Maternal fibre and gluten intake during pregnancy and risk of childhood celiac disease: the MoBa study

Nicolai A Lund-Blix,Anne Lise Brantsæter,Siddhartha Mandal,German Tapia,Merete Eggesbø,Ketil Størdal,Lars C Stene,Karl Mårild

doi:10.1038/s41598-020-73244-4

Abstract

Maternal diet can influence the developing immune system of the offspring. We hypothesized that maternal fibre and gluten intake during pregnancy were associated with the risk of celiac disease in the child. In the Norwegian Mother, Father and Child Cohort Study (MoBa, n = 85,898) higher maternal fibre intake (median 29.5 g/day) was associated with a lower risk of celiac disease in the offspring (adjusted relative risk 0.90, 95% CI 0.83 to 0.98 per 10 g/d increase). Gluten intake during pregnancy (median 13.0 g/d) was associated with a higher risk of childhood CD (adjusted relative risk = 1.21, 95% CI 1.02 to 1.43 per 10 g/d increase). These results were largely unaffected by adjustment for the child’s gluten intake at 18 months. In an independent study of 149 mother/child dyads, maternal fibre intake did not predict concentrations of total or sub-types of short-chain fatty acids in repeated infant stool samples, or fecal microbiome diversity in the mother or child. Our results suggest that high fibre and low gluten intake during pregnancy could be protective factors for celiac disease, although the mechanism is unknown.

Highlights

Maternal diet can influence the developing immune system of the offspring
Maternal gluten intake was associated with the risk of celiac disease in the offspring in adjusted continuous exposure analyses (adjusted relative risk 1.21, 95%CI 1.02–1.43 per 10 g/day increase, p = 0.031, Fig. 2a)
In categorical analyses the relative risk (RR) for Celiac disease (CD) in the highest compared to the lowest category of gluten intake was 1.41 and across centiles the P trend was 0.028

Summary

Introduction

Maternal diet can influence the developing immune system of the offspring. We hypothesized that maternal fibre and gluten intake during pregnancy were associated with the risk of celiac disease in the child. In the Norwegian Mother, Father and Child Cohort Study (MoBa, n = 85,898) higher maternal fibre intake (median 29.5 g/day) was associated with a lower risk of celiac disease in the offspring (adjusted relative risk 0.90, 95% CI 0.83 to 0.98 per 10 g/d increase). Serial screening of children at risk of CD has demonstrated that antibodies usually develop during the first years of life, often several years before clinical symptoms arise[3] This motivates the study of environmental factors that operate early in life as potential triggers for the disease. A low intake of refined cereals and sweet beverages at age 1 year has been associated with a reduced risk of celiac disease autoimmunity by age six y ears[8] This may suggest that the individual’s gluten intake and other dietary factors may modify the risk of disease. High-fibre diet has been shown to regulate the maturation of immune cells 13, protect against airway inflammation 14 and Scientific Reports | (2020) 10:16439

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