August 13th, 2019- A study published by the Journal of the American Medical Association (JAMA) concluded that higher gluten intake during the first 5 years of life is correlated with an increased risk of celiac disease among children who possess the HLA genes associated with celiac disease. The study was conducted in research centers in the United States, Finland, Germany, and Sweden.
The TEDDY study- The Environmental Determinants of Diabetes in the Young- aimed to identify environmental triggers of type 1 diabetes and celiac disease. From 2004 to 2010, researchers identified 8,676 newborns carrying HLA genotypes associated with type 1 diabetes and celiac disease. In 6,757 children, screening for celiac disease was performed annually from the ages of 2-5 years; data were available on gluten intake for 6,605 children.
Researchers screened for celiac disease with tissue transglutaminase autoantibodies (tTG-IgA)- a diagnostic marker for celiac disease. Every few months, researchers recorded the children’s gluten intake. Higher gluten consumption was found to be associated with a 6.1% increased risk of celiac disease autoimmunity (the first sign of a negative response to gluten) and a 7.2% increased risk of celiac disease per each additional gram of gluten consumed each day (corresponding to a half slice of white bread).
Of the children studied, 18% developed celiac disease autoimmunity and 7% developed celiac disease. The risk of developing celiac disease autoimmunity or celiac disease was highest in 2-3 year olds.
The finding of a point at which gluten intake was associated with an increased risk is relevant for gluten-feeding recommendations in at-risk children; however, this conclusion is based on a post-hoc analysis, meaning that simply because there is a relationship between gluten intake and risk of celiac disease does not mean that one causes the other. This conclusion should be confirmed by further studies.