Researchers 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.
In the results from the EAT (Enquiring About Tolerance) study, published in JAMA Pediatrics late last month, researchers from King's College London, Guy's and St Thomas' NHS Foundation Trust, St George's, University of London, and Benaroya Research Institute, Seattle, found that the early introduction of high-dose gluten may be an effective prevention strategy against developing celiac disease, an autoimmune disease whereby eating gluten (a protein found in wheat) causes damage to the small intestine.
High-dose wheat introduction
The Celiac Disease Foundation estimates that 1 in 100 people worldwide are affected by celiac disease, and that 2.5 million are undiagnosed.
There are currently no strategies to prevent celiac disease and treatment involves long-term exclusion of gluten from the diet, noted researchers, adding that even very small amounts of gluten in the diet of those with celiac disease can cause damage to the lining of the gut, prevent proper absorption of food, and result in symptoms including bloating, vomiting, diarrhea, constipation, and fatigue.
According to researchers, previous studies have explored the early introduction of gluten in infants but have varied in the amount of gluten consumed and timing of introduction. For instance, current products markets as food allergen introduction products for infants contain a variety of common food allergens but in much smaller doses.
“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.
"This strategy may also have implications for other autoimmune diseases,” commented lead author Professor Gideon Lack, who led the 2015 LEAP study, which showed that if you deliberately expose infants at high risk of peanut allergy (babies with severe eczema, an allergy to egg, or both) to peanuts in early life, they are far less likely to develop allergies.
Study design and results
Infants in the intervention arm (488 infants) of the EAT study were given 4g of wheat protein a week (in the form of two wheat-based cereal biscuits) starting at four months of age.
Researchers tested 1,004 children for antitransglutanimase antibodies, an indicator of celiac disease, at three years of age. Those with raised antibody levels were referred for further testing by a specialist.
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.
"Early introduction of gluten and its role in the prevention of celiac disease should be explored further, using the results of the EAT Study as the basis for larger clinical trials to definitively answer this question," said study author Dr. Kirsty Logan, researcher in pediatric allergy at King’s College London.
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