When I was a baby, I not only was afflicted with severe allergies (asthmatic allergy), but celiac disease as well.  (And, both my parents died of autoimmune diseases.)  Which became a family joke (no one ever said I had a normal family) when it was clear that I loved cottage cheese, even though I was forced to eat it almost every morning, noon, and night.  (My kids still swear I make cottage cheese with noodles, not noodles and cheese.)

And, now many of my Shabat evening guests (Friday night dinner guests) demand gluten-free diets.  Which is among the best diets for those who suffer from celiac disease (which afflicts some 1% of the world’s population).  (The gluten, prevalent in wheat, barley, rye among other grain items, is a prime issue in this auto-immune disease, as well.)  So, I was intrigued when I found out that breast-feeding is one of the best ways to preclude infants from developing the disease (since my partner is a board-certified lactation specialist).

It turns out that celiac sufferers have one plus factor when compared to those afflicted with other autoimmune diseases.  We know that there is a genetic factor- human leukocyte antigen (HLA) that augments the immune response to gluten, so that omitting gluten from the diet can render these folks almost normal.

It turns out 30% of the European peoples carry the predisposing genes- even though more than 95% of them do not manifest the disease.  But, since celiac disease is doubling in prevalence nowadays- that ‘plus’ factor may not be the real factor. Is it the gluten-rich diets (thank you, processed foods) that prevail in America that is doubling the incidence? (The answer, in a nutshell, is probably not- since Russian populations consume tons of wheat- and their celiac incidence is nowhere near the American rate.)

But, a scientist who has been comparing celiac incidence between Finland and Russia thinks it may be related to one’s intestinal bacterial populations. Drs. Kondrashova and Hyoty (University of Tampere, Finland) believe it may be a function of Helicobater pylori infestations in the body (which protects against asthma while it causes ulcers and stomach cancer).

But, it may be related to yet another microbial flora- bifidobacteria.These microbes (also called probiotics in popular press) are Gram positive, non-motile, anaerobes (that means they don’t like oxygen).   Dr. Yolanda Sanz et. al. has found that these species amplified the response of human intestinal flora from inflammation to tolerance to gluten. Which is where breast-feeding comes in…

Breast milk is laden with the microbe, plus a slew of other protective antibodies and proteins.  (Breast milk cells may also be comprised of almost 30% stem cells- but that’s a subject for another blog.) And, breast-fed infants have higher intestinal populations of this microbe compared to those infants that are fed formula.  With a cohort of 164 newborns with potential for celiac, 117 had much lower bifidobacteria in their intestines compared to those with no celiac-associated genotypes. But, breast feeding those infants boosted the bifidobacterial census.

Which may explain why Swedish children tripled their incidence of celiac disease between 1984 and 1996, when the health guidelines seemed to imply that breast feeding was not the best mode to raise one’s child.  And, then, when the guidelines were changed- voila, lowered incidence of celiac disease. (Dr. A Myleus et. al.  Journal of Pediatic Gastroenterology and Nutrition.)

Another problem- not all breast milk is the same.  Mothers who live in agricultural environments have a more diverse microbial population and more anti-inflammatory proteins.  And, overweight mothers provide fewer bifidobacteria than from thinner mothers.

But, there’s still yet another factor to this equation besides breast milk.  It’s Caesarean section. Drs. Azad, Konya, Maughan, Guttman, Field, Chari, Sears, Becker, Scott, and Kozyrskyj (Universities of Alberta and Toronto) reported these results in the Canadian Medical Association Journal by studying the stool of newborns and 3 month old babies.  Those born via C-section lacked the critical bifidobacteria bacteria- and if they were fed formula (and not breast milk), it stayed that way.

By the way, celiac disease has a similar genetic susceptibility to Type 1 diabetes. And, both diseases are associated with a lowered prevalence of lactobacilli (another probiotic microbe)  census.  The problem is that we need larger studies (larger number of subjects) to be certain of all these facts.

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