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Eating Gluten Early in Life Raises Celiac Disease Risk for Some Kids
By Kimberly Holland
Children who eat a lot of gluten in their earliest years may have an increased risk of developing celiac disease and gluten intolerance, according to a new study published in JAMA.
Swedish researchers followed 6,605 children from birth to age 5. They recorded each child's gluten intake over a 3-day span every few months during these early years.
At the end of the observational period, the researchers found that children who ate higher amounts of gluten were more likely to develop celiac disease autoimmunity (the presence of antibodies in the blood that indicates celiac disease may develop) and celiac disease itself.
Indeed, children who had a higher gluten intake in that period saw a 6.1 percent increased risk of showing the immunological response to gluten. Also, children who ate higher than typical gluten amounts had a 7.2 percent increased risk of developing celiac disease.
What's more, for every gram of gluten intake per day, the risk for developing the condition increased.
Over the course of the study, which ran from 2004 to 2010, 1,216 children, or about 20 percent of the study participants, developed celiac disease autoimmunity. About 7 percent, or 450 children, developed celiac disease. Most diagnoses came between ages 2 and 3.
"Our study shows a clear association between the amount of gluten the children consumed and the risk of developing celiac disease or pre-celiac disease," Dr. Daniel Agardh, associate professor at Lund University in Sweden and leader of the study, said in a statement.
Agardh and colleagues had previously found similar results in a smaller study group of Swedish children only. This new study confirmed those preliminary findings.
Gluten and Your Genes
It's important to note with this study, said Dr. Gina Posner, pediatrician at MemorialCare Orange Coast Medical Center in Fountain Valley, California, that the children who were part of the experiment were already predisposed to developing celiac disease and gluten sensitivity.
"These are kids that all carry the genotype associated with type 1 diabetes and celiac, so they are more likely to get celiac disease than the general population," Posner said. "Eating more gluten likely triggers the antibodies to be formed. The study is not looking at people without the genotype."
For that reason, the results of the study may be a bit more dramatic than would likely occur in a group that wasn't comprised of all predisposed individuals.
"The incidence of [celiac disease] in the general public is 1 percent, but for young people who suffer from type I diabetes, the incidence substantially increases to between 5 to 10 percent," said Dr. Robert Hamilton, FAAP, pediatrician at Providence Saint John's Health Center in Santa Monica, California, and author of "7 Secrets of the Newborn." "In other words, 5 to 10 percent of young people who have type I diabetes will also have [celiac disease]. This is, of course, a big increase."
Gluten is a protein found in grains like wheat, rye and barley. It helps form the "glue" that holds these foods together, and it's an essential component of many carbohydrate-heavy foods like pasta, bread and cakes.
People who are sensitive to the protein are often unable to eat these foods because they experience cramping, bloating, diarrhea and gastrointestinal (GI) distress when they do.
Celiac disease, on the other hand, is an autoimmune disease. In people with celiac disease, the body attacks and damages the lining of the small intestine. Over time, that can prevent nutrient absorption.
The attention to gluten has been increasing in recent years as diagnoses for gluten sensitivity and celiac disease have been rising. According to the Celiac Disease Foundation, it's estimated that 1 in 100 people worldwide have celiac disease.
The organization also says more than 2 million adults in the U.S. have the condition and don't know it. These people could, if left undiagnosed, face a lifetime of health complications.
Children who have celiac disease and are undiagnosed could develop a condition called failure to thrive. This happens when children don't attain standard developmental benchmarks because of a disease or disorder that leaves them undernourished.
Recognizing possible risk factors or triggers, such as eating more gluten in a child's developing years, can help doctors and parents shape diets that might be able to lower a child's risk.
Should Kids Avoid Gluten?
Celiac disease and gluten sensitivity have no cure. However, painful and uncomfortable symptoms can largely be avoided if you also avoid gluten.
But Dr. David Blanco, pediatric gastroenterologist at St. Luke's University Health Network in Bethlehem, Pennsylvania, said parents should "absolutely not" avoid giving their children gluten during these early years.
"The gluten-free alternatives are not fortified with B vitamins and are not considered a healthier alternative unless [you're] diagnosed with one of the three diagnoses," Blanco explained.
Posner added, "A lot of the gluten-free products are higher calorie and lower nutritional value. Unless you are high risk, I wouldn't stop giving your child gluten."
While the results of the recent study might suggest that exposure to gluten could lead to the development of the gluten-related conditions, the results may not apply to your child at all.
Hamilton explained that because this study was done with children who have specific genes for celiac disease, it's not advisable to infer that its results apply to children at large.
"The vast majority of the population is not at risk for [developing a gluten-related condition]," he said. "Thus, for healthy children who do not have these HLA genotypes, there is no reason to stop enjoying gluten-containing foods. They are going to be fine."
In other words, unless you or your child's other parent has a genetic history of such conditions, your child can eat all the crackers, chips and bread you want to give them.
The Bottom Line
When it's time for your child to begin eating solid foods, talk with their pediatrician. The doctor may suggest testing your child for the genotypes related to celiac disease and type 1 diabetes if there's a family history of either condition.
If the results show your child is predisposed, you can work with the doctor to create a diet plan that may help your child avoid gastric distress and potentially skip a future diagnosis.
But even then, the answer may not be to completely avoid gluten at all costs. Only additional research will be able to uncover if it's possible to somehow switch off genes by adopting a gluten-free diet.
"Going gluten-free prior to speaking to a healthcare professional will many times make the management more difficult. Patients should be screened for celiac disease prior to going gluten-free, because after they have gone gluten-free for several months, the screen will no longer be valid," Hamilton said.
Reposted with permission from our media associate Healthline.
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