In time: celiac disease - some current aspects of epidemiology and research

c i e b Since the association between gluten intake and celiac disease (CD) was established by Dicke1 during World War II, our understanding of the pathophysiology of gluten-sensitive enteropathy has markedly increased, especially with the resources of molecular research. However, although it is clear that gluten intake causes enteropathy and extraintestinal disease in genetically-susceptible individuals, we still lack information on additional factors to triggering mechanisms and disease prevention. In the 60s, there were a huge tendency to introduce cereals early in infant feeding to prevent iron deficiency and anemia. As a consequence, a marked increase in new cases of celiac disease was observed and the disease seemed to also be related to the type of feeding, which would influence the age of onset of this disease.2 In the 80s and 90s, there was an important increase in the incidence of CD in Sweden, causing the famous ‘‘Swedish epidemic of Celiac Disease’’, which led to several publications and analyses. The most immediate explanation seemed to be related to the age of gluten introduction in the diet and breastfeeding pattern. After implementation of measures to delay the introduction of gluten in infant feeding, there was a marked reduction in the number of new cases.3--5