(Celiac.com 08/13/2000) Because celiac disease has emerged as a public health problem, Swedish researchers conducted a study to analyze the trends in the occurrence of symptomatic celiac disease in Swedish children from 1973 to 1997, and to explore any temporal relationship to changes in infant dietary patterns. The researchers established a population-based prospective incidence register of celiac disease in 1991, and collected data retrospective date from 1973. A total of 2,151 cases met their diagnostic criteria, and were used in the study.

In addition the researchers collected national data on an annual basis regarding the duration of breastfeeding and intake of gluten-containing cereals and recommendations on when and how to introduce gluten to the diets of infants. The incidence of celiac disease in children below 2 years of age increased fourfold (200-240 cases per 100,000 person years) between 1985 and 1987, followed in 1995 by a sharp decline to the previous level (50-60 cases per 100,000 person years). A pattern like this one is quite unique for a chronic disease of immunological pathogenesis, which suggests that prevention could be possible.

This study demonstrates that the celiac disease epidemic is in part the result of a change in three factors within the area of infant feeding, including the amount of gluten given, the age of gluten introduction, and whether breastfeeding was ongoing or not when it was introduced. There may also be additional factors involved, and the search for them should be intensified.

Ivarsson A, Persson LA, Nystrom L, et al
Acta Paediatr. 2000 Feb;89(2):165-71

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