Delayed gluten introduction increases celiac risk

Delayed gluten introduction increases celiac risk
Delayed gluten introduction increases celiac risk

HealthDay News -- Delaying gluten introduction until after 6 months of age and breastfeeding longer than 12 months may increase a child's risk for developing celiac disease, results of a prospective birth cohort study indicate.

Children who were introduced gluten at 7 months of age or older were 27% more likely to develop celiac disease by age 2 years (adjusted OR 1.27; 95% CI:1.01-1.65; P=0.045), Ketil Størdal, MD, PhD, from the Norwegian Institute of Public Health in Oslo, and colleagues reported in Pediatrics.

The risk remained significant after adjusting for the child's age and gender, maternal celiac disease and length of breastfeeding.

Among children who were given gluten at 4 months of age or earlier, the researchers found no significant impact on the development of celiac disease (aOR 1.05; 95% CI 0.69-1.58; P=0.89).

Størdal and colleagues analyzed data on 107,000 children from the Norwegian Mother and Child Cohort Study. Celiac disease status was determined using questionnaires and data from the Norwegian Patient Register. Mothers reported time of gluten introduction monthly from 0 to 6 months of age, and breastfeeding status monthly from 0 to 18 months of age. A total of 82,167 children were included in the final analyses, of whom 324 had celiac disease.

Complete information was available for up to 6 months for 324 children with celiac disease and 81,843 cohort controls, and up to 18 months for 287 with celiac disease and 67,628 cohort controls.

Celiac disease was diagnosed in 3.68 per 1,000 among infants who were introduced gluten at age 5 to 6 months, compared with 4.15 per 1,000 older than 6 months and 4.24 per 107,000 at 4 months of age or younger.

There was also a higher rate of celiac disease in infants who breastfed longer than 12 months compared with 6 months (aOR 1.49, 95% CI 1.01-2.21, P=0.046).

"We found an increased risk of celiac disease in children introduced to gluten after 6 months and a higher risk in children breastfed after 12 months age," the researchers concluded.

Study limitations included basing celiac disease diagnoses on data from the national patient registry or parental reports and not patient records.


References

  1. Størdal K et al. Pediatrics. 2013;132;1-8.
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