Sari Niinistö

Food consumption and advanced β cell autoimmunity in young children with HLA-conferred susceptibility to type 1 diabetes: a nested case-control design

BACKGROUND Evidence for the role of food consumption during childhood in the development of β cell autoimmunity is scarce and fragmentary. OBJECTIVE We set out to study the associations of longitudinal food consumption in children with the development of advanced β cell autoimmunity. DESIGN Children with advanced β cell autoimmunity (n = 232) (ie, with repeated positivity for antibodies against islet cells) together with positivity for at least one of the other 3 antibodies analyzed or clinical type 1 diabetes were identified from a prospective birth cohort of 6069 infants with HLA-DQB1-conferred susceptibility to type 1 diabetes who were born in 1996-2004, with the longest follow-up to the age of 11 y. Repeated 3-d food records were completed by the families and daycare personnel. Diabetes-associated autoantibodies and diets were measured at 3-12-mo intervals. Four control subjects, who were matched for birth date, sex, area, and genetic risk, were randomly selected for each case. RESULTS In the main food groups, only intakes of cow-milk products (OR: 1.05; 95% CI: 1.00, 1.10) and fruit and berry juices (OR: 1.09; 95% CI: 1.02, 1.12) were significantly, although marginally, associated with advanced β cell autoimmunity. The consumption of fresh milk products and cow milk-based infant formulas was related to the endpoint, whereas no evidence was shown for consumption of sour milk products and cheese. The intake of fat from all milk products and protein from fresh milk products was associated with risk of advanced β cell autoimmunity. CONCLUSION Intakes of cow milk and fruit and berry juices could be related to the development of advanced β cell autoimmunity. This trial was registered at clinicaltrials.gov as number NCT00223613.

Dietary fatty acid composition during pregnancy and the risk of asthma in the offspring

To cite this article: Lumia M, Luukkainen P, Kaila M, Tapanainen H, Erkkola M, Uusitalo L, Niinistö S, Kenward MG, Ilonen J, Simell O, Knip M, Veijola R, Virtanen SM. Dietary fatty acid composition during pregnancy and the risk of asthma in the offspring. Pediatr Allergy Immunol 2011: 22: 827–835.

Serum fatty acids and risk of advanced β-cell autoimmunity: a nested case–control study among children with HLA-conferred susceptibility to type I diabetes

Background/Objectives:N-3 (omega-3) fatty acids have been reported to decrease the risk for development of β-cell autoimmunity and clinical type I diabetes. We set out to examine whether different serum fatty acids are associated with the development of advanced β-cell autoimmunity in children carrying human leukocyte antigen DQ β-1 (HLA-DQB1)-conferred susceptibility to type I diabetes.Subjects/Methods:Within a cohort, serum total fatty acid composition of 108 children with advanced β-cell autoimmunity and of 216 matched persistently autoantibody-negative controls was analyzed using gas chromatography. Non-fasting serum samples were obtained annually at the ages of 1–6 years. Conditional logistic regression was applied to analyze the associations between advanced β-cell autoimmunity and serum fatty acids.Results:The serum fatty acid profile of myristic acid (odds ratio (OR) 1.48, 95% confidence interval (CI) 1.09–2.00, P=0.011), pentadecanoic acid (OR 1.65, 95% CI 1.19–2.28, P=0.003), palmitoleic acid isomers 16:1 n-7 (omega-7) (OR 1.41, 95% CI 1.03–1.92, P=0.030) and 16:1 n-9 (omega-9) (OR 1.45, 95% CI 1.05–2.01, P=0.026) and conjugated linoleic acid (OR 1.67, 95% CI 1.16–2.41, P=0.006) closest to the time of the appearance of multiple autoantibodies were positively associated with the risk of advanced β-cell autoimmunity after adjustment for potential confounding factors. Serum linoleic acid showed inverse, marginal association with the end point.Conclusions:Serum biomarkers of milk and ruminant meat fat consumption are directly associated and linoleic acid is inversely associated with advanced β-cell autoimmunity in children with HLA-conferred susceptibility to type I diabetes.

Microbial Exposure in Infancy and Subsequent Appearance of Type 1 Diabetes Mellitus-Associated Autoantibodies A Cohort Study

IMPORTANCE The role of microbial exposure during early life in the development of type 1 diabetes mellitus is unclear. OBJECTIVE To investigate whether animal contact and other microbial exposures during infancy are associated with the development of preclinical and clinical type 1 diabetes. DESIGN, SETTING, AND PARTICIPANTS A birth cohort of children with HLA antigen-DQB1-conferred susceptibility to type 1 diabetes was examined. Participants included 3143 consecutively born children at 2 hospitals in Finland between 1996 and 2004. EXPOSURES The following exposures during the first year of life were assessed: indoor and outdoor dogs and cats, farm animals, farming, visit to a stable, day care, and exposure to antibiotics during the first week of life. MAIN OUTCOMES AND MEASURES Clinical and preclinical type 1 diabetes were used as outcomes. The latter was defined as repeated positivity for islet-cell antibodies plus for at least 1 of 3 other diabetes-associated autoantibodies analyzed and/or clinical type 1 diabetes. The autoantibodies were analyzed at 3- to 12-month intervals since the birth of the child. RESULTS Children exposed to an indoor dog, compared with otherwise similar children without an indoor dog exposure, had a reduced odds of developing preclinical type 1 diabetes (adjusted odds ratio [OR], 0.47; 95% CI, 0.28-0.80; P = .005) and clinical type 1 diabetes (adjusted OR, 0.40; 95% CI, 0.14-1.14; P = .08). All of the other microbial exposures studied were not associated with preclinical or clinical diabetes: the odds ratios ranged from 0.74 to 1.58. CONCLUSIONS AND RELEVANCE Among the 9 early microbial exposures studied, only the indoor dog exposure during the first year of life was inversely associated with the development of preclinical type 1 diabetes. This finding needs to be confirmed in other populations.

Maternal food consumption during pregnancy and risk of advanced β-cell autoimmunity in the offspring

Virtanen SM, Uusitalo L, Kenward MG, Nevalainen J, Uusitalo U, Kronberg‐Kippilä C, Ovaskainen M‐L, Arkkola T, Niinistö S, Hakulinen T, Ahonen S, Simell O, Ilonen J, Veijola R, Knip M. Maternal food consumption during pregnancy and risk of advanced β‐cell autoimmunity in the offspring.

Sociodemographic and lifestyle characteristics are associated with antioxidant intake and the consumption of their dietary sources during pregnancy

OBJECTIVE To analyse the associations of selected sociodemographic and lifestyle factors with the intake of antioxidant nutrients and consumption of their main dietary sources among pregnant women. DESIGN A population-based cohort study. Dietary intake during pregnancy was assessed by a self-administered FFQ one to three months after the delivery. SETTING Type 1 Diabetes Prediction and Prevention (DIPP) Project. SUBJECTS Subjects comprised 3730 women (70.1 % of those invited) who entered the DIPP Nutrition Study after delivering a child at increased genetic risk for type 1 diabetes at the university hospitals in Oulu and Tampere, Finland, 1997-2002. RESULTS All sociodemographic and lifestyle factors studied showed significant associations with antioxidant intake in multiple regression models adjusting for all other factors. Older and more educated women tended to have higher intake of most antioxidants. Parity was positively associated with retinol intake and inversely with vitamin C intake. Smokers had lower intakes of most antioxidants. Only the partners education was positively associated with high intake of fruits, whereas own education was positively associated with berry consumption. Vegetable consumption was positively associated with partners education except for women with academic education, who tended to have high vegetable consumption irrespective of partners education. CONCLUSIONS Young women, smokers and those with a low education are at risk for low antioxidant intake and non-optimal food choices during pregnancy.

Maternal dietary fat and fatty acid intake during lactation and the risk of asthma in the offspring.

Aim:  To explore the association between maternal dietary fat and fatty acid (FA) intake during lactation, and the risk of asthma in the offspring by the age of 5 years.

Fatty acids in serum and diet – a canonical correlation analysis among toddlers

Fatty acid concentrations in blood are potential biomarkers of dietary fat intake, but methodological studies among children are scarce. The large number of fatty acids and their complex interrelationships pose a special challenge in research on fatty acids. Our target was to assess the interrelationships between the total fatty acid profiles in diet and serum of young children. The study subjects were healthy control children from the birth cohort of the Type 1 Diabetes Prediction and Prevention Study. A 3-day food record and a frozen serum sample were available from 135 children at the age of 1 year, from 133 at 2 years, and from 92 at 3 years. The relationship between dietary and serum fatty acid profiles was analysed using canonical correlation analysis. The consumption of fatty milk correlated positively with serum fatty acids, pentadecanoic acid, palmitic acid and conjugated linoleic acid (CLA) at all ages. Correlations between dietary and serum eicosapentaenoic and/or docosahexaenoic acid were observed at 2 and 3 years of age. Serum linoleic acid was positively associated with the consumption of infant formula at the age of 1 year, and with the consumption of vegetable margarine at 2 and 3 years. The results indicate a high quality of the 3-day food records kept by parents and other caretakers of the children, and suitability of non-fasting, un-fractioned serum samples for total fatty acid analyses. The correlation between intake of milk fat and serum proportion of CLA is a novel finding.

Maternal dietary fatty acid intake during pregnancy and the risk of preclinical and clinical type 1 diabetes in the offspring

The aim of the present study was to examine the associations between the maternal intake of fatty acids during pregnancy and the risk of preclinical and clinical type 1 diabetes in the offspring. The study included 4887 children with human leucocyte antigen (HLA)-conferred type 1 diabetes susceptibility born during the years 1997-2004 from the Finnish Type 1 Diabetes Prediction and Prevention Study. Maternal diet was assessed with a validated FFQ. The offspring were observed at 3- to 12-month intervals for the appearance of type 1 diabetes-associated autoantibodies and development of clinical type 1 diabetes (average follow-up period: 4·6 years (range 0·5-11·5 years)). Altogether, 240 children developed preclinical type 1 diabetes and 112 children developed clinical type 1 diabetes. Piecewise linear log-hazard survival model and Cox proportional-hazards regression were used for statistical analyses. The maternal intake of palmitic acid (hazard ratio (HR) 0·82, 95 % CI 0·67, 0·99) and high consumption of cheese during pregnancy (highest quarter v. intermediate half HR 0·52, 95 % CI 0·31, 0·87) were associated with a decreased risk of clinical type 1 diabetes. The consumption of sour milk products (HR 1·14, 95 % CI 1·02, 1·28), intake of protein from sour milk (HR 1·15, 95 % CI 1·02, 1·29) and intake of fat from fresh milk (HR 1·43, 95 % CI 1·04, 1·96) were associated with an increased risk of preclinical type 1 diabetes, and the intake of low-fat margarines (HR 0·67, 95 % CI 0·49, 0·92) was associated with a decreased risk. No conclusive associations between maternal fatty acid intake or food consumption during pregnancy and the development of type 1 diabetes in the offspring were detected.

Maternal fatty acid intake during pregnancy and the development of childhood overweight: a birth cohort study

Maternal diet during pregnancy may contribute to the risk of offspring adiposity.