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Delayed gluten introduction increased celiac disease risk
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Children who are introduced to gluten after age 6 months and those who are breast-fed after age 12 months have an increased risk for celiac disease, according to recent study findings published in Pediatrics.
The study, conducted by Ketil Stordal, MD, PhD, of the Norwegian Institute of Public Health and Ostfold Hospital Trust in Norway, and colleagues, included data from 107,000 children in the Norwegian Mother and Child Cohort Study. From aged 0 to 6 months, gluten introduction was reported monthly and breast-feeding was reported from aged 0 to 18 months.
Ketil Stordal
Eight percent of participants were introduced to gluten by age 4 months, 45.3% were introduced at age 5 or 6 months, and 46.6% were introduced after age 6 months. Seventy-eight percent of the mothers continued breast-feeding their children at age 6 months.
After adjustment for age and sex, breast-feeding, and maternal celiac disease, later gluten introduction caused an increased risk for celiac disease (adjusted OR=1.27; 95% CI, 1.01-1.65). Breast-feeding after age 12 months also caused an increased risk for celiac disease (adjusted OR=1.49; 95% CI, 1.01-2.21).
“We observed a higher risk of [celiac disease] with delayed gluten introduction as well as with prolonged breast-feeding >12 months, though the effects were of modest sizes,” the researchers wrote. “Gluten introduction <4 months was uncommon in the population, and the study was not powered to assess this association. Development of tolerance may be facilitated by timely introduction of gluten, but factors involved in loss of tolerance needs further studies.”
Disclosure: The study was funded in part by the Norwegian Ministry of Health and the Ministry of Educations and Research, NIH/National Institute of Environmental Health Sciences, NIH/National Institute of Neurological Disorders and Stroke, and the Norwegian Research Council/FUGE.
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