For children with a high inherited risk of developing celiac disease, it doesn't matter how much the most-consumed gluten porridge, bread, pasta and shallots eat. This shows a large international study in which even children from Scandinavia were observed until they were fifteen years old.
Already small amounts of gluten, corresponding to one slice of white bread a day, increased the risk of autoimmune celiac disease that causes inflammation of the small intestine.
– Daily gluten intake of more than 2 grams when two-year-old children were associated with a 75% increase in celiac disease risk, says Carin Andrén Aronsson, a dietitian from Lund University and the lead author of the research article.
When young children start eating the same foods as the rest of the family, they gain more gluten. Protein is found in all foods that include wheat, rye and barley, such as bread, porridge, pizza, and pasta.
The study includes just over 6,600 children who have a combination of genes that is associated with an increased risk of developing celiac disease, as seen in the so-called Teddy study. It was launched in 2004 and is being implemented in Sweden (Skane), Finland, Germany and the USA.
– This is the largest study so far, and the unique is that it was carried out in four countries in the same way in children with risk genes. This increases credibility, and you also keep a diary of what children ate, instead of just asking later, says Daniel Agardh, who is studying celiac disease at the University of Lund and is responsible for the study.
The children were selected at birth on the basis of blood tests, and the diet was followed for five years. The results, when the group's average age is now 9 years, confirm previous suspicions: high gluten intake in the early years increases the risk of developing celiac disease or celiac precursors.
In the Western white world, a relatively high percentage of one of the genes at risk for developing gluten intolerance is around 30-40 percent. But most of them still don't have celiac disease, even though they all get gluten in their childhood, says Daniel Agardh.
– Research results are a puzzle that identifies which factors cause celiac disease. He says it is a combination of hereditary factors and the environment.
– Is this infection combined with high gluten intake an inflammatory spark?
This will be the next step in research collaboration. The study analyzed real relationships in a large group, but showed no causal relationships.
In Sweden, which has one of the highest incidence rates in the world, the percentage of gluten intolerance in the population is 2-3 percent. Here, the habit of giving young children gruel and porridge has been the subject of discussion for years. In Teddy's study, more Swedish children also developed celiac disease.
But also in other countries there is an increased prevalence, for example in the United States and India.
– Maybe it happened because it became more common, but also because of increased awareness of the problem and more tests being carried out. Celiac disease is found mainly in countries where wheat is consumed, says Daniel Agardh.
Can you check if it's flour, pasta, white bread or anything else in your kids' diet is more risky? It is also something that should continue the study.
Daniel Agardh and Carin Andrén Aronsson do not want to give any general diet advice.
– This is the task of the Swedish Food Agency. And I'd like to point out that two-thirds of the population have no risk genes, and only a few carriers develop celiac disease, says Daniel Agardh.
– But removing wheat and rye from your diet means losing important minerals and vitamins that are difficult to cover with a gluten-free diet. If you can eat gluten, you should do it, says Carin Andrén Aronsson.
An autoimmune disease in which the immune system attacks its own body. This means that you cannot tolerate protein gluten found in wheat, rye and barley. The small intestine is inflamed and cannot properly absorb nutrients.
The most common symptoms are diarrhea, stomach gas, fatigue and weight loss.
In countries with a predominantly white population, about 1 percent have celiac disease, but the disease is currently being reported from around the world.