Can we prevent type 1 diabetes by modifying infant nutrition?

Within the next 10 years an international study called TRIGR (Trial to Reduce IDDM in the Genetically at Risk) will generate a definite answer to the question whether early nutritional modification may prevent type 1 diabetes later in childhood.

Type 1 diabetes is a growing health problem among European children. European data indicate that the disease incidence has increased five-six-fold among children under the age of 15 years after World War II, and there are no signs that the increase in incidence is levelling off. The most conspicuous increase has been seen among children under the age of 5 years.

The TRIGR study is the first study ever aimed at primary prevention of type 1 diabetes. The study is designed to answer to the question whether excluding cow's milk protein from the infant's diet decreases the risk of fu-ture diabetes. All subjects are followed for 10 years to get information on whether the dietary recommendations for infants at increased genetic risk of type 1 diabetes should be revised.

Starting in May 2002, 76 study centres from 15 countries (Australia, Canada, the Czech Republic, Estonia, Finland, Germany, Hungary, Italy, Luxembourg, the Netherlands, Poland, Spain, Sweden, Switzerland and USA) have been recruiting families for the study. To be eligible the newborn infant has to have at least one family member (mother, father and/or sib) affected by type 1 diabetes and carry a HLA genotype conferring increased risk for type 1 diabetes. The initial recruitment target of 2032 eligible infants was reached at the be-ginning of September 2006, but the Study Group has decided to continue recruitment till the end of December 2006 (when the EU contribution will finish) to make the study even more powerful statistically.

A majority of the study participants (52%) have been recruited in Europe. The International Coordinating Cen-tre (ICC) is located at the University of Helsinki, Helsinki, Finland and the Data Management Unit (DMU) at the University of South Florida, Tampa, Florida, USA. The trial has logistically been a true challenge for both the ICC and DMU. DMU has been successful in establishing a secure, real-time, web-based, interactive data management system that works extremely well. This system can be directly applied to future international mul-ticentre studies.

The TRIGR study is generating a wealth of information on breast-feeding practices, infant nutrition and growth in young children in various countries. At 2 weeks of age almost all the participating infants were breast-fed. Exclusive breast-feeding continued longer in Europe than in North America. More than one third of the infants (35 %) received other foods in addition to breast milk and/or infant formulas at the age of 4 months, while WHO recommends that supplementary food should be introduced at the earliest by the age of 6 months. In Europe the first foods to be introduced are typically vegetables and fruits, whereas gluten-free cereals are most commonly introduced in North America.

Newborn infants in Northern Europe (NE) had a higher birth weight but a shorter birth length than infants in Central and Southern Europe (CSE). The NE children remained heavier than those from CSE at least up to the age of 18 months. The NE children were also taller than the CSE children starting already from the age of 3 months up to the age of 18 months. Accelerated growth in infancy has been identified as a risk factor for type 1 diabetes later in childhood. Accordingly the observed growth pattern may contribute to the higher incidence of type 1 diabetes in NE compared to CSE.

Source: University of Helsinki

Related stories:

Young type-2 diabetic men suffer low testosterone levels, study shows
Young men with type 2 diabetes have significantly low levels of testosterone, endocrinologists at the University at Buffalo have found -- a condition that could have a critical effect on their quality of life and on their ability to father children.
Caesarean babies more likely to develop diabetes
Babies delivered by Caesarean section have a 20 per cent higher risk than normal deliveries of developing the most common type of diabetes in childhood, according to a study led by Queen's University Belfast.
First detection of 'odor profile' for skin cancer may lead to rapid, non-invasive diagnostic test
Chemists today described the first identification of a specific "odor profile" for skin cancer, a discovery that could form the basis of a rapid, non-invasive test for diagnosing the most common type of cancer in the United States. The findings may enable doctors in the future to diagnose skin cancer quickly and accurately by waving a handheld scanner or sensor above the skin, they reported today at the 236th national meeting of the American Chemical Society.
Researcher develops novel method to grow human embryonic stem cells
(PhysOrg.com) -- The majority of researchers working with human embryonic stem cells (hESCs) – cells which produce any type of specialized adult cells in the human body – use animal-based materials for culturing the cells. But because these materials are animal-based, they could transmit viruses and other pathogens to the hESCs, making the cells unsuitable for medical use.
Arsenic exposure could increase diabetes risk
Inorganic arsenic, commonly found in ground water in certain areas, may increase the risk of developing type 2 diabetes, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health. The study found that individuals with diabetes had higher levels of arsenic in the urine compared to individuals without diabetes. The results are published in the August 20, 2008, issue of JAMA.
Blood pressure response to daily stress provides clues for better hypertension treatment
How the body regulates blood pressure in response to daily stress is the focus of a study geared toward helping people whose pressure is out of control.
Poor coordination in childhood is linked to obesity in later life
Poor physical control and coordination in childhood are linked to an increased risk of obesity in later life, suggests a study published on BMJ.com today.
Researchers Report Periodontal Disease Independently Predicts New Onset Diabetes
(PhysOrg.com) -- Periodontal disease may be an independent predictor of incident Type 2 diabetes, according to a study by researchers at Columbia University Mailman School of Public Health. While diabetes has long been believed to be a risk factor for periodontal infections, this is the first study exploring whether the reverse might also be true, that is, if periodontal infections can contribute to the development of diabetes. The full study findings are published in the July 2008 issue of Diabetes Care.

News discussion:

Medicine & Health news