Leiden University Scholarly Publications

Persistent URL of this record https://hdl.handle.net/1887/3576015

Documents

In Collections

This item can be found in the following collections:

Szajewska, H.; Shamir, R.; Strozyk, A.; Chmielewska, A.; Zalewski, B.M.; Auricchio, R.; ... ; PreventCD Project Grp (2022)

Systematic review: early feeding practices and the risk of coeliac disease: a 2022 update and revision

Article / Letter to editor
BackgroundThe effects of early feeding practices on the risk of coeliac disease (CD) remain debated. AimsTo update evidence on these practices on the risk of CD and/or CD-related autoimmunity (CDA), defined as anti-transglutaminase or anti-endomysial antibody positivity MethodsWe searched MEDLINE, EMBASE and the Cochrane Library to May 2022 for randomised controlled trials (RCTs) and observational studies. ResultsWe included 36 publications (30 studies). In the population at genetic risk of developing CD (HLA DQ2/DQ8-positive), exclusive or any breastfeeding and longer breastfeeding duration did not reduce the risk of developing CD/CDA during childhood. While a meta-analysis of four case-control studies showed a decreased risk for CD when gluten was introduced during breastfeeding, this was not shown in RCTs and cohort studies. Age at gluten introduction was not associated with cumulative CD/CDA risk, although two RCTs suggested that earlier gluten introduction was associated with...Show moreBackgroundThe effects of early feeding practices on the risk of coeliac disease (CD) remain debated. AimsTo update evidence on these practices on the risk of CD and/or CD-related autoimmunity (CDA), defined as anti-transglutaminase or anti-endomysial antibody positivity MethodsWe searched MEDLINE, EMBASE and the Cochrane Library to May 2022 for randomised controlled trials (RCTs) and observational studies. ResultsWe included 36 publications (30 studies). In the population at genetic risk of developing CD (HLA DQ2/DQ8-positive), exclusive or any breastfeeding and longer breastfeeding duration did not reduce the risk of developing CD/CDA during childhood. While a meta-analysis of four case-control studies showed a decreased risk for CD when gluten was introduced during breastfeeding, this was not shown in RCTs and cohort studies. Age at gluten introduction was not associated with cumulative CD/CDA risk, although two RCTs suggested that earlier gluten introduction was associated with earlier CDA appearance. Evidence from six observational studies suggests that consumption of a higher amount of gluten at weaning and/or thereafter may increase CD risk. There is insufficient evidence to determine the amount of gluten associated with an increased CD/CDA risk. Regarding whether infant feeding practices modulate the risk conferred by different HLA genotypes results were inconsistent. ConclusionsFor the population at genetic risk of CD, breastfeeding and age at gluten introduction have no effect on its cumulative incidence during childhood. There is some evidence for an effect of the amount of gluten consumed at weaning and/or thereafter on CD/CDA risk.Show less
All authors
Szajewska, H.; Shamir, R.; Strozyk, A.; Chmielewska, A.; Zalewski, B.M.; Auricchio, R.; Koletzko, S.; Korponay-Szabo, I.R.; Mearin, M.L.; Meijer, C.; Ribes-Koninckx, C.; Troncone, R.; PreventCD Project Grp
Date
2022-11-21
Journal
Alimentary Pharmacology and Therapeutics
Volume
57
Issue
1
Pages
8 - 22
DOI
doi:10.1111/apt.17290
Link
https://onlinelibrary.wiley.com/doi/10.1111/apt.17290