Can ‘early introduction’ also prevent coeliac disease?

There is a growing body of evidence that supports the early introduction of peanut-based foods to infants to prevent peanut allergies, and studies are now looking into the impact of early introduction of other main allergens. A study led by King’s College London is the first to find that introducing high doses of gluten early in a child’s life could offer protection against coeliac disease.

A total of 1,004 infants from the general population of England and Wales were enrolled in the study and were all breast-fed until they were 4 months old. They were then randomised to consume six allergenic foods: cow’s milk, hen’s egg, peanut, sesame, cod fish and wheat in addition to breast milk (intervention group), or, to continue with exclusively with breast milk until 6 months of age (control group), as recommended by UK government guidelines.

The weekly recommended dose of wheat for a child was set at 4g of wheat protein and this was usually provided as Weetabix. The families were asked to complete weekly questionnaires through to one year and then every three months until the children reached three years of age.

By age three, seven children in the control group but none of those in the Weetabix group had developed coeliac disease. While these are promising new results, given the small sample size the authors called for more studies to confirm whether early introduction of gluten is an effective strategy to prevent the development of coeliac disease.

Reference: Logan K et al. 2020. JAMA Pediatrics. DOI:10.1001/jamapediatrics.2020.2893