Gluten consumption in early childhood is associated with an increased risk of coeliac disease among youngsters genetically predisposed to the condition, a study suggests.
Children who ate more gluten during the first five years of their life were also more at risk of coeliac disease autoimmunity – having antibodies in their blood.
However, it remains unclear whether the amount of gluten consumed can trigger the condition.
An observational study included 6,605 children born between 2004 and 2010 in Finland, Germany, Sweden and the United States who had a genetic predisposition for coeliac disease.
Researchers estimated gluten intake from food records collected at six, nine and 12 months, and then biannually until the age of five.
Some 18% of the children developed coeliac disease autoimmunity and 7% developed coeliac disease.
The incidence of both outcomes peaked at two to three years old, scientists say.
For every one gram per day increase in gluten consumption, there was an associated higher risk of coeliac disease and coeliac disease autoimmunity, researchers say.
They found that if gluten intake was one gram per day higher than the average at aged two (the equivalent of half a slice of white bread), the absolute risk differences for coeliac disease autoimmunity and coeliac disease were 6% and 7% higher, respectively, by age three.
The authors write: “Higher gluten intake during the first five years of life was associated with statistically significantly increased risks of coeliac disease autoimmunity and coeliac disease among genetically predisposed children.”
The research was published in the Journal of the American Medical Association (JAMA).
Its authors, from Lund University in Malmo, Sweden, say a limitation of the study is the uncertainty of the accuracy of the reported gluten intake.
They suggest a randomised clinical trial be done of different amounts of gluten during early childhood in genetically at-risk children.
Prof Kevin Whelan, Professor of Dietetics at King’s College London, said: “Gluten is contained in wheat, barley and rye, and so is present in breads, many breakfast cereals, pasta, cakes, pastries and biscuits.
“But wheat flour is often used as a thickening, bulking or coating agent in sauces, puddings, meat and fish products and ready meals and so gluten is widely consumed in a large variety of foods eaten by both children and adults.”
He added: “What this study tells us is that, in children genetically predisposed to develop coeliac disease, eating more gluten than average may increase the risk of developing coeliac disease.
“However, this study is only observational, so before we start giving dietary advice we need a large clinical trial to tell us whether removing gluten from the diet reduces the risk of developing coeliac disease, how strictly gluten needs to be removed from the diet and for how long.
“Certainly, any special dietary restrictions in babies and toddlers needs to be done following consultation with a doctor and a dietitian for expert advice.”