Children who eat more foods with gluten before they're 2 years old have a greater risk of developing coeliac disease if they carry a genetic risk factor for the condition, new research suggests.
"This finding offers insight into why some, but not all, children at genetic risk develop coeliac disease," lead study author Carin Andren Aronsson, from the department of clinical sciences at Lund University in Sweden, said in a prepared statement.
"Our study provides convincing evidence that the amount of gluten ingested at an early age plays a role in disease course," Aronsson added.
It's important to note, however, that while the study found an association between eating more gluten early in life and coeliac disease, it wasn't designed to prove a cause-and-effect relationship.
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The findings were published online in the journal Clinical Gastroenterology and Hepatology. The study was funded by the U.S. National Institutes of Health.
About 1 percent to 3 percent of the world's population has coeliac disease, according to background information in the report. Coeliac disease is an autoimmune condition that causes damage to the small intestine when someone with the disease eats foods containing gluten, according to the Coeliac Disease Foundation.
Gluten is a protein found in grains, such as wheat, rye and barley.
More gluten in Sweden
For the study, the researchers matched 146 children with coeliac disease to 436 children who didn't have the disease. All of the children were from Sweden. Each group shared the same age, gender and specific combination of genetic risk factors. Approximately half of white people have genetic risk factors for coeliac disease, the study authors noted.
The children in the study were between 15 months old and 8 years old when they were diagnosed with coeliac disease.
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The children's gluten intake was tracked at 9, 12, 18 and 24 months of age. Babies in Sweden tend to consume more gluten-containing foods than they do in other countries, the study authors pointed out. Foods with gluten are also often introduced into a baby's diet sooner than tends to occur in other countries, the researchers said.
The researchers found that children who consumed more than 5 grams of gluten per day before age 2 had a higher risk of coeliac disease than those who consumed less than 3.4 grams of gluten per day.
Dr Joseph Levy is a professor of paediatrics and director of special projects in the division of paediatric gastroenterology at NYU Langone Medical Centre in New York City. He said, "If you are to conclude something from this study, it's that reducing the amount of gluten in the first few years of life might reduce the risk of coeliac in children who are predisposed genetically for coeliac disease." Levy was not involved with the study.
Another expert agreed.
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his point, it's too early to say all newborns should moderate their gluten intake. But those at the highest risk, with affected parents or siblings, may want to avoid doses higher than 5 grams per day during early life," said Dr Arun Swaminath, director of the inflammatory bowel disease program at Lenox Hill Hospital in New York City.
"Whether there is a 'low but safe' boundary isn't clear," Swaminath added.
But, Levy emphasized, skipping or reducing gluten for a few years is not a guarantee of escaping coeliac disease.
"What this study doesn't tell us is what happens later in life because you don't only develop coeliac disease in childhood," Levy explained. "You can develop coeliac disease at any time in life. It could occur from a trigger, such as a viral infection, or something else. So what would be very interesting is to see what happens to these cohorts of children later."
There's also no need for parents to rush out to test their children for the genetic risk factors for coeliac disease, Levy said.
"Testing is definitely not recommended because it (coeliac disease) is so widespread in the population that finding what your [genetic risk] type is will not change what you do," Levy said. "It's a precondition for the disease, but it's not a real determinant. Knowing about it doesn't really help, and it might add stress to parents' lives."
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