Why is Celiac Disease Increasing? Clues from the Swedish epidemic.

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 It seems that celiac disease is on the rise and is becoming a major public health issues. I remember when I was a kid at summer camp we all ate at the same table. By the time I was a camp counselor there was a special "peanut-free table" and admission to it was enforced through inspection. I am imagine at my children's camps there will probably be a new gluten-free table. 

But celiac incidence has risen and fallen in several cases, most notably in Sweden. In the 1980s, the incidence rate among children under two increased fourfold, then suddenly declined around 1995. Epidemiologists looked for what else had changed during this time and came up with two major factors

breastfeeding, the other was use of gluten-containing infant cereals. Further study into the matter produced a rather strong body of evidence that breast-feeding protects against celiac disease. A possible mechanism is the gut flora. I have written before about the unique properties of prebiotics in human breast milk and their role in establishment of gut flora. C-sections also interrupt establishment of gut flora, and not surprisingly they have also been connected to celiac.

One of my favorite quotes is by Joan Gussow: "I trust cows more than chemists."

I also trust millions of years of human evolution more than chemists. Breast milk is the perfect and most appropriate food for human infants. I become quite disappointed in continous misdirection in citing rare cases in which breast-feeding is literally impossible, such as adoption or after breast-cancer. In countries where breast-feeding is considered the default and formula is considered a last resort, such as Norway, breast-feeding rates are very high (around 99% of women breast feed in the first week) and many out of the remaining 20% receive donor milk. As long as formula is considered a good alternative, governments, employers, and hospitals will have an excuse not to provide support.