title: Early introduction of root vegetables in infancy associated with advanced ß-cell autoimmunity in young children with human leukocyte antigen-conferred susceptibility to Type 1 diabetes.
abstract: OBJECTIVE
  Early introduction of supplementary foods has been implicated to play a role in the development of ß-cell autoimmunity. We set out to study the effects of breastfeeding and age at introduction of supplementary foods on the development of ß-cell autoimmunity.
  
  
  METHODS
  A prospective birth cohort of 6069 infants with HLA-DQB-conferred susceptibility to Type 1 diabetes was recruited between 1996 and 2004. Antibodies against islet cells, insulin, glutamate dehydroxylase and islet antigen 2 were measured at 3- to 12-month intervals. The families recorded at home the age at introduction of new foods and, for each visit, completed a structured dietary questionnaire. The endpoint was repeated positivity for islet cell antibodies plus at least one other antibody and/or clinical Type 1 diabetes (n = 265).
  
  
  RESULTS
  Early introduction of root vegetables (by the age of 4 months) was related to increased risk of developing positivity for the endpoint [hazard ratio (95% CI) for the earliest third 1.75 (1.11-2.75) and for the middle third 1.79 (1.22-2.62) compared with the last third (> 4 months), likelihood ratio test P = 0.006], independently of the introduction of other foods and of several putative socio-demographic and perinatal confounding factors. Introducing wheat, rye, oats and/or barley cereals (P = 0.013) and egg (P = 0.031) early was related to an increased risk of the endpoint, but only during the first 3 years of life.
  
  
  CONCLUSIONS
  Early introduction of root vegetables during infancy is independently associated with increased risk of ß-cell autoimmunity among Finnish children with increased genetic susceptibility to Type 1 diabetes.
authors.affiliation: Department of Lifestyle and Participation, Nutrition Unit, National Institute for Health and Welfare, Helsinki, Finland. suvi.virtanen@thl.fi
authors.forename: S M
authors.initials: SM
authors.lastname: Virtanen
authors.forename: H-M
authors.initials: HM
authors.lastname: Takkinen
authors.forename: J
authors.initials: J
authors.lastname: Nevalainen
authors.forename: C
authors.initials: C
authors.lastname: Kronberg-Kippilä
authors.forename: M
authors.initials: M
authors.lastname: Salmenhaara
authors.forename: L
authors.initials: L
authors.lastname: Uusitalo
authors.forename: M G
authors.initials: MG
authors.lastname: Kenward
authors.forename: M
authors.initials: M
authors.lastname: Erkkola
authors.forename: R
authors.initials: R
authors.lastname: Veijola
authors.forename: O
authors.initials: O
authors.lastname: Simell
authors.forename: J
authors.initials: J
authors.lastname: Ilonen
authors.forename: M
authors.initials: M
authors.lastname: Knip
mesh_terms: D001323:Autoantibodies / Q000276:immunology / Q000302:isolation & purification*; D015551:Autoimmunity / Q000235:genetics*; D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics / Q000276:immunology*; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D006683:HLA-DQ Antigens / Q000235:genetics / Q000276:immunology; D006801:Humans; D007223:Infant; D007515:Islets of Langerhans / Q000276:immunology; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D014675:Vegetables / Q000378:metabolism*; D014886:Weaning
chemical_list: D001323:Autoantibodies; D006683:HLA-DQ Antigens; C024211:islet cell antibody