Breast-Feeding Protects Against Celiac Disease in Childhood — Epidemiological Evidence

  • L. Å. Persson
  • A. Ivarsson
  • O. Hernell
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 503)


Celiac disease, or permanent gluten sensitive enteropathy, is now recognized as a common disease in many populations. Genetic susceptibility is a prerequisite, as is dietary exposure to wheat gluten or related proteins in rye and barley. Once initiated, the disease is considered to be life-long, although transient cases have been reported. However, on exclusion of wheat gluten and related proteins from the diet, the enteropathy and symptoms almost always resolve.


Celiac Disease Coeliac Disease Infant Feeding Wheat Gluten Infant Feeding Practice 
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  1. 1.
    Mylotte M, Egan-Mitchell B, McCarthy CF, McNicholl B. Inci-dence of coeliac disease in the west of Ireland, BMJ 703–705 (1973).Google Scholar
  2. 2.
    Gumaa SN, McNicholl B, Egan-Mitchell B, Connolly K, Loftus BG. Coeliac disease in Galway, Ireland 1971–1990, Ir. Med. J. 90:60–61 (1997).PubMedGoogle Scholar
  3. 3.
    Hed J, Lieden G, Ottosson E, Ström M, Walan A, Groth O, et al. IgA anti-gliadin antibodies and jejunal mucosal lesions in healthy blood donors [letter], Lancet 2:215 (1986)PubMedCrossRefGoogle Scholar
  4. 4.
    Grodzinsky E, Franzen L, Hed J, Ström M. High prevalence of celiac disease in healthy adults revealed by antigliadin antibodies, Ann. Allergy 69:66–70 (1992).PubMedGoogle Scholar
  5. 5.
    Hallert C, Gotthard R, Jansson G, Norrby K, Walan A. Similar prevalence of coeliac disease in children and middle-aged adults in a district of Sweden, Gut 24:389–391 (1983).PubMedCrossRefGoogle Scholar
  6. 6.
    Midhagen G, Järnerot G, Kraaz W. Adult coeliac disease within a defined geographic area in Sweden. A study of prevalence and associated diseases, Scand. J. Gastroenterol. 23:1000–1004 (1988).Google Scholar
  7. 7.
    Uibo O, Uibo R, Kleimola V, Jogi T, Maki M. Serum IgA anti-gliadin antibodies in an adult population sample. High prevalence without celiac disease, Dig. Dis. Sci. 38:2034–2037 (1993).PubMedCrossRefGoogle Scholar
  8. 8.
    Meloni G, Dore A, Fanciulli G, Tanda F, Bottazzo GF. Sub-clinical coeliac disease in schoolchildren from northern Sardinia [letter], Lancet 353:37 (1999).PubMedCrossRefGoogle Scholar
  9. 9.
    Catassi C, Rätsch IM, Gandolfi L, Pratesi R, Fabiani E, El Asmar R, et al. Why is coeliac disease endemic in the people of the Sahara? [letter], Lancet 354:647–648 (1999).PubMedCrossRefGoogle Scholar
  10. 10.
    Gandolfi L, Pratesi R, Cordoba JC, Tauil PL, Gasparin M, Catassi C. Prevalence of celiac disease among blood donors in Brazil, Am. J. Gastroenterol. 95:689–692 (2000).PubMedCrossRefGoogle Scholar
  11. 11.
    Walia BNS, Sidhu JK, Tandon BN, Ghai OP, Bhargava S. Coeliac disease in North Indian children, Br. Med. J. 2:1233–1234 (1966).PubMedCrossRefGoogle Scholar
  12. 12.
    Rabassa EB, Sagaró E, Fragoso T, Castañeda C, Gra B. Coeliac disease in Cuban children, Arch. Dis. Child. 56:128–131 (1981).PubMedCrossRefGoogle Scholar
  13. 13.
    Sher KS, Fraser RC, Wicks AC, Mayberry JF. High risk of coeliac disease in Punjabis. Epidemiological study in the south Asian and European populations of Leicestershire, Digestion 54:178–182 (1993).PubMedCrossRefGoogle Scholar
  14. 14.
    Rawashdeh MO, Khalil B, Raweily E. Celiac disease in Arabs, J. Pediatr. Gastroenterol. Nutr. 123:415–418 (1996).CrossRefGoogle Scholar
  15. 15.
    Demir H, Yuce A, Kocak N, Ozen H, Gurakan F. Celiac disease in Turkish children: presentation of 104 cases, Pediatr. Int. 42:483–487 (2000).PubMedCrossRefGoogle Scholar
  16. 16.
    Ascher H, Krantz I, Rydberg L, Nordin P, Kristiansson B. In-fluence of infant feeding and gluten intake on coeliac disease, Arch. Dis. Child. 76:113–7 (1997).PubMedCrossRefGoogle Scholar
  17. 17.
    Ascher H, Kristiansson B. The highest incidence of celiac disease in Europe: The Swedish experience, J. Pediatr. Gastroenterol. Nutr. 24:3–6 (1997).CrossRefGoogle Scholar
  18. 18.
    Ascher H. The role of quantity and quality of gluten-containing cereals in the epidemiology of coeliac disease. In: Mäki M, Collin P, Visakorpi JK, ed. Coeliac disease: Proceedings of the seventh international symposium on coeliac disease,1996, Tampere, Finland. Coeliac Disease Study Group, Tampere: 1997; 15–22.Google Scholar
  19. 19.
    Greco L. Epidemiology of coeliac disease. In: Mäki M, Collin P, Visakorpi JK, ed. Coeliac disease: Proceedings of the seventh interna-tional symposium on coeliac disease,1996, Tampere, Finland. Coeliac Disease Study Group, Tampere: 1997; 9–14.Google Scholar
  20. 20.
    Troncone R, Greco L, Auricchio S. The controversial epidemi-ology of coeliac disease [comment], Acta Paediatr. 89:140–141 (2000).PubMedCrossRefGoogle Scholar
  21. 21.
    Morris MA, Ciclitira PJ. Coeliac disease, J. R. Coll. Physicians Lond. 31:614–618 (1997).PubMedGoogle Scholar
  22. 22.
    Present-day practice in infant feeding. Report of a working party of the panel on child nutrition. Committee on Medical Aspects of Food Policy. Her Majesty’s Stationery Office;London, 9:24–26 (1974).Google Scholar
  23. 23.
    Dossetor JFB, Gibson AAM, McNeish AS. Childhood coeliac disease is disappearing [letter], Lancet i:322–323 (1981).CrossRefGoogle Scholar
  24. 24.
    Logan RFA, Rifkind EA, Busuttil A, Gilmour HM, Ferguson A. Prevalence and “incidence” of celiac disease in Edinburgh and the Lothian region of Scotland, Gastroenterology 90:334–342 (1996).Google Scholar
  25. 25.
    Challacombe DN, Mecrow IK, Elliott K, Clarke FJ, Wheeler EE. Changing infant feeding practices and declining incidence of coeliac disease in West Somerset, Arch. Dis. Child. 77:206–209 (1997).PubMedCrossRefGoogle Scholar
  26. 26.
    ESPGAN committee on nutrition. Guidelines on infant nutrition III. Recommendations for infant feeding, Acta Paediatr. Scand. Suppl. 302:16–20 (1982).Google Scholar
  27. 27.
    Mäki M, Holm K. Incidence and prevalence of coeliac disease in Tampere: Coeliac disease is not disappearing, Acta Paediatr. Scand. 79:980–982 (1990).PubMedCrossRefGoogle Scholar
  28. 28.
    Greco L, Mäki M, Di Donato F, Visakorpi JK. Epidemiology of coeliac disease in Europe and the Mediterranean area. A summary report on the multicentre study by the European Society of Paediatric Gastroenterology and Nutrition. In: Auricchio S, Visakorpi JK, ed. Common food intolerances I: Epidemiology of coeliac disease, Karger, Basel: 1992; 25–44.Google Scholar
  29. 29.
    Lindberg T. Coeliac disease and infant feeding practices [letter], Lancet i:449 (1981).CrossRefGoogle Scholar
  30. 30.
    Stenhammar L, Ansved P, Jansson G, Jansson U. The incidence of childhood celiac disease in Sweden, J. Pediatr. Gastroenterol. Nutr. 6:707–709 (1987).PubMedCrossRefGoogle Scholar
  31. 31.
    Andersen DH, Di Sant’ Agnese PA. Idiopathic celiac disease: I. Mode of onset and diagnosis, Pediatrics 11:207–222 (1953).PubMedGoogle Scholar
  32. 32.
    Auricchio S, Follo D, De Ritis G, Giunta A, Marzorati D, Prampolini L, et al. Does breast feeding protect against the development of clinical symptoms of celiac disease in children? J. Pediatr. Gastroenterol. Nutr. 2:428–433 (1983).PubMedCrossRefGoogle Scholar
  33. 33.
    Greco L, Auricchio S, Mayer M, Grimaldi M. Case control study on nutritional risk factors in celiac disease, J. Pediatr. Gastroenterol. Nutr. 7:395–399 (1988).PubMedCrossRefGoogle Scholar
  34. 34.
    Faith-Magnusson K, Franzén L, Jansson G, Laurin P, Stenhammar L. Infant feeding history shows distinct differences between Swedish celiac and reference children, Pediatr. Allergy Immunol. 7:1–5 (1996).CrossRefGoogle Scholar
  35. 35.
    Mäki M, Holm K, Ascher H, Greco L. Factors affecting clinical presentation of coeliac disease: Role of type and amount of gluten-containing cereals in the diet. In: Auricchio S, Visakorpi JK, ed. Common food intolerances 1: Epidemiology of coeliac disease. Karger, Basel: 1992; 76–82.Google Scholar
  36. 36.
    Ascher H, Holm K, Kristiansson B, Maki M. Different features of coeliac disease in two neighbouring countries, Arch. Dis. Child. 69:375–380 (1993).PubMedCrossRefGoogle Scholar
  37. 37.
    Weile B, Cavell B, Nivenius K, Krasilnikoff PA. Striking diff-erences in the incidence of childhood celiac disease between Denmark and Sweden: A plausible explanation, J. Pediatr. Gastroenterol. Nutr. 21:64–68 (1995).PubMedCrossRefGoogle Scholar
  38. 38.
    Mitt K, Uibo O. Low cereal intake in Estonian infants: the possible explanation for the low frequency of coeliac disease in Estonia, Eur. J. Clin. Nutr. 52:85–88 (1998).PubMedCrossRefGoogle Scholar
  39. 39.
    Marsh MN. Gluten, major histocompatibility complex, and the small intestine. A molecular and immunobiologic approach to the spectrum of gluten sensitivity (‘celiac sprue’), Gastroenterology 102:330–354 (1992).PubMedGoogle Scholar
  40. 40.
    Ascher H, Krantz I, Kristiansson B. Increasing incidence of coeliac disease in Sweden, Arch. Dis. Child. 66:608–611 (1991).PubMedCrossRefGoogle Scholar
  41. 41.
    Cavell B, Stenhammar L, Ascher H, Danielsson L, Dannaeus A, Lindberg T, et al. Increasing incidence of childhood coeliac disease in Sweden. Results of a national study, Acta Paediatr. 81:589–592 (1992).PubMedCrossRefGoogle Scholar
  42. 42.
    Ivarsson A, Persson LA, Nyström L, Ascher H, Cavell B, Danielsson L, Dannaeus A, Lindberg T, Lindquist B, Stenhammar L, Hernell O. Epidemic of coeliac disease in Swedish children, Acta Paediatr. 89:165–171 (2000).PubMedCrossRefGoogle Scholar
  43. 43.
    Ivarsson A, Hemell O, Stenlund H, Persson LA. Breast-feeding protects against celiac disease, Am. J. Clin. Nutr. In press, (2001).Google Scholar
  44. 44.
    Hanson LA. Breastfeeding provides passive and likely long-lasting active immunity, Ann. Allergy Asthma Immunol. 81:523–537 (1998).PubMedCrossRefGoogle Scholar
  45. 45.
    Goldman AS. Modulation of the gastrointestinal tract of infants by human milk. Interfaces and interactions. An evolutionary perspective, J. Nutr. 4265–431S (2000).Google Scholar
  46. 46.
    Greco L, Mayer M, Grimaldi M, Follo D, De Ritis G, Auricchio S. The effect of early feeding on the onset of symptoms in celiac disease, J. Pediatr. Gastroenterol. Nutr. 4:52–55 (1985).PubMedCrossRefGoogle Scholar
  47. 47.
    Mäki M, Kallonen K, Ländeaho ML, Visakorpi JK. Changing pattern of childhood coeliac disease in Finland, Acta Paediatr. Scand. 77:408–412 (1988).PubMedCrossRefGoogle Scholar
  48. 48.
    Kelly DA, Phillips AD, Elliott EJ, Dias JA, Walker-Smith JA. Rise and fall of coeliac disease 1960–85, Arch. Dis. Child. 64:1157–1160 (1989).PubMedCrossRefGoogle Scholar
  49. 49.
    Stevens FM, Egan-Mitchell B, Cryan E, McCarthy CF, McNicholl B. Decreasing incidence of coeliac disease, Arch. Dis. Child. 62:465–468 (1987).PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2002

Authors and Affiliations

  • L. Å. Persson
    • 1
    • 3
  • A. Ivarsson
    • 1
    • 2
  • O. Hernell
    • 2
  1. 1.Department of Public Health and Clinical Medicine, EpidemiologyUmeå UniversitySweden
  2. 2.Department of Clinical Sciences, PediatricsUmeå UniversitySweden
  3. 3.ICDDR,B: Centre for Health and Population ResearchDhakaBangladesh

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