Increased Gluten Intake During Childhood Tied to Higher Rates of Celiac Disease

Celiac.com 07/02/2019 - Does gluten intake in childhood influence the development of celiac disease later in life? It's a basic question that hasn't had a good answer, until now. That's mainly due to an absence of good data. Looking to change that, a team of researchers recently set out to examine the connection between the amount of gluten intake in childhood and later celiac disease.

The research team included Karl Mårild, MD, PhD; Fran Dong, MS; Nicolai A Lund-Blix, PhD; Jennifer Seifert, MPH; Anna E Barón, PhD; Kathleen C Waugh, MS; Iman Taki, BS; Ketil Størdal, MD, PhD; German Tapia, PhD; Lars C Stene, PhD; Randi K Johnson, MPH; Edwin Liu, MD; Marian J Rewers, MD, PhD; and Jill M Norris, MPH, PhD.

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For their prospective Diabetes Autoimmunity Study in the Young, the team included 1,875 at-risk children with annual estimates of daily gluten intake from age 1 year. 

From 1993 through January 2017, the team used repeated tissue transglutaminase (tTGA) screening to identify 161 children with celiac disease autoimmunity and persistent tTGA positivity. A total of eighty-five children from this group met the celiac disease criteria of biopsy-verified histopathology or persistently high tTGA levels. 

The team used Cox regression to model gluten intake in children between ages 1 and 2 years, along with joint modeling of total gluten consumption throughout childhood to estimate hazard ratios adjusted for confounders (aHR).

The data showed that children with the highest third of gluten intake between the ages of 1 and 2 years had double the chance of developing celiac disease, and celiac disease autoimmunity, compared with those in the lowest third. The results showed that every daily gram increase in gluten intake in 1-year olds increases the risk of developing celiac disease autoimmunity by 5%.
 
The child's human leukocyte antigen genotype had no influence on the association between gluten intake in 1-year-olds and later celiac disease or celiac disease autoimmunity. Rates of celiac disease rose in direct relation to increased overall gluten intake throughout childhood.

This is one of the first studies to show that gluten intake in 1-year-olds can influence the development of celiac disease, and celiac disease autoimmunity, in children at risk for the disease.

Obviously, further study is needed, but the main takeaway from this study is that parents of 1-year old children with known risk factors for celiac disease might want to consider reducing the gluten intake in those children. 

Read more at the American Journal of Gastroenterology

The researchers in this study are variously affiliated with the Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway; the Department of Pediatrics, Queen Silvia Children's Hospital, Gothenburg, Sweden; the Barbara Davis Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; the Department of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; the Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; the Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; and the Department of Pediatrics, Østfold Hospital Trust, Grålum, Norway.