gluten tolerance

Celiac Disease: Prevention and Tolerance

Juan-Ignacio Serrano Vela

Coeliac disease is a chronic immune-mediated systemic disorder elicited by gluten in the small intestine of genetically predisposed individuals upon the consumption of gluten-containing foods. It affects 1% of the general population at any age.

Gluten is a complex storage protein found in the grains of the cereals wheat, barley, rye and oats, as well as in their ancient and crossbred varieties. It is responsible for the baking properties of the flours obtained from such cereals, so the gluten content of these grains has been one of the driving forces for selection since the onset of agriculture, 10.000 years ago in the Near East.

The ‘Swedish epidemic’ of coeliac disease in the mid-1980’s was the kick-off for the hypothesis that prevention could be possible. Changes in the age of gluten introduction, the amount of gluten in babyfoods and breastfeeding were the three factors associated with a four-fold increase in the incidence of coeliac disease in children below 2 years old in Sweden between 1985 and 1987, followed by a decline to previous values in 1995.

Although further studies supported those findings, further investigations were not able to show any effect of any of these factors on the risk of coeliac disease.

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