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Mamas, don’t let your babies grow up to be gluten intolerant

We’ve previously covered peanut introduction in infants, and next up is gluten introduction. These researchers analyzed the changing literature looking at celiac disease risk when gluten is introduced at different times.

Study under review: Gluten Introduction to Infant Feeding and Risk of Celiac Disease: Systematic Review and Meta-Analysis

Introduction

Gluten, which is depicted in Figure 1, has become a hot topic ever since the gluten-free food industry exploded in the last decade. Gluten consumption can be an extremely serious issue for a little less than 1%[1] of the US population who have celiac disease. Celiac disease is an autoimmune disorder caused by a combination of genetic factors and environmental exposure to gluten. It causes the body’s immune system to overreact in the presence of gluten and attack the tissue of the small intestine, eventually leading to long-term damage. However, most people with a genetic predisposition to celiac disease will not actually develop the disease, despite being exposed to gluten-containing foods.

Current EU recommendations[2] suggest introduction of gluten between 17 and 26 weeks of age (about 4-6.5 months), ideally while an infant is still being breastfed. However, this recommendation was based on a single review[3] that provided no calculation of the risk of actually developing celiac disease.

The authors wanted to provide an updated review of the literature analyzing the timing of the introduction of gluten, and to calculate the associated risk for the development of celiac disease in infants by conducting a meta-analysis of existing studies.

Celiac disease, an autoimmune disorder that causes inflammation in the small intestine after exposure to gluten, affects a little less than 1% of the US population. Development of celiac disease is due to a combination of genetic and environmental factors, and while it is currently recommended that infants are introduced to gluten between four to six months of age, there is not a lot of evidence supporting a reduction in risk by adhering to those guidelines.
Figure 1: Anatomy of gluten

Source: Fasano, A. Physiol Rev. 2011 Jan.

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