In contrast to opinions and research presented, a new study indicated that there is no significant association between maternal use of dietary supplements during pregnancy and celiac disease in offspring.
Celiac disease (CD) is an autoimmune disorder resulting from a reaction in the gut to gluten. Gluten is mainly found in cereals such as wheat, rye, and barley. It affects the small intestine and can cause symptoms such as abdominal pains, tiredness, and weight loss. There is a limited amount of research related to the relationship of maternal diet and celiac disease in children. However, a prospective cohort suggested that there was a positive association between the use of iron supplements during pregnancy and the development of celiac disease in offspring. Therefore, Yang et al. published a related study in the British Journal of Nutrition to investigate the association between maternal supplements such as vitamin D, n-3 fatty acids (FA) and iron (Fe) supplements during pregnancy and the increased risk for celiac disease autoimmunity (CDA) and celiac disease in children.
The Environmental Determinants of Diabetes in the Young (TEDDY) study is a longitudinal observational study of type 1 diabetes and celiac disease that took place at six clinical research centers located in Colorado, Georgia, Washington, Finland, Germany, and Sweden. The study occurred from September 2004 to February 2010 and consisted of 6627 newborn infants based on the criteria of HLA genotyping and parental consent for a 15-year follow-up study. Screening for celiac disease began at the age of two and it was found that 1136 children were diagnosed with CDA around the age of three and 409 with celiac disease at approximately four years old. Questions and characteristics investigated included: the mother’s age at delivery, whether she smoked or consumed alcohol during pregnancy, maternal education, and the mother’s use of dietary supplements and the quantity during pregnancy. A dietary supplement user was defined as anyone that took at least one supplement during pregnancy. These included vitamins, minerals, FA, Fe supplements, probiotics, and antioxidant compounds. Child characteristics included in this study were: HLA genotype, country, sex, whether the child had an intermediate family member (i.e. mother, father and/or sibling) diagnosed with celiac disease, and gestational age and birth weight at the time of delivery.
Based on the analysis of the data, it was found that factors that had a strong association with CDA or celiac disease were HLA genotype, celiac disease in intermediate relatives, sex, duration of breastfeeding, and household crowding. However, while these covariates suggested a strong association to the disease, data from the TEDDY study suggested that maternal use of vitamin D, n-3 FA, or Fe supplements during pregnancy did not increase the risk for CDA and celiac disease in their children by 6 years of age. Furthermore, it was found that the supplements were beneficial to the nutrition and health of these women, especially during their pregnancy, as women in Finland, on average, had a lower value than required of vitamin D. Similarly, the German and Swedish mothers in this study had a lower than required level of n-3 FA. Another important finding was that mothers that gave birth to children developing celiac disease were found to have different pregnancy serum cytokine (small proteins that are important for cell signaling and that regulate immune and inflammatory responses) profiles in comparison to mothers with healthy children. This proposes that the dietary supplements are perhaps not the cause of celiac disease in offspring but rather the irregular serum cytokine profile, creating a prenatal environment that may have had an impact on autoimmunity in the offspring.
This study consists of limitations such as using data that is self-reported by the participants, where some may have over or underreported. Additionally, the study was limited in terms of nutrient values from foods, as the mothers joined the study following 3 months of postpartum, where hormonal and nutrient levels could have been inaccurate. Despite these two factors, the study depicts strong and quantitative evidence to support that maternal intake of vitamin D and n-3 FA is beneficial to the nutrient recommendations for mothers in Finland, Germany, Sweden and the USA. Therefore, it can be concluded that there is no correlation between vitamin D, n-3 FA and FE and pregnancy risks for celiac disease in children, and in fact, these nutrients are more beneficial than harmful.
Written By: Seema N. Goolie, BSc