July 08, 2013
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DAISY: Early, late exposure to solid food linked to type 1 diabetes risk

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Infants introduced to solid foods before 3 months of age and after 6 months of age could be more likely to develop type 1 diabetes, according to data published in JAMA Pediatrics. Data also indicate that solid foods introduced between ages 4 to 5 months in conjunction with breast-feeding could attenuate the risk for type 1 diabetes.

Brittni Frederiksen, MPH, of the Colorado School of Public Health at the University of Colorado in Aurora, and colleagues examined the potential link between perinatal and infant exposures to solid food and the development of type 1 diabetes in a prospective analysis of the Diabetes Autoimmunity Study in the Young (DAISY).

They included 1,835 children with an increased genetic risk for type 1 diabetes who were followed from birth. First exposures were considered early if solid food was given to the infant at age <4 months and late if given at ≥6 months of age. This was compared with those exposed at ages 4 to 5 months. Ultimately, 53 children developed type 1 diabetes, researchers wrote.

After adjusting for the HLA-DR genotype, first-degree relatives with type 1 diabetes, maternal education and delivery type, researchers reported that early (HR=1.91; 95% CI, 1.04-3.51) and late (HR=3.02; 95% CI, 1.26-7.24) first exposure to any solid food predicted development of type 1 diabetes.

Further, early exposure to fruit (HR=2.23; 95% CI, 1.14-4.39) and late exposure to rice/oat products (HR=2.88; 95% CI, 1.36-6.11) predicted type 1 diabetes. However, breast-feeding at the time of introduction to wheat/barley appeared to reduce the risk for type 1 diabetes (HR=0.47; 95% CI, 0.26-0.86). If a complicated vaginal delivery transpired, the risk for type 1 diabetes also increased (HR=1.93; 95% CI, 1.03-3.61).

“In summary, there appears to be a safe window in which to introduce solid foods between 4 and 5 months of age; solid foods should be introduced while continuing to breast-feed to minimize type 1 diabetes risk in genetically susceptible children. These findings should be replicated in a larger cohort for confirmation,” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.