Diet diary: Infant feeding practices may protect against Celiac disease
Celiac disease is a condition where an individual is intolerant to gluten for life. Gluten is a protein found in cereals like wheat, oats, barley, rye and some others. An individual with this condition has to avoid these grains. The diagnosis of this condition as well as its dietary management is challenging. Untreated, the condition can be fatal. Eating foods with gluten causes an immune reaction in the small intestines that can damage the lining of the intestines and lower absorption of essential nutrients, leading to malabsorption and nutritional deficiencies. With an incidence suspected to be 1 in 100 in India, consistent with the global average, over 95 per cent remains undiagnosed. Typical symptoms of Celiac disease include diarrhoea, gastrointestinal disturbances like abdominal distension, flatulence, pain, constipation; nausea, vomiting; growth problems; stunting; anaemia; but not everyone has these symptoms. Why does one get Celiac disease? The answers are not clear. With better understanding of Celiac disease among healthcare professionals and researchers, several mechanisms have been suggested. It is clear that it is an autoimmune hereditary condition and involves a complex interaction of genetic and environmental factors. Early infant feeding practices including breast feeding and early introduction of gluten have been found to be associated with development of this disease. Until a baby’s immune system develops, most foods are “foreign material”. Breast milk or a substitute formula is the first food. Breast milk is more easily tolerated by immature immune systems and provides antibodies to the child. Human milk is known to protect gastrointestinal system, strengthens the intestinal lining (mucosa), improves barrier function and enhances immune function. Fruits, vegetables, meats, and so forth eventually replace formula so that a baby’s immune system can slowly get used to different external substances entering into the body. At some stage in this process, some develop allergies, intolerances, and /or sensitivities to specific foods or substances. A food that is tolerated by most people may become an antigen and trigger an immune response in another person. It has been found that fewer breast-fed children develop Celiac disease, and, when they do, it is at a later age. Research shows that the risk of developing Celiac disease decreased by 63 per cent for children breast-fed for more than two months as compared with children breast-fed for two months or less. The gradual or slow introduction of gluten containing foods into the diet of infants, while they are still being breastfed, is believed to reduce the risk of Celiac disease in early childhood. Another research shows that infants at “high risk” or genetically predisposed, who eat nothing containing gluten until after their first year, can delay the onset of Celiac disease or, better yet, prevent it entirely.
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