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Gluten Intake in Early Childhood and Risk of Celiac Disease in Childhood: A Nationwide Cohort Study.

Journal article
Authors Nicolai A Lund-Blix
Karl Mårild
German Tapia
Jill M Norris
Lars C Stene
Ketil Størdal
Published in The American journal of gastroenterology
Volume 114
Issue 8
Pages 1299-1306
ISSN 1572-0241
Publication year 2019
Published at Institute of Clinical Sciences, Department of Pediatrics
Pages 1299-1306
Language en
Subject categories Pediatrics


Celiac disease (CD) may occur in genetically predisposed individuals exposed to gluten, but it is unclear whether the amount of gluten influences the risk of disease. We aimed at determining whether the amount of gluten intake at age 18 months predicted later risk of CD.In an observational nationwide cohort study, the Norwegian Mother and Child Cohort Study (MoBa), we included 67,608 children born during 2000-2009 and followed up for a mean of 11.5 years (range 7.5-15.5) after exclusions for missing data. Information regarding CD diagnosis was obtained from the Norwegian Patient Register 2008-2016 and from parental questionnaires at child age 7 and 8 years. We estimated gluten intake at age 18 months from a prospectively collected parental questionnaire.CD was diagnosed in 738 children (1.1%, 62% girls). The mean estimated amount of gluten in the diet at 18 months was 8.8 g/d (SD 3.6). The adjusted relative risk of CD was 1.10 (95% confidence interval 1.03-1.18) per SD increase in daily gluten amount at age 18 months. Children in the upper quartile of gluten intake compared with the lower quartile had an increased risk of CD (adjusted relative risk 1.29, 95% confidence interval 1.06-1.58). The association with gluten amount was independent of the age at introduction of gluten. Gluten introduction ≥6 months was also an independent risk factor for CD.In this nationwide study, increased gluten intake at 18 months was associated with a modestly increased risk of CD later in childhood.

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