PuSH - Publication Server of Helmholtz Zentrum München

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

Longitudinal micronutrient exposure reveals country-specific associations with risk of celiac disease in genetically susceptible children: The prospective TEDDY cohort: Nutrient intake and risk of celiac disease.

Am. J. Clin. Nutr. 123:101276 (2026)
Postprint Research data DOI PMC
Open Access Green
BACKGROUND: The role of nutrient intake in celiac disease pathogenesis is poorly understood. OBJECTIVE: To examine whether longitudinal childhood intake of selected vitamins and minerals is associated with celiac disease autoimmunity (CDA, primary outcome) and celiac disease (secondary outcome) in genetically at-risk children. METHODS: A total of 6,520 HLA-conferred at-risk children in the observational TEDDY study were prospectively screened for tissue transglutaminase autoantibodies (tTGA) annually from ages 2 to 13 years. CDA was defined as persistent tTGA positivity in two samples ≥3 months apart. Celiac disease was defined by biopsy-confirmed Marsh score ≥2 or mean tTGA ≥100 U/mL in two consecutive samples. Micronutrient intake was assessed via repeated 3-day food records, and adjusted hazard ratios (HRs) were estimated using time-dependent Cox proportional hazards and Bayesian joint models. RESULTS: Out of 6,520 children, 1,268 (19%) developed CDA and 479 (7.8%) were diagnosed with celiac disease. Results from both models suggested heterogeneity in associations by country as nutrients such as folate showing sporadic associations in the same or opposite direction across ages. Higher vitamin D intake (every 5 μg/1000 kcal) at multiple ages was associated with increased risk of CDA and celiac disease in Sweden, with the strongest at age 5 years for CDA (HR: 1.23, 95%CI: 1.11, 1.37; p<0.001) and at age 4 years for celiac disease (HR: 1.20, 95%CI: 1.03, 1.40; p=0.021). Higher iron intake (every 5 mg/1000 kcal) was also associated with increased risks of CDA and celiac disease in Sweden, with the highest observed up to age 5 years (HR: 1.70, 95%CI: 1.39, 2.08; p<0.001 for CDA and HR:1.80, 95%CI: 1.37, 2.36; p<0.001 for celiac disease). CONCLUSIONS: Modest country-specific associations were found between childhood micronutrient intake with the risk of CDA and celiac disease, potentially reflecting influence from regional dietary practices, fortification policies, and host factors in disease pathogenesis.
Altmetric
Additional Metrics?
[➜Log in]
Edit extra informations Login
Publication type Article: Journal article
Document type Scientific Article
Keywords Celiac Disease ; Children ; Iron ; Nutrient Intake ; Supplement ; Vitamin D; Environmental Determinants; Iron Supplementation; Vitamin-d; Young; Pregnancy; Infants
ISSN (print) / ISBN 0002-9165
e-ISSN 1938-3207
Journal American Journal of Clinical Nutrition
Quellenangaben Volume: 123, Issue: 5, Pages: , Article Number: 101276 Supplement: ,
Publisher American Society for Nutrition
Publishing Place Ste 800, 230 Park Ave, New York, Ny 10169 Usa
Reviewing status Peer reviewed
Institute(s) Institute of Diabetes Research (IDF)
Grants Breakthrough T1D
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)
NIH/NCATS Clinical and Translational Science Awards to the University of Florida
University of Colorado
National Institute of Diabetes and Digestive and Kidney diseases (NIDDK)