Early gluten intake tied to celiac risk among susceptible children

  • Andrén Aronsson C & al.
  • JAMA
  • 13 Aug 2019

  • International Clinical Digest
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Takeaway

  • Among children with a genetic predisposition for celiac disease (CD), higher gluten intake in the first 5 years of life is linked to increased risk for CD and CD autoimmunity.

Why this matters

  • Editorial: the amount of gluten intake cited here “cannot fully explain the increased prevalence of celiac disease” or patterns such as that in Italy, with high gluten intake but low CD prevalence.

Key results

  • For each 1-g/day increase in intake at age 2 years, HRs at age 3 years were:
    • 1.30 (P<.001 for cd autoimmunity.>
    • 1.50 (P<.001 for cd.>
  • Absolute risks for CD autoimmunity by age 3, by gluten intake:
    • Reference amount: 28.1%.
    • 1 g/day more: 34.2%.
    • Absolute risk difference: 6.1% (95% CI, 4.5%-7.7%).
  • Absolute risks for CD by age 3, by gluten intake:
    • Reference amount: 20.7%.
    • 1 g/day more: 27.9%.
    • Absolute risk difference: 7.2% (95% CI, 6.1%-8.3%).

Study design

  • The Environmental Determinants of Diabetes in the Young (TEDDY) prospective, observational, international birth cohort study.
  • Data analyzed for 6605 newborns, 2004-2010, all with genotypes linked to CD or type 1 diabetes.
  • Gluten intake based on 3-day food records collected at 6, 9, 12 months and then biannually to age 5 years.
  • Funding: NIH, others.

Limitations

  • Self-reported data; gluten calculations are approximate.