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Early diet and the risk of coeliac disease. An update 2024 position paper by the ESPGHAN special interest group on coeliac disease

Szajewska, Hania ; Shamir, Raanan ; Auricchio, Renata ; Chmielewska, Anna ; Dolinsek, Jernej ; Kivelä, Laura ; Koletzko, Sibylle ; Korponay-Szabo, Ilma R. ; Af Segerstad, Elin M.Hård LU orcid and Mearin, M. Luisa , et al. (2024) In Journal of Pediatric Gastroenterology and Nutrition 79(2). p.438-445
Abstract

This position paper by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Special Interest Group on Coeliac Disease (SIG-CD) presents an update to the 2016 recommendations concerning early diet and the risk of coeliac disease (CD). This update adheres to the policy that mandates reviewing guidelines every 5 years, particularly when new data emerge. The 2024 statements and recommendations are essentially similar to the 2016 recommendations. Breastfeeding, whether any amount, exclusive, or of any duration, does not reduce the risk of developing CD. Introducing gluten into an infant's diet at any time between completed 4 months (≥17 weeks) and 12 months of age does not affect the cumulative incidence... (More)

This position paper by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Special Interest Group on Coeliac Disease (SIG-CD) presents an update to the 2016 recommendations concerning early diet and the risk of coeliac disease (CD). This update adheres to the policy that mandates reviewing guidelines every 5 years, particularly when new data emerge. The 2024 statements and recommendations are essentially similar to the 2016 recommendations. Breastfeeding, whether any amount, exclusive, or of any duration, does not reduce the risk of developing CD. Introducing gluten into an infant's diet at any time between completed 4 months (≥17 weeks) and 12 months of age does not affect the cumulative incidence of CD, although earlier introduction may lead to earlier seroconversion and CD. In observational studies involving cohorts with a known risk for CD, consuming a high amount of gluten compared to a low amount during weaning and in the subsequent childhood years—specifically the first 2–3 years, and even up to 5 years in some studies—was associated with an increased risk for CD. However, the specific optimal amounts of gluten consumption remain undetermined due to insufficient evidence on safe thresholds, and the impact of restricting gluten in the diet of healthy children of unknown risk for CD is unknown. Thus, any recommendation on the gluten amount is currently unjustifiable for the general population and infants with known HLA risk types. There is no specific guidance on the type of gluten-containing foods to be introduced at weaning.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
coeliac disease risk, gluten amount, gluten introduction, infant feeding, infant nutrition
in
Journal of Pediatric Gastroenterology and Nutrition
volume
79
issue
2
pages
8 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85195564954
  • pmid:38847232
ISSN
0277-2116
DOI
10.1002/jpn3.12280
language
English
LU publication?
yes
id
5f1ef692-8d34-4215-90ec-143378733fc0
date added to LUP
2024-09-16 11:30:50
date last changed
2025-07-08 14:49:27
@article{5f1ef692-8d34-4215-90ec-143378733fc0,
  abstract     = {{<p>This position paper by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Special Interest Group on Coeliac Disease (SIG-CD) presents an update to the 2016 recommendations concerning early diet and the risk of coeliac disease (CD). This update adheres to the policy that mandates reviewing guidelines every 5 years, particularly when new data emerge. The 2024 statements and recommendations are essentially similar to the 2016 recommendations. Breastfeeding, whether any amount, exclusive, or of any duration, does not reduce the risk of developing CD. Introducing gluten into an infant's diet at any time between completed 4 months (≥17 weeks) and 12 months of age does not affect the cumulative incidence of CD, although earlier introduction may lead to earlier seroconversion and CD. In observational studies involving cohorts with a known risk for CD, consuming a high amount of gluten compared to a low amount during weaning and in the subsequent childhood years—specifically the first 2–3 years, and even up to 5 years in some studies—was associated with an increased risk for CD. However, the specific optimal amounts of gluten consumption remain undetermined due to insufficient evidence on safe thresholds, and the impact of restricting gluten in the diet of healthy children of unknown risk for CD is unknown. Thus, any recommendation on the gluten amount is currently unjustifiable for the general population and infants with known HLA risk types. There is no specific guidance on the type of gluten-containing foods to be introduced at weaning.</p>}},
  author       = {{Szajewska, Hania and Shamir, Raanan and Auricchio, Renata and Chmielewska, Anna and Dolinsek, Jernej and Kivelä, Laura and Koletzko, Sibylle and Korponay-Szabo, Ilma R. and Af Segerstad, Elin M.Hård and Mearin, M. Luisa and Meijer-Boekel, Caroline and Konickx, Carmen Ribes and Rodriguez-Herrera, Alfonso and Stordal, Ketil and Troncone, Riccardo and Wessels, Margreet}},
  issn         = {{0277-2116}},
  keywords     = {{coeliac disease risk; gluten amount; gluten introduction; infant feeding; infant nutrition}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{438--445}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Journal of Pediatric Gastroenterology and Nutrition}},
  title        = {{Early diet and the risk of coeliac disease. An update 2024 position paper by the ESPGHAN special interest group on coeliac disease}},
  url          = {{http://dx.doi.org/10.1002/jpn3.12280}},
  doi          = {{10.1002/jpn3.12280}},
  volume       = {{79}},
  year         = {{2024}},
}