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Observational Study
. 2021 Jul;64(7):1604-1612.
doi: 10.1007/s00125-021-05446-y. Epub 2021 Mar 30.

Maternal food consumption during late pregnancy and offspring risk of islet autoimmunity and type 1 diabetes

Randi K Johnson  1 , Roy Tamura  2 , Nicole Frank  3 , Ulla Uusitalo  2 , Jimin Yang  2 , Sari Niinistö  4 , Carin Andrén Aronsson  5 , Anette-G Ziegler  6 , William Hagopian  7 , Marian Rewers  8 , Jorma Toppari  9 , Beena Akolkar  10 , Jeffrey Krischer  2 , Suvi M Virtanen  4   11   12   13 , Jill M Norris  14 ; TEDDY Study Group
Affiliations
Observational Study

Maternal food consumption during late pregnancy and offspring risk of islet autoimmunity and type 1 diabetes

Randi K Johnson et al. Diabetologia. 2021 Jul.

Abstract

Aims/hypothesis: We aimed to investigate the association between maternal consumption of gluten-containing foods and other selected foods during late pregnancy and offspring risk of islet autoimmunity (IA) and type 1 diabetes in The Environmental Determinants of Diabetes in the Young (TEDDY) study.

Methods: The TEDDY study recruited children at high genetic risk for type 1 diabetes at birth, and prospectively follows them for the development of IA and type 1 diabetes (n = 8556). A questionnaire on the mother's diet in late pregnancy was completed by 3-4 months postpartum. The maternal daily intake was estimated from a food frequency questionnaire for eight food groups: gluten-containing foods, non-gluten cereals, fresh milk, sour milk, cheese products, soy products, lean/medium-fat fish and fatty fish. For each food, we described the distribution of maternal intake among the four participating countries in the TEDDY study and tested the association of tertile of maternal food consumption with risk of IA and type 1 diabetes using forward selection time-to-event Cox regression.

Results: By 28 February 2019, 791 cases of IA and 328 cases of type 1 diabetes developed in TEDDY. There was no association between maternal late-pregnancy consumption of gluten-containing foods or any of the other selected foods and risk of IA, type 1 diabetes, insulin autoantibody-first IA or GAD autoantibody-first IA (all p ≥ 0.01). Maternal gluten-containing food consumption in late pregnancy was higher in Sweden (242 g/day), Germany (247 g/day) and Finland (221 g/day) than in the USA (199 g/day) (pairwise p < 0.05).

Conclusions/interpretation: Maternal food consumption during late pregnancy was not associated with offspring risk for IA or type 1 diabetes.

Trial registration: ClinicalTrials.gov NCT00279318.

Keywords: Autoimmunity; Gluten; Maternal diet; Pregnancy; Type 1 diabetes.

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Figures

Fig. 1
Fig. 1
Study population
Fig. 2
Fig. 2
Kaplan–Meier survival curves from any IA (a), type 1 diabetes (T1D) (b), IAA-first IA (c) and GADA-first IA (d) by tertile (cut-points: 168, 247 g/day) of maternal gluten-containing food consumption in late pregnancy; tertile 1, blue; tertile 2, red; tertile 3, green
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