Lack of Association Between Early Exposure to Cow's Milk Protein and β-Cell Autoimmunity

Norris, Jill M.; Beaty, Brenda; Klingensmith, Georgeanna J.; Yu, Liping; Hoffman, Michelle; Chase, H. Peter; Erlich, Henry A.; Hamman, Richard F.; Eisenbarth, George S.; Rewers, Marian

doi:10.1001/jama.1996.03540080031025

Cited by 135 publications

(26 citation statements)

References 26 publications

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“…Some case-control studies, but not all, have shown that early introduction of cow's milk during infancy may be diabetogenic (21,22). The statistical power of the available cohort study (7) and another nested case-control study (23) addressing the effect of the early introduction of cow's milk feeding on the development of type 1 diabetes and/or on the seroconversion to positivity of diabetes-specific autoantibodies was too weak to detect a relative risk of the same magnitude as that observed in case-control studies. (100) *Adjusted for the matching factors, the length of maternal education, and maternal and child's ages, and stratified for HLA-DQB1 risk grouping.…”

Section: Discussionmentioning

confidence: 99%

Cow's milk consumption, HLA-DQB1 genotype, and type 1 diabetes: a nested case-control study of siblings of children with diabetes. Childhood diabetes in Finland study group.

Virtanen¹,

Läärä²,

Hyppönen³

et al. 2000

Diabetes

113

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, and the Childhood Diabetes in Finland Study GroupThe evidence for the putative role of cow's milk in the development of type 1 diabetes is controversial. We studied infant feeding patterns and childhood diet by structured questionnaire (n = 725) and HLA-DQB1 genotype by a polymerase chain reaction-based method (n = 556) in siblings of affected children and followed them for clinical type 1 diabetes. In a nested case-control design in a population who had both dietary and genetic data available, we selected as cases those siblings who progressed to clinical diabetes during the follow-up period (n = 33). For each case, we chose as matched control subjects siblings who fulfilled the following criteria: same sex, age within 1 year, not from the same family, the start of the follow-up within 6 months of that of the respective case, and being at risk for type 1 diabetes at the time the case presented with that disease (n = 254). The median followup time was 9.7 years (range 0.2-11.3). Early age at introduction of cow's milk supplements was not signific a n t l y associated with progression to clinical type 1 diabetes (relative risk adjusted for matching factors, maternal education, maternal and child's ages, childhood milk consumption, and genetic susceptibility markers was 1.60 [95% CI 0.5-5.1]). The estimated relative risk of childhood milk consumption for progression to type 1 diabetes was 5.37 (1.6-18.4) when adjusted for the matching and aforementioned sociodemographic factors, age at introduction of supplementary milk feeding, as well as for genetic susceptibility markers. In conclusion, our results provide support for the hypothesis that high consumption of cow's milk during childhood can be diabetogenic in siblings of children with type 1 diabetes. However, further studies are needed to assess the possible interaction between genetic disease susceptibility and dietary exposures in the development of this disease. Diabetes 4 9 :9 1 2-917, 2000

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Section: Discussionmentioning

confidence: 99%

Cow's milk consumption, HLA-DQB1 genotype, and type 1 diabetes: a nested case-control study of siblings of children with diabetes. Childhood diabetes in Finland study group.

Virtanen¹,

Läärä²,

Hyppönen³

et al. 2000

Diabetes

113

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“…in the high-risk population of Sardinia [76], or in cross-sectional studies [77], other (nested) case-control studies [78,79] or in several prospective trials [[80], and references therein].…”

Section: Type 1 Diabetesmentioning

confidence: 99%

Timing of Introduction of Complementary Food: Short- and Long-Term Health Consequences

Przyrembel¹

2012

Ann Nutr Metab

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Complementary food is needed when breast milk (or infant formula) alone is no longer sufficient for both nutritional and developmental reasons. The timing of its introduction, therefore, is an individual decision, although 6 months of exclusive breastfeeding can be recommended for most healthy term infants. The new foods are intended to ‘complement’ ongoing breastfeeding with those dietary items whose intake has become marginal or insufficient. Both breastfeeding and complementary feeding can have direct or later consequences on health. The evaluation of consequences of both early and late introduction of complementary food can neither disregard the effect of breastfeeding compared to formula feeding nor the composition or quality of the complementary food. Possible short-term health effects concern growth velocity and infections, and possible long-term effects may relate to atopic diseases, type 1 and 2 diabetes, obesity and neuromuscular development. On the basis of the currently available evidence, it is impossible to exactly determine the age when risks related to the start of complementary feeding are lowest or highest for most of these effects, with the possible exception of infections and early growth velocity. The present knowledge on undesirable health effects, however, is mainly based on observational studies, and although some mechanisms have been proposed, further prospective studies have to clarify these unsolved issues. Even less evidence on the consequences of the timing of complementary food introduction is available for formula-fed infants.

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“…Epidemiology suggests there is a relationship between early introduction of cow's milk (or derivatives) and diabetes mellitus I, even though a few years may elapse before agreement on a definitive and widely accepted conclusion on this issue 5 . Meanwhile, the American Academy of Pediatrics recommends breast-feeding in infants of families with a positive familial history of diabetes mellitus, avoiding, if possible, any product containing whole cow's milk protein in the first year of life 6 .…”

mentioning

confidence: 99%

Breast-feeding in Spain

Torre

Hernández-Aguilar

2001

Public Health Nutr.

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Human milk is the best way to nurture the human infant. By breast-feeding their babies, mothers provide them with the best opportunities to wholly develop their potential, while protecting the infants and themselves from a whole range of diseases in the near future and in the years to come. Even though these benefits are widely known and there is ample scientific evidence on the topic, it seems from published data that Spanish women are not breastfeeding their babies as much and for as long as they should. Less than 90% start breast-feeding, at 1 month there is already an attrition of 30%, at 3 months more than half of the infants are taking artificial milk and by 6 months only 10% continue to breast-feed their infants. Low birth weight, Caesarean section and low study level are among the more significant factors that negatively affect breast-feeding. There is still work to do to improve this situation. Promotion of breast-feeding among the general population, mothers and health professionals is needed.

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Lack of Association Between Early Exposure to Cow's Milk Protein and β-Cell Autoimmunity

Cited by 135 publications

References 26 publications

Cow's milk consumption, HLA-DQB1 genotype, and type 1 diabetes: a nested case-control study of siblings of children with diabetes. Childhood diabetes in Finland study group.

Cow's milk consumption, HLA-DQB1 genotype, and type 1 diabetes: a nested case-control study of siblings of children with diabetes. Childhood diabetes in Finland study group.

Timing of Introduction of Complementary Food: Short- and Long-Term Health Consequences

Breast-feeding in Spain

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