A recent study published in the Journal of the American Medical Association Pediatrics reports that children who were given gluten in higher doses and at a younger age than their peers were less likely to develop celiac disease by 3 years old.
What the Study Showed
This study looked at over 1,000 infants from England and Wales who were split into two groups. One group was introduced to allergens, including gluten, from 4 months of age. The other group followed standard United Kingdom guidelines that recommend delaying food introduction until 6 months of age. The early introduction group was also fed a much higher dose of gluten than the standard introduction group. At six months, the early introduction group had an average of 4.0 grams of gluten per week, while the standard group had an average of 0.9 grams of gluten a week. Both groups only contained breastfed infants. Therefore further studies would need to be conducted on formula-fed infants to determine if similar results would be found in these babies. Results showed that at 3 years old, zero children from the early intervention group were diagnosed with celiac disease. However, seven children from the group who followed standard guidelines were diagnosed with celiac disease.
What About the Other High-Allergen Foods?
Although this particular research paper did not address the outcomes of the other allergenic foods introduced, research over the past decade has shown that delaying the introduction of allergenic foods such as peanuts, fish, or eggs does not decrease the incidence of allergies forming, and in some cases delays may actually increase the risk of a child developing allergies. With this in mind, researchers have started looking at the early introduction of gluten in children as a possible preventative strategy for celiac disease. Maternal and pediatric dietician Kerry Jones explains that the research will need to continue before we can adopt any new practices; however, the current results are promising. “I believe that early introduction to prevent celiac disease could be a reasonable theory…I am looking forward to seeing if this study’s results are able to be replicated in future studies to better understand if early introduction is effective at preventing the prevalence of celiac disease.” Kerry Jones, MPH, RDN, LDN.
Is Celiac Disease an Allergy to Gluten?
No. Although people often say they are allergic to gluten, celiac disease is not actually an allergy. Jones explains that celiac disease is classed as an autoimmune disease, not an allergy. “Celiac disease is NOT an allergy at all. Celiac disease is an autoimmune disease that can lead to damage to the small intestine when gluten is consumed. When people with celiac disease eat gluten (a protein found in wheat, rye, and barley), their immune system responds by attacking the small intestine, leading to damage that can lead to a host of problems, such as nutrient deficiencies, digestive issues, and serious long-term complications.” She explains that some people will have a true allergy to wheat (which contains gluten), and this can cause typical allergic reactions such as hives, respiratory issues, or anaphylaxis. But this is different from celiac disease. “The easiest way, I believe, to differentiate the two is that celiac disease is an autoimmune disease, where the body is attacking itself in the presence of gluten, while a food allergy is an immune response where the body views the food as a threat and tries to attack it.”
Celiac Might Be Hereditary
This study doesn’t clearly state if any parents of the studied children had celiac disease themselves nor what difference this would make to the results. According to the Celiac Disease Foundation, celiac is currently believed to be hereditary, and therefore, if a parent has celiac disease, there is a greater chance that the child will develop celiac disease. Nutritionist Ayelet Goldhaber specializes in working with families who have children with celiac disease and other specialized diets. If a family history of celiac disease exists, she says, “it is a good indicator to closely monitor these kids and test for celiac disease in a timely fashion, usually around their 2nd birthday.” However, she also says, “There is no evidence that holding off gluten introduction has any advantage in this population. And there is no evidence that early introduction of gluten itself will impact [the] likelihood [of] developing celiac disease in their future. Even amongst kids with celiac disease in their family.”
Where Do We Go From Here?
Researchers plan to review the studied children at 7 to 10 years of age to determine if high dose and early introduction of gluten caused a decrease in the cases of diagnosed celiac disease or if it just delayed the onset of the disease. Jones reminds parents that if they are considering an earlier introduction of gluten for any reason, “early consumption of gluten in a safe way should be done on a case-by-case basis as approved by the child’s healthcare professionals." For now, it is best to follow recommendations set out by national health authorities. The Centers for Disease Control and Prevention (CDC) recommend the introduction of all types of food, including allergenic foods, from approximately 6 months of age, and only if your baby has the muscle control required for sitting, leaning toward the food, and head control. If you are concerned, it is a good idea to find an experienced nutritionist or dietitian to guide you through the journey.