Salek Shadi, Hashemipour Mahin, Feizi Awat, Hovsepian Silva, Kelishadi Roya
Isfahan Endocrine and Metabolism Research Center, Imam Hossien Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Int J Endocrinol Metab. 2020 Jul 22;18(3):e93076. doi: 10.5812/ijem.93076. eCollection 2020 Jul.
Considering the increasing trend in the incidence of type 1 diabetes mellitus (T1DM), the identification of its environmental determinants, especially those related to the prenatal and lactation period, might ultimately result in primary prevention of the disease. We aimed to review the evidence of the association between mothers' dietary components during pregnancy and/or lactation with T1DM.
An electronic and comprehensive literature search was performed until August 2019 in the international databases, including Web of Science (ISI), PubMed, and Scopus, using the following keywords: type 1 diabetes mellitus, autoimmunity, mother, maternal, diet and lactation in different combinations. Papers related to the objectives of the study were selected.
Based on our review, the maternal consumption of meat, especially processed meat, was associated with increased risk of T1DM, whereas the maternal use of vegetables, potato, low-fat margarine, and berries showed protective effects against the development of T1DM in offspring. There was no significant association between the use of multivitamins and mineral supplements with T1DM, according to the available data. The results of the reviewed studies regarding the association between the maternal use of vitamin D, fatty acids, and coffee during pregnancy with T1DM were not consistent and conclusive.
Findings of this review indicate that the maternal consumption of some foods is associated with increased or decreased risk of T1DM. However, for some foods or dietary components, including coffee, vitamin D, and fatty acids, the results are not conclusive. We conclude that although maternal diet could influence the development of insulin autoantibodies (IA) and T1DM in offspring, there is no sufficient evidence for most nutrients, and available data are controversial, which should be dealt with in future cohort or interventional studies.
鉴于1型糖尿病（T1DM）发病率呈上升趋势，确定其环境决定因素，尤其是与孕期和哺乳期相关的因素，最终可能实现该疾病的一级预防。我们旨在综述孕期和/或哺乳期母亲饮食成分与T1DM之间关联的证据。
截至2019年8月，在国际数据库（包括科学网（ISI）、PubMed和Scopus）中进行了电子全面文献检索，使用了以下关键词：1型糖尿病、自身免疫、母亲、母体、饮食和哺乳的不同组合。选取了与研究目标相关的论文。
根据我们的综述，母亲食用肉类，尤其是加工肉类，与T1DM风险增加相关，而母亲食用蔬菜、土豆、低脂人造黄油和浆果对后代患T1DM有保护作用。根据现有数据，服用多种维生素和矿物质补充剂与T1DM之间无显著关联。关于孕期母亲使用维生素D、脂肪酸和咖啡与T1DM之间关联的综述研究结果并不一致且尚无定论。
本综述结果表明，母亲食用某些食物与T1DM风险增加或降低相关。然而，对于某些食物或饮食成分，包括咖啡、维生素D和脂肪酸，结果尚无定论。我们得出结论，虽然母亲饮食可能影响后代胰岛素自身抗体（IA）的产生和T1DM的发生，但大多数营养素缺乏充分证据，现有数据存在争议，这应在未来的队列研究或干预研究中加以解决。
