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===Risk modifiers=== There are various theories as to what determines whether a genetically susceptible individual will go on to develop coeliac disease. Major theories include surgery, pregnancy, infection and emotional stress.<ref name=Glutengovca>{{cite web |title=The Gluten Connection |url=https://www.canada.ca/en/health-canada/services/food-nutrition/reports-publications/food-safety/celiac-disease-gluten-connection-1.html |publisher=Health Canada |access-date=1 October 2013 |url-status=live |archive-url=https://web.archive.org/web/20170705183625/https://www.canada.ca/en/health-canada/services/food-nutrition/reports-publications/food-safety/celiac-disease-gluten-connection-1.html |archive-date=5 July 2017 |date=May 2009}}</ref> The eating of gluten early in a baby's life does not appear to increase the risk of coeliac disease but later introduction after six months may increase it.<ref>{{cite journal |vauthors=Pinto-SΓ‘nchez MI, Verdu EF, Liu E, Bercik P, Green PH, Murray JA, Guandalini S, Moayyedi P |title=Gluten Introduction to Infant Feeding and Risk of Celiac Disease: Systematic Review and Meta-Analysis |journal=The Journal of Pediatrics |volume=168 |pages=132β43.e3 |date=January 2016 |pmid=26500108 |doi=10.1016/j.jpeds.2015.09.032 |doi-access=free}}</ref><ref>{{cite journal |vauthors=Ierodiakonou D, Garcia-Larsen V, Logan A, Groome A, Cunha S, Chivinge J, Robinson Z, Geoghegan N, Jarrold K, Reeves T, Tagiyeva-Milne N, Nurmatov U, Trivella M, Leonardi-Bee J, Boyle RJ |title=Timing of Allergenic Food Introduction to the Infant Diet and Risk of Allergic or Autoimmune Disease: A Systematic Review and Meta-analysis |journal=JAMA |volume=316 |issue=11 |pages=1181β1192 |date=September 2016 |pmid=27654604 |doi=10.1001/jama.2016.12623 |hdl=10044/1/40479 |hdl-access=free}}</ref> There is uncertainty whether being breastfed reduces risk. Prolonging [[breastfeeding]] until the introduction of gluten-containing grains into the diet appears to be associated with a 50% reduced risk of developing coeliac disease in infancy; whether this persists into adulthood is not clear.<ref>{{cite journal |vauthors=Akobeng AK, Ramanan AV, Buchan I, Heller RF |title=Effect of breast feeding on risk of coeliac disease: a systematic review and meta-analysis of observational studies |journal=Archives of Disease in Childhood |volume=91 |issue=1 |pages=39β43 |date=January 2006 |pmid=16287899 |pmc=2083075 |doi=10.1136/adc.2005.082016}}</ref> These factors may just influence the timing of onset.<ref>{{cite journal |vauthors=Lionetti E, Castellaneta S, Francavilla R, Pulvirenti A, Tonutti E, Amarri S, Barbato M, Barbera C, Barera G, Bellantoni A, Castellano E, Guariso G, Limongelli MG, Pellegrino S, Polloni C, Ughi C, Zuin G, Fasano A, Catassi C |title=Introduction of gluten, HLA status, and the risk of celiac disease in children |journal=The New England Journal of Medicine |volume=371 |issue=14 |pages=1295β303 |date=October 2014 |pmid=25271602 |doi=10.1056/NEJMoa1400697 |type=comparative study |author-link18=Alessio Fasano |hdl=2318/155238 |doi-access=free |hdl-access=free }}</ref>
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