Early introduction of gluten may prevent Celiac disease, study finds

Introducing high doses of gluten from four months of age into infants' diets could prevent them from developing Celiac disease, according to results from the Enquiring About Tolerance (EAT) study by King’s College London and collaborators published in the journal JAMA Pediatrics.

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 old. The results were compared to children who avoided allergenic foods and consumed only breast milk until they were six months old.

Infants in the intervention arm of the EAT study were given four grams of wheat protein a week from four months of age. This was in the form of two wheat-based cereal biscuits, representing an age-appropriate portion of wheat. Additionally, 1,004 children were tested for antitransglutaminasa 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 percent 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.

Celiac disease is an autoimmune disease whereby eating gluten causes the body's immune system to attack its own tissues. There are currently no strategies to prevent Celiac disease and treatment involves long-term exclusion of gluten from the diet. 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 tiredness.

The results suggest the early introduction of high-dose gluten may be an effective prevention strategy for the disease, though researchers said further studies are needed before being applied in practice.

“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,” said Gideon Lack, MD, MA, MBBCH, FRCPCH, professor of pediatric allergy at King's College London and head of the children's allergy service at Evelina London Children's Hospital, in a statement. “This strategy may also have implications for other autoimmune diseases.”