Regional differences in milk and complementary feeding patterns in infants participating in an international nutritional type 1 diabetes prevention trial

Authors

Anita M. Nucci, Georgia State University
Suvi M. Virtanen, National Institute for Health and Welfare
Suvi M. Virtanen, National Institute for Health and Welfare
Susa Sorkio, National Institute for Health and Welfare
Sonja Bärlund, National Institute for Health and Welfare
David Cuthbertson, University of South Florida, Tampa
David Cuthbertson, University of South Florida, Tampa
Ulla Uusitalo, University of South Florida, Tampa
Margaret L. Lawson, Children's Hospital of Eastern Ontario, Ottawa
Margaret L. Lawson, Children's Hospital of Eastern Ontario, Ottawa
Margaret L. Lawson, Children's Hospital of Eastern Ontario, Ottawa
Marja Salonen, Children's Hospital Helsinki
Marja Salonen, Children's Hospital Helsinki
Carol L. Berseth, Mead Johnson Pediatric Nutrition Institute
Anne Ormisson, Tartu Ülikool
Eveliina Lehtonen, National Institute for Health and Welfare
Erkki Savilahti, Children's Hospital Helsinki
Dorothy J. Becker, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh
John Dupré, Robarts Research Institute
Jeffrey P. Krischer, University of South Florida, Tampa
Jeffrey P. Krischer, University of South Florida, Tampa
Jeffrey P. Krischer, University of South Florida, Tampa
Mikael Knip, Children's Hospital Helsinki
Hans K. Åkerblom, Children's Hospital Helsinki
Hans K. Åkerblom, Children's Hospital Helsinki
Thomas Mandrup-Poulsen
Elias Arjas
Esa Läärä
Åke Lernmark

Document Type

Article

Publication Date

7-1-2017

Journal

Maternal and Child Nutrition

Volume

13

Issue

3

URL with Digital Object Identifier

10.1111/mcn.12354

Abstract

Differences in breastfeeding, other milk feeding and complementary feeding patterns were evaluated in infants at increased genetic risk with and without maternal type 1 diabetes (T1D). The Trial to Reduce IDDM in the Genetically at Risk is an international nutritional primary prevention double-blinded randomized trial to test whether weaning to extensively hydrolyzed vs. intact cow's milk protein formula will decrease the development of T1D-associated autoantibodies and T1D. Infant diet was prospectively assessed at two visits and seven telephone interviews between birth and 8 months. Countries were grouped into seven regions: Australia, Canada, Northern Europe, Southern Europe, Central Europe I, Central Europe II and the United States. Newborn infants with a first-degree relative with T1D and increased human leukocyte antigen-conferred susceptibility to T1D were recruited. A lower proportion of infants born to mothers with than without T1D were breastfed until 6 months of age in all regions (range, 51% to 60% vs. 70% to 80%). Complementary feeding patterns differed more by region than by maternal T1D. In Northern Europe, a higher proportion of infants consumed vegetables and fruits daily compared with other regions. Consumption of meat was more frequent in all European regions, whereas cereal consumption was most frequent in Southern Europe, Canada and the United States. Maternal T1D status was associated with breastfeeding and other milk feeding patterns similarly across regions but was unrelated to the introduction of complementary foods. Infant feeding patterns differed significantly among regions and were largely inconsistent with current recommended guidelines.