Gluten intake of toddler ‘linked to higher risk of developing type 1 diabetes’

The gluten intake of a toddler, rather than the amount consumed by the mother in pregnancy, is linked to a higher risk of the child developing type 1 diabetes, according to new research.

A study in Norway shows that a child’s intake of gluten at age 18 months is associated with a 46% increased risk of developing type 1 diabetes for each extra 10g of gluten consumed.

There was no association found between the mother’s intake of gluten during pregnancy and type 1 diabetes in her child, the authors said.

The research is being presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in Barcelona, Spain.

The findings differ from a previous study in Denmark, which suggested that a high maternal gluten intake during pregnancy increased the risk of type 1 diabetes in the child.

The authors say the existing evidence, including their study, is not enough to encourage people to avoid or reduce gluten intake.

The researchers analysed data on 86,306 children in the Norwegian Mother and Child Cohort Study born from 1999 to 2009, followed up until April 2018.

They estimated the mother’s gluten intake from a questionnaire filled in at 22 weeks pregnant and the child’s intake at 18 months from a questionnaire filled in by their parent or guardian.

The main sources of gluten were cereal and bread.

During an average follow-up of 12.3 years, 346 children (0.4%) developed type 1 diabetes.

The average gluten intake was 13.6 grams per day for mothers during pregnancy, and 8.8 grams per day for the child at 18 months.

The child’s gluten intake at 18 months was associated with an increased risk of later developing type 1 diabetes, with risk increasing by 46% for each 10g per day increase in gluten intake.

Maternal gluten intake in mid-pregnancy was not associated with the development of type 1 diabetes in the child.

The authors, including Dr Nicolai Lund-Blix, Oslo University Hospital, and the Norwegian Institute of Public Health, Oslo, said: “This study suggests that the child’s gluten intake at 18 months of age, and not the maternal intake during pregnancy, could increase the risk of type 1 diabetes in the child.

“Our observations may motivate future interventional studies with reduced gluten intake to establish whether there is a true causal association between amount of gluten intake in the child’s early diet and type 1 diabetes in susceptible individuals.”

Possible reasons for the findings could be that increased gluten intake can induce inflammation in the gut.

But they said the exact mechanism is not known and they believe the effects of gluten take place in combination with other environmental factors.

The authors added: “We need confirmation from further studies, and ideally a randomised controlled trial (RCT) to determine any relationship between gluten intake and type 1 diabetes with certainty.

“Since our findings show the highest risk of developing type 1 diabetes is in the group with the highest gluten consumption, it could be that simply reducing gluten intake would be enough to reduce risk and this is easier to achieve than complete avoidance.

“Based on experiences from patients with celiac disease, complete avoidance of gluten is hard but manageable, but this would probably not be necessary.”