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Associations of early life dietary diversity and healthy eating with celiac disease : A prospective cohort study

Af Segerstad, Elin M Hård LU orcid ; Guo, Annie ; Mårild, Karl ; Stene, Lars C ; Brantsæter, Anne Lise and Størdal, Ketil (2025) In Clinical Nutrition 52. p.171-178
Abstract

BACKGROUND & AIMS: The role of early-life overall diet in celiac disease risk is not well explored. The aim was to investigate associations of dietary diversity, and healthy eating in the second year of life with subsequent celiac disease risk.

METHODS: In 64,315 children born 2002-2009 with available data in the Mother, Father and Child Cohort Study, a Dietary Diversity Score (0-4) and Healthy Eating Index (0-36) were calculated using questionnaire data collected at age 18 months. The outcome was celiac disease diagnosis in the nationwide patient registry. Associations of dietary diversity and healthy eating per standard deviation (SD) increase with celiac disease risk were estimated as adjusted odds ratios (aOR) using... (More)

BACKGROUND & AIMS: The role of early-life overall diet in celiac disease risk is not well explored. The aim was to investigate associations of dietary diversity, and healthy eating in the second year of life with subsequent celiac disease risk.

METHODS: In 64,315 children born 2002-2009 with available data in the Mother, Father and Child Cohort Study, a Dietary Diversity Score (0-4) and Healthy Eating Index (0-36) were calculated using questionnaire data collected at age 18 months. The outcome was celiac disease diagnosis in the nationwide patient registry. Associations of dietary diversity and healthy eating per standard deviation (SD) increase with celiac disease risk were estimated as adjusted odds ratios (aOR) using logistic regression, accounting for maternal pregnancy smoking and gluten intake, parent's celiac disease, early-life infections, and gluten intake. Data on celiac disease-associated human leukocyte antigen (HLA) haplotypes were available in 50,383 children (78.3 %) RESULTS: After a mean of 16.1 (SD 1.8) years of follow-up, 1041 (1.6 %) children were diagnosed with celiac disease. At age 18 months, the mean Dietary Diversity Score was 2.3 (SD 0.4) and mean Healthy Eating Index 24.9 (SD 3.6). Higher dietary diversity was associated with a lower subsequent celiac disease risk (aOR 0.91, 95 %CI = 0.85-0.98). The association remained in children with HLA risk haplotypes, and when additionally adjusting for potential confounders, including breastfeeding. Healthy eating was not associated with celiac disease (aOR 1.03, 95 %CI = 0.96-1.10).

CONCLUSIONS: In this population-based study, child dietary diversity in the second year of life (but not healthy eating) was associated with a modestly reduced risk of celiac disease.

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author
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author collaboration
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publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical Nutrition
volume
52
pages
171 - 178
publisher
Elsevier
external identifiers
  • pmid:40780128
  • scopus:105012517398
ISSN
1532-1983
DOI
10.1016/j.clnu.2025.07.012
language
English
LU publication?
yes
additional info
Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.
id
2d1cb432-db62-4042-872c-70e5a2a0ab01
date added to LUP
2025-08-18 23:10:59
date last changed
2025-10-14 12:48:22
@article{2d1cb432-db62-4042-872c-70e5a2a0ab01,
  abstract     = {{<p>BACKGROUND &amp; AIMS: The role of early-life overall diet in celiac disease risk is not well explored. The aim was to investigate associations of dietary diversity, and healthy eating in the second year of life with subsequent celiac disease risk.</p><p>METHODS: In 64,315 children born 2002-2009 with available data in the Mother, Father and Child Cohort Study, a Dietary Diversity Score (0-4) and Healthy Eating Index (0-36) were calculated using questionnaire data collected at age 18 months. The outcome was celiac disease diagnosis in the nationwide patient registry. Associations of dietary diversity and healthy eating per standard deviation (SD) increase with celiac disease risk were estimated as adjusted odds ratios (aOR) using logistic regression, accounting for maternal pregnancy smoking and gluten intake, parent's celiac disease, early-life infections, and gluten intake. Data on celiac disease-associated human leukocyte antigen (HLA) haplotypes were available in 50,383 children (78.3 %) RESULTS: After a mean of 16.1 (SD 1.8) years of follow-up, 1041 (1.6 %) children were diagnosed with celiac disease. At age 18 months, the mean Dietary Diversity Score was 2.3 (SD 0.4) and mean Healthy Eating Index 24.9 (SD 3.6). Higher dietary diversity was associated with a lower subsequent celiac disease risk (aOR 0.91, 95 %CI = 0.85-0.98). The association remained in children with HLA risk haplotypes, and when additionally adjusting for potential confounders, including breastfeeding. Healthy eating was not associated with celiac disease (aOR 1.03, 95 %CI = 0.96-1.10).</p><p>CONCLUSIONS: In this population-based study, child dietary diversity in the second year of life (but not healthy eating) was associated with a modestly reduced risk of celiac disease.</p>}},
  author       = {{Af Segerstad, Elin M Hård and Guo, Annie and Mårild, Karl and Stene, Lars C and Brantsæter, Anne Lise and Størdal, Ketil}},
  issn         = {{1532-1983}},
  language     = {{eng}},
  pages        = {{171--178}},
  publisher    = {{Elsevier}},
  series       = {{Clinical Nutrition}},
  title        = {{Associations of early life dietary diversity and healthy eating with celiac disease : A prospective cohort study}},
  url          = {{http://dx.doi.org/10.1016/j.clnu.2025.07.012}},
  doi          = {{10.1016/j.clnu.2025.07.012}},
  volume       = {{52}},
  year         = {{2025}},
}