Breastfeeding, delaying gluten won’t lower risk of celiac disease

HealthDay News — A newborn’s risk of developing celiac disease is not reduced by breastfeeding or by postponing the introduction of gluten into the diet, results of two studies published in the New England Journal of Medicine indicate.

“The relationship between the risk of celiac disease and both the age at which gluten is introduced to a child’s diet and a child’s early dietary pattern is unclear,” noted Elena Lionetti, MD, and colleagues.

To examine the prevalence of celiac disease autoimmunity and of overt celiac disease, the investigators followed 707 infants with a family history of celiac disease. The participants were assigned to two groups: in the first group, children began eating foods with gluten at age 6 months, and in the second, children began eating food with gluten at age 12 months.

Postponing the introduction of gluten had no effect on a child’s long-term risk of developing celiac disease, although it did delay the onset of celiac disease, found the researchers. Breastfeeding did not affect the development of celiac disease either way. Children who had certain genes that influence the human leukocyte antigen (HLA) system were twice as likely to develop celiac disease compared with children who had normal-risk HLA genes.

A second study investigated the effect of postponing gluten in infants’ diets on the development of celiac disease. Sabine L. Vriezinga, MD, and colleagues performed a double-blind, placebo-controlled dietary-intervention study involving 944 children who were positive for HLA-DQ2 or HLA-DQ8 (two of the main genes associated with celiac disease) and had at least one first-degree relative with celiac disease.

The study group of participants aged 16 to 24 weeks (n=475) was assigned to receive 100 mg of immunologically active gluten daily, and the control group (n=469) was assigned to receive a placebo. The primary outcome was the frequency of biopsy-confirmed celiac disease at age three years.

Celiac disease was confirmed in 80 participants. The cumulative incidence of celiac disease among children aged three years was 5.2% (95% confidence interval [CI], 3.6-6.8). Participants in the gluten group had an incidence rate of 5.9% (95% CI: 3.7- 8.1), whereas children in the control group had a 4.5% incidence rate for celiac disease (95% CI: 3.7- 8.1).

“Breastfeeding, regardless of whether it was exclusive or whether it was ongoing during gluten introduction, did not significantly influence the development of celiac disease or the effect of the intervention,” noted the researchers.