We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Association of Cereal, Gluten, and Dietary Fiber Intake With Islet Autoimmunity and Type 1 Diabetes.
- Authors
Hakola, Leena; Miettinen, Maija E.; Syrjälä, Essi; Åkerlund, Mari; Takkinen, Hanna-Mari; Korhonen, Tuuli E.; Ahonen, Suvi; Ilonen, Jorma; Toppari, Jorma; Veijola, Riitta; Nevalainen, Jaakko; Knip, Mikael; Virtanen, Suvi M.
- Abstract
Key Points: Question: Is childhood cereal, gluten, and dietary fiber intake associated with the risk of developing islet autoimmunity and type 1 diabetes? Findings: In this large birth cohort study, the intake of oats, gluten-containing cereals, gluten, and dietary fiber was associated with an increased risk of islet autoimmunity in children with increased genetic risk of type 1 diabetes. Meaning: Further research is needed to understand the role of dietary cereals and their components in the development of type 1 diabetes. Importance: Dietary proteins, such as gluten, have been suggested as triggers of the disease process in type 1 diabetes (T1D). Objective: To study the associations of cereal, gluten, and dietary fiber intake with the development of islet autoimmunity (IA) and T1D. Design, Setting, and Participants: The prospective birth cohort Finnish Type 1 Diabetes Prediction and Prevention Study recruited children with genetic susceptibility to type 1 diabetes from September 1996 to September 2004 from 2 university hospitals in Finland and followed up every 3 to 12 months up to 6 years for diet, islet autoantibodies, and T1D. Altogether 6081 infants (78% of those invited) participated in the study. Dietary data were available for 5714 children (94.0%) and dietary and IA data were available for 5545 children (91.2%), of whom 3762 (68%) had data on islet autoantibodies up to age 6 years. Information on T1D was available for all children. Data were analyzed in 2018 and end point data were updated in 2015. Exposures: Each child's intake of cereals, gluten, and dietary fiber was calculated from repeated 3-day food records up to 6 years. Main Outcomes and Measures: Islet autoimmunity was defined as repeated positivity for islet cell antibodies and at least 1 biochemical autoantibody of 3 analyzed, or T1D. Data on the diagnosis of T1D were obtained from Finnish Pediatric Diabetes Register. Results: Of 5545 children (2950 boys [53.2%]), 246 (4.4%) developed IA and of 5714 children (3033 boys [53.1%]), 90 (1.6%) developed T1D during the 6-year follow-up. Based on joint models, the intake of oats (hazard ratio [HR], 1.08; 95% CI, 1.03-1.13), wheat (HR, 1.09; 95% CI, 1.03-1.15), rye (HR, 1.13; 95% CI, 1.03-1.23), gluten-containing cereals (HR, 1.07; 95% CI, 1.03-1.11), gluten without avenin from oats (HR, 2.23; 95% CI, 1.40-3.57), gluten with avenin (HR, 2.06; 95% CI, 1.45-2.92), and dietary fiber (HR, 1.41; 95% CI, 1.10-1.81) was associated with the risk of developing IA (HRs for 1 g/MJ increase in intake). The intake of oats (HR, 1.10; 95% CI, 1.00-1.21) and rye (HR, 1.20; 95% CI, 1.03-1.41) was associated with the risk of developing T1D. After multiple testing correction, the associations with IA remained statistically significant. Conclusions and Relevance: A high intake of oats, gluten-containing cereals, gluten, and dietary fiber was associated with an increased risk of IA. Further studies are needed to confirm or rule out the findings and study potential mechanisms. This cohort study of Finnish children with an increased genetic risk for type 1 diabetes examines the association of the energy-adjusted intake of oats, wheat, rye, gluten-containing cereals, gluten, and dietary fiber with the risk of developing islet autoimmunity.
- Subjects
FINLAND; TYPE 1 diabetes; AUTOANTIBODIES; AUTOIMMUNE diseases; CONFIDENCE intervals; DIETARY fiber; GLUTEN; GRAIN; IMMUNITY; INGESTION; LONGITUDINAL method; OATS; WHEAT; ODDS ratio; DISEASE risk factors; DIABETES risk factors
- Publication
JAMA Pediatrics, 2019, Vol 173, Issue 10, p953
- ISSN
2168-6203
- Publication type
Article
- DOI
10.1001/jamapediatrics.2019.2564