title: Coeliac disease and gluten avoidance in New Zealand children.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Massachusetts General Hospital for Children, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Pornthep
authors.initials: P
authors.lastname: Tanpowpong
authors.forename: Tristram R
authors.initials: TR
authors.lastname: Ingham
authors.forename: Phillipa K
authors.initials: PK
authors.lastname: Lampshire
authors.forename: Franca F
authors.initials: FF
authors.lastname: Kirchberg
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Epton
authors.forename: Julian
authors.initials: J
authors.lastname: Crane
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Camargo
mesh_terms: D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy / Q000453:epidemiology*; D002648:Child; D055050:Diet, Gluten-Free / Q000706:statistics & numerical data*; D004812:Epidemiologic Methods; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007787:Lactose Intolerance / Q000178:diet therapy / Q000453:epidemiology; D008297:Male; D009520:New Zealand / Q000453:epidemiology