Avoidance of Cow's Milk–Based Formula for At-Risk Infants Does Not Reduce Development of Celiac Disease: A Randomized Controlled Trial

Hyytinen, Mila; Virtanen, Suvi Μ.; Härkönen, Taina; Ilonen, Jorma; Luopajärvi, Kristiina; Uibo, Raivo; Vaarala, Outi; Åkerblom, Hans K.; Knip, Mikael; Eskola, Vesa; Haavisto, H.; Hämäläinen, Anu‐Maaria; Järvenpää, Anna‐Liisa; Jokisalo, R.; Käär, M.‐L.; Kaski, U.; Komulainen, Jorma; Korpela, Paavo; Lautala, Pentti; Niemi, Katri; Nuuja, A.; Rantanen, Pekka; R, Renko; Renlund, Martin; Salö, Martin; Talvitie, T.; Uotila, T.; Wetterstrand, G.; Hyöty, Heikki; Klemetti, Paula; Kulmala, Petri; Paronen, Johanna; Reunanen, Antti; Saukkonen, Tero; Savilahti, Erkki; Savola, K.; Teramo, Kari

doi:10.1053/j.gastro.2017.06.049

Cited by 21 publications

(14 citation statements)

References 32 publications

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Section: Envionmental Factors Behind Changing Patterns Of Celiac Diseasementioning

confidence: 99%

“…A recent study by Hyytinen et al did not find evidence that weaning off a diet of extensively hydrolyzed formula (compared to the implementation of cow's milk-based formula) would decrease the risk of CD later in life (87). It is not clear whether the breastfeeding and gluten introduction timelines presented in this study (87) are comparable with those from the previous, aforementioned studies (22–24). Furthermore, it is also currently unclear whether the cow's milk formula used by Hyytinen et al (87) (80% intact milk protein, Enfamil; Mead Johnson, Chicago, IL, USA, and 20% hydrolyzed milk protein) mimicked the protein content and osmolarity of the homemade, cooked, diluted cow's milk used during the 1960s and early 1970s.…”

Section: Envionmental Factors Behind Changing Patterns Of Celiac Diseasementioning

confidence: 99%

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Changing Pattern of Childhood Celiac Disease Epidemiology: Contributing Factors

Popp

Mäki

2019

Front. Pediatr.

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Up until the 1960s and 1970s, diarrhea, malabsorption syndrome, and failure to thrive were the presenting symptoms and signs of celiac disease (CD) in young infants; however this disease was also at the same time reported to be disappearing. Indeed, clinical childhood CD was seen to transform into a milder form, resulting in an upward shift in age at diagnosis during the 1970s (and years later for many countries). This changing pattern of CD presentation then altered the epidemiology of the disease, with major differences between and within countries observed. An awareness of the changing clinical nature of CD and use of case-finding tools to detect even clinically silent CD became an important factor in this changing epidemiology. Countries report both low and high prevalence but it seems to be on the increase resulting in a population-based level of 1–2%. This paper discusses the potential causes and environmental factors behind these observed clinical changes, identifying new clues from different studies published at the time this transformation took place. For instance, it was found that breastfeeding postponed the diagnosis of the disease but did not altogether prevent it. Moreover, gluten introduction at a young age, specifically at the mean age of 2 months, seemed to also have a clear impact in inducing malabsorption syndrome and failure to thrive in young infants in addition to other factors such as gluten intake volume and type of cereal present in the weaning food. Further, the impact of cow's milk and its high osmolarity might have played an important role; humanized milk formulas were not yet invented. Future epidemiological studies on the contributing environmental factors to the shift in CD presentation are thus recommended for countries in which these changing clinical features are still being observed.

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Section: Envionmental Factors Behind Changing Patterns Of Celiac Diseasementioning

confidence: 99%

Section: Envionmental Factors Behind Changing Patterns Of Celiac Diseasementioning

confidence: 99%

Changing Pattern of Childhood Celiac Disease Epidemiology: Contributing Factors

Popp

Mäki

2019

Front. Pediatr.

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“…The effects of dairy product intake on the risk of celiac disease is less studied. Although the vast majority of patients with celiac disease have antibodies directed against tissue transglutaminase (tTGA) [ 4 ], a proportion also have detectable antibodies against milk protein [ 5 ]. Although a recent study did not find avoidance of cow´s milk-based products to protect from celiac disease compared with extensively hydrolyzed formula [ 5 ], it is not entirely clear whether other components in milk products may trigger celiac disease.…”

Section: Introductionmentioning

confidence: 99%

Daily Intake of Milk Powder and Risk of Celiac Disease in Early Childhood: A Nested Case-Control Study

Segerstad¹,

Lee

Aronsson³

et al. 2018

Nutrients

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Milk powder and gluten are common components in Swedish infants’ diets. Whereas large intakes of gluten early in life increases the risk of celiac disease in genetically at-risk Swedish children, no study has yet evaluated if intake of milk powder by 2 years of age is associated with celiac disease. A 1-to-3 nested case-control study, comprised of 207 celiac disease children and 621 controls matched for sex, birth year, and HLA genotype, was performed on a birth cohort of HLA-DR3-DQ2 and/or DR4-DQ8-positive children. Subjects were screened annually for celiac disease using tissue transglutaminase autoantibodies (tTGA). Three-day food records estimated the mean intake of milk powder at ages 6 months, 9 months, 12 months, 18 months, and 24 months. Conditional logistic regression calculated odds ratios (OR) at last intake prior to seroconversion of tTGA positivity, and for each time-point respectively and adjusted for having a first-degree relative with celiac disease and gluten intake. Intake of milk powder prior to seroconversion of tTGA positivity was not associated with celiac disease (OR = 1.00; 95% CI = 0.99, 1.03; p = 0.763). In conclusion, intake of milk powder in early childhood is not associated with celiac disease in genetically susceptible children.

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“…On the other hand, several studies have analyzed the characteristics of powdered formulas and their relationship with the development of CD. Hyytinenet al, [132], analyzed whether there was a difference in genetically predisposed subjects in taking conventional artificial formula or extensively hydrolyzed formula during the first 6-8 months of life, finding no differences in this regard. Segerstad et al, [133], evaluated the risk of developing CD in relation to artificial feeding in genetically predisposed subjects.…”

Section: Breastfeeding Vs Infant Formula and Celiac Diseasementioning

confidence: 99%

The Role of Early Programming and Early Nutrition on the Development and Progression of Celiac Disease: a review.

Martín-Masot

Díaz‐Castro

Moreno‐Fernández

et al. 2020

Preprint

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Experimental and epidemiological evidence has shown that modifications of the intrauterine environment can have deleterious consequences for individuals, expressed as an increased risk of suffering non-communicable pathologies in adult life, which is known as the hypothesis of the early origin of diseases or programming fetal. On the other hand, changes in gene expression patterns through epigenetic modifications can be the basis for long-term maintenance of the effects of fetal programming. In this sense, epigenetics comprises the study of intrauterine disturbances, which develop diseases in the adult, including Celiac Disease (CD). In addition, early feeding practices could influence the risk of CD development, such as breastfeeding timing and duration and age at gluten introduction in the diet. Gluten acts as a trigger for CD in genetically predisposed subjects, although approximately 30% of the world population has HLA DQ2 or DQ8, the prevalence of the disease is only 1-3%. It is not known what factors act to modify the risk of disease in genetically at risk subjects. Taking into account all these considerations, the aim of the current review is to elucidate the role of early programming and the effect of early nutrition on the development and progression of CD.

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Avoidance of Cow's Milk–Based Formula for At-Risk Infants Does Not Reduce Development of Celiac Disease: A Randomized Controlled Trial

Cited by 21 publications

References 32 publications

Changing Pattern of Childhood Celiac Disease Epidemiology: Contributing Factors

Changing Pattern of Childhood Celiac Disease Epidemiology: Contributing Factors

Daily Intake of Milk Powder and Risk of Celiac Disease in Early Childhood: A Nested Case-Control Study

The Role of Early Programming and Early Nutrition on the Development and Progression of Celiac Disease: a review.

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