by EBSCO Medical Review Board

Celiac disease is a problem with the immune system. It leads to swelling and damage to the small intestine and problems absorbing nutrients. In children, it can cause problems like belly pain, nausea and vomiting, diarrhea, and irritability. It can even delay puberty and affect adult height. Risk factors include having other family members with celiac or another immune system disease.

Researchers wanted to investigate if the amount of gluten intake is associated with celiac disease autoimmunity (pre-celiac disease) and celiac disease in genetically at risk children. The study, published in JAMA, found that higher gluten intake during the first five years of life was associated with an increased risk of celiac disease autoimmunity and celiac disease among genetically predisposed children.

About the Study

The prospective observational study monitored 6,605 newborns born who had a gene that increased the risk of celiac disease. Gluten intake was estimated from 3-day food records collected at ages 6, 9, and 12 months. The intake was estimated every other year after that until participants reached the age of five. Blood tests were done every year to look for signs of pre-celiac disease. Those who had regular signs of pre-celiac had biopsies to confirm celiac disease.

During the study, 18% of the children developed pre-celiac (celiac disease autoimmunity) and 7% developed celiac disease. The incidence for both peaked at the age of 2 to 3 years. The study found that:

  • Those with a higher gluten intake had a 6.1% increased risk of celiac disease autoimmunity
  • Each additional gram of gluten eaten per day led to 7.2% increased risk of celiac disease

How Does This Affect You?

During an observational study, researchers observe events to look for potential links. They cannot determine cause and effect. This study found that there may be a connection between early gluten intake and celiac disease in children with high risk of celiac. The reason for the connection is not clear. More studies will need to be done before the connection is confirmed. Future studies should also look at which foods that contain gluten are more likely to lead to celiac disease than others.

It is important to note that the study was for infants with a genetic risk of celiac and not the general population. It is also important that the majority of participants in this study did not develop celiac disease. Talk to your doctor about your infant's nutrition and family history. If your infant is at risk for celiac disease, talk to the doctor before you consider making changes to your baby's diet. A restrictive diet can do more harm than good for your baby if it is not medically needed.


Celiac Disease Foundation 

National Institute of Diabetes and Digestive and Kidney Diseases 


Andrén Aronsson C, Lee H, et al. Association of gluten intake during the first 5 years of life with incidence of celiac disease autoimmunity and celiac disease among children at increased risk. JAMA. 2019;322(6):514-523. doi:10.1001/jama.2019.10329.

Celiac disease. EBSCO DynaMed website. Available at: . Updated July 19, 2018. Accessed August 15, 2019.

Revision Information

  • Reviewer: EBSCO Medical Review Board
  • Review Date: 08/2019