Maternal gluten, cereal, and dietary fiber intake during pregnancy and lactation and the risk of islet autoimmunity and type 1 diabetes in the child
Hakola, Leena; Lund-Blix, Nicolai A.; Takkinen, Hanna Mari; Tapanainen, Heli; Niinistö, Sari; Korhonen, Tuuli E.; Stene, Lars C.; Hyöty, Heikki; Toppari, Jorma; Ilonen, Jorma; Knip, Mikael; Veijola, Riitta; Virtanen, Suvi M.; HEDIMED Investigator group (2024-05-11)
Leena Hakola, Nicolai A. Lund-Blix, Hanna-Mari Takkinen, Heli Tapanainen, Sari Niinistö, Tuuli E. Korhonen, Lars C. Stene, Heikki Hyöty, Jorma Toppari, Jorma Ilonen, Mikael Knip, Riitta Veijola, Suvi M. Virtanen, Eurén Anna, Hyöty Heikki, Kurppa Kalle, Laiho Jutta, Laitinen Olli, Lehtonen Jussi, Lindfors Katri, Lönnrot Maria, Malkamäki Johannes, Nurminen Noora, Nykter Matti, Oikarinen Sami, Puustinen Leena, Sioofy-Khojine Amirbabak, Viiri Keijo, Agardh Daniel, Aronsson Carin Andrén, Lundgren Markus, Mäkelä Iida, Romantschuk Martin, Soininen Laura, Lund-Blix Nicolai A, Magnus Maria, Rantala Aino-Kaisa, Stene Lars, Størdal Ketil, Tapia German, Elo Laura, Junttila Sini, Lahesmaa Riitta, Lempainen Johanna, Moulder Robert, Rasool Omid, Suomi Tomi, Toppari Jorma, Ullah Ubaid, Veijola Riitta, Peet Aleksandr, Simre Kärt, Tillmann Vallo, Bargagli Elena, Dotta Francesco, Nigi Laura, Sebastiani Guido, Hakola Leena, Kiviranta Hannu, Rantakokko Panu, Virtanen Suvi M, Cinek Ondrej, Fronkova Eva, Havlik Jaroslav, Molinier Matthieu, Pajula Juha, Parmes Eija, Pärkkä Juha, Saviranta Petri, Ylén Peter, Aints Alar, Bärenson Anu, Kirss Anne, Laidmäe Ivo, Oras Astrid, Tagoma Aili, Uibo Raivo, Vorobjova Tamara, Burr Loïc, Cattaneo Stefano, Chai-Gao Hui, Cristofollini Peter, Generelli Silvia, Paoletti Samantha, Ruth Edith, Berg Gabriele, Wicaksono Wisnu, Petrosino Joseph, Thiel Rainer, Daniel Schmidtmann, Salo Rosanna, Häme Lauri, Berler Alexander, Papadopoulou Korina, Bisgaard Hans, Bonnelykke Klaus, Brandt Sarah, Sevelsted Astrid, Stokholm Jakob, Thorsen Jonathan, Knip Mikael, Sinkkonen Aki, Roslund Marja, Maternal gluten, cereal, and dietary fiber intake during pregnancy and lactation and the risk of islet autoimmunity and type 1 diabetes in the child, Clinical Nutrition ESPEN, Volume 62, 2024, Pages 22-27, ISSN 2405-4577, https://doi.org/10.1016/j.clnesp.2024.05.001
© 2024 The Author(s). Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
https://creativecommons.org/licenses/by/4.0/
https://urn.fi/URN:NBN:fi:oulu-202405223826
Tiivistelmä
Background & aims:
Maternal gluten intake in relation to child's risk of type 1 diabetes has been studied in few prospective studies considering the diet during pregnancy but none during lactation. Our aim was to study whether gluten, cereals, or dietary fiber in maternal diet during pregnancy and lactation is associated with the risk of islet autoimmunity or type 1 diabetes in the offspring.
Methods:
We included 4943 children with genetic susceptibility to type 1 diabetes from the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Study, born between 1996 and 2004. Maternal intake of gluten, different types of cereals, and dietary fiber were derived from a semi-quantitative validated food frequency questionnaire covering the eighth month of pregnancy and the third month of lactation. Children were monitored for islet autoantibodies up to age of 15 years and type 1 diabetes until year 2017. Risk of islet autoimmunity and clinical type 1 diabetes were estimated using Cox regression model, adjusted for energy intake, child's sex, HLA genotype, and familial diabetes.
Results:
Altogether 312 children (6.4%) developed islet autoimmunity at median age of 3.5 (IQR 1.7, 6.6) years and 178 children (3.6%) developed type 1 diabetes at median age of 7.1 (IQR 4.3, 10.6) years. Gluten intake during pregnancy was not associated with islet autoimmunity (HR 0.96; 95% CI 0.68, 1.35), per 1 g/MJ increase in intake nor type 1 diabetes (HR 0.96; 95% CI 0.62, 1.50) in the offspring. Higher barley consumption during lactation was associated with increased risk of type 1 diabetes (HR 3.25; 95% CI 1.21, 8.70) per 1 g/MJ increase in intake. Maternal intake of other cereals or dietary fiber was not associated with the offspring outcomes.
Conclusions:
We observed no association between maternal intake of gluten, most consumed cereals, or dietary fiber during pregnancy or lactation and the risk of islet autoimmunity or type 1 diabetes in children from a high-risk population.
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