Food Consumption and Risk of Islet Autoimmunity and Type 1 Diabetes in Children at Increased Genetic Susceptibility for Type 1 Diabetes

Suvi M Virtanen; Essi J Peltonen; Leena Hakola; Sari Niinistö; Hanna-Mari Takkinen; Suvi Ahonen; Mari Åkerlund; Ulla Uusitalo; Markus Mattila; Tuuli E I Salo; Jorma Ilonen; Jorma Toppari; Riitta Veijola; Mikael Knip; Jaakko Nevalainen

doi:10.1016/j.tjnut.2024.09.018

Food Consumption and Risk of Islet Autoimmunity and Type 1 Diabetes in Children at Increased Genetic Susceptibility for Type 1 Diabetes

J Nutr. 2024 Sep 21:S0022-3166(24)01035-6. doi: 10.1016/j.tjnut.2024.09.018. Online ahead of print.

Authors

Affiliations

¹ Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland; Tampere University Hospital, Wellbeing Services County of Pirkanmaa; Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland. Electronic address: suvi.virtanen@thl.fi.
² Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland; Tampere University Hospital, Wellbeing Services County of Pirkanmaa.
³ Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland; Tampere University Hospital, Wellbeing Services County of Pirkanmaa; Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
⁴ Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
⁵ Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
⁶ Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland; Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
⁷ Immunogenetics Laboratory, Institute of Biomedicine, University of Turku, Turku, Finland.
⁸ Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, and Centre for Population Health Research, University of Turku, Turku, Finland; Turku University Hospital, Department of Pediatrics, Turku, Finland.
⁹ Department of Paediatrics, Research Unit of Clinical Medicine, Medical Research Centre, University of Oulu, Oulu, Finland; Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.
¹⁰ Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Tampere University Hospital, Department of Pediatrics, Tampere, Finland.
¹¹ Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.

PMID: 39313195
DOI: 10.1016/j.tjnut.2024.09.018

Abstract

Background: Prospective longitudinal evidence considering the entire childhood food consumption in relation to development of islet autoimmunity (IA or) type 1 diabetes is lacking.

Objectives: We studied the associations of consumption of various foods and their combinations with IA and type 1 diabetes risk.

Methods: Children with genetic susceptibility to type 1 diabetes born in 1996-2004 were followed from birth up to 6 years of age in the prospective birth cohort Type 1 Diabetes Prediction and Prevention Study (n=5674). Exposure variables included 34 food groups covering the entire diet based on repeated 3-day food records at age 3 months to 6 years. Endpoints were islet cell antibodies (ICA) plus biochemical IA (n=247), multiple biochemical IA (n=206), and type 1 diabetes (n=94). We analyzed associations between longitudinally observed foods and the risk of IA/type 1 diabetes using a Bayesian approach to joint models in one-food and multi-food models adjusted for energy intake, sex, human leukocyte antigen (HLA) genotype, and familial diabetes.

Results: The final multi-food model for ICA plus biochemical IA included oats [hazard ratio (HR) 1.09, 95% credible interval (CI) 1.04-1.14], banana (HR 1.07, 95% CI 1.03-1.11), and cruciferous vegetables (HR 0.83, 95% CI 0.73-0.94). The final model for multiple biochemical IA included, in addition to above-mentioned foods, fermented dairy (HR 1.42, 95% CI 1.12-1.78) and wheat (HR 1.10, 95% CI 1.03-1.18). The final multi-food model for type 1 diabetes included rye (HR 1.27, 95% CI 1.07-1.50), oats (HR 1.15, 95% CI 1.03-1.26), fruits (HR 1.05, 95% CI 1.01-1.09), and berries (HR 0.67, 95% CI 0.50-0.93).

Conclusions: Higher consumption of oats, gluten-containing cereals, and fruits was associated with increased and that of cruciferous vegetables with decreased risk of several type 1 diabetes related endpoints when considering all the foods in combination. Further etiological and mechanistic studies are warranted.

Keywords: child; diabetes mellitus; diet; food consumption; islet autoimmunity; multivariate joint models; survival analysis; type 1.