Study Links Behavior Problems in Toddlers to Celiac Disease

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In the United States, over 2.4 million people have celiac disease, which amounts to about one in every 33 individuals. However, the majority of the people with celiac disease actually do not even know they have it.

Celiac disease is one of the most under-diagnosed conditions in the United States, meaning that doctors do not always diagnose it properly or that individuals do not seek help in the first place for their symptoms.

And a new study by the American Academy of Pediatrics highlighted that one of the largest groups of individuals, toddlers, may be missing celiac disease diagnoses.

What Is Celiac Disease?

Celiac disease is an autoimmune disorder in which the body can not digest the wheat protein gluten. Gluten, instead of nourishing the body, can actually damage the small intestine.

The link Between Behavior and Celiac Disease in Toddlers

A study published in Pediatrics in March of 2017 examined behavioral issues at different ages reported by mothers who were unaware that their children had celiac disease, as compared to behavior reported by mothers who were aware that their children had celiac and mothers of children who did not have celiac disease at all.

The study began by testing 8,676 children at the age of two for tissue transglutaminase autoantibodies (tTGA), which show up when a child has celiac disease.

Thus, if tTGA antibodies are present, a child has celiac disease. The researchers then collected mothers' reports of their child's behavior at 3.5 years old and again at 4.5 years old.

What They Found

At the conclusion of the study, the researchers discovered that at 3.5 years old, mothers who did not know that their children had celiac disease reported far more negative behavior in their children.

Mothers of 66 children who had celiac disease but didn't know it yet reported more child anxiety and depression, withdrawn behavior, aggressive behavior, and sleep problems when compared to the more than 3,651 mothers of children who did not have celiac disease at all. The unaware mothers also reported more aggressive behavior, sleep problems, and child anxiety and depression than mothers who knew that their children had celiac disease.

What Does It Mean?

What this study means is that there may be a link between celiac disease and behavior in children, especially at a young age and potentially more so if parents are unaware that there could be a health issue causing their child's behavior. Although researchers aren't entirely clear on the exact ways that gluten can affect the brain, there are theories that the gluten particles that the body can not digest cause inflammation in the brain, which can lead to the negative behaviors.

Because the study also found that at older ages, there was no difference in reported symptoms for behavior, researchers have theorized that behavioral symptoms may be especially pronounced in younger children who are unable to process or talk about their feelings as much.

For example, a toddler may act out more because her tummy hurts, while an older child may lay down or do a quiet activity instead.

Should You Have Your Child Tested for Celiac Disease?

So if your toddler or preschooler is acting out and having negative behavior, does that mean he has celiac disease? Obviously, toddlers are not the most rational or well-behaved group of humans around, so does this study mean that all toddlers who misbehave should get tested for celiac? Probably not.

But if your child has a family history of celiac disease, it would be a good idea to have him or her tested, since they are more likely to have the disease if a first-degree relative (meaning a parent or sibling) has it.

It's also helpful to speak to your doctor in any situation where your child is having behavioral problems. Diet can be a factor, and there can be many brain-gut links that can contribute to negative behavior in a child. Simply paying attention to what your child eats and how he/she acts following certain foods can be helpful. And if you notice that your child appears to have an increase in symptoms after consuming, be sure to talk to your doctor about appropriate celiac testing.

Sources:

Smith LB, Lynch KF, Kurppa K, et al, The TEDDY study group (2017, March). Psychological manifestations of celiac disease autoimmunity in young children. Pediatrics, 139(3): e20162848. Retrieved from http://pediatrics.aappublications.org/content/139/3/e20162848

Fasano, A. (2017, March). Celiac disease, gut-brain axis, and behavior: Cause, consequence, or merely epiphenomenon? Pediatrics, 139(3): e20164323. Retrieved from http://pediatrics.aappublications.org/content/139/3/e20164323

Rubio-Tapio A et al. The prevalence of celiac disease in the United States. The American Journal of Gastroenterology. 2012 Oct;107(10):1538-44.

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