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Associations of Pregnancy Dietary Quality and Diversity with Childhood Celiac Disease

Hård af Segerstad, Elin M. LU orcid ; Borge, Tiril Cecilie ; Guo, Annie ; Mårild, Karl ; Stene, Lars C. ; Brantsæter, Anne Lise and Størdal, Ketil (2024) In Journal of Nutrition 154(12). p.3770-3779
Abstract

Background: High gluten and low dietary fiber in pregnancy intake is associated with an increased risk of celiac disease (CeD) in the child. Early life higher dietary quality is suggested to reduce the subsequent risk of CeD. Objectives: The aim was to investigate associations of pregnancy dietary quality and diversity with child risk of CeD. Methods: In The Norwegian Mother, Father and Child Cohort Study, 85,122 mother-child pairs had available data from a validated pregnancy food frequency questionnaire. Pregnancy dietary quality and diversity were estimated by a Pregnancy Healthy Eating Index [mean 99.3, standard deviation (SD) 9.9, range 48.8–128.3], and a Diet Diversity Score (mean 7.0, SD 1.0, range 1.6–9.8), respectively. Child... (More)

Background: High gluten and low dietary fiber in pregnancy intake is associated with an increased risk of celiac disease (CeD) in the child. Early life higher dietary quality is suggested to reduce the subsequent risk of CeD. Objectives: The aim was to investigate associations of pregnancy dietary quality and diversity with child risk of CeD. Methods: In The Norwegian Mother, Father and Child Cohort Study, 85,122 mother-child pairs had available data from a validated pregnancy food frequency questionnaire. Pregnancy dietary quality and diversity were estimated by a Pregnancy Healthy Eating Index [mean 99.3, standard deviation (SD) 9.9, range 48.8–128.3], and a Diet Diversity Score (mean 7.0, SD 1.0, range 1.6–9.8), respectively. Child CeD was captured by ≥2 diagnostic codes in the Norwegian Patient Registry. Logistic regression was used to estimate associations between pregnancy dietary quality, diversity and child CeD, adjusted for socioeconomic factors, and parents CeD [adjusted odds ratio (aOR), 95% confidence intervals (CI)]. CeD-susceptible human leukocyte antigen haplotypes (DQ2/DQ8) were present in 30,718 (45.5%). Results: Up to mean age 16.0 (SD 1.8, 12.4–19.8) y, 1363 (1.6%) children were diagnosed with CeD. Lower as well as higher pregnancy dietary quality associated with a reduced risk of CeD in the child (<5th percentile aOR = 0.67, 95% CI: 0.48, 0.93, >95th percentile aOR = 0.71, 95% CI: 0.52, 0.98, respectively, nonlinear squared term P = 0.011). Analyses on genetically susceptible children, adjustments for pregnancy iron supplementation, gluten, and dietary fiber intake, and child early life dietary quality, gluten intake and iron supplementation, supported the finding. Pregnancy dietary diversity was not associated with child CeD (aOR = 1.00, 95% CI: 0.94, 1.07/score). Conclusions: In this population-based study, lower as well as higher pregnancy dietary quality associated with a reduced risk of CeD diagnosis in the child. In contrast, no such association was observed with maternal dietary diversity.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Dietary Diversity Score, food frequency questionnaire, Healthy Eating Index, HLA DQ2 DQ8, The Norwegian Mother, Father, and Child Cohort study
in
Journal of Nutrition
volume
154
issue
12
pages
10 pages
publisher
Oxford University Press
external identifiers
  • scopus:85209561854
  • pmid:39428068
ISSN
0022-3166
DOI
10.1016/j.tjnut.2024.10.033
language
English
LU publication?
yes
id
d164f8ec-2f5e-4077-a7c3-2492c4dee064
date added to LUP
2025-01-09 11:08:10
date last changed
2025-07-11 02:38:02
@article{d164f8ec-2f5e-4077-a7c3-2492c4dee064,
  abstract     = {{<p>Background: High gluten and low dietary fiber in pregnancy intake is associated with an increased risk of celiac disease (CeD) in the child. Early life higher dietary quality is suggested to reduce the subsequent risk of CeD. Objectives: The aim was to investigate associations of pregnancy dietary quality and diversity with child risk of CeD. Methods: In The Norwegian Mother, Father and Child Cohort Study, 85,122 mother-child pairs had available data from a validated pregnancy food frequency questionnaire. Pregnancy dietary quality and diversity were estimated by a Pregnancy Healthy Eating Index [mean 99.3, standard deviation (SD) 9.9, range 48.8–128.3], and a Diet Diversity Score (mean 7.0, SD 1.0, range 1.6–9.8), respectively. Child CeD was captured by ≥2 diagnostic codes in the Norwegian Patient Registry. Logistic regression was used to estimate associations between pregnancy dietary quality, diversity and child CeD, adjusted for socioeconomic factors, and parents CeD [adjusted odds ratio (aOR), 95% confidence intervals (CI)]. CeD-susceptible human leukocyte antigen haplotypes (DQ2/DQ8) were present in 30,718 (45.5%). Results: Up to mean age 16.0 (SD 1.8, 12.4–19.8) y, 1363 (1.6%) children were diagnosed with CeD. Lower as well as higher pregnancy dietary quality associated with a reduced risk of CeD in the child (&lt;5th percentile aOR = 0.67, 95% CI: 0.48, 0.93, &gt;95th percentile aOR = 0.71, 95% CI: 0.52, 0.98, respectively, nonlinear squared term P = 0.011). Analyses on genetically susceptible children, adjustments for pregnancy iron supplementation, gluten, and dietary fiber intake, and child early life dietary quality, gluten intake and iron supplementation, supported the finding. Pregnancy dietary diversity was not associated with child CeD (aOR = 1.00, 95% CI: 0.94, 1.07/score). Conclusions: In this population-based study, lower as well as higher pregnancy dietary quality associated with a reduced risk of CeD diagnosis in the child. In contrast, no such association was observed with maternal dietary diversity.</p>}},
  author       = {{Hård af Segerstad, Elin M. and Borge, Tiril Cecilie and Guo, Annie and Mårild, Karl and Stene, Lars C. and Brantsæter, Anne Lise and Størdal, Ketil}},
  issn         = {{0022-3166}},
  keywords     = {{Dietary Diversity Score; food frequency questionnaire; Healthy Eating Index; HLA DQ2 DQ8; The Norwegian Mother, Father, and Child Cohort study}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{3770--3779}},
  publisher    = {{Oxford University Press}},
  series       = {{Journal of Nutrition}},
  title        = {{Associations of Pregnancy Dietary Quality and Diversity with Childhood Celiac Disease}},
  url          = {{http://dx.doi.org/10.1016/j.tjnut.2024.10.033}},
  doi          = {{10.1016/j.tjnut.2024.10.033}},
  volume       = {{154}},
  year         = {{2024}},
}