Food diaries provide answers to researchers’ questions
Food can make us ill and it can make us healthy.
“The current dietary recommendations are too general. Ideally, diets would be personalised for each individual, on the basis of a blood test taken at birth”, says Carin Andrén Aronsson, research dietician and head of unit at Skåne University Hospital.
An important part of the faculty’s major population studies is to ask participants what they eat. For many years, Carin Andrén Aronsson worked on collecting dietary information in the Malmö Diet and Cancer study (MKC) which aimed to explore the connection between diet and cancer, and the TEDDY study – the world’s largest study involving children – aimed at finding out what causes type 1 diabetes.
In both studies, MKC with 28 000 participants and TEDDY with 2526 Swedish participants, the subjects related in detail what they ate and kept food diaries. Together with blood samples and other information from the subjects, this provided researchers with valuable data resulting in new knowledge about the significance of diet for various diseases.
Now, Carin Andrén Aronsson is using the material in her own research on coeliac disease (gluten intolerance). A year or so ago, she published a research article showing that, for children found in screening to have an increased hereditary risk of coeliac disease, the more gluten they ate in the first years of life, the greater their risk of developing the disease. The finding received a great deal of media attention.
Screening for coeliac disease
Carin Andrén Aronsson is head of unit at Skåne University Hospital and coordinator of the PreCiSe study on children shown in screening to have a high genetic risk of developing coeliac disease.
“Today, we know that the disease requires a genetic predisposition in the form of particular risk genes. Without these genes, known as HLA genes, you do not get coeliac disease even if you eat food that contains gluten, i.e. bread, pasta and so on. But we don’t know what triggers the onset of the disease”, she says.
"We hope to find a method that will prevent children from getting coeliac disease at all."
About two per cent of all newborns screened in Skåne since 2018 were shown to carry the genes that entail the highest risk of getting coeliac disease. Of these children, 20 per cent will develop coeliac disease before the age of ten.
The subjects in PreCiSe are divided into three groups, one in which the children eat gluten-free food for the first three years, a second where they eat a “normal diet”, i.e. the same food that the family would have eaten anyway, with a daily supplement in the form of a capsule containing probiotics, and a third group in which the children eat a normal diet, with a daily supplement of a capsule containing a placebo (i.e. an inactive substance). After three years, all the children are allowed to eat a diet without any restrictions for a further four years.
“We hope to find a method that will prevent children from getting coeliac disease at all.”
Deciding to stop eating gluten on your own initiative is not something she recommends.
“It is not dangerous to avoid gluten, but you risk deficiencies in various nutrients normally present in foods that contain gluten: vitamins, minerals and above all dietary fibre. You might therefore need the advice of a dietician to make sure you have a complete diet.”
Text: Sara Liedholm
Facts/ About gluten
Gluten is a protein present in our most common grains; wheat, rye and barley. In some individuals, the protein causes an inflammation in the small intestine that eventually destroys the mucous membranes in the gut, preventing it from absorbing nutrients from food. A person given a diagnosis of coeliac disease today must eat a gluten-free diet for the rest of their life. An indication that the immune defence system is reacting to the gluten protein is the formation of tTG antibodies (tissue transglutaminase) in the blood.
Symptoms can vary a lot but the most common are abdominal pain, diarrhoea or constipation, vomiting and bloating. The disease can also lead to osteoporosis, infertility and depression. Children can suffer from malnourishment and delayed development due to their gut’s inability to absorb nutrients from their food.
The article above was previously published in a longer version on the website for the GPPAD research study.
CARIN ANDRÉN ARONSSON
Name: Carin Andrén Aronsson
Work: Coordinator for clinical studies focusing on coeliac disease. Unit head at the Endocrinology clinic at Skåne University Hospital responsible for staff such as research nurses, biomedical analysts and dieticians who work on studies in Malmö, Helsingborg and Kristianstad.
Education: Qualified as a dietician at Gothenburg University. Completed a PhD in 2016 with a doctoral thesis on dietary habits in early childhood and the risk of developing coeliac disease.
Leisure interests: Does a lot of yoga and loves to go skiing in the winter