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Introducing Gluten At 4 Months Of Age May Prevent Celiac Disease In Children

Weetabix biscuits Credit: Wikipedia

Exciting research from the UK suggests that to prevent celiac disease in children, the answer may be to feed the child gluten in early childhood (starting at 4 months of age). Early exposure!

Celiac disease, which occurs in about 1 in 100 people, is a lifelong condition caused by an abnormal reaction to gluten - a protein found in wheat, barley and rye. Eating gluten results in the body mounting an immune response that attacks and damages the small intestine, so that nutrients cannot be absorbed properly into the body. The only treatment for celiac disease is to strictly adhere to a gluten free diet.

The study included one group of children that had early exposure to high doses of gluten starting at 4 months (4 grams of wheat protein per week in the form of 2 Weetabix biscuits - wheat biscuits produced in the UK). They were compared to children who did not have gluten exposure until 6 months (standard dietary recommendations of breast milk only). At three years of age none of the early gluten group (0 out of 488 children) had celiac disease, while 1.4% (7 of 516 children) of the delayed gluten exposure had celiac disease.

This finding is along the lines of research suggesting that to prevent peanut allergies from developing feed small amounts of pureed peanut products (such as peanut butter or peanut puffs) to a child in the first year of life, starting as early as 4 months of age.

Another bit of interesting celiac disease research from 2019 found a link with higher fiber intake by the mother during pregnancy, especially of fruits and vegetables, and a lower incidence of celiac disease in the children. Also, gluten intake (high or low) by the pregnant woman had no effect on whether her child would later develop celiac disease.

From Science Daily: Early introduction of gluten may prevent celiac disease in children, study finds

Introducing high doses of gluten from four months of age into infants' diets could prevent them from developing celiac disease, a study has found. 

These results from the Enquiring About Tolerance (EAT) Study, published today in JAMA Pediatrics, by researchers from King's College London, Guy's and St Thomas' NHS Foundation Trust, St George's, University of London, and Benaroya Research Institute, Seattle, suggest the early introduction of high-dose gluten may be an effective prevention strategy for the disease, though researchers say further studies are needed before being applied in practice.

Celiac disease is an autoimmune disease whereby eating gluten causes the body's immune system to attack its own tissues. There are currently no strategies to prevent celiac disease and treatment involves long-term exclusion of gluten from the diet. Even very small amounts of gluten in the diet of those with celiac disease can cause damage to the lining of the gut, prevent proper absorption of food and result in symptoms including bloating, vomiting, diarrhea, constipation, and tiredness.

Previous studies exploring early introduction of gluten in infants have varied in the amount of gluten consumed and the timing of the introduction. The EAT study investigated the effects of gluten alongside breastfeeding, from the age of four months. The results were compared to children who avoided allergenic foods and consumed only breast milk until age six months as per UK government guidelines.

Infants in the intervention arm of the EAT study were given 4g of wheat protein a week from four months of age. This was in the form of two wheat-based cereal biscuits such as Weetabix, representing an age-appropriate portion of wheat.

1004 children were tested for antitransglutanimase antibodies, an indicator of celiac disease, at three years of age. Those with raised antibody levels were referred for further testing by a specialist.

The results showed that among children who delayed gluten introduction until after six months of age, the prevalence of celiac disease at three years of age was higher than expected -- 1.4% of this group of 516 children. In contrast, among the 488 children who introduced gluten from four months of age, there were no cases of celiac disease.

Lead author Professor Gideon Lack, Professor of Paediatric Allergy at King's College London and head of the children's allergy service at Evelina London Children's Hospital said: "This is the first study that provides evidence that early introduction of significant amounts of wheat into a baby's diet before six months of age may prevent the development of celiac disease. This strategy may also have implications for other autoimmune diseases such as Type 1 diabetes."

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