title: Maternal use of dietary supplements during pregnancy is not associated with coeliac disease in the offspring: The Environmental Determinants of Diabetes in the Young (TEDDY) study.
abstract: Perinatal exposure to nutrients and dietary components may affect the risk for coeliac disease (CD). We investigated the association between maternal use of vitamin D, n-3 fatty acids (FA) and Fe supplements during pregnancy and risk for CD autoimmunity (CDA) and CD in the offspring. Children at increased genetic risk were prospectively followed from birth in The Environmental Determinants of Diabetes in the Young (TEDDY) study. CDA was defined as having persistently positive tissue transglutaminase autoantibodies (tTGA). Diagnosis of CD was either biopsy-confirmed or considered likely if having persistently elevated levels of tTGA>100 AU. Of 6627 enrolled children, 1136 developed CDA at a median 3·1 years of age (range 0·9-10) and 409 developed CD at a median 3·9 years of age (range 1·2-11). Use of supplements containing vitamin D, n-3 FA and Fe was recalled by 66, 17 and 94 % of mothers, respectively, at 3-4 months postpartum. The mean cumulative intake over the entire pregnancy was 2014 μg vitamin D (sd 2045 μg), 111 g n-3 FA (sd 303 g) and 8806 mg Fe (sd 7017 mg). After adjusting for country, child's human leucocyte antigen genotype, sex, family history of CD, any breast-feeding duration and household crowding, Cox's proportional hazard ratios did not suggest a statistically significant association between the intake of vitamin D, n-3 FA or Fe, and risk for CDA or CD. Dietary supplementation during pregnancy may help boost nutrient intake, but it is not likely to modify the risk for the disease in the offspring.
authors.affiliation: 1Health Informatics Institute,Morsani College of Medicine,University of South Florida,Tampa,FL 33612,USA.
authors.forename: Jimin
authors.initials: J
authors.lastname: Yang
authors.affiliation: 1Health Informatics Institute,Morsani College of Medicine,University of South Florida,Tampa,FL 33612,USA.
authors.forename: Roy N
authors.initials: RN
authors.lastname: Tamura
authors.affiliation: 2The Diabetes and Celiac Disease Unit,Department of Clinical Sciences,Lund University,20502 Malmö,Sweden.
authors.forename: Carin A
authors.initials: CA
authors.lastname: Aronsson
authors.affiliation: 1Health Informatics Institute,Morsani College of Medicine,University of South Florida,Tampa,FL 33612,USA.
authors.forename: Ulla M
authors.initials: UM
authors.lastname: Uusitalo
authors.affiliation: 2The Diabetes and Celiac Disease Unit,Department of Clinical Sciences,Lund University,20502 Malmö,Sweden.
authors.forename: Åke
authors.initials: Å
authors.lastname: Lernmark
authors.affiliation: 3Barbara Davis Center for Childhood Diabetes,University of Colorado School of Medicine,Aurora,CO 80045,USA.
authors.forename: Marian
authors.initials: M
authors.lastname: Rewers
authors.affiliation: 4Pacific Northwest Diabetes Research Institute,Seattle,WA 98122,USA.
authors.forename: William A
authors.initials: WA
authors.lastname: Hagopian
authors.affiliation: 5Center for Biotechnology and Genomic Medicine,Augusta University,Augusta,GA 30912,USA.
authors.forename: Jin-Xiong
authors.initials: JX
authors.lastname: She
authors.affiliation: 6Department of Physiology,Institute of Biomedicine,University of Turku,20014 Turku,Finland.
authors.forename: Jorma
authors.initials: J
authors.lastname: Toppari
authors.affiliation: 8Institute of Diabetes Research,Helmholtz Zentrum München and Klinikum rechts der Isar,Technische Universität München, and Forschergruppe Diabetes e.V.,80804 Neuherberg,Germany.
authors.forename: Anette G
authors.initials: AG
authors.lastname: Ziegler
authors.affiliation: 9National Institute of Diabetes and Digestive and Kidney Diseases,National Institutes of Health,Bethesda,MA 20892,USA.
authors.forename: Beena
authors.initials: B
authors.lastname: Akolkar
authors.affiliation: 1Health Informatics Institute,Morsani College of Medicine,University of South Florida,Tampa,FL 33612,USA.
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Krischer
authors.affiliation: 10Department of Epidemiology,Colorado School of Public Health,University of Colorado Anschutz Medical Campus,Aurora,CO 80045,USA.
authors.forename: Jill M
authors.initials: JM
authors.lastname: Norris
authors.affiliation: 11Unit of Nutrition,National Institute for Health and Welfare,00300 Helsinki,Finland.
authors.forename: Suvi M
authors.initials: SM
authors.lastname: Virtanen
authors.affiliation: 2The Diabetes and Celiac Disease Unit,Department of Clinical Sciences,Lund University,20502 Malmö,Sweden.
authors.forename: Daniel
authors.initials: D
authors.lastname: Agardh
mesh_terms: D015551:Autoimmunity; D002446:Celiac Disease / Q000209:etiology; D002648:Child; D019587:Dietary Supplements / Q000009:adverse effects; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007501:Iron / Q000494:pharmacology*; D008297:Male; D018977:Micronutrients / Q000494:pharmacology*; D011247:Pregnancy; D039401:Prenatal Nutritional Physiological Phenomena; D016016:Proportional Hazards Models; D014807:Vitamin D / Q000494:pharmacology*
chemical_list: D015525:Fatty Acids, Omega-3; D018977:Micronutrients; D014807:Vitamin D; D007501:Iron
keywords:  CDA coeliac disease autoimmunity;  FA fatty acids;  HLA human leucocyte antigen;  HR hazard ratio;  TEDDY The Environmental Determinants of Diabetes in the Young;  tTGA tissue transglutaminase antibodies; Coeliac disease; Dietary supplements; Maternal consumption; Offspring