House CallOct/Nov 2010 Issue

Research Roundup: Baby's First Bite, Diagnosing Autism and More!

The latest medical news for people with allergies and food sensitivities

Baby Eatting Food

©science photo LIBRARY/

Baby’s First Bite

Gluten-containing cereals are typically introduced in the first year of life, when infants average more than four infectious episodes.

Because gastrointestinal infections may play a role in increasing intestinal permeability, allowing gluten proteins into the underlying tissue where they can trigger an immune response, Swedish researchers recently examined whether any infection at the time of gluten introduction increased the risk of developing celiac disease in childhood.

In the study, part of the All Infants in Southeast Sweden project, over 9,000 parents recorded when breast-feeding started and stopped, dates of first gluten-containing foods, and all infections during the child’s first year of life. Occurrences of biopsy-confirmed celiac disease were then recorded over approximately seven years of follow-up.

No increased risk was found. The majority of the children with infections occurring within 21 days before or seven days after gluten introduction did not develop celiac disease.

“Our results indicate that recent or ongoing infection is no absolute obstacle to introducing gluten in the diet of small children,” the researchers report.

However, they caution that neither the type nor the severity of parent-reported infections was assessed. Further, they say to fully explore a possible relationship, active screening (rather than relying on clinically detected celiac cases), as well as extending the follow-up period into adulthood where celiac is increasingly diagnosed, would be necessary.

The study was published in March in Pediatrics.

The Gut May Not Heal

Intestinal (mucosal) damage may persist among adults diagnosed with celiac disease even after treatment with the gluten-free diet, according to a recent study conducted at the Mayo Clinic.

Researchers examined the rate of mucosal recovery among a sample of 241 adults, median age 47, with biopsy-proven celiac disease. Two years after diagnosis, just 34 percent had confirmed mucosal recovery, determined by a follow-up biopsy. Five years post-diagnosis, the rate was 66 percent, suggesting a longer time frame may be required for the adult gut to heal. Other research has shown that up to 95 percent of children with celiac disease may achieve mucosal recovery within two years of treatment with the gluten-free diet.

The reason why nearly a third of the adults in the current study had persistent damage, despite generally good compliance with the gluten-free diet, is unknown. Researchers think gluten cross-contamination is a possibility, as well as unexplored factors, such as genetics, age or duration of gluten exposure before treatment.

A second finding from the study was that mucosal recovery appears to be somewhat associated with an overall reduction in mortality, leading researchers to conclude that patients diagnosed with celiac disease as adults may want to consider systematic follow-up with intestinal biopsies. The biopsy remains the best tool to evaluate mucosal response in adults with celiac disease, the researchers say.

The study was published in June in the American Journal of Gastroenterology.

Putting Weight Gain to Bed

Most of us don’t get the recommended eight hours of sleep a night. Now a new study suggests that sleep deprivation could have a sizable impact on our waistlines.

Researchers at the European Center for Taste Sciences in Dijon, France, had 12 healthy men of normal weight track their sleeping, eating and exercising habits for two days. They then had participants sleep either a full eight hours or four hours. Following the abbreviated night’s sleep, the men consumed, on average, 560 more calories—a 22 percent increase. Despite marked sleepiness, the physical activity level was slightly higher following the shorter sleep but it wasn’t enough to overcome the calorie surplus.

Researchers hypothesize that people might eat more after a short sleep because mammals evolved to store up calories in the summer when nights are short and food is plentiful.

The study, the first to find a significant effect of sleep duration on calorie intake in normal-weight men, was published in June in The American Journal of Clinical Nutrition.

Immune System and Celiac Disease

A team of researchers at the University of London has identified four types of genetic disturbance in the immune system that lead to celiac disease. There are now 40 known inherited factors that increase the risk of developing the condition.

According to team leader David Van Heel, professor of gastrointestinal genetics at Barts and The London School of Medicine and Dentistry, researchers discovered how the body's T-cells (a type of white blood cell that originates in bone marrow and matures in the thymus) react to wheat, how the thymus gland eliminates toxic wheat proteins in infancy, and how the body responds to viral infection.

“We now understand that many of these genetic risk factors work by altering the amounts of these immune system genes that cells make. The data also suggests that celiac disease is made up of hundreds of genetic risk factors. We can have a good guess at nearly half of the genetic risk at present,” he said.

Researchers have found evidence in earlier studies to suggest there is a shared risk between the gene linked to celiac disease and several other common chronic diseases involving the immune system, such as type 1 diabetes and rheumatoid arthritis. They hope the study results will help improve diagnostic tools and treatment for celiac disease and give researchers a new way to look at related autoimmune diseases.

More than 4,500 people with celiac disease participated in the study, published online in February in Nature Genetics.

Diagnosing Autism

A new study by the Imperial College London and the University of South Australia indicates that children with autism have a different chemical makeup in their urine than non-autistic children. Children with autism are known to suffer from gastrointestinal disorders and have a different makeup of bacteria in their guts, as well.

Study results mean that it may be possible in the future to distinguish between autistic and non-autistic children by looking at a simple urine test, leading to earlier diagnosis and treatment. Early intervention greatly improves chances for progress. At present, diagnosis is based on tests of social interaction, communication and imaginative skills that cannot be performed on very young children.

Researchers also hope their new understanding of the bacteria differences in autistic children's guts can help scientists develop new treatments for the GI problems often seen in these children.

Early Arrival

Researchers at Glasgow University have found that babies born just a week or two before their normal gestation due date (40 weeks) are more likely to develop learning difficulties, such as autism or dyslexia, than are full-term babies.

Previous studies have shown that premature babies born as early as 24 weeks of gestation are at higher risk of developing learning disabilities but risks for 24- to 39-week gestation had not been previously studied.

Since even one week early delivery can put a child at risk, researchers say that mothers and obstetricians should carefully consider c-section schedule dates.

The study was published in the Public Library of Science Medicine in June.

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