title: Diet, growth, and the risk for type 1 diabetes in childhood: a matched case-referent study.
abstract: OBJECTIVE
  To study the association between type 1 diabetes risk and previous intake of energy, accounting for body size and previous intake of nutrients and foods, accounting for the energy intake.
  
  
  METHODS
  We conducted an incident population-based case-referent study in Stockholm, Sweden, including 99 of 100 eligible 7- to 14-year-old diabetic children and 180 of 200 age-, sex-, and area-matched referent children identified through the Swedish population register. Average daily energy and nutrient intake 1 year before diabetes diagnosis/interview was estimated using the food frequency questionnaire with assessment of consumed food amounts. Mean SD scores of growth measurements taken during the last 4 years before the diagnosis were used. Odds ratios (ORs) were calculated by conditional logistic regression.
  
  
  RESULTS
  Average intake of energy, carbohydrate, fat, and protein was significantly higher among the case subjects as well as mean weight-for-age SD score. Higher energy intake and weight-for-age were both associated with increased diabetes risk after adjustment for each other: OR (95% CI) for medium and high levels of energy intake were 1.33 (0.52-3.42) and 5.23 (1.67-16.38), respectively, and for weight-for-age were 3.20 (1.30-7.88) and 3.09 (1.16-8.22), respectively. High intake of carbohydrates, especially disaccharides and sucrose, increased diabetes risk.
  
  
  CONCLUSIONS
  Higher energy intake and larger body size were independently associated with increased diabetes risk. Of the different nutrients, higher intake of carbohydrates, particularly disaccharides and sucrose, increased the risk. Lifestyle habits leading to higher energy intake and more rapid growth in childhood may contribute to the increase of childhood-onset type 1 diabetes by different mechanisms.
authors.affiliation: Department of Clinical Sciences, Pediatrics, Umeå University 901 85 Umeå, Sweden. auste.pundziute.lycka@pediatri.umu.se
authors.forename: Auste
authors.initials: A
authors.lastname: Pundziute-Lyckå
authors.forename: Lars-Ake
authors.initials: LA
authors.lastname: Persson
authors.forename: Gunilla
authors.initials: G
authors.lastname: Cedermark
authors.forename: Agneta
authors.initials: A
authors.lastname: Jansson-Roth
authors.forename: Ulla
authors.initials: U
authors.lastname: Nilsson
authors.forename: Vera
authors.initials: V
authors.lastname: Westin
authors.forename: Gisela
authors.initials: G
authors.lastname: Dahlquist
mesh_terms: D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D004032:Diet; D004734:Energy Metabolism; D005247:Feeding Behavior; D005260:Female; D006128:Growth / Q000502:physiology*; D006801:Humans; D008297:Male; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology