Early provision of energy and protein may reduce postnatal weight loss and risk of morbidity in extremely preterm infants.

OBJECTIVE -To study the association between type 1 diabetes risk and previous intake of energy, accounting for body size and previous intake of nutrients and foods, accounting for the energy intake.RESEARCH DESIGN AND METHODS -We conducted an incident populationbased case-referent study in Stockholm, Sweden, including 99 of 100 eligible 7-to 14-year-old diabetic children and 180 of 200 age-, sex-, and area-matched referent children identified through the Swedish population register. Average daily energy and nutrient intake 1 year before diabetes diagnosis/interview was estimated using the food frequency questionnaire with assessment of consumed food amounts. Mean SD scores of growth measurements taken during the last 4 years before the diagnosis were used. Odds ratios (ORs) were calculated by conditional logistic regression.RESULTS -Average intake of energy, carbohydrate, fat, and protein was significantly higher among the case subjects as well as mean weight-for-age SD score. Higher energy intake and weight-for-age were both associated with increased diabetes risk after adjustment for each other: OR (95% CI) for medium and high levels of energy intake were 1.33 (0.52-3.42) and 5.23 (1.67-16.38), respectively, and for weight-for-age were 3.20 (1.30 -7.88) and 3.09 (1.16 -8.22), respectively. High intake of carbohydrates, especially disaccharides and sucrose, increased diabetes risk.CONCLUSIONS -Higher energy intake and larger body size were independently associated with increased diabetes risk. Of the different nutrients, higher intake of carbohydrates, particularly disaccharides and sucrose, increased the risk. Lifestyle habits leading to higher energy intake and more rapid growth in childhood may contribute to the increase of childhoodonset type 1 diabetes by different mechanisms. Diabetes Care 27:2784 -2789, 2004D ietary intake of certain nutrients and possible toxic food components is of interest in the search for triggers or promoters of the autoimmune ␤-cell destruction that may lead to type 1 diabetes (1-3). Studies of infant diet indicated that short breast-feeding duration and early introduction of cow's milk proteins may be causally related to the development of childhood diabetes (4) and progressive ␤-cell autoimmunity before the age of 4 years (5). Some studies also found that high intake of cow's milk later in childhood is associated with increased risk of diabetes (6,7). In a previous population-based case-referent study, our group showed a dose-response relationship between the risk of developing childhood diabetes and the frequency of intake of foods rich in protein, carbohydrates, and nitrosamines (8). Moreover, the nutrition-associated risk profiles differed between the age-groups (9). Analyzing prospectively recorded childhood growth data, we have also showed that future diabetic children had a higher linear growth rate several years before the diagnosis compared with age-and sex-matched referents (10). Studies from different populations have confirmed that and also found that children who dev...

Neonatal nutrition improved significantly in Stockholm from 2004 to 2011. Above all, parenteral nutrition was initiated more promptly during the first week and was provided at higher quantities. However, many of the EPT infants born during the later years still did not reach the recommended macronutrient intake levels. A significant weight gain improvement was observed between 2004-2005 and 2006-2011.