No major association of breast-feeding, vaccinations, and childhood viral diseases with early islet autoimmunity in the German BABYDIAB Study.

Abstract

OBJECTIVE: Environmental factors have been suggested to play an important role in the pathogenesis of type 1 diabetes. The aim of this study was to assess the influence of breast-feeding, vaccinations, and childhood viral diseases on the initiation of islet autoimmunity in early childhood. RESEARCH DESIGN AND METHODS: Data were prospectively collected from questionnaires obtained at birth, at 9 months of age, and at 2 years of age in 823 offspring from parents with type 1 diabetes. By 2 years of age, 31 offspring had islet antibodies, and 10 developed overt diabetes by the time of follow-up. RESULTS: In offspring from mothers with type 1 diabetes, duration of exclusive and total breast-feeding did not differ between islet antibody-positive and -negative children, regardless of HLA genotype, and breast-feeding of 3 months or longer was not associated with protection from antibody development or diabetes onset. In offspring from diabetic fathers, non-statistically significant reductions in exclusive and total breast-feeding times were observed in the antibody-positive cohort. Neither type nor quantity of vaccinations (including Bacille Calmette-Guerin vaccine; haemophilus influenzae vaccine; diphtheria, tetanus, and pertussis vaccine; tick-born encephalitis vaccine; or measles, mumps, and rubella vaccine) were associated with the development of islet antibodies and diabetes. Measles, mumps, and rubella were not reported in children with islet antibodies or diabetes. CONCLUSIONS: This study showed no evidence that proposed environmental factors affect islet antibody development in the first 2 years of life in offspring from parents with type 1 diabetes.

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

“…The increased risk of developing type 1 diabetes has been linked to improved hygiene and to decreased or changed exposure to infections. Caesarean section [25,27] and decreased exposure to common infections during infancy [31][32][33] were associated, although inconsistently [24,28,34,35], with increased risk of type 1 diabetes, and day-care attendance [32,34] with reduced risk. The adoption of hygiene practices is influenced to some degree by social, lifestyle and environmental factors [36].…”

Natural History of Type 1 Diabetes

“…It has been suggested by some investigators that breast-feeding may protect against type 1 diabetes (45), whereas early introduction of supplementary milk feeding may promote the development of islet autoantibodies and type 1 diabetes (46). The debate as to whether cow's milk ingestion increases the risk for islet autoimmunity has been controversial (47)(48)(49)(50). Prospective studies in at-risk neonates have not demonstrated an increased risk for developing islet autoantibodies in children who were not breast-fed and received cow's milk proteins early in life (48,49).…”

“…The debate as to whether cow's milk ingestion increases the risk for islet autoimmunity has been controversial (47)(48)(49)(50). Prospective studies in at-risk neonates have not demonstrated an increased risk for developing islet autoantibodies in children who were not breast-fed and received cow's milk proteins early in life (48,49). Nevertheless, an interventional trial is currently ongoing committed to exploring the impact of cow's milk proteins in an infant's diet on the development of type 1 diabetes (the TRIGR study) (51).…”

Dietary manipulation of beta cell autoimmunity in infants at increased risk of type 1 diabetes: a pilot study

“…While most of the surveys on breastfeeding and weaning diets have been retrospective, prospective studies have been initiated, but their results have also been inconsistent, e.g. [4,5].…”