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Sources of dietary gluten in the first two years of life and associations with celiac disease autoimmunity and celiac disease in Swedish genetically predisosed children: : TEDDY study

Hård af Segerstad, Elin M LU orcid ; Liu, Xiang ; Uusitalo, Ulla ; Agardh, Daniel LU and Andrén Aronsson, Carin LU orcid (2022) In The American journal of clinical nutrition 116(2). p.394-403
Abstract
Background
High gluten intake is associated with increased risk of celiac disease (CD) in children at genetic risk.

Objectives
To investigate if different dietary gluten sources up to age two years confer different risks of celiac disease autoimmunity (CDA) and CD in children at genetic risk.

Design
Three-day food records were collected at age six, nine, 12, 18 and 24 months from 2088 Swedish genetically at-risk children participating in a 15-year follow-up cohort study on type 1 diabetes and celiac disease. Screening for celiac disease was performed with tissue transglutaminase autoantibodies (tTGA). The primary outcome was CDA, defined as persistent tTGA positivity. The secondary outcome was CD, defined as... (More)
Background
High gluten intake is associated with increased risk of celiac disease (CD) in children at genetic risk.

Objectives
To investigate if different dietary gluten sources up to age two years confer different risks of celiac disease autoimmunity (CDA) and CD in children at genetic risk.

Design
Three-day food records were collected at age six, nine, 12, 18 and 24 months from 2088 Swedish genetically at-risk children participating in a 15-year follow-up cohort study on type 1 diabetes and celiac disease. Screening for celiac disease was performed with tissue transglutaminase autoantibodies (tTGA). The primary outcome was CDA, defined as persistent tTGA positivity. The secondary outcome was CD, defined as having a biopsy showing Marsh score ≥ 2 or an averaged tTGA level ≥ 100 Units. Cox regression adjusted for total gluten intake estimated hazard ratios (HR) with 95% confidence intervals (CI) for daily intake of gluten sources.

Results
During follow-up, 487 (23.3%) children developed CDA, and 242 (11.6%) developed CD. Daily intake of ≤158 g porridge at age nine months was associated with increased risk of CDA (HR 1.53, 95% CI 1.05, 2.23, P = 0.026). A high daily bread intake (>18.3 g) at age 12 months was associated with increased risk of both CDA (HR 1.47, 95% CI 1.05, 2.05, P = 0.023) and CD (HR 1.79, 95% CI 1.10, 2.91, P = 0.019). At age 18 months, milk cereal drink was associated with an increased risk of CD (HR 1.16, 95% CI 1.00, 1.33, P = 0.047) per 200 g/day increased intake. No association was found for other gluten sources up to age 24 months and risk of CDA or CD.

Conclusions
A high daily intake of bread at age 12 months and milk cereal drink during the second year in life is associated with increased risk of both celiac disease autoimmunity and celiac disease in genetically at-risk children. (Less)
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; ; ; and
author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
The American journal of clinical nutrition
volume
116
issue
2
pages
394 - 403
publisher
Oxford University Press
external identifiers
  • pmid:35394004
  • scopus:85135596944
ISSN
0002-9165
DOI
10.1093/ajcn/nqac086
language
English
LU publication?
yes
id
4cd9d9cd-a25e-41d7-8890-c6b77e4f47bc
date added to LUP
2022-05-08 16:16:27
date last changed
2022-10-06 11:12:04
@article{4cd9d9cd-a25e-41d7-8890-c6b77e4f47bc,
  abstract     = {{Background<br/>High gluten intake is associated with increased risk of celiac disease (CD) in children at genetic risk.<br/><br/>Objectives<br/>To investigate if different dietary gluten sources up to age two years confer different risks of celiac disease autoimmunity (CDA) and CD in children at genetic risk.<br/><br/>Design<br/>Three-day food records were collected at age six, nine, 12, 18 and 24 months from 2088 Swedish genetically at-risk children participating in a 15-year follow-up cohort study on type 1 diabetes and celiac disease. Screening for celiac disease was performed with tissue transglutaminase autoantibodies (tTGA). The primary outcome was CDA, defined as persistent tTGA positivity. The secondary outcome was CD, defined as having a biopsy showing Marsh score ≥ 2 or an averaged tTGA level ≥ 100 Units. Cox regression adjusted for total gluten intake estimated hazard ratios (HR) with 95% confidence intervals (CI) for daily intake of gluten sources.<br/><br/>Results<br/>During follow-up, 487 (23.3%) children developed CDA, and 242 (11.6%) developed CD. Daily intake of ≤158 g porridge at age nine months was associated with increased risk of CDA (HR 1.53, 95% CI 1.05, 2.23, P = 0.026). A high daily bread intake (&gt;18.3 g) at age 12 months was associated with increased risk of both CDA (HR 1.47, 95% CI 1.05, 2.05, P = 0.023) and CD (HR 1.79, 95% CI 1.10, 2.91, P = 0.019). At age 18 months, milk cereal drink was associated with an increased risk of CD (HR 1.16, 95% CI 1.00, 1.33, P = 0.047) per 200 g/day increased intake. No association was found for other gluten sources up to age 24 months and risk of CDA or CD.<br/><br/>Conclusions<br/>A high daily intake of bread at age 12 months and milk cereal drink during the second year in life is associated with increased risk of both celiac disease autoimmunity and celiac disease in genetically at-risk children.}},
  author       = {{Hård af Segerstad, Elin M and Liu, Xiang and Uusitalo, Ulla and Agardh, Daniel and Andrén Aronsson, Carin}},
  issn         = {{0002-9165}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{394--403}},
  publisher    = {{Oxford University Press}},
  series       = {{The American journal of clinical nutrition}},
  title        = {{Sources of dietary gluten in the first two years of life and associations with celiac disease autoimmunity and celiac disease in Swedish genetically predisosed children: : TEDDY study}},
  url          = {{http://dx.doi.org/10.1093/ajcn/nqac086}},
  doi          = {{10.1093/ajcn/nqac086}},
  volume       = {{116}},
  year         = {{2022}},
}