We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Early diet and the risk of coeliac disease. An update 2024 position paper by the ESPGHAN special interest group on coeliac disease.
- Authors
Szajewska, Hania; Shamir, Raanan; Auricchio, Renata; Chmielewska, Anna; Dolinsek, Jernej; Kivelä, Laura; Koletzko, Sibylle; Korponay‐Szabo, Ilma R.; Af Segerstad, Elin M Hård; Mearin, M. Luisa; Meijer‐Boekel, Caroline; Konickx, Carmen Ribes; Rodriguez‐Herrera, Alfonso; Stordal, Ketil; Troncone, Riccardo; Wessels, Margreet
- 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 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. What is Known: Previous European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) position papers have addressed the relationship between breastfeeding, gluten introduction in infants, and the risk of developing coeliac disease (CD) during childhood.There is a recognised need for an update considering new evidence. What is New: The ESPGHAN Special Interest Group on Coeliac Disease has formulated key questions concerning early feeding practices/diet and the risk of coeliac disease autoimmunity (CDA) and CD.Recommendations from previous position papers have been updated or reaffirmed based on the latest published evidence.Knowledge gaps were identified, underscoring the need for further research to better understand the impact of early feeding practices on the risk of CDA/CD.
- Publication
Journal of Pediatric Gastroenterology & Nutrition, 2024, Vol 79, Issue 2, p438
- ISSN
0277-2116
- Publication type
Article
- DOI
10.1002/jpn3.12280