(Abstract)

HeConnection-CauseOBJECTIVE:

To assess prospectively whether longitudinal food intakes during childhood, especially the intake of cow milk– based infant formulas, other cow-milk products, cereals, meat products, fish products, dietary fats, vegetables, roots and potatoes, fruit, and sweets, are associated with risk of emergence of diabetes-associated autoantibodies in a population-based cohort of young children with HLA-DQB1–conferred susceptibility to type 1 diabetes.

DESIGN:

Children with advanced beta cell autoimmunity (n = 232) (ie, with repeated positivity for antibodies against islet cells) together with positivity for at least one of the other 3 antibodies analyzed or clinical type 1 diabetes were identified from a prospective birth cohort of 6069 infants with HLA-DQB1-conferred susceptibility to type 1 diabetes who were born in 1996-2004, with the longest follow-up to the age of 11 y. Repeated 3-d food records were completed by the families and daycare personnel. Diabetes-associated autoantibodies and diets were measured at 3-12-mo intervals. Four control subjects, who were matched for birth date, sex, area, and genetic risk, were randomly selected for each case.

RESULTS:

In the main food groups, only intakes of cow-milk products and fruit and berry juices  were significantly, although marginally, associated with advanced beta cell autoimmunity. The consumption of fresh milk products and cow milk-based infant formulas was related to the endpoint, whereas no evidence was shown for consumption of sour milk products and cheese. The intake of fat from all milk products and protein from fresh milk products was associated with risk of advanced beta cell autoimmunity.

CONCLUSION: Intakes of cow milk and fruit and berry juices could be related to the development of advanced beta cell autoimmunity.

Health-e-Solutions comment: The strength of this longitudinal prospective study is that these type 1 diabetic subjects were followed for years. This gives more power to any associations uncovered. For cow’s milk we have known about the antibody association, and it was once again shown in this study. It would be nice to learn which fruits and berries they used for this study. However, when the intake of fruit and berry juices was adjusted for the total amount of beverages and liquid milk products, it was no longer significantly associated with advanced beta cell autoimmunity. In other words, the milk products are the strongest association. It is possible that the observed association between cow-milk intake and advanced beta cell autoimmunity reflected a causal relation. The current findings did not clarify whether protein or fat or some other component in cow’s milk could explain this association.

There is increasing evidence that the early introduction of cow’s milk proteins may induce mucosal inflammation and increased gut permeability. Enhanced humoral immune responses to cow-milk proteins have been observed in children with newly diagnosed type 1 diabetes and in infants who progressed to overt type 1 diabetes later in childhood. This effect may be due to increased consumption of cow milk, enhanced immunological reactivity, or increased intestinal permeability in children who develop type 1 diabetes.

Studies such as these must be done repeatedly in order to corroborate findings and build a body of solid evidence. Until then, the Health-e-Solutions lifestyle is on pretty solid ground by eliminating dairy products and minimizing higher-glycemic fruits and berries, only including those that are very low glycemic and alkalizing.

Journal References:

      i.        http://ajcn.nutrition.org/content/95/2/471.full.pdf

     ii.        Vaarala O. Gut and the induction of immune tolerance in type 1 diabetes. Diabetes Metab Res Rev 1999;15:353–61.

    iii.        Vaarala O, Atkinson MA, Neu J. The “perfect storm” for type 1 diabetes: the complex interplay between intestinal microbiota, gut permeability, and mucosal immunity. Diabetes 2008;57:2555–62.

    iv.        Luopaja¨rvi K, Savilahti E, Virtanen SM, Ilonen J, Knip M, Akerblom HK, Vaarala O. Enhanced levels of cow’s milk antibodies in infancy in children who develop type