Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland; Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Finland; Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland; Norwegian Institute of Public Health, Oslo, Norway; Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Norway.
Clin Nutr ESPEN. 2024 Aug;62:22-27. doi: 10.1016/j.clnesp.2024.05.001. Epub 2024 May 11.
BACKGROUND & AIMS: Maternal gluten intake in relation to child's risk of type 1 diabetes has been studied in few prospective studies considering the diet during pregnancy but none during lactation. Our aim was to study whether gluten, cereals, or dietary fiber in maternal diet during pregnancy and lactation is associated with the risk of islet autoimmunity or type 1 diabetes in the offspring.
We included 4943 children with genetic susceptibility to type 1 diabetes from the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Study, born between 1996 and 2004. Maternal intake of gluten, different types of cereals, and dietary fiber were derived from a semi-quantitative validated food frequency questionnaire covering the eighth month of pregnancy and the third month of lactation. Children were monitored for islet autoantibodies up to age of 15 years and type 1 diabetes until year 2017. Risk of islet autoimmunity and clinical type 1 diabetes were estimated using Cox regression model, adjusted for energy intake, child's sex, HLA genotype, and familial diabetes.
Altogether 312 children (6.4%) developed islet autoimmunity at median age of 3.5 (IQR 1.7, 6.6) years and 178 children (3.6%) developed type 1 diabetes at median age of 7.1 (IQR 4.3, 10.6) years. Gluten intake during pregnancy was not associated with islet autoimmunity (HR 0.96; 95% CI 0.68, 1.35), per 1 g/MJ increase in intake nor type 1 diabetes (HR 0.96; 95% CI 0.62, 1.50) in the offspring. Higher barley consumption during lactation was associated with increased risk of type 1 diabetes (HR 3.25; 95% CI 1.21, 8.70) per 1 g/MJ increase in intake. Maternal intake of other cereals or dietary fiber was not associated with the offspring outcomes.
We observed no association between maternal intake of gluten, most consumed cereals, or dietary fiber during pregnancy or lactation and the risk of islet autoimmunity or type 1 diabetes in children from a high-risk population.
已有少数前瞻性研究探讨了母体麸质摄入与儿童 1 型糖尿病风险之间的关系，这些研究考虑了妊娠期间的饮食，但没有考虑哺乳期的饮食。我们的目的是研究母体在妊娠和哺乳期饮食中的麸质、谷物或膳食纤维是否与后代胰岛自身免疫或 1 型糖尿病的风险相关。
我们纳入了来自芬兰 1 型糖尿病预测和预防（DIPP）研究的 4943 名具有 1 型糖尿病遗传易感性的儿童，这些儿童均于 1996 年至 2004 年期间出生。母体麸质、不同类型谷物和膳食纤维的摄入量来自于一份半定量的验证过的食物频率问卷，涵盖妊娠第 8 个月和哺乳期第 3 个月。对儿童进行胰岛自身抗体监测，直至 15 岁，监测 1 型糖尿病直至 2017 年。使用 Cox 回归模型估计胰岛自身免疫和临床 1 型糖尿病的风险，调整了能量摄入、儿童性别、HLA 基因型和家族性糖尿病。
共有 312 名儿童（6.4%）在中位年龄 3.5 岁（IQR 1.7，6.6）时发展为胰岛自身免疫，178 名儿童（3.6%）在中位年龄 7.1 岁（IQR 4.3，10.6）时发展为 1 型糖尿病。妊娠期间的麸质摄入量与胰岛自身免疫（HR 0.96；95%CI 0.68，1.35）或后代的 1 型糖尿病（HR 0.96；95%CI 0.62，1.50）均无相关性，以每 1MJ 摄入量增加 1g 为单位。哺乳期大麦摄入量每增加 1MJ 1g，与 1 型糖尿病风险增加相关（HR 3.25；95%CI 1.21，8.70）。母体摄入其他谷物或膳食纤维与后代结局无关。
在高危人群中，我们未观察到母体在妊娠或哺乳期摄入麸质、最常食用的谷物或膳食纤维与儿童胰岛自身免疫或 1 型糖尿病风险之间存在关联。
