Trying to pin the cause on the celiac disease (CD) donkey has been going on for decades. But lately it seems research is ramping up, especially with numbers of those diagnosed with CD in the U.S. quadrupling in the past 50 years. Needless to say, people want answers on both the prevention and treatment ends of the spectrum. While researchers have pretty much nailed down two definite factors that those with CD have – the Human Leukocyte Antigen (HLA DQ2 or DQ8) genetics, and an immune response to the proteins called gliadins and glutenins found in wheat, barley and rye can provoke CD – the question remains why some people who have the genes and eat the proteins get CD, while others don’t?
Two researched-backed, bacteria-driven theories are now emerging in answer to this question. The first theory asserts that certain bacteria humans are - or at least used to be – exposed to in the environment can have potentially protective actions against the development of CD. The second theory suggests specific bacterias found in breast milk (including bifiobacteria) can also have a defensive effect against the development of this autoimmune disease. A February 2013 New York Times article written by Moises Velasquez-Manoff, author of “An Epidemic of Absence: A New Way of Understanding Allergies and Autoimmune Disease” (set to release in September 2013) touched on some of the research behind these two theories.
The last century has brought about a more sterile (clean, hygienic – whatever you want to call it) environment that has subsequentially contributed to less exposure to potentially threating – but also potentially protective – bacterias. In a June 2012 Scientific American article, Martin Blaser, professor of internal medicine and microbiology at New York University, noted a few of the contributing factors to reduced bacteria exposures. Among those were the widespread use of antibiotics, a dramatic increase in the past few decades in the number of C-section deliveries (which limits the transfer of bacteria through the birth canal to the baby), smaller family sizes where siblings share a microbial material with their siblings during early childhood years, and even cleaner water.
Velasquez-Manoff cites research that looked at the incidence of autoimmune conditions between bordering populations of Russian and Finnish children. While these two populations live right next to each other, the incidence of CD was one in 100 among Finnish children and one in 500 among their Russian neighbors. Their diet was essentially the same, with Russians actually consuming more wheat then their neighbors. The scientists behind the study postulated that since the economically deprived Russians has less sanitary conditions, and were thereby exposed to a greater variety of microbes, this microbial wealth (including helicobacter pylori) actually strengthened the Russians' immune systems ability to protect against autoimmune conditions including CD.
While potentially harmful bacteria, including E. coli, has been found to exacerbate the body’s response to gluten, two bacteria called bifidobacteria and lactobacilli have been shown to actually protect against an immune response to gluten. It just so happens that both occur naturally in breast milk (and not in formula). Small studies have shown that children who develop CD have fewer amounts of these two bacteria in their GI tracts. On a wider note, incidence of CD tripled among Swedish newborns between 1984 and 1996, when mothers weaned their children from breast milk while at the same time introducing gluten.
Velasquez-Manoff points out, research has shown that not only does breast milk from overweight mothers contain less beneficial bacteria’s but neither does milk from urban mothers who are not exposed to a microbial enriched environments.
As more research emerges on the role bacteria is playing in the obesity epidemic, now it seems that some of these same microbes may play a pivotal role in how our immune systems respond to the potentially inflammatory effects of gluten. If the goal is to encourage healthy bacteria balance in the gut, breast feeding may be beneficial (for a number of reasons), and beyond that, it may not be a bad idea to let your kids play in the dirt from time to time.