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Introducing Gluten During Infection Carries No Increased Risk of Celiac Disease

Celiac.com 03/23/2010 - Introducing gluten to a baby's diet during a period of infection does not increase the risk of the child developing celiac disease later on, according to a study by Swedish researchers.

The team of researchers, led by Dr. Jonas F. Ludvigsson of Sweden's Karolinska Institute, used data from the population-based All Infants in Southeast Sweden study to search for independent associations of childhood infections with the risk of developing celiac disease.

The team had parents chronicle their children's diet and infectious diseases in their first year of life, including breastfeeding start and stop dates, and dates the babies first ate gluten-containing foods.

They enrolled a total of 9,408 children, and logged a total of 42,826 reports of infectious disease in the first year of life, including 4,003 episodes of gastroenteritis.

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Of 2,528 children who suffered infection at the time of gluten introduction, 18 developed celiac disease, while 26 of 6,880 children without infection developed celiac disease; for a total of 44 biopsy-proven cases of celiac disease after the children's first birthday  (p = 0.035). 167 children suffered from gastroenteritis during gluten introduction, but just one child developed celiac disease, compared to 43 of 9,241 with no gastroenteritis during gluten introduction (p = ns).

Once adjusted for age at gluten introduction, age at breastfeeding termination, and age at infection, the results showed no significant connection between infection or gastroenteritis at the time of gluten introduction and the later development of celiac disease.

The team pointed out that they lack data on specific infection types, which limits the scope of their conclusions, and that further study is warranted.

"We cannot rule out the possibility that specific pathogens constitute risk factors for celiac disease, because risk estimates for infection at the time of gluten introduction were of borderline significance," they said, noting that the study design precluded identification of subclinical infections.

The added that "because celiac disease is increasingly diagnosed in adulthood, screening...and a longer follow-up period would be required for complete elucidation of the possible relationship between infections and [the development of] celiac disease."

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