Study: Eating More Gluten at an Early Age Raises Celiac Disease Risk

Research Shows Amount of Gluten Consumed Matters

young child with bread
Eating more gluten could lead to celiac. Aliyev Alexei Sergeevich/Getty Images

Babies and young children who carry a gene that makes them susceptible to celiac disease are more likely to develop the condition if they eat more gluten than average during their first two years, a study shows.

The study, part of wide-ranging research on possible environmental causes of type 1 diabetes (type 1 diabetes shares some of the same genetic roots as celiac disease), considered whether the amount of daily gluten intake would affect a baby's odds of being diagnosed with celiac.

The researchers found it did: "Intake of gluten before two years of age increases risk of celiac disease at least two-fold in children with genetic risk factors for this disease," concluded the study, published in the medical journal Clinical Gastroenterology and Hepatology.

However, the study was conducted in Sweden, and the study's authors warned that the results might not apply to babies in the United States and in other countries, since in Sweden it's traditional to feed babies gluten-containing foods earlier and in greater quantities. Additional research will be needed to determine if the results hold true elsewhere.

Study Looked at Children with Celiac Gene

The researchers looked at 436 pairs of children who all carried one of the two so-called "celiac disease genes": either HLA-DQ2 or HLA-DQ8.

Clinicians long have known that, even though almost everyone who develops celiac disease carries one or both of these genes, the genes by themselves aren't the sole cause of the condition — in other words, some as-yet unidentified environmental factors are involved.

 

Since celiac disease involves a reaction to gluten, It seems logical to look at the specifics of gluten consumption — the age at which gluten foods are first introduced, plus how much gluten actually is consumed. And that's what these researchers did: they tracked when each child first was introduced to gluten, and had the parents keep food diaries to determine how much gluten each was eating.

They also routinely tested them for signs of celiac disease.

More Gluten = Higher Risk

The study found that babies and young children in the group who ultimately developed celiac disease were eating more gluten than those who didn't develop the condition — a median of 4.9 grams of gluten per day in those who did develop celiac, compared with 3.9 grams of gluten in those who didn't. For comparison, two slices of whole wheat bread contain about 5 grams of gluten.

This increase in risk held for the genetically susceptible children regardless of which specific genes they carried.

Meanwhile, the study found that the length of time an infant was breastfed and the age at the baby's first introduction to gluten didn't make a difference in which children developed celiac disease.

The Bottom Line

It's logical to think you might be able to avoid celiac disease completely in your genetically at-risk young child if you never, ever feed that child gluten (while this has never been tested in a clinical trial and certainly isn't recommended by physicians, I know of parents who are trying it).

But identifying environmental factors that could raise that child's risk and then eliminating those factors could accomplish the same goal without a gluten-free diet. Although more research is needed (in the U.S. especially) to confirm this study's findings, its conclusion gives strong hints that when it comes to gluten in babies and young children who are known to be at risk for celiac disease, less may be best.

Source:

Andrén Aronsson C et al. Effects of Gluten Intake on Risk of Celiac Disease: a case-control study on a Swedish birth cohort. Clinical Gastroenterology and Hepatology. 2015 Oct 7. pii: S1542-3565(15)01332-4.

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