Evidence-Based Research in Pediatric NutritionEditor(s): Szajewska H. (Warsaw)
Shamir R. (Petach-Tikva)
Issues in Nutrition of Children
Celiac Disease - Prevention Strategies through Early Infant NutritionChmielewska A.a · Szajewska H.a · Shamir R.b
aThe Medical University of Warsaw, Warsaw, Poland, and bSchneider Children's Medical Center, Sackler Faculty of Medicine, Petach-Tikva, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Celiac disease (CD) is an immune-mediated disease of considerable incidence, which negatively influences the quality of life of affected individuals and their families. The only currently available treatment is a lifelong gluten-free diet. Possible prevention strategies for CD focus on early infant feeding practices, namely breastfeeding and the time and mode of gluten introduction into the infant's diet. A systematic review of available data suggested that the risk of developing CD may be decreased by breastfeeding and breastfeeding at the time of gluten introduction. It is not clear whether this strategy prevents the disease or only delays the onset of symptoms. Gluten introduction should not be done earlier than at 4 months of age and not later than 7 months of age since both early and late introduction of gluten have been shown to increase the risk of CD. A large randomized controlled trial is being conducted in 10 European countries to clarify whether breastfeeding and early gluten introduction are effective in preventing CD in genetically susceptible individuals.
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