Wednesday, August 01, 2012

When is it Safe to Introduce Gluten to an Infant


It has always bothered me that research concerning introducing gluten to infants cited 4 months as a time to begin. It never rang true for me that it would be a good idea to introduce a potentially toxic substance to such a young body when the immune system isn’t at full strength and the liver doesn’t have its full detoxification abilities engaged.

Fortunately I found some new research to support my ‘gut’ reaction on this topic. Just a few months ago, March 2012, several researchers from the United States and Italy published a study titled “Proof of concept of microbiome-metabolome analysis and delayed gluten exposure on celiac disease autoimmunity in genetically at-risk infants”. While the title is a mouthful, the results are easy to understand. This study can be found in PLoS One, an open access peer-reviewed scientific journal published by the Public Library of Science (PLoS).

Thirty infants were part of this study and each had the genetic markers that showed susceptibility to celiac disease. All infants were breastfed for the first 6 months of life and then they were put into two separate groups. The first group was exposed to gluten beginning at 6 months while the second group received no gluten until 12 months of age.

The researchers analyzed the types of bacteria that made up the microbiome or population of good bacteria contained in the gut. The techniques they used were very sophisticated in that they revealed the DNA make-up of the various species present.

All the children were tracked until they were two years of age.
There was a profound difference in the population of bacteria found in the two groups of infants. It was so much better and healthier in the group that did not receive early exposure to gluten that the researchers concluded that a benefit could be derived from delaying gluten exposure until at least 12 months of age. Perhaps another study will be done to see if waiting until 18 months or even 24 months would provide greater benefit.

The reason for the difference in bacterial health is not known at this time, although it could have something to do with the maturity of the digestive tract as time passes.

We know that abundant and strong good bacteria actually have the ability to keep ‘bad’ genes, such as those that cause celiac disease, turned off. If early exposure to gluten so weakens the good bacteria present that they cannot prevent bad gene expression, this study could be a landmark that will forever change the way our infant population is fed.

More research will tell, but in the meantime I will hold to my recommendation of waiting minimally a year, if not two, before introducing gluten to an at-risk infant. Also appreciate that this was a celiac-prone population. We have yet to get information on how this might relate to that greater population suffering from gluten sensitivity.

Have you had any experience with at-risk babies and introducing gluten? I’d love to hear from you.
If you have questions or would like a free health analysis, please give me a call – 408-733-0400. Awareness of gluten intolerance needs to be raised dramatically and I am committed to do so.


To your good health,
Dr Vikki Petersen, DC, CCN
Author of “The Gluten Effect”
Co-author of the e-Book: “Gluten Intolerance – What you don’t know may be killing you!”
Reference:
“Proof of concept of microbiome-metabolome analysis and delayed gluten exposure on celiac disease autoimmunity in genetically at-risk infants”. M. Sellitto, G. Bai, G. Serena, W.F. Frickle, C. Sturgeon, P. Gajer, J.R. White, S.S. Koenig, J. Sakamoto, D. Boothe, R. Gicquelais, D. Kryszak, E. Puppa, C. Catassi, J. Ravel, A. Fasano, PLoS One. 2012/7(3):e33387. 

2 comments:

Keith Grimaldi said...

Regarding the timing of gluten introduction, what evidence there is points towards a 4-6 month window as the ideal time. This might seem too early - but there is something else to consider. The immune system is extremely complex, the first few months of life are important for the development and refinement of the "self" vs. "non-self" recognition. It's interesting that the HLA genes involved function as antigen presenting proteins. One hypothesis to explain the findings regarding 4-6 months is that it increases the chances of gliadin peptides being recognised by the immune system as innocuous and so reduces the chances of developing an autoimmune reaction and eventually celiac disease.

The cited study is interesting, but i find it strange that in the trial the two time points were 6m and 12m so when the full trial is over, it won't inform us about the effectiveness of the 4-6m window of introduction. There are some other clinical trials (eg www.preventcd.com) that a looking at this.

I agree with you that it is a difficult subject, hopefully in a few years we will have better evidence one way or another

Amy Martinez said...

I followed my children's previous pediatrician's advice and started my children on rice cereal at 4 months. How I wish I had not done so.

My three kids, ages 4, almost 3 and 20 months, have all had their "gluten sensitive" genes turned on. My 20 month old son was affected the worst. Thankfully I discovered they are gluten sensitive and made the necessary diet adjustments for them.

Pediatricians really need to be schooled on this topic of gluten sensitivity ASAP and not tell parents to give cereals such as rice and oatmeal to infants at 4 and 6 months of age.