Issue 176 Item 8 Kids’ Diabetes Risk Tied to Cereal Food Timing

The age at which infants are introduced to cereal foods may affect their risk of developing childhood, or type 1, diabetes. Waiting until the age of 3 to introduce solid foods is recommended.

That finding comes from two studies published in this week’s issue of the Journal of the American Medical Association. Both research teams suggest parents can perhaps reduce the risk of diabetes by complying with infant feeding guidelines, which suggest waiting until after the age of 3 months to introduce solid foods.

Type 1 diabetes is an autoimmune disorder in which the body produces antibodies against itself — in this case, against the insulin-producing cells in the pancreas. Children found to have high levels of these "autoantibodies" are liable to develop diabetes.

For the Diabetes Autoimmunity Study in the Young (DAISY), Dr. Jill M. Norris, at the University of Colorado Health Sciences Center in Denver, and others enrolled nearly 1200 children who were at increased risk for type 1 diabetes, because of their genetic or family background.

Thirty-four newborns tested positive for pancreatic autoantibodies over an average 4-year period. The likelihood of developing autoantibodies was four times higher for infants who began cereal feeds before 3 months of age or after 7 months, compared with those who started during months 4 through 6.

There appears to be "a window of exposure to cereals" outside which the risk of developing pancreatic autoantibodies rises in susceptible children, Norris and colleagues suggest.

Meanwhile, Dr. Anette-G. Ziegler of the Diabetes Research Institute in Munich, Germany, and colleagues enrolled just over 1600 newborns who had a parent with type 1 diabetes in the BABYDIAB trial. Eighty-five children developed pancreatic autoantibodies by five years of age.

In this study, the risk of developing autoantibodies was five times higher for infants given gluten-containing foods prior to age 3 months, compared with those not fed gluten until age 3 to 6 months.

"Early introduction of gluten-containing foods should be avoided in children who are genetically predisposed to type 1 diabetes," Ziegler’s group maintains.

In a commentary in the journal, two physicians urge "cautious interest" in these findings. They especially caution that the evidence not be misinterpreted as "infant cereal causes diabetes."

Dr. Mark Atkinson, at the University of Florida in Gainesville, and Dr. Edwin Gale, at the University of Bristol, England, note that the most critical outcome is the development of diabetes, which was not addressed directly in either study. Therefore, "current infant feeding guidelines should not be changed." Journal of the American Medical Association, October 1, 2003.

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FACT: Americans’ life expectancy continued to rise despite a 27 percent jump over five years in the prevalence of diabetes and an increased number of overweight Americans, according to a National Center for Health Statistics report released Friday.