A retrospective analysis of a societal experiment among the Danish population suggests that exposure to extra doses of vitamin A during fetal development may lower type 2 diabetes mellitus (T2DM) risk later in life.
Vitamin A deficiency has been associated with impaired fetal pancreatic development and increased risk of developing type 2 diabetes mellitus (T2DM). In 1962, mandatory margarine fortification with vitamin A was increased by 25 % in Denmark. We aimed to determine whether offspring of mothers who had been exposed to the extra vitamin A from fortification during pregnancy had a lower risk of developing T2DM in adult life, compared with offspring of mothers exposed to less vitamin A. Individuals from birth cohorts with the higher prenatal vitamin A exposure (born 1 December 1962-31 March 1964) and those with lower prenatal exposure (born 1 September 1959-31 December 1960) were followed up with regard to development of T2DM before 31 December 2012 in the Danish National Diabetes Registry and National Patient Register. Logistic and Cox regression analyses were performed to determine the risk of T2DM by vitamin A exposure level. A total of 193 803 individuals were followed up until midlife. Our results showed that individuals exposed prenatally to extra vitamin A from fortified margarine had a lower risk of developing T2DM than those exposed to lower levels: OR 0·88; 95 % CI 0·81, 0·95, P=0·001, after adjustment for sex. Fetal exposure to small, extra amounts of vitamin A from food fortification may reduce the risk of T2DM. These results may have public health relevance, as they demonstrate that one of the most costly chronic diseases may be prevented by food fortification - a simple and affordable public health nutrition intervention.
1Research Unit for Dietary Studies,The Parker Institute and Department of Clinical Epidemiology (formerly 'Institute of Preventive Medicine'),Bispebjerg and Frederiksberg University Hospitals - the Capital Region,Nordre Fasanvej 57, Hovedvejen, entrance 5, ground floor, 2000 Frederiksberg,Denmark.
Amélie
A
Keller
2Department of Clinical Epidemiology (formerly 'Institute of Preventive Medicine'),Bispebjerg and Frederiksberg Hospital - The Capital Region,Nordre Fasanvej 57, Hovedvejen, entrance 5, first floor, 2000 Frederiksberg,Denmark.
Lars
L
Ängquist
1Research Unit for Dietary Studies,The Parker Institute and Department of Clinical Epidemiology (formerly 'Institute of Preventive Medicine'),Bispebjerg and Frederiksberg University Hospitals - the Capital Region,Nordre Fasanvej 57, Hovedvejen, entrance 5, ground floor, 2000 Frederiksberg,Denmark.
Ramune
R
Jacobsen
3AstraZeneca,CardioVascular and Metabolic Diseases (CVMD) Translational Medical Unit (TMU),Pepparsleden 1,43184 Mölndal,Sweden.
Allan
A
Vaag
1Research Unit for Dietary Studies,The Parker Institute and Department of Clinical Epidemiology (formerly 'Institute of Preventive Medicine'),Bispebjerg and Frederiksberg University Hospitals - the Capital Region,Nordre Fasanvej 57, Hovedvejen, entrance 5, ground floor, 2000 Frederiksberg,Denmark.
Berit L
BL
Heitmann
D000328:Adult; D003718:Denmark / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D047109:Fetal Development; D005527:Food, Fortified; D006801:Humans; D008297:Male; D008383:Margarine; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D014801:Vitamin A / Q000008:administration & dosage*
D014801:Vitamin A; D008383:Margarine
 ICD International Classification of Diseases;  RAE retinol activity equivalents;  T2DM type 2 diabetes mellitus; Fortification; Public health; Type 2 diabetes mellitus; Vitamin A