Early gluten exposure probably not associated with an increase in coeliac disease

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Early gluten exposure probably not associated with an increase in coeliac disease

The authors of this Nestle-funded study searched multiple databases to find any study that compared the dietary introduction of gluten to infants with the subsequent development of coeliac disease (CD).1 

Comment from Associate Professor Rohan Ameratunga: It is clear there is a genetic predisposition to CD as virtually all patients who develop CD have either HLADQ2 or HLADQ8. Not all patients with these genes develop CD.

The timing of gluten introduction might influence the incidence of CD, similar to the early introduction of peanuts in infants at risk of allergy.

 At this time there is insufficient data to support early introduction of gluten in at-risk infants.  Some data suggests that delayed introduction of gluten might be harmful and increase the incidence of CD in at-risk patients.  The method of introduction (gradual vs larger quantities) is uncertain. This is an evolving field.  

This Gem has been checked by Associate Professor Rohan Ameratunga, Adult and Paediatric Allergy Specialist and Immunologist ADHB and Grafton Specialists.

Reference:

  1. Pinto-Sánchez MI, Verdu EF, Liu E, et al. Gluten introduction to infant feeding and risk of celiac disease: systematic review and meta-analysis. J Pediatr 2016. Click here

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.

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As published in NZ Doctor 29/03/2017