title: Omega-3 polyunsaturated fatty acid intake and islet autoimmunity in children at increased risk for type 1 diabetes.
abstract: BACKGROUND
  Cod liver oil supplements in infancy have been associated with a decreased risk of type 1 diabetes mellitus in a retrospective study.
  
  
  OBJECTIVE
  To examine whether intakes of omega-3 and omega-6 fatty acids are associated with the development of islet autoimmunity (IA) in children.
  
  
  METHODS
  A longitudinal, observational study, the Diabetes Autoimmunity Study in the Young (DAISY), conducted in Denver, Colorado, between January 1994 and November 2006, of 1770 children at increased risk for type 1 diabetes, defined as either possession of a high diabetes risk HLA genotype or having a sibling or parent with type 1 diabetes. The mean age at follow-up was 6.2 years. Islet autoimmunity was assessed in association with reported dietary intake of polyunsaturated fatty acids starting at age 1 year. A case-cohort study (N = 244) was also conducted in which risk of IA by polyunsaturated fatty acid content of erythrocyte membranes (as a percentage of total lipids) was examined.
  
  
  METHODS
  Risk of IA, defined as being positive for insulin, glutamic acid decarboxylase, or insulinoma-associated antigen-2 autoantibodies on 2 consecutive visits and still autoantibody positive or having diabetes at last follow-up visit.
  
  
  RESULTS
  Fifty-eight children developed IA. Adjusting for HLA genotype, family history of type 1 diabetes, caloric intake, and omega-6 fatty acid intake, omega-3 fatty acid intake was inversely associated with risk of IA (hazard ratio [HR], 0.45; 95% confidence interval [CI], 0.21-0.96; P = .04). The association was strengthened when the definition of the outcome was limited to those positive for 2 or more autoantibodies (HR, 0.23; 95% CI, 0.09-0.58; P = .002). In the case-cohort study, omega-3 fatty acid content of erythrocyte membranes was also inversely associated with IA risk (HR, 0.63; 95% CI, 0.41-0.96; P = .03).
  
  
  CONCLUSIONS
  Dietary intake of omega-3 fatty acids is associated with reduced risk of IA in children at increased genetic risk for type 1 diabetes.
authors: Department of Preventive Medicine and Biostatistics, University of Colorado at Denver and Health Sciences Center, Denver, CO 80262, USA. jill.norris@uchsc.edu
authors: Jill M
authors: JM
authors: Norris
authors: Xiang
authors: X
authors: Yin
authors: Molly M
authors: MM
authors: Lamb
authors: Katherine
authors: K
authors: Barriga
authors: Jennifer
authors: J
authors: Seifert
authors: Michelle
authors: M
authors: Hoffman
authors: Heather D
authors: HD
authors: Orton
authors: Anna E
authors: AE
authors: Barón
authors: Michael
authors: M
authors: Clare-Salzler
authors: H Peter
authors: HP
authors: Chase
authors: Nancy J
authors: NJ
authors: Szabo
authors: Henry
authors: H
authors: Erlich
authors: George S
authors: GS
authors: Eisenbarth
authors: Marian
authors: M
authors: Rewers
mesh_terms: D001323:Autoantibodies / Q000097:blood*; D015551:Autoimmunity; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000235:genetics; D004032:Diet; D004910:Erythrocyte Membrane / Q000378:metabolism*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000378:metabolism*; D043371:Fatty Acids, Omega-6 / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007223:Infant; D007515:Islets of Langerhans / Q000276:immunology*; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors
chemical_list: D001323:Autoantibodies; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6