Article in NEJM re. Dietary Intervention in Infancy and Later signs of Beta-cell Autoimmunity

[Asiago]

I thought this was interesting-

 

Dietary Intervention in Infancy and Later Signs of Beta-Cell Autoimmunity

Dietary Intervention in Infancy and Later Signs of Beta-Cell Autoimmunity

Mikael Knip, M.D., D.M.Sc., Suvi M. Virtanen, M.D., D.M.Sc., Karri Seppä, M.Sc., Jorma Ilonen, M.D., D.M.Sc., Erkki Savilahti, M.D., D.M.Sc., Outi Vaarala, M.D., D.M.Sc., Antti Reunanen, M.D., D.M.Sc., Kari Teramo, M.D., D.M.Sc., Anu-Maaria Hämäläinen, M.D., D.M.Sc., Johanna Paronen, M.D., D.M.Sc., Hans-Michael Dosch, M.D., Timo Hakulinen, Ph.D., and Hans K. Åkerblom, M.D., D.M.Sc. for the Finnish TRIGR Study Group

N Engl J Med 2010; 363:1900-1908November 11, 2010

 

BACKGROUND

Early exposure to complex dietary proteins may increase the risk of beta-cell autoimmunity and type 1 diabetes in children with genetic susceptibility. We tested the hypothesis that supplementing breast milk with highly hydrolyzed milk formula would decrease the cumulative incidence of diabetes-associated autoantibodies in such children.

 

METHODS

In this double-blind, randomized trial, we assigned 230 infants with HLA-conferred susceptibility to type 1 diabetes and at least one family member with type 1 diabetes to receive either a casein hydrolysate formula or a conventional, cow's-milk–based formula (control) whenever breast milk was not available during the first 6 to 8 months of life. Autoantibodies to insulin, glutamic acid decarboxylase (GAD), the insulinoma-associated 2 molecule (IA-2), and zinc transporter 8 were analyzed with the use of radiobinding assays, and islet-cell antibodies were analyzed with the use of immunofluorescence, during a median observation period of 10 years (mean, 7.5). The children were monitored for incident type 1 diabetes until they were 10 years of age.

 

RESULTS

The unadjusted hazard ratio for positivity for one or more autoantibodies in the casein hydrolysate group, as compared with the control group, was 0.54 (95% confidence interval [CI], 0.29 to 0.95), and the hazard ratio adjusted for an observed difference in the duration of exposure to the study formula was 0.51 (95% CI, 0.28 to 0.91). The unadjusted hazard ratio for positivity for two or more autoantibodies was 0.52 (95% CI, 0.21 to 1.17), and the adjusted hazard ratio was 0.47 (95% CI, 0.19 to 1.07). The rate of reported adverse events was similar in the two groups.

 

CONCLUSIONS

Dietary intervention during infancy appears to have a long-lasting effect on markers of beta-cell autoimmunity — markers that may reflect an autoimmune process leading to type 1 diabetes. (Funded by the European Commission and others; ClinicalTrials.gov number, NCT00570102.)

[Breathless Wonder]

This theory has been floating around for quite some time, but unfortunately, they have never done a study large enough to be considered "statistically significant" as far as the medical community is concerned.