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Objective: The associations of energy, protein, carbohydrate, and fat intake with weight status up to the age of 5.5 years were prospectively assessed in The Environmental Determinants of Diabetes in the Young (TEDDY) study.Methods: Food record data (over 3 days) and BMI measurements between 0.25 and 5.5 years were available from 5,563 children with an increased genetic risk for type 1 diabetes followed from shortly after birth. Odds ratios (ORs) were calculated for overweight and obesity by previous intake of energy, protein, carbohydrate, and fat with adjustment for potential confounders.Results: Having overweight or obesity at the age of 5.5 years was positively associated with mean energy intake in previous age intervals (e.g., adjusted OR [95% CI] for overweight: 1.06 [1.04-1.09] per 100 kcal intake at the age of 4.5-5.0 years) and with protein intake after the age of 3.5 and 4.5 years, respectively (e.g., adjusted OR for overweight: 1.06 [1.03-1.09] per 1% of energy intake at the age of 4.5-5.0 years). The respective associations with carbohydrate and fat intake were less consistent.Conclusions: These findings indicate that energy and protein intake are positively associated with increased risk for overweight in childhood but yield no evidence for potential programming effects of protein intake in infancy. [ABSTRACT FROM AUTHOR]

ObjectiveThe development of type 1 diabetes (T1D) is potentially influenced by nutrition. The aim of our study was to assess food and nutrient intakes of children at increased risk of T1D.DesignDietary intake of the last 4 weeks was assessed using a diet history interview. The daily nutrient and food intakes were compared with the German Dietary Reference Intakes, the Optimized Mixed Diet recommendations and those of a representative sample of children from the EsKiMo study.SettingChildren included in the analysis participated in the prospective TEENDIAB study.SubjectsFirst-degree relatives of people with T1D (n 268), aged 8–12 years.ResultsThe TEENDIAB children consumed 52·0 % of their total energy from carbohydrates, 32·6 % from fat and 14·3 % from protein. Compared with the reference values, their intake was lowest for folate at 61·3 % of the reference, for iodine at 58·1 % and for vitamin D at 8·9 %, and exceeded the reference for vitamin K about 5-fold, for Na about 3·5-fold and for protein about 1·5-fold. Their nutrient intakes were similar to those of a control cohort without increased T1D risk. The consumption of non-desirable food groups (meat products, sweets/snacks) was above the recommendations and the consumption of desirable food groups (fruits, vegetables, carbohydrate-rich foods) was below the recommendations.ConclusionsThe TEENDIAB children had intakes considerably below the recommendations for vitamin D, iodine, folate and plant-based foods, and intakes above for vitamin K, Na, protein, meat products and sweets/snacks. They showed similar dietary patterns to non-risk children. [ABSTRACT FROM PUBLISHER]

OBJECTIVE: To characterize distinct islet autoantibody profiles preceding stage 3 type 1 diabetes RESEARCH DESIGN AND METHODS: The T1DI (Type 1 Diabetes Intelligence) study combined data from 1,845 genetically susceptible prospectively observed children who were positive for at least one islet autoantibody: insulin autoantibody (IAA), GAD antibody (GADA), or islet antigen 2 antibody (IA-2A). Using a novel similarity algorithm that considers an individual's temporal autoantibody profile, age at autoantibody appearance, and variation in the positivity of autoantibody types, we performed an unsupervised hierarchical clustering analysis. Progression rates to diabetes were analyzed via survival analysis. RESULTS: We identified five main clusters of individuals with distinct autoantibody profiles characterized by seroconversion age and sequence of appearance of the three autoantibodies. The highest 5-year risk from first positive autoantibody to type 1 diabetes (69.9%; 95% CI 60.0–79.2) was observed in children who first developed IAA in early life (median age 1.6 years) followed by GADA (1.9 years) and then IA-2A (2.1 years). Their 10-year risk was 89.9% (95% CI 81.9–95.4). A high 5-year risk was also found in children with persistent IAA and GADA (39.1%) and children with persistent GADA and IA-2A (30.9%). A lower 5-year risk (10.5%) was observed in children with a late appearance of persistent GADA (6.1 years). The lowest 5-year diabetes risk (1.6%) was associated with positivity for a single, often reverting, autoantibody. CONCLUSIONS: The novel clustering algorithm identified children with distinct islet autoantibody profiles and progression rates to diabetes. These results are useful for prediction, selection of individuals for prevention trials, and studies investigating various pathways to type 1 diabetes. [ABSTRACT FROM AUTHOR]

Probiotics are linked to positive regulatory effects on the immune system. The aim of the study was to examine the association between the exposure of probiotics via dietary supplements or via infant formula by the age of 1 year and the development of celiac disease autoimmunity (CDA) and celiac disease among a cohort of 6520 genetically susceptible children. Use of probiotics during the first year of life was reported by 1460 children. Time-to-event analysis was used to examine the associations. Overall exposure of probiotics during the first year of life was not associated with either CDA (n = 1212) (HR 1.15; 95%CI 0.99, 1.35; p = 0.07) or celiac disease (n = 455) (HR 1.11; 95%CI 0.86, 1.43; p = 0.43) when adjusting for known risk factors. Intake of probiotic dietary supplements, however, was associated with a slightly increased risk of CDA (HR 1.18; 95%CI 1.00, 1.40; p = 0.043) compared to children who did not get probiotics. It was concluded that the overall exposure of probiotics during the first year of life was not associated with CDA or celiac disease in children at genetic risk. [ABSTRACT FROM AUTHOR]

Aims/hypothesis Vaccinations in early childhood potentially stimulate the immune system and may thus be relevant for the pathogenesis of autoimmune diseases such as type 1 diabetes (T1D). We determined the association of vaccination burden with T1D-associated islet autoimmunity in children with high familial risk followed prospectively from birth. Methods A total of 20,570 certified vaccination records from 1918 children were correlated with time to onset of T1D-associated islet autoimmunity using Cox regression, considering multiple time periods up until age two years and vaccination types, and adjusting for HLA genotype, sex, delivery mode, season of birth, preterm delivery and maternal T1D status. Additionally, prospective claims data of 295,420 subjects were used to validate associations for the tick-borne encephalitis (TBE) vaccination. Results Most vaccinations were not associated with a significantly increased hazard ratio (HR) for islet autoimmunity (e.g. HR [95% confidence interval]: 1.08 [0.96–1.21] per additional vaccination against measles, mumps and rubella at age 0–24 months). TBE vaccinations within the first two years of life were nominally associated with a significantly increased autoimmunity risk (HR: 1.44 [1.06–1.96] per additional vaccination at age 0–24 months), but this could not be confirmed with respect to outcome T1D in the validation cohort (HR: 1.02 [0.90–1.16]). Conclusions We found no evidence that early vaccinations increase the risk of T1D-associated islet autoimmunity development. The potential association with early TBE vaccinations could not be confirmed in an independent cohort and appears to be a false positive finding. [ABSTRACT FROM AUTHOR]

It is hypothesized that eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) protect against T1D. It was shown that erythrocyte EPA and DHA levels are higher in breastfed infants as compared to formula fed infants, but that there are differences in milk composition between mothers with and without T1D. The aim of this study was to determine whether erythrocyte EPA and DHA levels differ between breastfed infants from mothers with and without T1D participating in the BABYDIET Study. BABYDIET follows children with increased genetic risk from birth to age 3 years. Samples for determination of erythrocyte membrane phosphatidylethanolamine (PE) and phosphatidylcholine (PE) composition were collected at age 3 months in 48 infants. Feeding habits were obtained from 3-monthly questionnaires and 3-day diet records. Erythrocyte EPA and DHA levels were higher in infants who received full breastfeeding for ≥ 3 months (EPA: PC: 0.20±0.07 vs. 0.16±0.09 p≤0.01; PE: 0.67±0.26 vs. 0.44±0.18 p≤0.001; DHA: PC: 1.81±0.44 vs. 1.32±0.65 p≤0.01; PE: 8.52±1.42 vs. 6.73±1.85 p≤0.001), and in infants from mothers who used fish oil supplements during pregnancy or breastfeeding (all p<0.01). No difference in EPA and DHA levels were observed between infants from mothers with T1D and infants from non-diabetic mothers (EPA: PC: 0.20-3±0.07 vs. 0.19±0.08; PE: 0.74±0.32 vs. 0.63±0.22; DHA PC:. 1.77±0.36 vs. 1.83±0.48; PE: 8.05±1.07 vs. 8.53±1.62, p>0.05). Furthermore, maternal T1D did not influence EPA and DHA levels when analysis was performed only in infants who received 3 months full breastfeeding, and after correction for fish oil supplementation. These data suggest that breast milk is an optimal source of EPA and DHA and that diabetic breast milk offers a similar supply of EPA and DHA to infants compared to non-diabetic breast milk. [ABSTRACT FROM AUTHOR]

Emerging evidence supports an association between light at night (LAN) exposure with obesity or overweight in adults. However, effects of LAN exposure during childhood have yet to be further investigated. In this study, we aimed to determine whether LAN exposure is associated with body mass in young children. We used data from the Fr1da cohort study which screened children for early-stage islet autoimmunity in Bavaria, Germany from February 2015 to March 2019. A total of 62,212 children aged <11 years with complete residential information was included in the analysis. Self-reported weight and height were used to calculate age- and sex-specific body mass index (BMI) z-scores. LAN exposure was based on remotely sensed images from Visible Infrared Imaging Radiometer Suite and assigned to the children's residencies. We used generalized additive models to estimate the associations between LAN exposure and BMI adjusting for potential confounders. We observed an increase in BMI z-scores of 34.0% (95% confidence interval (CI): 25.4–42.6) per 10 nW/cm2/sr increment in LAN exposure at baseline (2015) and of 32.6% (24.3–41.0) for LAN exposure one year prior to screening, both adjusted for age and sex. Similar associations were observed after adjustment for socioeconomic status and urbanization degree. Our findings suggest that outdoor light exposure may be a risk factor for weight gain during childhood. • A large population-based cohort of children is investigated. • Address-level exposure to outdoor artificial light at night is included. • Higher night-time light exposure was associated with higher BMI z-score in children. • The associations were stronger in males. • Further long-term studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]