September 20, 2018

expert reaction to research on high gluten intake during pregnancy and type 1 diabetes in children

Reactions to a study published in the BMJ that show the risk of type 1 diabetes in children increases proportionally with maternal gluten intake.

Dr Matthew Simmonds, a member of the Society for Endocrinology and Senior Lecturer in Biomedical Science at the University of Lincoln, said:

“It has been known for some time that type 1 diabetes is caused by both genetic factors and factors within the environment we encounter both whilst we develop in the womb but also as we grow throughout life.  Currently, the environmental factors that trigger onset of type 1 diabetes in people are less well known.

“This work is a really well put together study looking at the incidence of type 1 diabetes in children in a very large Danish population and whether intake of gluten by their mother during their pregnancies could be linked to future onset of type 1 diabetes in their children.  The authors have for the first time shown a potential link between gluten intake by the mother during pregnancy and the future onset of type 1 diabetes within their children.

“Whilst this study covered a third of all pregnancies that took place in Demark over a six year period and a long period of follow up, the strength of the significance of the results produced are relatively small, due in part to the low number of children developing type 1 diabetes over the follow up period.  As such these results, whilst well executed and very interesting, would need to be confirmed within independent similarly sized or bigger studies as stated by the authors themselves.

“Even if in the future this potential link between gluten intake and onset of type 1 diabetes is confirmed, this does not necessarily mean that gluten itself is causing type 1 diabetes. Further investigation into both the mother and the child’s diet over a longer time period to determine whether it is truly gluten or something else related to diet that is causing this potential link, as very well explained in the accompanying BMJ editorial for this paper.

“Overall, this study produces some interesting potential links between gluten intake during pregnancy and future onset of type 1 diabetes in children. That said, additional independent studies are needed to confirm these results, and importantly further investigation not only into the mother’s gluten intake during pregnancy but also the children’s intake of gluten as they develop.  Until such future studies, it is too early to advise pregnant mothers to change their diet, and particularly gluten intake, based purely off these initial interesting findings.”

Dr Jenny Myers, Senior Lecturer in Maternal and Fetal Health at the University of Manchester, said:

“This is another interesting study from a large, well characterised birth cohort which has demonstrated another link between maternal diet, the intrauterine environment and childhood outcomes. What we lack are mechanistic studies which can explain the biology of these observations – only then can we begin to design dietary interventions and be able to advise pregnant women properly.

“Women should not make radical changes to their diet based on this evidence – it is important during pregnancy to eat a balanced diet and there is no evidence currently that gluten should be excluded from the diet during pregnancy.”

Declared interests

Dr Symonds declares no conflicts.

No others received.