Wagenvoort C, Hopman G D, Roovers E A, Wessels M M S
Department of Pediatrics, Rijnstate Hospital, Wagnerlaan 55, Arnhem, 6815 AD, The Netherlands.
Department of Dietetics, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZG, The Netherlands.
Eur J Pediatr. 2025 Jun 23;184(7):436. doi: 10.1007/s00431-025-06257-8.
This cross-sectional study was aimed to determine the daily gluten consumption of pediatric first-degree relatives (FDRs) and compare it with the general population and the recommended daily intake used in gluten challenges. Additionally, it aimed to identify predictors of a possible lower daily gluten consumption in FDRs. Gluten consumption in FDRs was assessed using the FQ-gluten18 (a food frequency questionnaire consisting only gluten containing products), and compared with the mean gluten intake of the general Dutch population using the results of the Dutch National Food Consumption Survey (DNFCS). Multivariable linear regression analyses were performed to assess differences in daily gluten consumption between FDRs and the general population, and to identify predictors of the daily gluten consumption. Out of 159 eligible families, 58 completed the FQ-gluten18 (36%). The mean daily gluten consumption of FDRs was not significantly different from that of the general population (12.9 ± 4.8 g/day vs 12.5 ± 5.8 g/day; P = 0.603). Eleven FDRs (18.3%) did not attain the ≥ 10 g/day recommendation used in gluten challenges. Only gluten free pasta variants eaten by everyone within the household was significantly associated with a lower daily gluten consumption.
The daily gluten consumption of pediatric FDRs is similar to that of the general population. Special attention has to be paid to FDRs who are regularly consuming the gluten free pasta variants, as they are at risk of a lower gluten intake, possibly leading to an under recognition of Coeliac Disease (CD) diagnoses.
• First-degree relatives (FDRs) of coeliac patients are at increased risk of developing Coeliac Disease (CD), and adequate daily intake is essential for reliable diagnosis. • A minimum daily intake of ≥10 grams gluten per day is currently recommended during gluten challenges to ensure diagnostic accuracy for CD.
• The daily gluten consumption of pediatric FDRs is, on average, comparable to that of the general Dutch pediatric population. • Regular consumption of gluten free pasta variants by FDRs may lead to an insufficient gluten intake, possibly resulting in underdiagnosis of CD.
本横断面研究旨在确定儿科一级亲属（FDRs）的每日麸质摄入量，并将其与普通人群以及麸质激发试验中使用的推荐每日摄入量进行比较。此外，该研究旨在确定FDRs每日麸质摄入量可能较低的预测因素。使用FQ - gluten18（一种仅包含含麸质产品的食物频率问卷）评估FDRs的麸质摄入量，并通过荷兰国家食品消费调查（DNFCS）的结果与荷兰普通人群的平均麸质摄入量进行比较。进行多变量线性回归分析以评估FDRs与普通人群之间每日麸质摄入量的差异，并确定每日麸质摄入量的预测因素。在159个符合条件的家庭中，58个家庭完成了FQ - gluten18（36%）。FDRs的平均每日麸质摄入量与普通人群没有显著差异（12.9±4.8克/天对12.5±5.8克/天；P = 0.603）。11名FDRs（18.3%）未达到麸质激发试验中使用的≥10克/天的推荐量。家庭中每个人都食用的无麸质面食变体与较低的每日麸质摄入量显著相关。
儿科FDRs的每日麸质摄入量与普通人群相似。必须特别关注经常食用无麸质面食变体的FDRs，因为他们有麸质摄入量较低的风险，这可能导致乳糜泻（CD）诊断的漏诊。
• 乳糜泻患者的一级亲属（FDRs）患乳糜泻（CD）的风险增加，足够的每日摄入量对于可靠诊断至关重要。• 目前在麸质激发试验期间建议每日最低摄入≥10克麸质，以确保CD诊断的准确性。
• 儿科FDRs的平均每日麸质摄入量与荷兰普通儿科人群相当。• FDRs经常食用无麸质面食变体可能导致麸质摄入不足，可能导致CD诊断不足。
