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Hård Af Segerstad, E.M.* ; Mramba, L.K.* ; Liu, X.* ; Uusitalo, U.* ; Yang, J.* ; Norris, J.M.* ; Virtanen, S.M.* ; Liu, E.* ; Kurppa, K.* ; Koletzko, S.* ; Ziegler, A.-G. ; Toppari, J.* ; Rewers, M.* ; Akolkar, B.* ; Krischer, J.P.* ; Aronsson, C.A.* ; Agardh, D.*

Associations of dietary patterns between age 9 and 24 months with risk of celiac disease autoimmunity and celiac disease among children at increased risk.

Am. J. Clin. Nutr. 118, 1099-1105 (2023)
DOI PMC
Creative Commons Lizenzvertrag
Open Access Green as soon as Postprint is submitted to ZB.
Background: Higher gluten intake in childhood is associated with increased incidence of celiac disease autoimmunity (CDA) and celiac disease. It remains to be studied whether different dietary patterns independent of gluten intake contribute to the incidence. Objectives: This study aimed to explore associations of dietary patterns by age 2 y with risk of CDA and celiac disease in genetically susceptible children. Methods: Data was used from 6726 participants at genetic risk of type 1 diabetes and celiac disease enrolled in the observational cohort, The Environmental Determinants of Diabetes in the Young (TEDDY) study. Children were annually screened for tissue transglutaminase autoantibodies (tTGAs) from age 2 y. Principal component analysis extracted dietary patterns, based on intake of 27 food groups assessed by 3-d food records at age 9 to 24 mo. The primary outcome was CDA (i.e., persistently tTGA-positive in at least 2 consecutive samples), and the secondary outcome was celiac disease. During follow-up to mean age 11.0 (standard deviation 3.6) y, 1296 (19.3%) children developed CDA, and 529 (7.9%) were diagnosed with celiac disease. Associations of adherence to dietary patterns (per 5-unit increase) with the study outcomes were estimated by Cox regression models adjusted for risk factors including gluten intake. Results: At age 9 mo, a dietary pattern higher in the food groups vegetable fats and milk was associated with reduced risk of CDA (hazard ratio [HR]: 0.88; 95% confidence interval [CI]: 0.79, 0.98; P = 0.02). At 24 mo, a dietary pattern higher in the food groups wheat, vegetable fats, and juices, and lower in milk, meat, and oats at age 24 mo was associated with increased risk of CDA (HR: 1.18; 95% CI: 1.05, 1.33; P < 0.001) and celiac disease (HR: 1.24; 95% CI: 1.03, 1.50; P = 0.03). Conclusions: Dietary patterns in early childhood are associated with risk of CDA and celiac disease in genetically predisposed children, independent of gluten intake.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Celiac Disease ; Celiac Disease Autoimmunity ; Complementary Feeding ; Dietary Patterns ; Gluten ; Hla-dq2/dq8 ; Infant Diet ; Principal Component Analysis ; Teddy; 1st Year; Food; Energy
ISSN (print) / ISBN 0002-9165
e-ISSN 1938-3207
Journal American Journal of Clinical Nutrition
Quellenangaben Volume: 118, Issue: 6, Pages: 1099-1105 Article Number: , Supplement: ,
Publisher American Society for Nutrition
Publishing Place Ste 800, 230 Park Ave, New York, Ny 10169 Usa
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Diabetes Research Type 1 (IDF)
Grants National Institute of Allergy and Infectious Diseases (NIAID)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
National Institute of Environmental Health Sciences (NIEHS)
Centers for Disease Control and Prevention (CDC)
JDRF
NIH/NCATS Clinical and Translational Science Awards to the University of Florida
University of Colorado
Swedish Research Council

National Institute of Diabetes and Digestive and Kidney diseases (NIDDK)