Introducing high doses of gluten from four months of age into infants' diets could prevent them from developing coeliac disease, a study has found.
These results from the Enquiring About Tolerance (EAT) Study conducted by researchers from King's College London and colleagues.
What is celiac disease?
Celiac disease is , a genetically-based disorder that occurs when gluten triggers the immune system to attack and damage the lining of the small intestine, interfering with nutrient absorption.
There are currently no strategies to prevent celiac disease and treatment involves a lifelong gluten-free diet. Even very small amounts of gluten in the diet of those with coeliac disease can cause damage to the lining of the gut, resulting in symptoms including bloating, vomiting, diarrhoea, constipation and fatigue.
Previous studies exploring early introduction of gluten in infants have varied in the amount of gluten consumed and the timing of the introduction. The EAT study investigated the effects of gluten alongside breastfeeding, from the age of four months.
The results were compared to children who avoided allergenic foods and consumed only breast milk until age six months as per UK government guidelines.
Infants in the intervention arm of the EAT study were given 4 grams of wheat protein each week from four months of age. This was in the form of two wheat-based cereal biscuits such as Weetabix, representing an age-appropriate portion of wheat.
1004 children were tested for gluten antibodies, an indicator of celiac disease, at three years of age. Those with raised antibody levels were referred for further testing by a specialist.
More celiac disease diagnosed when gluten introduction delayed
The results showed that among children who delayed gluten introduction until after six months of age, the prevalence of celiac disease at three years of age was higher than expected - 1.4% of this group of 516 children. In contrast, among the 488 children who introduced gluten from four months of age, there were no cases of celiac disease.
This is the first study that provides evidence that early introduction of significant amounts of wheat into a baby's diet before six months of age may prevent the development of celiac disease. The findings need to be explored further.
Source: JAMA Pediatrics, September 28, 2020.
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