PMID- 23836309
OWN - NLM
STAT- MEDLINE
DCOM- 20131104
LR  - 20211021
IS  - 2168-6211 (Electronic)
IS  - 2168-6203 (Print)
IS  - 2168-6203 (Linking)
VI  - 167
IP  - 9
DP  - 2013 Sep
TI  - Infant exposures and development of type 1 diabetes mellitus: The Diabetes 
      Autoimmunity Study in the Young (DAISY).
PG  - 808-15
LID - 10.1001/jamapediatrics.2013.317 [doi]
AB  - IMPORTANCE: The incidence of type 1 diabetes mellitus (T1DM) is increasing 
      worldwide, with the most rapid increase among children younger than 5 years of 
      age. OBJECTIVE: To examine the associations between perinatal and infant 
      exposures, especially early infant diet, and the development of T1DM. DESIGN: The 
      Diabetes Autoimmunity Study in the Young (DAISY) is a longitudinal, observational 
      study. SETTING: Newborn screening for human leukocyte antigen (HLA) was done at 
      St. Joseph's Hospital in Denver, Colorado. First-degree relatives of individuals 
      with T1DM were recruited from the Denver metropolitan area. PARTICIPANTS: A total 
      of 1835 children at increased genetic risk for T1DM followed up from birth with 
      complete prospective assessment of infant diet. Fifty-three children developed 
      T1DM. EXPOSURES: Early (<4 months of age) and late (>/=6 months of age) first 
      exposure to solid foods compared with first exposures at 4 to 5 months of age 
      (referent). MAIN OUTCOME AND MEASURE: Risk for T1DM diagnosed by a physician. 
      RESULTS: Both early and late first exposure to any solid food predicted 
      development of T1DM (hazard ratio [HR], 1.91; 95% CI, 1.04-3.51, and HR, 3.02; 
      95% CI, 1.26-7.24, respectively), adjusting for the HLA-DR genotype, first-degree 
      relative with T1DM, maternal education, and delivery type. Specifically, early 
      exposure to fruit and late exposure to rice/oat predicted T1DM (HR, 2.23; 95% CI, 
      1.14-4.39, and HR, 2.88; 95% CI, 1.36-6.11, respectively), while breastfeeding at 
      the time of introduction to wheat/barley conferred protection (HR, 0.47; 95% CI, 
      0.26-0.86). Complicated vaginal delivery was also a predictor of T1DM (HR, 1.93; 
      95% CI, 1.03-3.61). CONCLUSIONS AND RELEVANCE: These results suggest the safest 
      age to introduce solid foods in children at increased genetic risk for T1DM is 
      between 4 and 5 months of age. Breastfeeding while introducing new foods may 
      reduce T1DM risk.
FAU - Frederiksen, Brittni
AU  - Frederiksen B
AD  - Colorado School of Public Health, University of Colorado, Aurora.
FAU - Kroehl, Miranda
AU  - Kroehl M
FAU - Lamb, Molly M
AU  - Lamb MM
FAU - Seifert, Jennifer
AU  - Seifert J
FAU - Barriga, Katherine
AU  - Barriga K
FAU - Eisenbarth, George S
AU  - Eisenbarth GS
FAU - Rewers, Marian
AU  - Rewers M
FAU - Norris, Jill M
AU  - Norris JM
LA  - eng
GR  - P30 DK057516/DK/NIDDK NIH HHS/United States
GR  - P30 DK 57516/DK/NIDDK NIH HHS/United States
GR  - R01 DK049654/DK/NIDDK NIH HHS/United States
GR  - R01 DK032493/DK/NIDDK NIH HHS/United States
GR  - R01-DK32493/DK/NIDDK NIH HHS/United States
GR  - R01-DK49654/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - JAMA Pediatr
JT  - JAMA pediatrics
JID - 101589544
RN  - 0 (Genetic Markers)
RN  - 0 (HLA-DQ beta-Chains)
RN  - 0 (HLA-DQB1 antigen)
RN  - 0 (HLA-DR3 Antigen)
RN  - 0 (HLA-DR4 Antigen)
SB  - IM
CIN - Nat Rev Endocrinol. 2013 Sep;9(9):504. PMID: 23856818
CIN - J Pediatr. 2014 Jan;164(1):216-9. PMID: 24359907
CIN - Evid Based Nurs. 2015 Jan;18(1):17. PMID: 24920044
MH  - Breast Feeding
MH  - Child
MH  - Child, Preschool
MH  - Diabetes Mellitus, Type 1/*etiology/genetics
MH  - *Diet
MH  - Diet Surveys
MH  - *Feeding Behavior
MH  - Female
MH  - Genetic Markers
MH  - HLA-DQ beta-Chains/genetics
MH  - HLA-DR3 Antigen/genetics
MH  - HLA-DR4 Antigen/genetics
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Longitudinal Studies
MH  - Male
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - Risk Factors
PMC - PMC4038357
MID - NIHMS571346
COIS- Conflict of Interest Disclosures: None reported.
EDAT- 2013/07/10 06:00
MHDA- 2013/11/05 06:00
PMCR- 2014/05/29
CRDT- 2013/07/10 06:00
PHST- 2013/07/10 06:00 [entrez]
PHST- 2013/07/10 06:00 [pubmed]
PHST- 2013/11/05 06:00 [medline]
PHST- 2014/05/29 00:00 [pmc-release]
AID - 1707785 [pii]
AID - 10.1001/jamapediatrics.2013.317 [doi]
PST - ppublish
SO  - JAMA Pediatr. 2013 Sep;167(9):808-15. doi: 10.1001/jamapediatrics.2013.317.