Central America in Transition: From Maize to Wheat Challenges and Opportunities.
The Central American countries: Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica, and Panama are in transition from a dietary culture based mainly on maize to a wheat-containing diet. Several other changes are occurring, such as a decrease of parasitic and infectious diseases. The environmental changes permit a prediction of an increase of celiac disease and other autoimmune diseases such as type I diabetes and thyroid disease in these genetically heterogeneous countries. At present, celiac disease and gluten-related disorders are considered to be of no relevance at the level of public health in these nations. This review documents the presence of celiac disease in Central America. It draws attention to some of the challenges in planning systematic studies in the region since up until recently celiac disease was unknown. The aim of this review is to disseminate knowledge obtained with preliminary data, to stimulate clinical and basic scientists to study these diseases in Central America and to alert authorities responsible for the planning of education and health, to find possibilities to avoid a rise in these disorders before the epidemics start, as has occurred in the Mediterranean countries.
Laboratory of Immunogenetics, VU University Medical Center, Department of Medical Microbiology and Infection Control, PO Box 7057, 1007 MB Amsterdam, The Netherlands. pena.as@gmail.com.
Amado Salvador
AS
Peña
Laboratory of Immunogenetics, VU University Medical Center, Department of Medical Microbiology and Infection Control, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
Jakob Bart Arie
JB
Crusius
D000818:Animals; D001323:Autoantibodies / Q000097:blood; D015551:Autoimmunity; D015415:Biomarkers / Q000097:blood; D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy / Q000208:ethnology* / Q000235:genetics / Q000276:immunology; D002489:Central America / Q000453:epidemiology; D003466:Cultural Characteristics; D004032:Diet / Q000009:adverse effects* / Q000208:ethnology; D055050:Diet, Gluten-Free; D020022:Genetic Predisposition to Disease; D006801:Humans; D007197:Indians, Central American / Q000235:genetics; D011237:Predictive Value of Tests; D012307:Risk Factors; D013997:Time Factors; D014908:Triticum / Q000009:adverse effects* / Q000276:immunology; D003313:Zea mays
D001323:Autoantibodies; D015415:Biomarkers
Central America; HLA-DQ; anti-Endomysium antibodies; celiac disease; hygiene hypothesis; old-friend hypothesis; prevalence; serological tests; tissue transglutaminase antibodies