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 Earlier studies had suggested that introducing gluten between the
ages of four and six months might lower the risk of celiac disease,
a condition in which gluten in food triggers a damaging immune
response in the small intestines.
But in this new study, children introduced to gluten before age 17
weeks or after 26 weeks were not at an increased risk of developing
celiac disease, compared to those who were introduced to the protein
between those ages, researchers found.
Carin Andrén Aronsson, the study’s lead author from Lund University
in Malmö, Sweden, said parents should still follow the general
recommendation for introducing children to gluten.
“For Europe anyway you should introduce gluten in small amounts at
four to six months of ages,” she said. “I think we can still stick
with that.”
In the U.S. and Europe, about one in 100 people have celiac disease.
If they consume wheat, barley or rye, or foods that contain those
grains, their immune response leads to intestinal damage,
malnutrition and other problems.
As reported in the journal Pediatrics, Aronsson's group used data
from a study of type I diabetes in children from Sweden, Finland,
Germany and the U.S. They followed 6,436 children with a genetic
predisposition for celiac disease.
On average, children in Sweden were introduced to gluten at about
age 22 weeks. Kids in Finland were started on gluten a bit later, at
26 weeks. Those in Germany and the U.S. were introduced to gluten
even later, at about 30 weeks, on average.
After five years, 773 children had a marker of celiac disease known
as tTGA (tissue transglutaminase antibody) in their blood, and 307
actually developed celiac disease – based on an intestinal biopsy or
consistently high tTGA levels.
Overall, children with a specific genetic predisposition, those born
in Sweden, females and kids with a family history of celiac disease
were more likely to develop the condition.
After adjusting for those factors, there was no link between when
the children were introduced to gluten and their risk of developing
celiac disease.
The researchers did find that children in Sweden are more likely to
develop celiac disease, compared to children in the U.S. Based on
the results, the researchers suggest it may be due to an interaction
of gluten and weaning, but that result needs more research.
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Currently, the American Academy of Pediatrics recommends that women
exclusively breastfeed their newborns for six months after birth.
Then, they should continue breastfeeding for one year or more as
they introduce other foods.
Around the world, the incidence of celiac disease is increasing, but
researchers still don’t know why, said Dr. Peter Green, director of
the Celiac Disease Center at Columbia University.
“We have to address the reason,” said Green, who was not involved
with the new study.
He also said the new study, with the support of previous research,
does not suggest that people need to follow any specific
recommendation about gluten introduction.
Two other recent studies also found that timing of gluten
introduction to a baby's diet doesn’t protect them from celiac
disease (see Reuters Health story of October 1, 2014 here: http://reut.rs/17XPgud.)
Green said the new results can probably apply to the general
population, but cautioned “they’re not studying the general
population.” Instead, this research involved high-risk children.
SOURCE: http://bit.ly/1ABoSNA
Pediatrics, online January 19, 2014.
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