High Childhood Gluten Intake Increases Risk of Celiac Disease and Celiac Autoimmunity

Celiac.com 08/26/2019 - Does the amount of gluten consumed during the first 5 years of life influence the risk of celiac disease autoimmunity and celiac disease in at-risk children? A new study says it does.

There's been some previous study data to suggest that high gluten intake during childhood may increase risk of celiac disease. A team of researchers working for The Environmental Determinants of Diabetes in the Young (TEDDY) study group recently set out to investigate if gluten intake levels are associated with celiac disease autoimmunity and celiac disease in genetically at-risk children. The TEDDY group is a prospective observational birth cohort study designed to identify environmental triggers of type 1 diabetes and celiac disease. 

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The research team included Carin Andrén Aronsson, PhD; Hye-Seung Lee, PhD; Elin M. Hård af Segerstad, MSc; et al Ulla Uusitalo, PhD; Jimin Yang, PhD; Sibylle Koletzko, MD, PhD; Edwin Liu, MD, PhD; Kalle Kurppa, MD, PhD; Polly J. Bingley, MD; Jorma Toppari, MD, PhD; Anette G. Ziegler, MD; Jin-Xiong She, PhD; William A. Hagopian, MD, PhD; Marian Rewers, MD, PhD; Beena Akolkar, PhD; Jeffrey P. Krischer, PhD; Suvi M. Virtanen, MD, PhD; Jill M. Norris, MPH, PhD; Daniel Agardh, MD, PhD; for the TEDDY Study Group

For their multinational prospective birth study, the team looked at gluten consumption in 6,605 genetically predisposed children in 6 clinical centers in Finland, Germany, Sweden, and the United States.

The team defined celiac disease autoimmunity as positive tissue transglutaminase autoantibodies found in 2 consecutive serum samples. The team defined celiac disease as cases confirmed by intestinal biopsy or persistently high tissue transglutaminase autoantibody levels.

The team estimated gluten intake from 3-day food records collected at ages 6, 9, and 12 months and biannually thereafter until the age of 5 years. Their results showed that children with higher gluten intake levels had a significantly higher risk of celiac disease autoimmunity, with an absolute risk difference of 6.1%.

Children with higher gluten intake levels also had a significantly higher risk of celiac disease, with an absolute risk difference of 7.2%, for every gram increase of gluten intake per day.

This study shows that genetically predisposed children with higher gluten intake during the first 5 years of life face an increased risk of celiac disease autoimmunity and celiac disease.

Read more at JAMA. 2019;322(6):514-523. doi:10.1001/jama.2019.10329

The researchers are variously affiliated with the Department of Clinical Sciences, Lund University, Malmö, Sweden; the Health Informatics Institute, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa; the Dr von Hauner Children’s Hospital, Ludwig Maximilians University, Munich, Germany; the University of Warmia and Mazuri, Olsztyn, Poland; the Digestive Health Institute, University of Colorado Denver, Children’s Hospital Colorado, Denver; the Tampere Centre for Child Health Research, University of Tampere, Tampere University Hospital, Tampere, Finland; the School of Clinical Sciences, University of Bristol, Bristol, England; Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, Turku, Finland; Department of Pediatrics, Turku University Hospital, Turku, Finland; the Institute of Diabetes Research, Helmholtz Zentrum München, Klinikum rechts der Isar, Technische Universität München, and Forschergruppe Diabetes eV, Neuherberg, Germany; the Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, Georgia; Pacific Northwest Diabetes Research Institute, Seattle, Washington; the Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora; the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland; the National Institute for Health and Welfare, Department of Public Health Solutions, Helsinki, Finland; the Faculty of Social Sciences/Health Sciences, University of Tampere, Tampere, Finland; the Research Center for Child Health, Tampere University, University Hospital, Science Center of Pirkanmaa Hospital District, Tampere, Finland; and the Colorado School of Public Health, Department of Epidemiology, University of Colorado, Aurora, Colorado.