Updated: Jul 19, 2020
Children fed gluten-heavy foods such as pasta and breads frequently in their early years may be more likely to develop gluten intolerance or celiac disease, according to a new study.
Researchers found that "higher gluten intake during the first 5 years of life was associated with increased risk of celiac disease autoimmunity and celiac disease among genetically predisposed children," according to a study published last week in the peer-reviewed journal JAMA.
Celiac disease autoimmunity is the presence of blood of antibodies that are specific to celiac disease and signal its development. The study examined whether gluten intake could be linked to celiac disease and celiac disease autoimmunity in genetically at-risk children.
Children who consumed higher-than-average levels of gluten were 7.2% more likely to have celiac disease and 6.1% more likely to have celiac disease autoimmunity, the study said.
"These are quite notable findings and could have impacts in terms of guidelines for what foods babies are introduced to and when," Claire Baker, director of communications for Beyond Celiac told USA TODAY.
The study involved 19 researchers with differing affiliations including The University of Colorado and Augusta University. Together, they looked at more than 6,600 children born between 2004 and 2010 in Sweden, Finland, Germany and the United States for the TEDDY Study Group.
The children, studied from the time they were newborns, all had a genotype associated with celiac disease and Type 1 diabetes.
Gluten intake was evaluated over three-day periods at 6 months, 9 months and 12 months and then biannually until they reached age 5.
"We follow the children from the age of 4 months until 15 years of age. This fall, the oldest in the cohort turn 15 and leave the study," Carin Andrén Aronsson, study manager, told USA TODAY.
The first data from the study was made available in 2017.
Eighteen percent of the children in the study developed celiac disease autoimmunity, while 7% developed celiac disease. The diagnoses came at 2 and 3 years of age for both.
"That could have a long-term impact on guidelines pediatricians give their patients for newborns," Baker said.
Celiac disease is a genetic autoimmune disorder. It impacts the small intestine's digestive process, according to the Celiac Disease Center at the University of Chicago.
The disease is increasing in prevalence around the world, Stefano Guandalini, professor at the University of Chicago who focuses on pediatric gastroenterology, told USA TODAY.
One percent of Americans, or roughly 3 million people, have celiac disease.
Only people with a genetic predisposition are susceptible to celiac disease. But because of rising prevalence, people have been searching for environmental causes of increase, Guandalini said.
Other environmental factors that could pose a risk to developing celiac include certain antibiotics, viruses and C-sections, according to Guandalini.
It's possible to be diagnosed at any age, and celiac is sometimes present without symptoms showing themselves. And though it happens only in rare cases, celiac won't even show up in a blood test at times.
The disease can also be present with symptoms that may not seem related to a digestive disease such as fatigue, infertility and anemia. Because of these factors, it is often difficult to diagnose.
When a person with celiac disease consumes gluten, a protein in wheat, barley and rye, their immune system attacks the small intestine. When that happens, nutrients are not absorbed.
Guandalini said the study brings possibly consequential changes to the diets of infants that are born with a genetic risk – infants whose parents or siblings have celiac.
"In these cases, perhaps the parents should simply, in addition to adopting other measures such as trying to avoid unnecessary use of antibiotics, make sure that their child is not exposed to large amount of gluten-containing foods during their first 2-3 years of life," Guandalin said.
A normal amount of gluten would be about three to 5 grams daily and a large amount would be more that that, he said.
In wheat, gluten represents between 11% and 12% of the weight, so 2 ounces of wheat products daily would be a normal amount.
Cutting out gluten at any age can be difficult, Baker said. And if the study's findings imply that parents should not introduce their babies and young children to gluten, that could be an even larger challenge.
She described the study's information as an "enormous treasure trove" that can help experts glean what the future of celiac disease could be in an already changing field.
"The implications could be quite far-reaching, but I'm sure before anything like that happens we need more research," Baker said.
In 2015, Aronsson oversaw a paper on gluten intake in relation to celiac disease in Sweden. Her team found then that the amount of gluten consumed until a child is two years old increases the risk of celiac doubly in genetically at-risk children compared to healthy ones.
Though she has seen similar results in the studies, she thinks it's too early to make any dietary recommendations to parents.
"Our study is only an observational study, the next step is to do intervention studies where we test if we can find a safe level of gluten intake for children at-risk for celiac disease," Aronsson said.
By MORGAN HINES
Published at www.usatoday.com | 19 August 2019 |
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