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PLoS Med. 2020 Mar 2;17(3):e1003032. doi: 10.1371/journal.pmed.1003032. eCollection 2020 Mar.

Maternal and child gluten intake and association with type 1 diabetes: The Norwegian Mother and Child Cohort Study.

Author information

1
Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway.
2
Department of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
3
Department of Paediatrics, The Sahlgrenska Academy at University of Gothenburg and Queen Silvia Children's Hospital, Gothenburg, Sweden.
4
Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
5
Department of Paediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway.
6
KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway.
7
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
8
Department of Paediatrics, Østfold Hospital Trust, Grålum, Norway.

Abstract

BACKGROUND:

The relationship between maternal gluten intake in pregnancy, offspring intake in childhood, and offspring risk of type 1 diabetes has not been examined jointly in any studies. Our aim was to study the relationship between maternal and child intake of gluten and risk of type 1 diabetes in children.

METHODS AND FINDINGS:

We included 86,306 children in an observational nationwide cohort study, the Norwegian Mother and Child Cohort Study (MoBa), with recruitment from 1999 to 2008 and with follow-up time to April 15, 2018. We used registration of type 1 diabetes in the Norwegian childhood diabetes registry as the outcome. We used Cox proportional hazard regression to estimate hazard ratios (HRs) for the mother's intake of gluten up to week 22 of pregnancy and offspring gluten intake when the child was 18 months old. The average time followed was 12.3 years (0.70-16.0). A total of 346 children (0.4%) children were diagnosed with type 1 diabetes, resulting in an incidence rate of 32.6/100,000 person-years. Mean gluten intake per day was 13.6 g for mothers and 8.8 g for children. There was no association between the mother's intake of gluten in pregnancy and offspring type 1 diabetes, with an adjusted HR (aHR) of 1.02 (95% confidence interval [CI] 0.73-1.43, p = 0.91) for each 10-g-per-day increment. There was an association between offspring intake of gluten and a higher risk of type 1 diabetes, with an aHR of 1.46 (95% CI 1.06-2.01, p = 0.02) for each 10-g-per-day increment. Among the limitations are the likely imprecision in estimation of gluten intake and that we only had information regarding gluten intake at 2 time points in early life.

CONCLUSIONS:

Our results show that, while the mother's intake of gluten in pregnancy was not associated with type 1 diabetes, a higher intake of gluten by the child at an early age may give a higher risk of type 1 diabetes.

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