Infants who have a parent or sibling with celiac disease are considered to be at risk for developing the condition as well. Could timing the introduction of gluten into the diet of infants at risk for celiac disease prevent or delay their disease?
To investigate this, a group of researchers from Italy and the US studied newborns who had a close relative with celiac disease.
They found that delaying the introduction of gluten to infants’ diets delayed celiac disease symptoms somewhat. It did not prevent the disease.
The biggest predictor of whether a child would get celiac disease was having the genetic factors linked to the disease.
Brought on by an immune reaction to eating gluten, celiac disease is a painful chronic condition of the digestive system. Because the disease is linked to certain genetic types, it can run in families.
An investigator on the study, Elena Lionetti, MD, of the Department of Pediatrics at the University of Catania in Italy, said diet only played a small role in developing the disease. However, she said delaying gluten may help delay symptoms.
“Our results indicated we can tell mother not to worry so much about when they introduce gluten into their children’s diet,” remarked Carlo Catassi, MD, Co-director of the Center of Celiac Research and Treatment and another investigator on the study.
The study included 832 newborns. As part of the research, the parents of half the infants started to feed their babies gluten when they were 6 months old. Parents of the other half of the infants started to feed them gluten when they were 12 months old.
The parents fed their babies gluten in the form of pasta, semolina and biscuits.
The research team conducted genetic testing, blood studies and intestine biopsies to confirm the presence of celiac disease.
By 2 years of age, 12 percent of the children who had started to eat gluten at 6 months of age had celiac disease. Five percent of those who delayed eating gluten until they were 1 year old had celiac disease.
However, by the time the children were 5 years old, an equal number in each group had the disease.
Some past studies have suggested that breastfeeding may protect against celiac disease. In the current study, breastfeeding did not prevent the onset of celiac disease in children.
By age 10, the risk of developing celiac disease was much higher among children with genetic types linked to the disease than among those without that genetic risk.
"Of the several factors we studied, it’s very clear that genetic background is by far the most important in determining which infant will develop this autoimmune condition. We are particularly surprised that breastfeeding at any age provided no protective effect,” said Alessio Fasaon, MD, PhD, director of the Center of Celiac Research and Treatment and co-author of this study, in a press release.
This research was published Oct. 2 in The New England Journal of Medicine.
The Celiac Foundation of the Italian Society for Celiac Disease funded the study.