Çölyak Hastalığının Önlenmesinde Bebek Beslenmesinin Önemi

Çölyak hastalığı ÇH genetik olarak duyarlı kişilerde gluten ve prolaminlerin neden olduğu genetik ve çevresel faktörlerin rol oynadığı multifaktöriyel bir sorundur. Son yıllarda çocuklarda özellikle anne sütü verilme süresi, tamamlayıcı beslenmeye erken başlama ve hayatın ilerleyen dönemlerinde ÇH’nın gelişimi üzerine glutenle tanışma zamanı ve miktarının etkileri vb. konular üzerinde durulmaktadır. Anne sütünün ÇH’na karşı koruyucu etkileri olduğunu gösteren çalışmalar olmasına rağmen herhangi bir koruyucu etkisi olmadığını gösteren çalışmalar da mevcut olup uzun dönemde ÇH gelişimine karşı koruyucu olduğunu gösteren herhangi bir çalışma da bulunmamaktadır. Bu nedenle anne sütünün ÇH’nın klinik belirtilerinin görülmesini önleyip önlemediği ya da geciktirip geciktirmediği hala çelişkili bir konudur. Avrupa Pediatrik Gastroenteroloji, Hepatoloji ve Beslenme Birliği ESPGHAN glutenle tanışma zamanının hem erken < 4 ay hem de geç >7 ay olmasından kaçılması gerektiğini ve gluten bebeğin beslenme programına eklenirken anne sütü alımının da devam etmesinin gerekliliğini vurgulamaktadır. Gelecekte devam eden çalışmaların tamamlanmasıyla bu konuda daha detaylı bilgiler elde edilecek ve bebek beslenmesinde glutenle tanışma zamanı ve miktarı ile ilgili öneriler tekrar gözden geçirilecektir. Bu derlemede çölyak hastalığının önlenmesinde bebek beslenmesinde anne sütü alımı ve gluten ile ilgili çalışmalar irdelenmiştir

The Importance of Infant Nutrition For Preventing Celiac Disease

Celiac disease CD is a multifactorial problem caused by gluten and prola- mins, genetic and environmental factors in genetically susceptible individu- als. In recent years, studies are focused in the early complementary feeding and time of gluten introduction and amount on the development of CD. Al- thoughi some studies have shown a protective effect of breast milk against the development of CD. This has not been confirmed by other studies. Due to the lack of studies showing that breastfeeding would prevent CD in long term; the effect of breastmilk to prevent or delay the development of clini- cal manifestations remains a controversial issue. European Pediatric Gastro- enterology, Hepatology and Nutrition Association ESPGHAN suggests that time of gluten introduction should not be early < 4 months and late >7 months and, when gluten introduction to diet breast milk should continue. With the completion of ongoing trials in the future more detailed informa- tion in this regard will be obtained and the recommendations regarding the introduction time and the amound of gluten in infant diet will be revised over time. In this review, studies related with breast milk and gluten intake in infant nutrition in the prevention of celiac disease are discussed

Keywords:

celiac disease infant nutrition, breast milk,

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