Sweden’s national food agency, Livsmedelsverket, is assessing recently-published scientific publications in order to determine whether its current advice regarding gluten introduction needs to be revised.
The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) has already changed its guidance in light of new trials – their recommendation is now the slow introduction of small amounts of gluten sometime between four and 12 months. Previously, the advice was to introduce gluten between the ages of four and seven months, in line with that of Sweden’s agency.
The changes could in theory affect the market for gluten-free baby food, which has been in rude health recently as more and more parents introduce their children to food via specialised diets.
Coeliac disease affects the digestive system causing fatigue, anaemia, and intestinal problems in the presence of gluten protein found in grains such as wheat, barley and rye. However, there is no concrete information regarding how much and how fast the amount of gluten can be increased.
The environmental trigger, or triggers, for the disease is also not yet known, something that constitutes “the most gaping of holes in our knowledge about [the] disease”, according to Euromonitor. “Researchers in the field have their theories, of course […]. Stipulated triggers include being bottle fed, having been born via caesarean section, too-early exposure to gluten during weaning, the introduction of dietary gluten too late during childhood, and exposure to antibiotics.”
Introducing gluten to a baby’s diet has long been a minefield. Past advice was based on observational studies, but since two trials published in the past two years have shown that the age at which gluten is introduced to the diet does not affect overall rates of coeliac disease during childhood.
The research suggested that “it does not matter when during the first four to 12 months food with gluten is introduced”, reads a note on the Livsmedelsverket website.
“The new research provides important knowledge about what affects the risk of gluten intolerance, an area in which we still know very little,” said Ylva Sjögren Bolin, the agency’s immunologist and nutritionist.
In a position paper outlining its decision earlier this year, ESPGHAN noted: “Gluten may be introduced into the infant's diet anytime between four and 12 completed months of age. In children at high risk for CD [coeliac disease], earlier introduction of gluten (four versus six months or six versus 12 months) is associated with earlier development of CD autoimmunity (defined as positive serology) and CD, but the cumulative incidence of each in later childhood is similar.”
Baby food boom
The changes to advice could affect the producers of baby-food. In recent years more and more parents have turned to free-from foods for their children, which has created a lucrative market for the products, not least the gluten-free category.
“More and more babies and toddlers are used to gluten-free, and mums believe that gluten-free is a better diet for their kids,” noted Mintel’s Yannick Troalen in 2014.
This demand was being fuelled not just by diagnosis of coeliac disease, but an increased consciousness of allergens among many parents. The perception that gluten-free diets are healthier has also driven sales across the board.
Baby food had a 14% share of the global gluten-free market in 2014, according to Euromonitor International, with Russia, Spain and Italy key markets.