Dietary intake of soluble fiber and risk of islet autoimmunity by 5 y of age: results from the TEDDY study

Abstract

Background: Deficient soluble fiber intake has been suggested to dysregulate the immune response either directly or through alterations of the microbial composition in the gut.

Objective: We hypothesized that a high intake of dietary soluble fiber in early childhood decreases the risk of type 1 diabetes (T1D)-associated islet autoimmunity.

Design: We analyzed 17,620 food records collected between age 9 and 48 mo from 3358 children from the United States and Germany prospectively followed in the TEDDY (The Environmental Determinants of Diabetes in the Young) study. HRs for the development of any/multiple islet autoantibodies (242 and 151 events, respectively) and T1D (71 events) by soluble fiber intake were calculated in Cox regression models and adjusted for potential confounders.

Results: There were no statistically significantly protective associations observed between a high intake of soluble fiber and islet autoimmunity or T1D. For example, the adjusted HRs (95% CIs) for high intake (highest compared with lowest quintile) at age 12 mo were 0.90 (0.55, 1.45) for any islet autoantibody, 1.20 (0.69, 2.11) for multiple islet autoantibodies, and 1.24 (0.57, 2.70) for T1D. In analyzing soluble fiber intake as a time-varying covariate, there were also no short-term associations between soluble fiber intake and islet autoimmunity development, with adjusted HRs of 0.85 (0.51, 1.42) for high intake and development of any islet autoantibody, for example.

Conclusion: These results indicate that the intake level of dietary soluble fiber is not associated with islet autoimmunity or T1D in early life.

Keywords: TEDDY study; autoimmunity; diet; soluble fiber; type 1 diabetes.

FIGURE 1

Flowchart of children included and excluded. HLA, human leukocyte antigen; TEDDY, The Environmental Determinants of Diabetes in the Young.

FIGURE 2

Boxplots of soluble fiber intake, total energy intake from food items, and soluble fiber intake standardized to an energy intake of 1000 kcal by diet record visit (n = 3358 subjects). Standardized values of soluble fiber intake were not statistically significantly associated with age (Pearson’s r = −0.01, P = 0.12).