Which tells us it has to be a pervasive environmental influence."
Non-scientist that I am, I'm curious as to whether breastfeeding/formula feeding patterns have been a factor in this apparent change. In the article "Infant Feeding in the 20th Century: Formula and Beikost" (Journal of Nutrition, 2001), Samuel J. Fomon of the University of Iowa includes a chart showing that "commercially prepared formulas began to replace home-prepared formulas" starting in 1950.

And the Swedish study "Breast-feeding protects against celiac disease" (American Journal of Clinical Nutrition, May 2002) took note that
A major finding of this study was the lower risk of celiac disease in infants who were still being breast-fed than in infants who had discontinued breast-feeding at the time when gluten-containing foods were introduced into the diet. The risk was even lower in those infants who continued breast-feeding also beyond the time at which gluten was introduced. Larger amounts of gluten at the time of gluten introduction increased the risk, but for any given amount the type of food given was not important.
This study also noted that
It was suggested as early as the 1950s that breast-fed infants have a later onset of celiac disease, and this view was later shared by others. Furthermore, it was shown in case-referent studies based on prevalent cases that children with celiac disease had been breast-fed for a significantly shorter duration than had referents. However, the question was raised of whether the association of celiac disease with breast-feeding is direct and causal or indirect through postponed introduction of infant formula or a reduced amount of dietary gluten consumed.
Currently, as per this article by Nancy Lapid of, doctors recommend that to prevent celiac disease, at least during infancy, "It is prudent to avoid both early (before 4 months) and late (7 months) introduction of gluten, and to introduce gluten gradually while the infant is still breast-fed, inasmuch as this may reduce the risk of celiac disease, type 1 diabetes mellitus, and wheat allergy."

Here's Dr. Murray on celiac disease.

Source (5:26)


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