Early infant feeding and risk of developing islet autoimmunity and type 1 diabetes
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We investigated whether food supplementation within the first year life or age at introduction of gluten-containing foods influenced the risk of developing islet autoimmunity and type 1 diabetes. A total of 2,291 children with a family history of type 1 diabetes were prospectively followed from birth for 28,983 patient years (median 13.1 years). Dietary exposure data were collected by questionnaires, food records and by family interview. Exposure to gluten-containing foods before age 3 months, which occurred in 19 children, increased the risk of developing islet autoantibodies (n = 4), multiple islet autoantibodies (n = 4), and type 1 diabetes (n = 3) compared to exclusive breastfeeding within the first 3 months [adjusted hazard ratio (HR) 3.97 (95 % confidence interval 1.41–11.17), 5.39 (1.89–15.35), and 3.45 (1.04–11.48), respectively] and also compared to first exposure to gluten between 3.1 and 6.0 months of age [adjusted HR 3.40 (1.19–9.70), 4.25 (1.47–12.26), and 3.43 (1.01–11.66), respectively]. Children who received infant formula or other solid food within the first 3 months and children who received gluten-containing foods after age 6 months did not have an increased risk of islet autoantibodies, multiple islet autoantibodies or type 1 diabetes. Our present data affirm that compliance to infant feeding guidelines is a possible way to reduce type 1 diabetes risk in genetically susceptible children.
KeywordsInfant diet Islet autoimmunity Type 1 diabetes
We thank Lorenz Lachmann, Claudia Matzke, Marlon Scholz, Joanna Stock, Stephanie Krause for data collection and expert technical assistance, Ramona Puff for laboratory management. We also thank all pediatricians and family doctors in Germany for participating in the BABYDIAB and BABYDIET study. The work was supported by grants from the Kompetenznetz Diabetes mellitus (Competence Network for Diabetes mellitus) funded by the Federal Ministry of Education and Research (FKZ 01GI0805-07), the Juvenile Diabetes Research Fund (No 17-2012-16), and funding from the German Federal Ministry of Education and Research (BMBF) to the German Center for Diabetes Research (DZD e.V.).
Conflict of interest
Ruth Chmiel, Andreas Beyerlein, Annette Knopff, Sandra Hummel, Anette-G. Ziegler and Christiane Winkler declare that they have no conflict of interest.
All investigations were carried out in accordance with the principles of the Declaration of Helsinki.
Human and animal rights
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.
Informed consent was obtained from all patients for being included in the study.
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