Early Exposure to Cow's Milk and Solid Foods in Infancy, Genetic Predisposition, and Risk of IDDM

Abstract

Using a case-control study design, we examined the hypothesis that early exposure to cow's milk and solid foods increased the risk of IDDM. An infant diet history was collected from 164 IDDM subjects from the Colorado IDDM Registry with a mean birth year of 1973, and 145 nondiabetic population control subjects who were frequency matched to diabetic subjects on age, sex, and ethnicity. Early exposure was defined as exposure occurring before 3 mo of age. After controlling for ethnicity, birth order, and family income, more diabetic subjects were exposed early to cow's milk (OR 4.5, 95% CI 0.9-21.4) and solid foods (OR 2.5, CI 1.4-4.3) than control subjects. To examine this association while accounting for the genetic susceptibility to IDDM, we defined individuals as high and low risk by an HLA-DQB1 molecular marker. Early exposure to cow's milk was not associated with elevated risk for IDDM in low-risk individuals. Relative to unexposed low-risk individuals, early exposure to cow's milk was strongly associated in individuals with a high risK marker (OR 11.3, CI 1.2-102.0). Similar findings were observed for early exposure to solid foods. These data indicate that early exposure to cow's milk and solid foods may be associated with increased risk of IDDM. The inclusion of HLA-encoded risk in the analyses demonstrates the combined effect of genetic and environmental factors.

Role of human milk components in gastrointestinal development: Current knowledge and future NEEDS

“…32 Evidence for prevention of inflammatory bowel diseases (IBD) is inconclusive, with studies showing that breastfeeding reduces 33 or increases the risk for the development of IBD. 34 Exposure to beneficial components in HM that promote the development of the immune system, a lack of exposure to stimuli that would trigger an inappropriate immunologic response in genetically predisposed individuals, or both have been proposed as mechanisms underlying the reduced risk of developing autoimmune diseases, 35 although the relative contributions of these 2 effects are unknown. Further research is needed in this area, particularly in elucidating the interaction between host genetics and breastfeeding in modulating the risk of IBD.…”

Non‐genetic risk determinants for type 1 (insulin‐dependent) diabetes mellitus in childhood

“…Although a number of studies suggested a correlation between the incidence of childhood IDDM and some isolated putative risk determinants, such as coffee consumption by the mother (1) sugar consumption (2), cow's milk (3)(4)(5)(6) and viral infection (for review see (7)), there are very few studies in which the complexity of the environmental risk factors or triggers have been studied with a modern epidemiological approach (8-13). As pancreatic beta-cell destruction may begin many years before the clinical symptoms of diabetes (14), putative environmental risk factors may be operative during the whole lifespan of diabetic children, including intrauterine life.…”

Birth in the South and chronic disease mortality rates in the late twentiethcentury United States

“…Migrant studies typically report migrant death rates that fall between the region of birth and region of residence at time of death (Gerber and Madhavan, 1980;Hull, 1979;Kostraba et al, 1993). We compared the death rates of the Southern-born populations in the Northeast, Midwest, and West with the region-born populations.…”