Gluten intake and gluten-free diet in the Netherlands

Leiden Repository

Gluten intake and gluten-free diet in the Netherlands

Type: Doctoral Thesis
Title: Gluten intake and gluten-free diet in the Netherlands
Author: Hopman, Geertruida Dorothea
Publisher: Department Pediatry, Leiden University Medical Center (LUMC), Leiden University
Issue Date: 2008-09-25
Keywords: Adolescents
Celiac disease
Gluten tolerance
Gluten-free diet
Nutrient intake
Quality of life
Abstract: Celiac disease is an intolerance to dietary gluten in genetically predisposed individuals, leading to alterations of the small bowel mucosa. The treatment consists of a life-long, gluten-free diet. The aims of this thesis were to measure some of the environmental factors considered to play a role in the prevention of celiac disease. For that purpose breast milk was studied on the presence of glutenpeptides and a food frequency questionnaire was developed and validated to quantify gluten intake in young infants. Furthermore, the current treatment at different ages and the ability to develop gluten tolerance were studied. It became clear that the nutrient intake of adolescents on a gluten-free diet can be ameliorated, and that the rather new naturally gluten-free cereal tef is frequently used by Dutch celiac patients and a wide majority of them can consume tef without clinical symptoms. Therefore tef can be a valuable addition to their diet. Although celiac disease is considered to be a permanent condition, we made an attempt to find patients who have become tolerant to gluten. We found 2 of these exceptional patients and found that one of them had HLA-typing different from HLA-DQ2/DQ8, suggesting that genetic factors may play a role in the development of tolerance. The underlying mechanisms leading to prevention, disease development or tolerance to gluten are complex and need to be further studied.
Description: Promotor: J.M. Wit, Co-promotor: M.L. Mearin-Manrique
With summary in Dutch
Faculty: LUMC
Citation: Hopman, G.D., 2008, Doctoral thesis, Leiden University
ISBN: 9789090233819
Sponsor: Financial support for the publication of this thesis was kindly provided by Willem- Alexander Kinder- en Jeugdcentrum (Leiden University Medical Center), Celiac Disease Consortium, Dienst Diëtetiek (Leiden University Medical Center), Divisiebestuur Divisie 2 (Leiden University Medical Center), Nederlandse Coeliakie Vereniging, Friso Kindervoeding, Mead Johnson Nutritionals, Nutricia Advanced Medical Nutrition, Sorgente B.V., Nutri-akt b.v. - arbeidsmarktintermediair binnen Food, Technology, Nutrition & Health.

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