Currently, there is no information on the level of gluten intake for Spanish children. Recent studies have shown that the timing of gluten introduction in relation to breast-feeding as well as the amount of gluten could be related to a higher incidence of coeliac disease(Reference Ivarsson, Persson and Nyström1, Reference Norris, Barriga and Hoffenberg2). The food questionnaire estimates how frequently certain foods are eaten in a specific period of time. The aim of the present study was to develop and validate a food questionnaire for the assessment of gluten consumption of children aged 3–12 months in the Valencia area.
Information on the gluten-containing food intake of healthy children aged 3–12 months was collected prospectively, including the brand names. For the study the children were assigned to two groups: 3–6 months; 7–12 months. Information was compiled by interviewing parents to establish how and when foods other than breast milk or formula milk were introduced into their children's diet. The most-frequently-used gluten-containing food products were selected and included in the FFQ, which covered a period of 7 d. To calculate the amount of gluten in these products the vegetable protein content was multiplied by 0.8(Reference Overbeek, Uil-Dieterman, Mol, Köhler-Brands, Heymans and Mulder3). To validate the FFQ the results of this FFQ were compared with those from a 7 d food record(Reference Hopman, Kiefte-de Jong, le Cessie, Moll, Witteman, Bleeker and Mearin4). If gluten had been introduced before the study was conducted, the exact timing of introduction was recorded.
A total of 100 children were included in the study. In the age-category 3–6 months none of the thirty babies had started consuming gluten. Moreover, when asked about the timing of gluten introduction the thirty mothers with children aged between 7 and 24 months all reported that gluten had been introduced after the sixth month of life.
In the 7–12 months age-group (n 70) the most important gluten-containing food products consumed were muffins and croissants, cereals, chocolate, ready-to-eat fruit and ready-to-eat meals, biscuits, bread, pasta (macaroni, spaghetti etc.) and crumbed products. All children >9 months were consuming gluten-containing food products. In a preliminary study of the gluten intake in this group the mean gluten intake obtained from the FFQ was 2.55 mg/d.
The current amount of gluten consumed by children in Spain, and more specifically in Valencia, has been established. The variety of gluten-containing food is limited and controlled, and the mean daily gluten intake in this preliminary study is 2.55 mg/d. Moreover, the timing of gluten introduction for infants in Valencia is between 7 and 9 months of age. It has been shown previously that gluten introduction after 7 months of age in at-risk infants is associated with a higher risk of coeliac disease, i.e. 1.87 as compared with gluten introduction between 4 and 6 months (OD 1)(Reference Norris, Barriga and Hoffenberg2). It is possible that this late introduction of gluten could be related to the higher prevalence of coeliac disease observed in the Valencia area in the last 5 years.
