More Diverse Early Life Diet Reduces Celiac Disease Risk

Celiac.com 09/05/2025 - Celiac disease is an autoimmune condition where eating gluten—a protein found in wheat, barley, and rye—triggers damage to the small intestine. While genetics play a role, environmental factors, particularly those in early life, are believed to influence whether someone develops the disease. This study, based on a large group of Norwegian children, examined whether a child's overall diet in their second year of life affects their likelihood of developing celiac disease later on.

Study Design and Participants

Researchers used data from the Norwegian Mother, Father and Child Cohort Study, which followed over 64,000 children born between 2002 and 2009. Dietary information was collected through questionnaires when the children were 18 months old. The study tracked each child’s health over an average period of 16 years using national health records to identify cases of celiac disease.

What Was Measured

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Two key measures were used to assess the children’s diets:

• Dietary Diversity Score (ranging from 0 to 4): This score reflected how many different types of foods—such as fruits, vegetables, grains, dairy, and proteins—a child consumed regularly.
• Healthy Eating Index (ranging from 0 to 36): This index measured the overall quality of the diet, focusing on how closely the child's eating habits aligned with established dietary guidelines.

Key Findings

By the end of the study, 1.6% of the children had been diagnosed with celiac disease. The results showed:

• Children with higher dietary diversity at 18 months had a modestly lower risk of developing celiac disease later on.
• This protective association remained significant even after accounting for genetic risk, breastfeeding, gluten intake, and infections during infancy.
• Surprisingly, the overall “healthy eating” score did not appear to influence celiac disease risk.

Possible Explanations

A more diverse diet may expose a child’s developing immune system to a wider range of food antigens, which could help train the body to tolerate different substances, including gluten. It may also influence the gut microbiome, the community of bacteria living in the digestive system, which is known to affect immune function.

Interestingly, children who experienced more infections during early life seemed to benefit even more from having a varied diet. This suggests that dietary diversity might buffer some of the risks associated with early infections—a known factor in celiac disease development.

What This Study Does Not Show

While the findings are compelling, the study cannot prove cause and effect. Because it is observational, other unmeasured factors could have influenced the results. Also, the diet assessments relied on parent-reported questionnaires, which may be subject to inaccuracies.

Furthermore, the measure of “healthy eating” used in this study focused on limiting sugar and red meat, while promoting fruits, vegetables, and whole grains. It may not fully capture other protective or harmful dietary patterns related to celiac disease.

Why This Matters for People with Celiac Disease

Although the study focused on preventing the disease rather than managing it, the results highlight the potential importance of early-life dietary habits. For families with a history of celiac disease or known genetic risk, this study suggests that encouraging a broad, varied diet in toddlers might reduce the likelihood of developing the condition.

It also opens the door for more research on how diet diversity interacts with other environmental factors like infections and gut health in shaping the immune system’s tolerance to gluten.

Conclusion

This large-scale Norwegian study found that toddlers who eat a wider variety of foods at 18 months of age are slightly less likely to develop celiac disease as they grow older. However, simply eating a diet that meets general health recommendations without being diverse does not appear to have the same effect. These findings encourage further investigation into how early-life nutrition might help prevent autoimmune diseases like celiac disease, especially for children with known risk factors.

Read more at: clinicalnutritionjournal.com