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

Fecha de publicación: 01/08/2024 Fecha Ahead of Print: 07/06/2024

Autores de IIS La Fe

Carmen Ribes Koninckx

Autor

Participantes ajenos a IIS La Fe

Szajewska H
Shamir R
Auricchio R
Chmielewska A
Dolinsek J
Kivelä L
Koletzko S
Korponay-Szabo IR
Af Segerstad EMH
Mearin ML
Meijer-Boekel C
Rodriguez-Herrera A
Stordal K
Troncone R
Wessels M

Grupos

Enfermedad celíaca e Inmunopatología digestiva

Investigador Principal

Carmen Ribes Koninckx
Unidad Mixta De Investigación en Nutrición de Precisión para patologías digestivas (NUTRICURA PDig)

Investigador Principal

Carmen Ribes Koninckx

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.

Datos de la publicación

ISSN/ISSNe:: 0277-2116, 1536-4801
Tipo:: Article
Páginas:: 438-445
DOI:: 10.1002/jpn3.12280
Factor de Impacto:: 0,919 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Métricas

Filiaciones

Szajewska H:: Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland
Shamir R:: Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children's Medical Center of Israel, School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
Auricchio R:: Department of Translational Medical Sciences and European Laboratory for the Investigation of Food Induced Diseases, University Federico II, Naples, Italy
Chmielewska A:: Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
Dolinsek J:: Department of Pediatrics, University Medical Center Maribor, Maribor, Slovenia
Kivelä L:: Celiac Disease Research Center, Tampere University, Tampere, Finland

Department of Pediatrics, Tampere University Hospital, Tampere, Finland

Children's Hospital, Helsinki University Hospital, Helsinki, Finland

Department of Paediatric Research, Faculty of Medicine, University of Oslo, Oslo, Norway
Koletzko S:: Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Munich, Germany

Department of Pediatrics, School of Medicine Collegium Medicum, Gastroenterology and Nutrition, University of Warmia and Mazury, Olsztyn, Poland
Korponay-Szabo IR:: Celiac Disease Center, Heim Pál National Paediatric Institute, Budapest, Hungary

Department of Paediatrics, University of Debrecen, Debrecen, Hungary
Af Segerstad EMH:: Department of Pediatric Research, Oslo University Hospital, Oslo, Norway

Unit of Celiac and Diabetes Research, Clinical Sciences Malmö, Lund university, Lund, Sweden

Department of Pediatrics, Skane University Hospital, Malmö, Sweden
Konickx CR:: Pediatric Gastroenterology, La Fe University Hospital, Instituto de Investigation Sanitaria La FE Valencia, Valencia, Spain
Rodriguez-Herrera A:: St Luke's General Hospital, University College Dublin, Dublin, Ireland
Stordal K:: Department of Paediatric Research, Faculty of Medicine, University of Oslo, Oslo, Norway

Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
Troncone R:: Department of Translational Medical Sciences and European Laboratory for the Investigation of Food Induced Diseases, University Federico II, Naples, Italy