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G-O002 - ASSOCIATIONS OF ADHERENCE TO DIETARY PATTERNS THE FIRST 2 YEARS OF LIFE WITH RISK OF CELIAC DISEASE AUTOIMMUNITY AND CELIAC DISEASE AMONG HIGH-RISK CHILDREN. (ID 83)
Abstract
Objectives and Study
To explore associations of adherence to dietary patterns up to age 2 years with risk of celiac disease autoimmunity (CDA) and celiac disease (CeD).
Methods
Data were retrieved from 6,677 participants enrolled in The Environmental Determinants of Diabetes in the Young (TEDDY) study, a longitudinal observational birth cohort with a 15-year follow-up on type 1 diabetes and CeD. Children were annually screened for tissue transglutaminase autoantibodies (tTGA) from age 2 years. Dietary patterns were based on intake of 27 food groups assessed by 22,410 3-day food records from age of 9 to 24 months. The primary outcome, CDA, was defined as being persistently tTGA positive confirmed in at least 2 consecutive samples. The secondary outcome, CeD, was defined as an intestinal biopsy showing Marsh >2 or having a mean level of tTGA >100 units if a biopsy was not performed. Associations of adherence to dietary patterns with the study outcomes were estimated by Cox regression models adjusted for daily gluten intake.
Results
A total of 1287 (19.3%) children developed CDA and 527 (7.9%) CeD during follow-up to mean age 11.0 years (SD 3.6). At age 9 months, a dietary pattern high in vegetable fats and milk, and low in infant formula and breastmilk was associated with reduced risk of CDA (HR 0.88, 95% CI [0.81, 0.99], P=.04, per 5-unit increase). A dietary pattern high in wheat, vegetable fats, and juices, and low in milk, meat, and oats at age 24 months, was associated with increased risk of CDA (HR 1.18, 95% CI [1.05, 1.33], P<.001) and CeD (HR 1.24, 95% CI [1.03, 1.50], P=.03, per 5-unit increase).
Conclusions
Associations between dietary patterns in the first 2 years of life and risk of CDA and CeD indicate that additional dietary factors besides the gluten amount impact disease risk in genetically predisposed children.