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Age at gluten introduction and risk of celiac disease

Carin Andrén Aronsson1, Hye-Seung Lee2, Edwin Liu3

  • 1Department of Clinical Sciences, Lund University, Malmö, Sweden; carin.andren_aronsson@med.lu.se.

Pediatrics
|January 21, 2015
PubMed

Insights

Early or late gluten introduction in genetically predisposed infants was not linked to celiac disease (CD) risk. This finding from the TEDDY study suggests gluten timing isn't an independent risk factor for CD development.

Area of Science:

  • Pediatric gastroenterology
  • Immunology
  • Genetics

Background:

  • Celiac disease (CD) is an autoimmune disorder triggered by gluten in genetically susceptible individuals.
  • The optimal timing for introducing gluten to infants to prevent CD remains a subject of research.
  • The Environmental Determinants of Diabetes in the Young (TEDDY) study investigates environmental factors influencing CD development.

Purpose of the Study:

  • To investigate the association between the age of gluten introduction and the risk of developing celiac disease (CD) in genetically predisposed children.
  • To analyze differences in gluten introduction timing across participating countries within the TEDDY study.

Main Methods:

  • Prospective birth cohort study (TEDDY) involving 6,436 newborns screened for high-risk HLA-genotypes for CD.
  • Follow-up included infant feeding information collection every three months.
  • Outcomes assessed were persistent positive tissue transglutaminase autoantibodies (tTGA) and confirmed CD diagnoses.

Main Results:

  • Swedish infants were introduced to gluten significantly earlier (median 21.7 weeks) than infants in Finland, Germany, and the US (median 30.4 weeks).
  • Over a median follow-up of 5.0 years, 12% developed tTGA and 5% developed CD.
  • Gluten introduction before 17 weeks or after 26 weeks was not associated with an increased risk for tTGA or CD, after adjusting for covariates.

Conclusions:

  • The age of first gluten introduction was not found to be an independent risk factor for developing celiac disease in the TEDDY study.
  • These findings contribute to understanding the complex interplay of genetics and environmental factors in CD pathogenesis.
Abstract

Keywords:
breastfeedingceliac diseasegluteninfant feeding

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