Diverse Early-Life Diet Linked to Lower Celiac Disease Risk

TOPLINE:

Greater food variety in a child’s second year of life — but not healthy eating — was linked to a reduced subsequent risk for celiac disease.

METHODOLOGY:

• Researchers analysed data from an observational, longitudinal, population-based cohort study in Norway to examine associations between dietary diversity and healthy eating in the second year of life and the subsequent risk for celiac disease.
• Pregnant women were invited to participate between 1999 and 2008, and dietary data of toddlers were collected from their caregivers at 18 months of age.
• They used the dietary diversity score (0-4) to assess variation in dietary intake and the Healthy Eating Index (0-36) to assess children’s diet quality, with higher scores indicating more varied diets and healthier foods, respectively.
• The diagnosis of celiac disease was on the basis of registry data and responses to questionnaires collected at ages 7 and 8 years regarding the presence of celiac disease.

TAKEAWAY:

• Of 64,536 children followed up to a mean age of 16.1 years, 1033 (1.6%; 60.4% girls) were diagnosed with celiac disease (mean age at diagnosis, 8.6 years).
• Higher dietary diversity at 18 months of age was associated with a lower subsequent risk for celiac disease (adjusted odds ratio per SD increase, 0.91; 95% CI, 0.85-0.98) after adjusting for gluten intake, iron supplementation, and early-life infections.
• No significant association was found between healthy eating and the subsequent risk for celiac disease.

IN PRACTICE:

“These findings may indicate an interplay between the variation of the diet, gluten amounts, and infections as part of the celiac disease exposome that should be further investigated,” the authors wrote.

SOURCE:

This study was led by Elin M. Hård af Segerstad, PhD, Department of Pediatric Research, Oslo University Hospital, Oslo, Norway. It was published online on July 16, 2025, in Clinical Nutrition.

LIMITATIONS:

The 18-month dietary questionnaire provided limited and variable detail across food groups. Levels of food processing and saturated fat intake were not considered. Participant selection was skewed towards more educated women with healthier eating habits, potentially introducing bias.

DISCLOSURES:

This study was supported by the European Union’s Horizon 2020 Research and Innovation Program. One author was supported by the South East Norway Health Authorities. The cohort study was supported by the Norwegian Ministry of Health and Care Services and the Ministry of Education and Research. The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.