New research being presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in Madrid, Spain (9-13 September), shows that consuming fruits, oats, and rye during childhood may increase the risk of developing type 1 diabetes (T1D). In contrast, eating berries appears to be associated with a reduced risk of the condition.

Authors: S.M. Virtanen et al.

Background and aims: Prospective longitudinal evidence considering the entire childhood diet in relation to development of islet autoimmunity (IA), or type 1 diabetes is lacking. We studied the associations of food groups and their combinations with IA and type 1 diabetes risk.

Materials and methods: Children with genetic susceptibility to type 1 diabetes born in 1996-2004 were followed from birth up to 6 years of age in the Type 1 Diabetes Prediction and Prevention (DIPP) Study (n=5674). We analyzed the associations between food consumption and the risk of IA/type 1 diabetes using a Bayesian approach to joint models for multiple longitudinally observed foods and time-to-event data, adjusting for energy intake, sex, HLA genotype, and familial diabetes. Altogether 34 food groups covering the entire diet were included based on repeated 3-day food records at age 3 months to 6 years. The foods associated with the endpoint (P<.1) in one-food models were included in the preliminary multi-food model, from which the foods associated with the endpoint (P<.05) were selected to the final multi-food model. As endpoints we used islet cell antibodies (ICA) plus biochemical IA (n=247), multiple biochemical IA (n=206), and type 1 diabetes (n=94).

Results: In the final multi-food model for ICA plus biochemical IA, oats (hazard ratio (HR) 1.09, 95% credible interval (CI) 1.04-1.14) and banana (HR 1.07, 95% CI 1.03-1.11) were associated with increased and cruciferous vegetables (HR 0.83, 95% CI 0.73-0.94) with decreased risk. The model for multiple biochemical IA included, in addition to these foods, direct association of fermented dairy (HR 1.42, 95% CI 1.12-1.78) and wheat (HR 1.10, 95% CI 1.03-1.18). In the final multi-food model for type 1 diabetes, rye (HR 1.27, 95% CI 1.07-1.50), oats (HR 1.15, 95% CI 1.03-1.26), and fruits (HR 1.05, 95% CI 1.01-1.09) were associated with increased and berries (HR 0.67, 95% CI 0.50-0.93) with decreased type 1 diabetes risk.

Conclusion: The higher consumption of oats, gluten-containing cereals, and fruits was associated with increased and cruciferous vegetables with decreased risk of several type 1 diabetes related endpoints when considering all the foods in combination. Further studies need to confirm or deflate whether autoimmune process leading to type 1 diabetes can be modified by foods.

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