Gluten-Containing Foods, Infants, and Celiac Disease

Category: Children's Health , Diet and Nutrition , Gastrointestinal (GI) Health

The cause of Celiac Disease is not fully understood. Conversely, the pathophysiology of the disease is very well understood and it involves gluten, a protein found in grains such as wheat, barley, and rye. An autoimmune process takes place in the gut of individuals and results in the destruction of the cells lining the intestine after ingestion of gluten grains. The treatment recommendation is complete removal of gluten from the diet.

It has been postulated that early introduction of gluten-containing grains into the diet of an infant may play a role in the development of the disease. The immature gut of the infant may not be able to assimilate or digest the large gluten protein. Immune complexes may form if it enters the blood via absorption thru an immature gut.

A study published in JAMA in May investigated the risk of Celiac disease autoimmunity and in particular examined the effect of timing of introduction of gluten had on risk of disease. It was a prospective study that enrolled 1560 at risk infants. To be included in the study, individual risk was defined by genetic make-up, a first degree relative with Type I diabetes. The mean time period for follow up was 4.8 years.

Overall, 51 infants developed Celiac disease (<3.2%). Infants who had gluten grains introduced in the first 3 months of life had a five-fold increase in risk for developing the disease compared to infants given the grains between 4-6 months. There was a slight increase in risk for infants given the grains after 7 months compared to the 4-6 month period as well. This increase was not as significant as the less than 3-month group.

These results suggest that timing of introduction of gluten grains does in fact play a significant role in the development of Celiac disease in infants at risk. However, more studies are needed to determine the effects in the general population.

Posted by Kristopher Foster on June 10, 2013 11:00 AM