Infant feeding and the risk of type 1 diabetes
Open accessAbstract
Type 1 diabetes is generally considered to be a chronic, immune-mediated disease with a subclinical prodrome during which beta cell autoimmunity becomes overt disease at a variable rate in genetically susceptible individuals. Accumulated evidence supports a critical role of environmental factors in its development. Prospective birth cohort studies show that the first signs of beta cell autoimmunity may be initiated during the first year of life. This implies that risk factors for beta cell autoimmunity and type 1 diabetes must be operative in infancy. Early nutrition provides essential exogenous exposures in that period. This article discusses the role of factors related to infant nutrition in the development of beta cell autoimmunity and type 1 diabetes and the potential mechanistic pathways involved. So far, no specific dietary factor has been shown to be an unequivocal risk factor for beta cell autoimmunity or type 1 diabetes, and there are a number of contradictory observations with regard to the effect of various foods. This may reflect geographic and cultural differences in infant-feeding practices. Most studies suggest that the early introduction of complex foreign proteins may be a risk factor for beta cell autoimmunity, and a pilot intervention trial has implied that weaning to a highly hydrolyzed formula may decrease the risk of beta cell autoimmunity. Lack of vitamin D supplementation and accelerated growth might increase the risk of type 1 diabetes. Additional wor…
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A plethora of environmental influences have been purported to affect the epidemiology of type 1 diabetes, with infant and adolescent diets, vitamin D and vitamin D pathway constituents, and viruses receiving the most focus.
“A plethora of environmental influences have been purported to affect the epidemiology of type 1 diabetes,25 with infant and adolescent diets,26 vitamin D and vitamin D pathway constituents,27–29 and viruses receiving the most focus.30,31”
From Type 1 diabetes (2014) · cites this paper as [26]
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“The potential role of environmental factors is suggested by many facts: the increasing incidence of T1D in industrialized countries and in young children (13, 14); the low concordance among homozygotic twins (15); and the evidence that moving from a low incidence to a high incidence region increases the risk of the di…”
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“Since 2009 early life environmental exposures, such as, early life diet [27, 28], vitamin D levels [29–31], mode of delivery [32•, 33], and enteroviral infection [34, 35] have been receiving increasing attention.”
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“strategies to assign risk that depend on the potential toxicity of the planned intervention (6,7).”
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Infant Feeding and Timing of Complementary Foods in the Development of Type 1 Diabetes
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“And furthermore the confounding effect of breastfeeding was also not analyzed since breastfeeding could protect T1D was put forward more than 3 decades ago [38], although the reason why human milk might protect T1D remains uncertain.”
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“Early introduction to solids has been associated with an increased risk of being overweight or obese later in life and the development of chronic diseases((5,7,9,28,29)).”
BackgroundDiabetes Mellitus: The Pathophysiology as a Canvas for Management Elucidation and Strategies
Iheagwam, F., & Iheagwam, O. T. (2025) · Medicine in Novel Technology and Devices · doi:10.1016/j.medntd.2025.100351 · Cited by 20 · see citing works
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“Breastfeeding has some protective effect against the development of type 1 diabetes [6, 7, 26, 33].”
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“016 Environmental factors such as viral infections [2], dietary factors in infancy [3,4], caesarean section [5], high maternal age at delivery [6], and birth weight [7] have all been discussed as risk-factors.”
BackgroundSystematic Review: Early Infant Feeding and the Risk of Type 1 Diabetes
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“In addition to genetic background, a number of environmental factors have been claimed to influence the T1D epidemiology, including infant diet (9).”
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RetractedNiinistö, S., Takkinen, H.-M., Uusitalo, L., Rautanen, J., Vainio, N., Ahonen, S., Nevalainen, J., Kenward, M. G., Lumia, M., Simell, O., et al. (2015) · Acta Diabetologica · doi:10.1007/s00592-014-0673-0 · Cited by 16 · see citing works
“The accumulated evidence on the association of breastfeeding with type 1 diabetes is controversial [14].”
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“One of the aims of the TEDDY study is to examine the quantitative exposure to foods such as cow's milk, root vegetables and gluten-containing cereals which have been associated with increased risk of islet autoimmunity, type 1 diabetes and/or celiac disease in infancy and later in childhood (Knip et al., 2010; Virtane…”
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Childhood Bereavement and Type 1 Diabetes: a <scp>D</scp>anish National Register Study
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Exposures in early life: associations with DNA promoter methylation in breast tumors
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“Early introduction of cow milk proteins (complementary feeding) has been proposed to induce intestinal mucosa inflammation and increase gut permeability.(36) Inflammation has been found to alter the DNA promoter methylation pattern and critical gene regulation in several studies.”
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“Likewise, a link between cow’s milk consumption and T1D risk has not been firmly established [11].”
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“Additionally, environmental factors such as the seasonal environment at birth (3), infant diet (10), viral infections (11) and the gut microbiome (12) have also been suggested to play a role on type 1 diabetes development.”
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“The role of vitamin D in the development of T1D is conversely discussed, but there is no clear evidence that vitamin D intake is associated with T1D risk((1,8)).”
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“INTRODUCTION Environmental factors such as diet may play an important role in the development of type 1 diabetes (1).”
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- Authors
- Knip, M., Virtanen, S. M., & Åkerblom, H. K.
- Affiliations
- University of Helsinki (FI)
- Corresponding author
- Knip, Mikael
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2010-05
- Volume
- 91
- Issue
- 5
- Pages
- 1506S-1513S
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC6443298
- OpenAlex
- W2138015526
- Cited by
- 156
- References
- 0
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 7 · 2022: 5 · 2021: 9 · 2020: 8 · 2019: 6 · 2018: 5 · 2017: 12 · 2016: 10 · 2015: 15 · 2014: 16 · 2013: 19 · 2012: 15
- FWCI
- 9.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Funders
- NIH
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 1 diabetes, infant feeding, islet autoimmunity, infant nutrition, hydrolyzed formula, weaning, vitamin D supplementation, infant growth, environmental risk factors, dietary risk factors
- MeSH terms
- Breast Feeding, Cell Membrane Permeability, Diabetes Mellitus, Type 1, Female, Finland, Humans, Infant, Infant Food, Infant Nutritional Physiological Phenomena, Intestinal Absorption, Polymorphism, Genetic, Rickets, Risk Factors, Vitamin D, Vitamin D Deficiency, Incidence, Receptors, Calcitriol, Developed Countries, Dietary Supplements, Insulin-Secreting Cells
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