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A PUBLICATION OF THE UNIVERSITY OF CHICAGO CELIAC DISEASE CENTER CURECELIACDISEASE.ORG

In 2010, we published an article in IMPACT talking about the latest infant feeding guidelines. It discussed timing (the optimal time to introduce gluten to your baby) as well as the protective effect of breast feeding. That information was backed up by studies and was widely accepted.

As sometimes happens in science, new studies disprove the old and our knowledge changes and evolves. In this case, through a number of large prospective studies, we discovered that our old assumptions about infant feeding were largely inaccurate and that new feeding recommendations are needed.

The new recommendations, based on data that has emerged over the past 4 years, are

NEW INFANT? NEW GUIDELINES: FEEDING INFANTS AT RISK FOR CELIAC DISEASEBy Stefano Guandalini, MD

Celiac Skate

STEFANO GUANDALINI, MD

Fun Night with GIG

Spring Flours Month

simple and straightforward. They pertain strictly to families who are at risk for celiac disease, where one of the following two conditions exists:• One first degree family member (a parent

or a sibling) has celiac disease• The newborn baby has been tested for

genetic predisposition to celiac and is positive for DQ2.5 or DQ8

WHAT WE KNOW FROM THE RECENT STUDIES IS THE FOLLOWING:• Gluten in large amounts in the first two

years favors the onset of celiac disease (again, only in the patient population described above). Thus, gluten-containing foods should be given, beginning at the usual age of 4-6 months, but during the first 2 years should be less than 5 grams per day on the average, (i.e. less than

One thing that has not changed since 2010 is that the overall risk of your child developing celiac disease is still small.

about 1 ounce of pasta or 1 slice of bread);

• The best preventative strategy to reduce incidence of celiac disease in this vulnerable population is healthy eating in accordance with the Mediterranean Diet, again during

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the crucial first 2 years of life. Such a diet in particular should be based on high consumption of vegetables and grains and low consumption of refined cereals and sweet beverages.

Although breast feeding does not provide protective benefit to those at risk of celiac disease as we previously thought, we hope people do not conclude that breast feeding is not beneficial to newborns! It is, for many other reasons, and we do not want to discourage new mothers from breast feeding. However, it just does not appear to have a benefit in reducing incidence of celiac disease.

One thing that has not changed since 2010 is that the overall risk of your child developing celiac disease is still small: 1/8 of daughters and 1/13 of sons of celiac parents will develop celiac disease in the course of their lives. However, the steps outlined here can make it smaller still.

SIX STUDIES THAT DISCUSS RESEARCH ON INFANT FEEDING FOR BABIES AT RISK FOR CELIAC DISEASE:

1. Dietary Patterns After the Weaning and Lactation Period Are Associated With Celiac Disease Autoimmunity in Children, in Gastroenterology. 2018 Jun;154(8):2087-2096.e7. doi:10.1053/j.gastro.2018.02.024. Epub 2018 Mar 2.

2. Does infant feeding modulate the manifestation of celiac disease and type 1 diabetes? in Curr Opin Clin Nutr Metab Care. 2017 May;20(3):222-226. doi:10.1097/MCO.0000000000000367.

3. Randomized feeding intervention in infants at high risk for celiac disease, in N Engl J Med. 2014 Oct 2;371(14):1304-15. doi: 10.1056/NEJMoa1404172.

4. Systematic review with meta-analysis: early infant feeding and coeliac disease. update 2015, in Aliment Pharmacol Ther. 2015 Jun;41(11):1038-54. doi: 10.1111/apt.13163. Epub 2015 Mar 26.

5. Introduction of gluten, HLA status, and the risk of celiac disease in children. in N Engl J Med. 2014 Oct 2;371(14):1295-303. doi: 10.1056/NEJMoa1400697.

6. Infant feeding and risk of developing celiac disease: a systematic review. in BMJ Open. 2016 Jan 25;6(1):e009163. doi: 10.1136/bmjopen-2015-009163.

On February 12, GIG of Chicago met for dinner at Brightwok Kitchen in Chicago. Above are some photos from that fun event.

Please visit https://gluten.org/localbranches/chicago/ for more information about future meetings.

You can also email the group at GIG.Chicago@gluten.org and follow them on social media: www.instagram.com/gigchicago and www.facebook.com/gigofchicago

ANOTHER FUN NIGHT OUT WITH GIG

THE MEDITERRANEAN DIETAccording to the National Institutes of Health, The Mediterranean Diet “consists of fish, monounsaturated fats from olive oil, fruits, vegetables, whole grains, legumes/nuts, and mod-erate alcohol consumption” (1) Gener-ally, the emphasis is on unprocessed foods and less animal protein. In other words, it does not include goldfish crackers or chicken nuggets. This diet can certainly be challenging for a family that is pressed for time and resources, but a little research and effort, it can be implemented and will soon become second nature. Whole grains can easily be substituted for processed grains (think whole grain bread instead of white bread, brown rice and whole grain pasta in place of white rice and semolina pasta). Beans and rice are easy to prepare, and we can all eat more fruit and vegetables. For information on how to entice your kids to eat the Mediterranean way, here is a helpful article from the Acad-emy of Nutrition and Dietetics.1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339461/

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Stefano Guandalini, MD FOUNDER & MEDICAL DIRECTOR

Professor Emeritus, Section of Pediatric Gastroenterology, Hepatology and Nutrition

Bana Jabri, MD, PhD PhD Director of Research

Hilary Jericho, MD, MSCI Director of Pediatric Clinical Research

Sonia Kupfer, MD Director of Clinical Genetic Research

Vijaya Rao, MD Assistant Professor of Medicine

Carol Semrad, MD Director of Adult Clinical Research

Ritu Verma, MBChB Section Chief, The University of Chicago Comer Children’s Hospital, Pediatric Gastroenterology, Hepatology and Nutrition

Vicki Gainsberg, RD Nutrition Advisor

Courtney Schuchmann, MS, RD, LDN Nutrition Advisor

Lori Rowell Welstead, MS, RD, LDN Nutrition Advisor

STAFF MEMBERS Carol M. Shilson, Executive Director

Ronit Rose, Program Director

GENERAL OFFICE INFORMATION 5841 S. Maryland Avenue, MC 4069 Chicago IL 60637 773-702-7593

www.CureCeliacDisease.org

Facebook: cureceliac

Twitter: @cureceliac

Instagram: uchicagoceliaccenter

A Cure for Celiac Disease is possible ...

We are making it happen.

Donate Now.

RECENT PUBLICATIONS AND UPCOMING LECTURES FROM EXPERTS AT THE UNIVERSITY OF CHICAGO CELIAC DISEASE CENTERPublicationsRobert ME, Crowe SE, Burgart L, Yantiss RK, Lebwohl B, Greenson JK, Guandalini S, Murray JA. Statement on Best Practices in the Use of Pathology as a Diagnostic Tool for Celiac Disease: A Guide for Clinicians and Pathologists. Am J Surg Pathol. 2018 Sep;42(9):e44-e58. doi: 10.1097/PAS.0000000000001107. PubMed PMID: 29923907.

DeGeeter C, Guandalini S. Food Sensitivities: Fact Versus Fiction. Gastroenterol Clin North Am. 2018 Dec;47(4):895-908. doi: 10.1016/j.gtc.2018.07.012. Epub 2018 Oct 5. Review. PubMed PMID: 30337039.

Guandalini S, Sansotta N. Probiotics in the Treatment of Inflammatory Bowel Disease. Adv Exp Med Biol. 2019 Jan 11. doi: 10.1007/5584_2018_319. [Epub ahead of print] PubMed PMID: 30632114.

Lewis SK, Semrad CE. Capsule Endoscopy and Enteroscopy in Celiac Disease. Gastroenterol Clin North Am. 2019 Mar;48(1):73-84. doi: 10.1016/j.gtc.2018.09.005. Epub 2018 Dec 14.Lectures and Meetings

Dr. Guandalini will be making three presentations at the PediaCampus meeting in Sorrento, Italy, on:• Feeding the celiac child: prevention and treatment yesterday, today and tomorrow;• A debate between friends: Non-Celiac Gluten Sensitivity and other controversies in GI (with Dr. Alessio Fasano);

• Half an hour with Professor Guandalini: Ask Him Anything!

And in Naples, Italy, on September 9:• Pediatric Days: Chairing a debate between Drs. Freedman and Szajewska on the role of Lactobacillus GG in gastroenteritis

University of Chicago Celiac Disease Center will be at the Lab School Heath Fair, on March 7, to answer questions about celiac disease. Special thanks to Bakery on Main, Enjoy Life and Simple Mills.

A Cure for Celiac Disease is possible ...

We are making it happen.

Donate Now.

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The University of Chicago Celiac Disease Center is required to raise its own funding, for research and programming, every year. Our partners are an important part of this effort. We are pleased to partner with the companies listed here, and we thank them for their support. If your company is interested in partnering with us, please email us at cureceliacdisease.org/contact-us.

PARTNERS:

Celiac Skate— Coming Up!Sunday April 28, at 1 pm at Centennial Rink in Highland Park, IL

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The loyal chefs, bakers and purveyors who have long supported our annual fundraiser are helping fund research for a cure. This year, they invite YOU to come to their establishments to enjoy delicious gluten-free fare with family and friends.

We’re bringing The Spring Flours Gluten-Free Gala to You!

Beatrix Big Bowl Brightwok Kitchen Da Luciano Restaurant Ema Little Beet Table Maya Del Sol Mity Nice Bar & Grill

New Planet Beer Pinstripes Stella Barra Cafe Ba-Ba-Reba Mon Ami Gabi Summer House Santa Monica Sweet Ali’s Gluten Free Bakery Wildfire Restaurant

PARTICIPATING RESTAURANTS

Our first-ever Spring Flours Gluten-Free Dining Coupon Book—

brimming with hundreds of dollars in savings—will be available on our website beginning March 25.