Gluten watch

Coeliac disease is a condition in which a person is intolerant to gluten,a protein found in cereals like wheat,oats,barley and rye.

Coeliac disease is a condition in which a person is intolerant to gluten,a protein found in cereals like wheat,oats,barley and rye. The person has to avoid these grains for life. Eating foods with gluten causes an immune reaction in the small intestine that can damage the intestinal lining and absorption of essential nutrients,leading to nutritional deficiencies. With an incidence of 1 in 100 in India,consistent with the global average,over 95 per cent of cases remain undiagnosed. The disease can occur at any age.

Typical symptoms include diarrhoea,gastrointestinal disturbances like abdominal distension,flatulence,pain,constipation,nausea and vomiting,growth problems,stunting and anaemia. Other symptoms include weight loss,lethargy,tiredness,bone problems like osteoporosis and cramps,skin problems,infertility,mouth ulcers,numbness and behavioural problems like depression and anxiety. There is very often an absence of typical symptoms (50 per cent of patients dont have diarrhoea) which makes the diagnosis difficult.

Coeliac disease can increase the risk of auto-immune disorders like type-1 diabetes mellitus,thyroid disorders,pulmonary diseases such as asthma,ulcerative colitis,Crohns disease,liver disorders and cancer.
Why does one get coeliac disease? Their are no clear answers. It is an auto-immune hereditary condition and involves a complex interaction of genetic and environmental factors.

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A Swedish population study has revealed the relationship between infant feeding practices and coeliac disease. A three-fold increase in coeliac disease was seen among infants from mid 1980s to mid 1990s. Breast feeding had been on a decline in Sweden during 1980s. It has been found that fewer breast-fed children develop coeliac disease,and,when they do,it is at a later age. Research shows that the risk of developing coeliac disease decreased by 63 per cent among children breast-fed for more than two months as compared to children breast-fed for two months or less.

At what age you introduce gluten into the infant diet also affects the quantum of risk of coeliac disease. In a recent study,children exposed to foods containing wheat,barley or rye in the first three months of life had a five-fold increased risk of coeliac disease compared with children exposed at four to six months. Large amounts of gluten at weaning are also associated with an increased risk of developing coeliac disease.

Will early infant feeding practices protect against coeliac disease? At this point,it certainly presents an exciting area of research and may prove to be a potential strategy to prevent its occurrence in the future. Till then,follow precautionary measures such as exclusive breast feeding until six months,delayed and gradual introduction of gluten-containing grains until six months to one year and introduction of solids (weaning) without gluten-containing cereals at four to six months.