Early introduction of root vegetables in infancy associated with advanced ß-cell autoimmunity in young children with human leukocyte antigen-conferred susceptibility to Type 1 diabetes

• Published in: Diabetic medicine 2011-08, Vol.28 (8), p.965-971
• Main Authors: Virtanen, S. M., Takkinen, H.-M., Nevalainen, J., Kronberg-Kippilä, C., Salmenhaara, M., Uusitalo, L., Kenward, M. G., Erkkola, M., Veijola, R., Simell, O., Ilonen, J., Knip, M.
• Format: Article
• Language: English
• Subjects: Autoantibodies - immunology; Autoantibodies - isolation & purification; Autoimmunity - genetics; Breast Feeding; Child; Child, Preschool; children; Diabetes Mellitus, Type 1 - genetics; Diabetes Mellitus, Type 1 - immunology; Female; Genetic Predisposition to Disease - genetics; HLA-DQ Antigens - genetics; HLA-DQ Antigens - immunology; Humans; Infant; Islets of Langerhans - immunology; Male; nutrition; Prospective Studies; Risk Factors; Type 1 diabetes; Vegetables - metabolism; Weaning
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/j.1464-5491.2011.03294.x

Diabet. Med. 28, 965–971 (2011) Aims  Early introduction of supplementary foods has been implicated to play a role in the development of ß‐cell autoimmunity. We set out to study the effects of breastfeeding and age at introduction of supplementary foods on the development of ß‐cell autoimmunity. Methods  A prospective birth cohort of 6069 infants with HLA‐DQB‐conferred susceptibility to Type 1 diabetes was recruited between 1996 and 2004. Antibodies against islet cells, insulin, glutamate dehydroxylase and islet antigen 2 were measured at 3‐ to 12‐month intervals. The families recorded at home 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 plus at least one other antibody and/or clinical Type 1 diabetes (n = 265). Results  Early introduction of root vegetables (by the age of 4 months) was related to increased risk of developing positivity for the endpoint [hazard ratio (95% CI) for the earliest third 1.75 (1.11–2.75) and for the middle third 1.79 (1.22–2.62) compared with the last third (> 4 months), likelihood ratio test P = 0.006], independently of the introduction of other foods and of several putative socio‐demographic and perinatal confounding factors. Introducing wheat, rye, oats and/or barley cereals (P = 0.013) and egg (P = 0.031) early was related to an increased risk of the endpoint, but only during the first 3 years of life. Conclusions  Early introduction of root vegetables during infancy is independently associated with increased risk of ß‐cell autoimmunity among Finnish children with increased genetic susceptibility to Type 1 diabetes.