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Randomized Controlled Trial
. 2017 Jul;13(3):e12354.
doi: 10.1111/mcn.12354. Epub 2016 Oct 7.

Regional differences in milk and complementary feeding patterns in infants participating in an international nutritional type 1 diabetes prevention trial

Anita M Nucci  1 , Suvi M Virtanen  2   3   4   5 , Susa Sorkio  2 , Sonja Bärlund  2 , David Cuthbertson  6 , Ulla Uusitalo  6 , Margaret L Lawson  7 , Marja Salonen  8 , Carol L Berseth  9 , Anne Ormisson  10 , Eveliina Lehtonen  2 , Erkki Savilahti  8 , Dorothy J Becker  11   12 , John Dupré  13 , Jeffrey P Krischer  6 , Mikael Knip  8   14   15   16 , Hans K Åkerblom  8 ; TRIGR Investigators
Collaborators, Affiliations
Randomized Controlled Trial

Regional differences in milk and complementary feeding patterns in infants participating in an international nutritional type 1 diabetes prevention trial

Anita M Nucci et al. Matern Child Nutr. 2017 Jul.

Abstract

Differences in breastfeeding, other milk feeding and complementary feeding patterns were evaluated in infants at increased genetic risk with and without maternal type 1 diabetes (T1D). The Trial to Reduce IDDM in the Genetically at Risk is an international nutritional primary prevention double-blinded randomized trial to test whether weaning to extensively hydrolyzed vs. intact cow's milk protein formula will decrease the development of T1D-associated autoantibodies and T1D. Infant diet was prospectively assessed at two visits and seven telephone interviews between birth and 8 months. Countries were grouped into seven regions: Australia, Canada, Northern Europe, Southern Europe, Central Europe I, Central Europe II and the United States. Newborn infants with a first-degree relative with T1D and increased human leukocyte antigen-conferred susceptibility to T1D were recruited. A lower proportion of infants born to mothers with than without T1D were breastfed until 6 months of age in all regions (range, 51% to 60% vs. 70% to 80%). Complementary feeding patterns differed more by region than by maternal T1D. In Northern Europe, a higher proportion of infants consumed vegetables and fruits daily compared with other regions. Consumption of meat was more frequent in all European regions, whereas cereal consumption was most frequent in Southern Europe, Canada and the United States. Maternal T1D status was associated with breastfeeding and other milk feeding patterns similarly across regions but was unrelated to the introduction of complementary foods. Infant feeding patterns differed significantly among regions and were largely inconsistent with current recommended guidelines.

Keywords: breastfeeding; breastfeeding duration; complementary feeding; infant feeding; infant formula; type 1 diabetes.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Breastfeeding and supplementary milk feeding during the first 3 days of life.
Figure 2
Figure 2
(a) The proportion of overall breastfeeding among mothers with type 1 diabetes by region. (2b) The proportion of overall breastfeeding among mothers without type 1 diabetes by region. (2c) The proportion of exclusively breastfeeding mothers with type 1 diabetes by region. (2d) The proportion of exclusively breastfeeding mothers without type 1 diabetes by region.
Figure 3
Figure 3
Milk feeding during the first 6 months of the intervention by maternal type 1 diabetes status.
Figure 4
Figure 4
Proportion of daily users of complementary foods by age and region among infants of mothers with and without type 1 diabetes.
See this image and copyright information in PMC

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