Cow’s milk consumption, disease-associated autoantibodies and Type 1 diabetes mellitus: a follow-up study in siblings of diabetic children

Abstract

Evidence from case-control studies for the diabetogenicity of introduction of cow's milk-based formulas at early age in infancy is inconclusive. We followed siblings of children with Type 1 diabetes mellitus (Type 1 DM) to investigate a possible relationship between cow's milk consumption during infancy or later in childhood and the emergence of diabetes-associated autoantibodies and progression to clinical Type 1 DM. A cohort of 725 initially unaffected 0 to 25-year-old siblings of 801 index children with Type 1 DM diagnosed in 1986-1989 participated in the study (82% of those invited). The siblings were observed for Type 1 DM associated autoantibodies at intervals of 3-12 months for 4 years, starting from the diagnosis of Type 1 DM in the index child. The follow-up for Type 1 DM started at the same time and ended on 31 October 1995. The combined prevalence of Type 1 DM associated autoantibodies (islet cell antibodies (ICA), insulin autoantibodies (IAA), GAD autoantibodies (GADA), and/or antibodies to the insulinoma associated cDNA2 protein (IA-2A)) was 13.6% (95/697) at the beginning of the study. Of the initially seronegative siblings, 7.5% (45/602) converted to antibody positivity during 4 years, and of all siblings 4.6% (33/725) developed Type 1 DM during the total follow-up time. The age at introduction of supplementary milk feeding was not significantly related to seroconversion to positivity for Type 1 DM associated autoantibodies or to the development of Type 1 DM in the siblings. When adjusted for age, sex, infant feeding patterns, and maternal age and education, high milk consumption in childhood (> or =3 glasses daily) was associated with more frequent emergence of Type 1 DM-associated autoantibodies than low consumption (<3 glasses daily) (adjusted odds ratio 3.97, 95% confidence interval 1.3-11.7, p = 0.01). There was a non-significant association between high milk consumption and progression to clinical Type 1 DM (adjusted hazard ratio 2.75, 95% confidence interval 0.9-8.4, p = 0.07). To conclude, this study suggests that high consumption of cow's milk during childhood may be associated both with seroconversion to positivity for diabetes-associated autoantibodies and progression to clinical Type 1 DM among siblings of children with diabetes.

T Cells of Multiple Sclerosis Patients Target a Common Environmental Peptide that Causes Encephalitis in Mice

“…Although there is controversy (18), high cow milk consumption was identified as a significant risk factor for type I diabetes (19,20) and infants with diabetes risk-associated MHC alleles had a 13-fold higher T1DM risk when they were weaned early to cow milkbased infant formula (21). A nationwide Finnish pilot study for the international Trial to Reduce Insulin-Dependent Diabetes Mellitus in the Genetically at Risk (TRIGR) diabetes prevention effort (22) compared weaning of high-risk newborns to a nonantigenic (hydrolyzed) and a standard, cow milk-based infant formula.…”

Age at introduction of new foods and advanced beta cell autoimmunity in young children with HLA-conferred susceptibility to type 1 diabetes

“…In our cohort of infants, sex, gestational age, maternal age, education and smoking during pregnancy, Caesarean section, number of siblings in the family, and the area of birth were related to the age at introduction of some specific foods in the diet of the child. Other studies suggest that older maternal age is a risk factor for type 1 diabetes [24][25][26][27][28], while the influence of socio-economic status [29], maternal smoking during pregnancy [24,25], and parental education [26,29,30] remain controversial. The increased risk of developing type 1 diabetes has been linked to improved hygiene and to decreased or changed exposure to infections.…”

Fatty acid status in infancy is associated with the risk of type 1 diabetes-associated autoimmunity

“…Our findings are in line with previous prospective cohort studies on milk consumption during infancy and childhood and the development of islet autoimmunity and/or type 1 diabetes [17,[21][22][23][24]. Cow's milk as adjusting factor To investigate whether fatty acids are independently associated with type 1 diabetes autoimmunity, and not merely a reflection of the type of milk consumed, we adjusted the statistical models for the amount of cow's milk consumed.…”

“…Breastfeeding, measured as breastfeeding duration, was not found to be associated with the risk of islet autoimmunity or type 1 diabetes in cohort studies [17][18][19][20]. Looking at the other side of the coin, cow's milk consumption (measured as the quantity consumed) during infancy and childhood was related to increased risk of islet autoimmunity and/or type 1 diabetes in several prospective cohort series [17,[21][22][23][24]. The cause is unknown and several components in milk may be involved [25][26][27].…”