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Coeliac disease and gluten avoidance in New Zealand children
  1. Pornthep Tanpowpong1,
  2. Tristram R Ingham2,
  3. Phillipa K Lampshire2,
  4. Franca F Kirchberg3,
  5. Michael J Epton4,
  6. Julian Crane2,
  7. Carlos A Camargo Jr3 and the New Zealand Asthma and Allergy Cohort Study Group
  1. 1Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Massachusetts General Hospital for Children, Harvard Medical School, Boston, Massachusetts, USA
  2. 2Wellington Asthma Research Group, Department of Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
  3. 3Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA
  4. 4Department of Respiratory Medicine, Christchurch Hospital, Christchurch, New Zealand
  1. Correspondence to Carlos A Camargo, Department of Emergency Medicine, Massachusetts General Hospital, 326 Cambridge Street, Suite 410, Boston, Massachusetts 02114, USA; ccamargo{at}partners.org

Abstract

Objectives Although gluten avoidance is thought to be common among New Zealanders, the prevalence of gluten avoidance and of actual coeliac disease (CD) in children is uncertain. Our aims were: (1) to determine the prevalence of doctor-diagnosed CD and of gluten avoidance in New Zealand children; and (2) among children without CD, to identify independent predictors of gluten avoidance.

Design The New Zealand Asthma and Allergy Cohort Study has detailed information on participants' demographic, pregnancy-related and neonatal factors. The authors surveyed parents regarding their child's history of lactose intolerance and gluten-related issues (eg, gluten avoidance, history of wheat or gluten allergy in first degree relatives, testing and doctor diagnosis of CD). After excluding children with doctor-diagnosed CD, the authors identified independent predictors of gluten avoidance.

Results Among 916 children, most (78%) were of European ethnicity. The authors identified nine (1.0%, 95% CI 0.5% to 1.9%) who had doctor-diagnosed CD, while 48 (5.2%, 95% CI 4.0% to 6.9%) avoided gluten. Among children without diagnosed CD, significant independent predictors for gluten avoidance were Christchurch site (OR 2.2, 95% CI 1.02 to 4.7), prior testing for CD (OR 9.0, 95% CI 4.1 to 19.5) and doctor-diagnosed lactose intolerance (OR 5.2, 95% CI 2.0 to 13.9).

Conclusions CD affected 1% of these New Zealand children, but 5% reported gluten avoidance. The predictors of gluten avoidance in children without doctor-diagnosed CD suggest important regional differences in community belief or medical practice regarding implementation of gluten avoidance and the contributory role of non-specific subjective abdominal complaints.

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Footnotes

  • Funding This work was supported by grants from the Health Research Council of New Zealand, the David and Cassie Anderson Bequest (Wellington, New Zealand) and the Food Allergy & Anaphylaxis Network (Fairfax, Virginia, USA).

  • Competing interests None.

  • Ethics approval The Wellington and Canterbury Regional Ethics Committees approved the New Zealand Asthma and Allergy Cohort Study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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