Gluten - Friend or Enemy?

Editor(s): R. Shamir, H. Szajewska Annales Nestlé Vol.73 / 3,  2016


The global food supply depends heavily on the availability of cereal-based food products, with wheat being one of the largest crops in the world. The high demand is due to the unique properties of wheat gluten, which has a high nutritional value and is crucial for the preparation of high-quality dough.

In the last 10 years, however, wheat and gluten have received much negative attention. Many people believe that wheat is inherently bad for our health, and try to avoid consumption of gluten-containing cereals - a low-gluten lifestyle so to speak. In reality, there is only one medical condition where gluten is definitively the culprit: celiac disease.

  • Primary Prevention of Celiac Disease: Environmental Factors with a Focus on Early Nutrition

    Author(s): A. Chmielewska, M. Pieścik-Lech, H. Szajewska, R. Shamir

    Celiac disease (CD) is a common autoimmune disorder caused by ingestion of gluten. When diagnosed, it should be treated with a lifelong, strict gluten-free diet. Early infant feeding practices have been suggested as a means of preventing CD. In the last few decades, observational data have suggested that breastfeeding, especially at the time of introducing gluten into the infant’s diet, as well as the time and mode of gluten first being given to a child could prevent or delay the occurrence of CD. As a result, recommendations advised that it is prudent to avoid both early (<4 months) and late (>7 months) introduction of gluten, and to introduce gluten gradually while the infant is still being breastfed, as this may reduce the risk of celiac disease, type 1 diabetes mellitus, and wheat allergy. Recently, the results of two large randomized trials have shown that breastfeeding in general, breastfeeding during gluten introduction, and early or delayed gluten introduction do not influence the total risk of CD in genetically predisposed individuals. Introducing gluten at 4 versus 6 months in very small amounts, or at 6 versus 12 months, resulted in similar rates of CD in these children. Thus, early feeding practices seem to have no impact on the risk of developing CD during childhood. In children without the genetic predisposition, the age and mode of gluten introduction do not influence the risk anyway.

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