Variation and Interdependencies of Human Milk Macronutrients, Fatty Acids, Adiponectin, Insulin, and IGF-II in the European PreventCD Cohort.

Human milk composition is variable. The identification of influencing factors and interdependencies of components may help to understand the physiology of lactation. In this study, we analyzed linear trends in human milk composition over time, the variation across different European countries and the influence of maternal celiac disease.

The impact of human breast milk components on the infant metabolism.

Background & Aims: Breastfeeding is beneficial for mothers and infants. Underlying mechanisms and biochemical mediators thus need to be investigated to develop and support improved infant nutrition practices promoting the child health. We analysed the relation between maternal breast milk composition and infant metabolism.

Histopathological evaluation of duodenal biopsy in the PreventCD project. An observational interobserver agreement study.

Aim of the current study was to evaluate the inter-observer agreement between pathologists in the diagnosis of celiac disease (CD), in the qualified context of a multicenter study. Biopsies from the "PreventCD" study, a multinational- prospective- randomized study in children with at least one-first-degree relative with CD and positive for HLA-DQ2/HLA-DQ8. Ninety-eight biopsies were evaluated.

Anti-gliadin antibodies in breast milk from celiac mothers on a gluten-free diet.

Purpose: To analyze the presence of total IgA and anti-gliadin antibodies (AGA) in BM from CD mothers who follow a gluten-free diet (GFD) and from mothers on a normal gluten-containing diet (ND).

Methods: 218 samples of mature milk were obtained at different months of lactation (1-6) from 83 mothers (2 or more samples per mother) from Italy (Naples), The Netherlands (Leiden) and Spain (Madrid, Valencia and Reus): 42 CD mothers on GFD for more than 2 years and 41 non-CD mothers on a ND. Whey samples were analyzed for AGA-IgA by an indirect homemade ELISA and for total IgA (g/L) by a commercial ELISA kit.

Assessment of dietary compliance in celiac children using a standardized dietary interview.

Background & Aims: Compliance to a gluten free diet (GFD) in celiac disease (CD) is ideally assessed by dietary interviews, albeit time-consuming. Short dietary questionnaires have been developed for adults but not for children. Primary aim was to compare GFD compliance in celiac children, measured by a short dietary questionnaire against a dietary interview.

The role of gluten consumption at an early age in celiac disease development: a further analysis of the prospective PreventCD cohort study.

We previously found that the introduction of small quantities of gluten at 4-6 mo of age did not reduce the risk of celiac disease (CD) in a group of high-risk children. However, the consumption of high amounts of gluten early in life has been suggested to increase CD risk. The aim of this study was to evaluate this hypothesis by using data from the previous study of the PreventCD trial (www.

Comparison of Patients' and Doctors' Reports on Health-related Quality of Life in Celiac Disease.

Objective: To investigate whether implementation of a celiac disease (CD)-specific health-related quality of life (HRQOL) questionnaire would add value to CD follow-up visits; we compared patients' self-reported CD-specific HRQOL with the physician's report provided during a regular CD follow-up visit in children and young adults.

Methods: A cross-sectional study in the control group of a study on self-management in CD (CoelKids). Eligible patients had CD for ≥1 year and were 25 years or younger.

Investigating the early metabolic fingerprint of celiac disease - a prospective approach.

Objectives And Study: In the development of Celiac Disease (CD) both genetic and environmental factors play a crucial role. The Human Leukocyte Antigen (HLA)-DQ2 and HLA-DQ8 loci are strongly related to the disease and are necessary but not sufficient for the development of CD. Therefore, increasing interest lies in examining the mechanisms of CD onset from the early beginning.

Complementary Serologic Investigations in Children with Celiac Disease Is Unnecessary during Follow-Up.

Objectives: To determine the frequency of nutritional deficiencies and thyroid dysfunction in children with celiac disease (CD) and during follow-up after initiation of a gluten-free diet. Laboratory investigations of hemoglobin, ferritin, calcium, folate, vitamin B12, vitamin D, and thyroid function are regularly ordered in children with CD despite sufficient evidence for these.

Study Design: Between 2009 and 2014, test results of hemoglobin, ferritin, folate, vitamin B12, calcium, vitamin D (25[OH]D), free thyroxin, and thyroid stimulating hormone of children with CD regularly seen at the Leiden University Medical Center were investigated.

[Is it time for mass screening for celiac disease?].

Celiac disease is a common condition with a variable presentation, and is frequently not recognized by the physician. Although a gluten-free diet has a positive effect on the health of the celiac patient, prevention would be even more beneficial. In this article we outline the different possibilities for primary and secondary prevention of celiac disease.

Coeliac disease and gluten-related disorders in childhood.

Gluten-related disorders such as coeliac disease, wheat allergy and noncoeliac gluten sensitivity are increasingly being diagnosed in children. Coeliac disease occurs frequently, affecting 1-3% of the Western population. The condition manifests at a very young age, more so in girls, and is related to the HLA genotype.

Randomized feeding intervention in infants at high risk for celiac disease.

Background: A window of opportunity has been suggested for reducing the risk of celiac disease by introducing gluten to infants at 4 to 6 months of age.

Methods: We performed a multicenter, randomized, double-blind, placebo-controlled dietary-intervention study involving 944 children who were positive for HLA-DQ2 or HLA-DQ8 and had at least one first-degree relative with celiac disease. From 16 to 24 weeks of age, 475 participants received 100 mg of immunologically active gluten daily, and 469 received placebo.

Impact on parents of HLA-DQ2/DQ8 genotyping in healthy children from coeliac families.

Due to the association of coeliac disease and HLA-specificities DQ2 and DQ8, HLA-typing can be used for risk determination of the disease. This study was designed to evaluate the knowledge of parents from coeliac families regarding HLA-typing and the impact of HLA-typing on the perception of the health of their children. A structured questionnaire was sent to the Dutch, Spanish and German parents participating with their child in the European PreventCD study on disease prevention in high-risk families, addressing parents' understanding of and attitude towards HLA-typing, distress related to HLA-typing and perceived health and health-related quality of life of their children.

[Gluten tolerance as a result of earlier exposure?].

In a recently published article in Pediatrics on the Swedish coeliac disease 'epidemic', it is suggested that the gradual introduction of gluten-containing foods from 4 months of age, preferably while breastfeeding is still ongoing, is favourable for the prevention of coeliac disease. This stirred up the discussion about the timing of introduction of gluten to the diet of infants in the Netherlands, where gluten-containing foods are mostly introduced from 6 months of age onwards. The retrospective character of data collection, however, has to be taken into account when interpreting the Swedish study.