Research Article| August 01 2016 Gluten Intake and Risk of Developing Celiac Disease AAP Grand Rounds (2016) 36 (2): 13. https://doi.org/10.1542/gr.36-2-13 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Gluten Intake and Risk of Developing Celiac Disease. AAP Grand Rounds August 2016; 36 (2): 13. https://doi.org/10.1542/gr.36-2-13 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: celiac disease, gluten Source: Aronsson AC, Lee HS, Koletzko S, et alTEDDY Study Group. Effects of gluten intake on risk of celiac disease: A case-control study on a Swedish birth cohort. Clin Gastroenterol Hepatol. 2016; 14(3): 403– 409.e3; doi: https://doi.org/10.1016/j.cgh.2015.09.030Google Scholar Investigators from multiple institutions enrolled child participants from the Swedish site of The Environmental Determinants of Diabetes in the Young (TEDDY) study to assess the association between gluten intake before 2 years of age and the risk of developing celiac disease (CD). As part of the TEDDY study, participants were screened for CD annually beginning at age 2 years using serum tissue transglutaminase (TTGA). Participants with 2 consecutive positive TTGA samples were referred to their health care provider for evaluation of CD with an intestinal biopsy; a biopsy showing a Marsh score of ≥2 was considered proof of CD.1 For the current study, investigators categorized Swedish TEDDY participants as cases if they had biopsy-confirmed CD. Three controls who were TTGA-negative were matched to each case on gender, year of birth, and presence of HLA genotypes considered to confer increased risk for CD. The primary exposure was the amount and timing of gluten intake. This was measured using a 24-hour parent recall of the child’s food consumption at age 3–4 months and 3-day standardized food intake records completed by parents before study visits at 6, 9, 12, 18, and 24 months of age. At each visit, food records were reviewed by a study nurse. Gluten-containing foods were considered to be products and composite dishes containing wheat, rye, or barley. The mean intake of gluten was calculated as grams per day. The investigators compared timing and amount of gluten intake among cases and controls and used logistic regression to compare characteristics in cases and controls. Data were analyzed on 146 cases and 436 matched controls. Timing of introduction to gluten-containing foods was the same (a median age of 22 weeks) for cases and controls. However, the amount of gluten intake among cases was significantly more than in controls at the 12- and 24-month time points. Overall, a 1 g/day increase of gluten was associated with a 28% increase in risk of CD (P = .0002). This association did not differ between case-control pairs when HLA genotype was considered. The authors conclude that the amount of gluten consumed prior to 2 years of age increased the risk of CD and was independent of HLA genotype. Drs LeLeiko and Silverstein have disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device The results of this study suggest that the amount of gluten ingestion in the first 2 years of life affects the risk of CD. The study findings also help explain why some, but not all, children at genetic risk develop CD. Furthermore, the results suggest that timing of gluten introduction, a variable once thought to impact... You do not currently have access to this content.