Celiac disease, also known as gluten intolerance, is a chronic disease whose only treatment is a lifelong strict gluten-free diet, i.e. to exclude anything that contains wheat, rye or barley. Until the 1970s, celiac disease was unusual and was diagnosed in only 0.001% of all children. Between 1984 and 1996, however, Sweden was hit by an “epidemic” of celiac disease in children under 2 years of age. A fourfold increase in incidence of clinically detected disease, followed by a comparable decrease decade later, was conﬁrmed through the National Swedish Childhood Celiac Disease Register. Something similar had never been seen before anywhere in the world.
Through further investigation of the epidemic, researchers have now shown that celiac disease currently affects up to 3% of all young people. Two-thirds of them have still not received diagnosis and treatment. It is also shown that the risk of developing the disease can be reduced when the child is breastfed and preferably starting with small amounts of gluten while breastfeeding is still ongoing. These findings have contributed to the current Swedish recommendations on infant nutrition and has recently also influenced the recommendations in the rest of Europe and in the United States.
The researcher team, led Dr. Anneli Ivarsson at the Department of Public Health and Clinical Medicine, speculate that there may be a window of opportunity in which an infan
“We now have proven this way of introducing gluten reduces the risk of getting celiac disease,” says Dr. Anneli Ivarsson.
The findings in the study, published online Feb. 18 and in the March print issue of the journal Pediatrics, are based on ETICS – Exploring the Iceberg of Celiacs in Sweden, which is part of the PreventCD European project ETICS is a screening study conducted in 2005-2011 among 12-year-olds born during the epidemic (1993) and after (1997). Invited in the study were more than 18,000 sixth graders from five locations in Sweden: Lund, Växjö, Norrköping, Norrtälje and Umeå. Among them, 69% were given blood tests. The blood samples were analysed for celiac disease and the children who had elevated levels were called to the nearest pediatric clinic for a small intestinal biopsy to check for disease suspicion.
In summary, for a twelve year period starting in 1984, Sweden experienced a unique epidemic of celiac disease in the youngest children. It was developed by a decade of adverse infant nutrition and Sweden has by far the highest incidence of celiac disease in Europe and the United States. It is estimated that there are upwards of 150,000 people with celiac disease in Sweden, of which about 100,000 have not yet received proper diagnosis and treatment. Increased attention is needed at all for so many victims as possible to get the proper diagnosis and treatment.
Ivarsson A, Myléus A, Norström F, van der Pals M, Rosén A, Högberg L, Danielsson L, Halvarsson B, Hammarroth S, Hernell O, Karlsson E, Stenhammar S, Webb C, Sandström O, Carlsson A. Prevalence of Childhood Celiac Disease and Changes in Infant Feeding Pediatrics 2013;131:1-8 doi:10.1542/peds.2012-1015
Anneli Ivarsson, MD, Head Physician, Associate Professor
Department of Public Health and Clinical Medicine, Epidemiology and Global Health division, Umeå University
Mobile phone: +46 (0)70–355 77 46