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Protecting Children at High-Risk for Celiac Disease

Whether or not a child will develop an autoimmune disease, such as celiac disease or Type 1 diabetes, is influenced by both genetic and environmental factors. A recent paper in JAMA from the international TEDDY Study reveals clues about how the timing and amount of gluten exposure affects the development of celiac disease in genetically at-risk children. The study showed that genetically predisposed children who ate higher amounts of gluten in the first five years of life had a higher risk of developing celiac disease.

Dr. Hagopian
Bill Hagopian, MD, PhD of PNRI

William Hagopian, MD, PhD is a scientist at the Pacific Northwest Research Institute (PNRI) and one of the Principal Investigators of the TEDDY Study. According to Dr. Hagopian, “We knew that diet, especially gluten intake, is a risk factor in the development of celiac disease. Not until this study did we know precisely how much gluten intake influenced the risk of developing the disease. These results will help us better understand how we might protect young children with genetic risk by having parents cut back their gluten intake.”

About Celiac Disease

Celiac disease is an immune reaction to eating gluten — a protein found in wheat, rye, and barley — that leads to damage in the small intestines. The Celiac Disease Foundation estimates that 1 in 100 people worldwide have the disease. It can lead to malabsorption, anemia, vitamin deficiencies, osteoporosis, growth delay, and failure to thrive. The only cure is to avoid gluten in the diet. Children with the disease often go undiagnosed until their teen years or later. It only affects those with a certain genetic type at the HLA region, about one fifth of all children.

The TEDDY Study

The TEDDY Study included 6,605 children born between 2004 and 2010 in the United States, Finland, Germany, and Sweden who have a genetic risk for celiac disease. Gluten intake was estimated from food records collected during their first five years of life. The study found that for every gram per day increase in gluten consumption there was an associated higher risk of celiac disease.

Next Steps

“The next step should be a prospective clinical study to confirm that feeding lower gluten amounts in high-risk children decreases the development of celiac disease,” says Dr. Hagopian. “The ultimate goal is to take these findings into real-world actions that will keep these vulnerable children free of the disease.”

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