High Fiber Intake in Pregnancy Tied to Lower Risk of Celiac Disease in Offspring

By Megan Brooks

June 14, 2019

NEW YORK (Reuters Health) - A high intake of fiber during pregnancy was associated with a decreased risk of celiac disease in children in a large population-based study from Norway. Maternal gluten intake was not associated with risk of celiac in offspring, however.

"The finding of no association with maternal gluten intake is in line with a previous multicenter study," Dr. Ketil Stordal from the Norwegian Institute of Public Health in Oslo told Reuters Health by email. "To our knowledge, maternal fiber intake in relation to pediatric celiac disease has not been studied before. The study needs replication in similar cohorts or trials before firm recommendations regarding fiber can be made."

Dr. Stordal presented the results June 7 at the annual meeting of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) in Glasgow, Scotland.

The researchers studied more than 88,000 children from The Norwegian Mother and Child Cohort Study born between 1999 through 2009. They had information on mothers' intake of fiber and gluten during pregnancy and whether their child had a clinical diagnosis of celiac disease during an average follow-up of 11 years. The average gluten intake during pregnancy was 13.6 g/day and for fiber, 31.2 g/day.

During follow-up, 1.1% of the children were diagnosed with celiac disease, nearly two-thirds of them girls.

After adjusting for relevant cofounders, there was no significant association between maternal gluten intake and celiac disease in the child (adjusted odds ratio, 1.15; 95% confidence interval, 0.96 to 1.37 per 10 g/day increase in gluten intake).

Higher fiber intake was associated with an 8% reduction in the odds of celiac disease in the offspring (aOR, 0.92; 95% CI, 0.85 to 1.00 per 10 g increase).

For women with the highest fiber intake (>45 g/day), the risk was 34% lower in comparison to the lowest fiber intake (<19 g/day). High fiber intake from fruits and vegetables, rather than from cereals, were associated with the lowest risk, according to a conference news release.

The findings were largely the same when the researchers adjusted for the child's gluten intake at 18 months.

"Our findings do not support gluten restriction for pregnant women whereas high fiber diet needs to be further studied," the researchers conclude in their abstract.

They are currently assessing whether maternal fiber intake could impact children's gut flora, as one potential mechanism to explain the findings.

Many cases of celiac disease, particularly in children, remain undiagnosed. Undiagnosed celiac disease may contribute to impaired weight gain and growth problems, delayed puberty, iron-deficiency anemia, chronic fatigue and osteoporosis.

"By providing early-detection programs for children, we can achieve earlier diagnosis and treatment, reduce the risk of future associated health complications and give children the opportunity to thrive," Tunde Koltai, chair of the Association of European Coeliac Societies (AOECS), said in the news release. "Greater public awareness and the establishment of national detection programs for early identification of pediatric celiac diseases are two steps to achieve earlier diagnoses."

The study had no specific funding and the authors have no relevant disclosures.

SOURCE: http://bit.ly/2R9XDuJ

ESPGHAN 2019.

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