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Age at first introduction to complementary foods is associated with sociodemographic factors in children with increased genetic risk of developing type 1 diabetes

Authors

  • Carin Andrén Aronsson,

    Corresponding author
    1. Department of Clinical Sciences, Lund University/CRC, Malmö, Sweden
    2. Institute of Diabetes Research, Helmholtz Zentrum München, Klinikum rechts der lsar, Technische Universität, München, Germany
    • Correspondence: Ms Carin Andrén Aronsson, Department of Clinical Sciences, Diabetes and Celiac Disease Unit, Lund University/CRC, Jan Waldenströms gata 35, 205 02 Malmö, Sweden. E-mail: carin.andren_aronsson@med.lu.se

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  • Ulla Uusitalo,

    1. Morsani College of Medicine, University of South Florida, Pediatrics Epidemiology Center, Tampa, Florida, USA
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  • Kendra Vehik,

    1. Morsani College of Medicine, University of South Florida, Pediatrics Epidemiology Center, Tampa, Florida, USA
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  • Jimin Yang,

    1. Morsani College of Medicine, University of South Florida, Pediatrics Epidemiology Center, Tampa, Florida, USA
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  • Katherine Silvis,

    1. Georgia Regents University, Augusta, Georgia, USA
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  • Sandra Hummel,

    1. Institute of Diabetes Research, Helmholtz Zentrum München, Klinikum rechts der lsar, Technische Universität, München, Germany
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  • Suvi M. Virtanen,

    1. Nutrition Unit, National Institute for Health and Welfare, Helsinki, Finland
    2. School of Health Sciences, University of Tampere, Tampere, Finland
    3. Research Center for Child Health, Tampere University and University Hospital, Tampere, Finland
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    • Virtanen SM and Norris JM are sharing last authorship.
  • Jill M. Norris,

    1. Department of Epidemiology, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
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    • Virtanen SM and Norris JM are sharing last authorship.
  • TEDDY Study Group

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    • Members of the TEDDY Study Group are listed in the Appendix.

Abstract

Infant's age at introduction to certain complementary foods (CF) has in previous studies been associated with islet autoimmunity, which is an early marker for type 1 diabetes (T1D). Various maternal sociodemographic factors have been found to be associated with early introduction to CF. The aims of this study were to describe early infant feeding and identify sociodemographic factors associated with early introduction to CF in a multinational cohort of infants with an increased genetic risk for T1D. The Environmental Determinants of Diabetes in the Young study is a prospective longitudinal birth cohort study. Infants (N = 6404) screened for T1D high risk human leucocyte antigen-DQ genotypes (DR3/4, DR4/4, DR4/8, DR3/3, DR4/4, DR4/1, DR4/13, DR4/9 and DR3/9) were followed for 2 years at six clinical research centres: three in the United States (Colorado, Georgia/Florida, Washington) and three in Europe (Sweden, Finland, Germany). Age at first introduction to any food was reported at clinical visits every third month from the age of 3 months. Maternal sociodemographic data were self-reported through questionnaires. Age at first introduction to CF was primarily associated with country of residence. Root vegetables and fruits were usually the first CF introduced in Finland and Sweden and cereals were usually the first CF introduced in the United States. Between 15% and 20% of the infants were introduced to solid foods before the age of 4 months. Young maternal age (<25 years), low educational level (<12 years) and smoking during pregnancy were significant predictors of early introduction to CF in this cohort. Infants with a relative with T1D were more likely to be introduced to CF later.

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