Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Diabetologia
Published in: Diabetologia 7/2006

01-07-2006 | Article

Age at introduction of new foods and advanced beta cell autoimmunity in young children with HLA-conferred susceptibility to type 1 diabetes

Authors: S. M. Virtanen, M. G. Kenward, M. Erkkola, S. Kautiainen, C. Kronberg-Kippilä, T. Hakulinen, S. Ahonen, L. Uusitalo, S. Niinistö, R. Veijola, O. Simell, J. Ilonen, M. Knip

Published in: Diabetologia | Issue 7/2006

Login to get access

Abstract

Aims/hypothesis

Evidence for the role of infant feeding in the development of beta cell autoimmunity is inconsistent. We set out to study the effects of breastfeeding and of age at introduction of supplementary foods on the development of beta cell autoimmunity.

Subjects and methods

A prospective birth cohort of 3,565 infants with HLA-DQB1-conferred susceptibility to type 1 diabetes was recruited between 1996 and 2001 from two university hospital areas in Finland. Blood samples were collected at 3- to 12-month intervals to measure antibodies against islet cells, insulin, glutamate dehydroxylase and islet antigen 2. The families kept a record on the age at introduction of new foods, and for each visit completed a structured dietary questionnaire. The endpoint was repeated positivity for islet cell antibodies together with at least one of the other three antibodies.

Results

The overall or exclusive duration of breastfeeding was not associated with the risk of developing the endpoint. An early age at introduction of fruits and berries (≤4 months) was related to increased risk of developing positivity for the endpoint (hazard ratio [95% CI] for earliest tertile 2.02 [1.03–3.95] and for midtertile 1.97 [1.06–3.64] compared with latest tertile >4 months). Also, introducing roots between 3 and 3.9 months (midtertile) was related to increased risk of the endpoint (hazard ratio [95% CI] for the earliest tertile 1.04 [0.57–1.90] and for midtertile 1.82 [1.19–2.79] compared with latest tertile). These associations were independent of several putative socio-demographic and perinatal confounding factors.

Conclusions/interpretation

Our findings suggest that an early age at introduction of fruits and berries and roots associates independently with beta cell autoimmunity, contradicting earlier findings from smaller birth cohort studies.
Literature
1.
Virtanen SM, Knip M (2003) Nutritional risk predictors of β cell autoimmunity and type 1 diabetes at young age. Am J Clin Nutr 78:1053–1067PubMed
2.
Norris JM, Barriga K, Klingensmith G et al (2003) Timing of initial cereal exposure in infancy and risk of islet autoimmunity. JAMA 290:1713–1720CrossRefPubMed
3.
Ziegler AG, Schmid S, Huber D, Hummel M, Bonifacio E (2003) Early infant feeding and risk of developing type 1 diabetes-associated autoantibodies. JAMA 290:1721–1728CrossRefPubMed
4.
Kimpimäki T, Erkkola M, Korhonen S et al (2001) Short-term exclusive breastfeeding predisposes young children with increased genetic risk of type I diabetes to progressive β cell autoimmunity. Diabetologia 44:63–69CrossRefPubMed
5.
Borch-Johnsen K, Mandrup-Poulsen T, Zachau-Christiansen B et al (1984) Relation between breastfeeding and incidence rates of insulin-dependent diabetes mellitus. Lancet ii:1083–1086CrossRef
6.
7.
Bingley PJ, Bonifacio E, Williams AJK, Genovese S, Bottazzo GF, Gale EAM (1997) Prediction of IDDM in the general populations: strategies based on combinations of autoantibody markers. Diabetes 46:1701–1710PubMedCrossRef
8.
LaGasse JM, Brantley MS, Leech NJ et al (2002) Successful prospective prediction of type 1 diabetes in schoolchildren by multiple defined autoantibodies: eight year follow-up of the Washington State Diabetes Prediction Study. Diabetes Care 25:505–511PubMedCrossRef
9.
Kupila A, Muona P, Simell T et al (2001) Feasibility of genetic and immunological prediction of type I diabetes in a population-based birth cohort. Diabetologia 44:290–297CrossRefPubMed
10.
Ilonen J, Reijonen H, Herva E et al (1996) Rapid HLA-DQB1 genotyping for four alleles in the assessment of risk for IDDM in the Finnish population. Diabetes Care 19:795–800PubMedCrossRef
11.
Bottazzo GF, Florin-Christensen A, Doniach D (1974) Islet-cell antibodies in diabetes mellitus with autoimmune polyendocrine deficiencies. Lancet ii:1279–1282CrossRef
12.
Greenbaum CJ, Palmer JP, Nagataki S et al (1992) Improved specificity of ICA assay in the fourth international immunology of diabetes serum exchange workshop. Diabetes 41:1570–1574PubMedCrossRef
13.
Ronkainen M, Hämäläinen A-M, Koskela P, Åkerblom HK, Knip M, the Finnish TRIGR Study Group (2001) Pregnancy induces non-immunoglobulin insulin-binding activity in both maternal and cord blood serum. Clin Exp Immunol 124:131–136CrossRef
14.
Williams AJK, Bingley PJ, Bonifacio E, Palmer JP, Gale EAM (1997) A novel micro-assay for insulin autoantibodies. J Autoimmun 10:473–478CrossRefPubMed
15.
Savola K, Sabbah E, Kulmala P, Vähäsalo P, Ilonen J, Knip M (1998) Autoantibodies associated with type 1 diabetes mellitus persist after diagnosis in children. Diabetologia 41:1293–1297CrossRefPubMed
16.
Savola K, Bonifacio E, Sabbah E et al (1998) IA-2 antibodies-a sensitive marker of IDDM with clinical onset in childhood and adolescence. Diabetologia 41:424–429CrossRefPubMed
17.
Hämäläinen A-M, Ronkainen MS, Åkerblom HK, Knip M, the Finnish TRIGR Study Group (2000) Postnatal elimination of transplacentally acquired disease-associated antibodies in infants born to families with type 1 diabetes. J Clin Endocrinol Metab 85:4249–4253CrossRefPubMed
18.
Knip M (2002) Natural course of preclinical type 1 diabetes. Horm Res 57 [Suppl]:6–11CrossRef
19.
Vaarala O (1999) Gut and induction of immune tolerance in type 1 diabetes. Diabetes Metab Rev 15:353–361CrossRef
20.
North K, Emmett P, Noble S, the ALSPAC Study Team (2000) Types of drinks consumed by infants at 4 and 8 months of age: sociodemographic variations. J Hum Nutr Diet 13:71–82CrossRef
21.
Dubois L, Girard M (2003) Social inequalities in infant feeding during the first year of life. The Longitudinal Study of Child Development in Québec (LSCDQ 1998–2002). Public Health Nutr 6:773–783CrossRefPubMed
22.
Yngve A, Sjöström M (2001) Breastfeeding determinants and a suggested framework for action in Europe. Public Health Nutr 4:729–739PubMed
23.
Pande H, Unwin C, Haheim LL (1997) Factors associated with the duration of breastfeeding: analysis of the primary and secondary responders to a self-completed questionnaire. Acta Paediatr 86:173–177PubMedCrossRef
24.
Stene LC, Barriga K, Norris JM et al (2004) Perinatal factors and development of islet autoimmunity in early childhood: the diabetes autoimmunity study in the young. Am J Epidemiol 160:3–10CrossRefPubMed
25.
Dahlquist G, Källén B (1992) Maternal-child blood group incompatibility and other perinatal events increase the risk for early-onset type 1 (insulin-dependent) diabetes mellitus. Diabetologia 35:671–675CrossRefPubMed
26.
Blom L, Dahlquist G, Nyström L, Sandström L, Wall S (1989) The Swedish childhood diabetes study-social and perinatal determinants for diabetes in childhood. Diabetologia 32:7–13CrossRefPubMed
27.
McKinney PA, Parslow R, Gurney K, Law G, Bodansky HJ, Williams DRR (1997) Antenatal risk factors for childhood diabetes mellitus; a case-control study of medical record data in Yorkshire, UK. Diabetologia 40:933–939CrossRefPubMed
28.
Dahlquist GG, Patterson C, Soltesz G (1999) Perinatal risk factors for childhood type 1 diabetes in Europe. The EURODIAB Substudy 2 Study Group. Diabetes Care 22:1698–1702PubMedCrossRef
29.
Sipetic S, Vlajinac H, Kocev N, Saji S (2004) The Belgrade childhood diabetes study: prenatal and social associations for type 1 diabetes. Paediatr Perinat Epidemiol 18:33–39CrossRefPubMed
30.
Virtanen SM, Hyppönen E, Läärä E et al (1998) Cow's milk consumption, disease associated autoantibodies and type 1 diabetes mellitus: a follow-up study in siblings of diabetic children. Diabet Med 15:730–738CrossRefPubMed
31.
Gibbon C, Smith T, Egger P, Betts P, Phillips D (1997) Early infection and subsequent insulin dependent diabetes. Arch Dis Child 77:384–385PubMedCrossRef
32.
The EURODIAB Substudy 2 Study Group (2000) Infections and vaccinations as risk factors for childhood type I (insulin-dependent) diabetes mellitus: a multicentre case-control investigation. Diabetologia 43:47–53CrossRef
33.
Sipetic S, Vlajinac H, Kocev N, Badmanovic S (2003) The Belgrade childhood diabetes study: associations of infections and vaccinations on diabetes in childhood. Ann Epidemiol 13:645–651CrossRefPubMed
34.
McKinney PA, Okasha M, Parslow RC et al (2000) Early social mixing and childhood type 1 diabetes mellitus: a case-control study in Yorkshire, UK. Diabet Med 17:236–242CrossRefPubMed
35.
Hummel M, Fuchtenbusch M, Schenker M, Ziegler AG (2000) No major association of breast-feeding, vaccinations, and childhood viral diseases with early islet autoimmunity in the German BABYDIAB Study. Diabetes Care 23:969–974PubMedCrossRef
36.
Sherriff A, Golding J; Alspac Study Team (2002) Factors associated with different hygiene practices in the homes of 15 month old infants. Arch Dis Child 87:30–35CrossRefPubMed
37.
Åkerblom HK, Virtanen SM, Ilonen J et al (2005) Dietary manipulation of β-cell autoimmunity in infants at increased risk for type 1 diabetes. Diabetologia 48:829–837CrossRefPubMed
38.
Verge CF, Howard NJ, Irwig L, Simpson JM, Mackerras D, Silink M (1994) Environmental factors in childhood IDDM. Diabetes Care 17:1381–1389PubMedCrossRef
39.
Virtanen SM, Läärä E, Hyppönen E et al (2000) Cow’s milk consumption, HLA-DQB1 genotype and IDDM: a nested case-control study of siblings of children with diabetes. Diabetes 49:912–917PubMedCrossRef
40.
Pundziutè-Lyckå A, Persson L-Å, Cedermark G et al (2004) Diet, growth, and the risk for type 1 diabetes in childhood. Diabetes Care 27:2784–2789PubMedCrossRef
Metadata
Title
Age at introduction of new foods and advanced beta cell autoimmunity in young children with HLA-conferred susceptibility to type 1 diabetes
Authors
S. M. Virtanen
M. G. Kenward
M. Erkkola
S. Kautiainen
C. Kronberg-Kippilä
T. Hakulinen
S. Ahonen
L. Uusitalo
S. Niinistö
R. Veijola
O. Simell
J. Ilonen
M. Knip
Publication date
01-07-2006
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 7/2006
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-006-0236-1

Other articles of this Issue 7/2006

Diabetologia 7/2006 Go to the issue

Letter

Reply to comment on: Martin S, Schneider B, Heinemann L et al (2006) Self-monitoring of blood glucose in type 2 diabetes and long-term outcome: an epidemiological cohort study. Diabetologia 49:271–278

Article

Human adipose triglyceride lipase (PNPLA2) is not regulated by obesity and exhibits low in vitro triglyceride hydrolase activity

Short Communication

PEGylated glucagon-like peptide-1 displays preserved effects on insulin release in isolated pancreatic islets and improved biological activity in db/db mice

Letter

Comment to: Hoi-Hansen T, Pedersen-Bjergaard U, Thorsteinsson B (2005) The Somogyi phenomenon revisited using continuous glucose monitoring in daily life. Diabetologia 48:2437–2438

Article

High prevalence of abnormal glucose homeostasis secondary to decreased insulin secretion in individuals with hereditary haemochromatosis

Article

Genetic variation in the hepatic lipase gene and the risk of coronary heart disease among US diabetic men: potential interaction with obesity
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits