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1.
Clin Exp Allergy ; 47(3): 401-409, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28198577

RESUMEN

BACKGROUND: The antioxidant hypothesis regarding the risk of asthma in childhood has resulted in inconsistent findings. Some data indicate that the role of antioxidants in childhood asthma risk may have a critical time window of effect, but only a well-designed longitudinal cohort study can clarify this hypothesis. OBJECTIVE: To study the longitudinal associations between serum carotenoid and tocopherol concentrations during the first 4 years of life and asthma risk by the age of 5 years. METHODS: Based on a case-control design nested within a Finnish birth cohort, 146 asthma cases were matched to 270 controls on birth time, sex, genetic risk, and birth place. Non-fasting blood samples were collected at the ages of 1, 1.5, 2, 3, and 4 years and serum carotenoids and tocopherols were analysed. Parents reported the presence and age at start of persistent doctor-diagnosed asthma in the child at the age of 5 years. Data analyses were conducted using generalized estimating equations. RESULTS: We did not find strong associations between serum carotenoids and tocopherols and the risk of asthma based on age-specific and longitudinal analyses. Both lower and higher quarters of α-carotene and γ-tocopherol increased the risk of asthma. CONCLUSIONS: The current findings do not support the suggestion that the increased prevalence of asthma may be a consequence of decreased intake of antioxidant nutrients. Moreover, we did not confirm any critical time window of impact of antioxidants on asthma risk. Replication of these findings in similar longitudinal settings will strengthen this evidence base.


Asunto(s)
Asma/sangre , Asma/epidemiología , Carotenoides/sangre , Tocoferoles/sangre , Antioxidantes , Estudios de Casos y Controles , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Oportunidad Relativa , Evaluación del Resultado de la Atención al Paciente , Prevalencia , Riesgo
2.
Paediatr Perinat Epidemiol ; 31(6): 485-492, 2017 11.
Artículo en Inglés | MEDLINE | ID: mdl-28815662

RESUMEN

BACKGROUND: Repeat terminations of pregnancy (TOPs) are associated with an increased risk of adverse outcomes in the subsequent birth. The perinatal outcomes after repeat TOPs by their methods have not yet been properly studied. This study aimed to examine perinatal outcomes in subsequent pregnancy among the women with a singleton birth and a history of TOPs. METHODS: All the first-time mothers (n = 419 879) with a singleton birth during 1996-2013 in Finland were identified from the Medical Birth Register and linked to the Abortion Register. Adjusted multivariable logistic regression analysis was used to estimate risks of adverse perinatal outcomes. RESULTS: The increased incidence of adverse perinatal outcomes was found with increasing number of surgical TOPs. After adjusting for confounders, the women with one surgical TOP had slightly increased but significant odds of 1.07 (95% CI 1.02, 1.13) for being small for gestational age compared with the women having no TOP. A significantly high risk for extremely preterm birth (OR 1.51, 95% CI 1.03, 2.23) was found among the women having had repeat surgical TOPs when compared to the women with no TOP. Non-significant risks were found for adverse perinatal outcomes after women's repeat surgical TOPs than repeat medical TOPs. CONCLUSION: Information regarding the consequences of repeat induced TOPs will be significant in sexual health education as well as counselling women after first termination.


Asunto(s)
Aborto Inducido , Complicaciones del Embarazo/epidemiología , Aborto Inducido/efectos adversos , Aborto Inducido/estadística & datos numéricos , Adulto , Estudios de Cohortes , Femenino , Finlandia/epidemiología , Humanos , Recién Nacido de Bajo Peso , Recién Nacido , Recién Nacido Pequeño para la Edad Gestacional , Evaluación de Necesidades , Embarazo , Resultado del Embarazo , Nacimiento Prematuro/epidemiología , Factores de Riesgo , Educación Sexual
3.
Clin Exp Allergy ; 45(1): 137-45, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24943808

RESUMEN

BACKGROUND: Evidence on the association between post-natal exposure to antibiotics and the development of asthma is extensive, but inconsistent and even less is known about prenatal exposure. OBJECTIVE: The aim of this study was to examine the associations between prenatal and post-natal exposure to different antibiotics and the risk of childhood asthma in a population- and register-based nested case-control study. METHODS: All children who were born in 1996-2004 in Finland and diagnosed with asthma by 2006 were identified from a national health register. For each case, one matched control was selected. Information on asthma diagnoses, purchased anti-asthmatic drugs and antibiotics as well as putative confounders was obtained from national health registries. The associations were analysed using conditional logistic regression for children diagnosed at the age of 3 years or later (n = 6 690 case-control pairs). RESULTS: Maternal use of any antibiotics during pregnancy was associated with an increased risk of asthma in the offspring [adjusted odds ratio (OR) = 1.31 (95% confidence interval (CI): 1.21-1.42)]. Several maternal specific antibiotics were associated with the risk of asthma, and the strongest association was observed for cephalosporins [OR = 1.46 (95% CI 1.30-1.64)]. Child's use of antibiotics during the first year of life was associated with an increased risk of asthma [OR = 1.60 (95% CI 1.48-1.73)]. Child's use of cephalosporins [OR = 1.79 (95% CI 1.59-2.01)], sulphonamides and trimethoprim [OR = 1.65 (95% CI 1.34-2.02)], macrolides [OR = 1.61 (95% CI 1.46-1.78)] and amoxicillin [OR = 1.46 (95% CI 1.35-1.58)] was associated with an increased risk of asthma. CONCLUSIONS AND CLINICAL RELEVANCE: Both prenatal and post-natal exposure to antibiotics was associated with an increased risk of asthma. The potential role of adverse effects of antibiotics on the gut microbiota and the development of asthma should be further explored.


Asunto(s)
Antibacterianos/efectos adversos , Asma/inducido químicamente , Asma/epidemiología , Efectos Tardíos de la Exposición Prenatal/inducido químicamente , Efectos Tardíos de la Exposición Prenatal/epidemiología , Sistema de Registros , Adulto , Antibacterianos/administración & dosificación , Preescolar , Femenino , Finlandia/epidemiología , Humanos , Lactante , Recién Nacido , Masculino , Embarazo , Factores de Riesgo
4.
Allergy ; 69(1): 87-94, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24205866

RESUMEN

BACKGROUND: Prospective studies investigating the role of serum vitamin E concentrations during early life in the development of childhood allergies and asthma are limited. OBJECTIVE: To study the associations between serum vitamin E concentrations at first year of life and longitudinal development of atopy, atopic dermatitis, wheeze, and asthma up to 6 years of age. METHODS: The setting was the PASTURE study, a multicenter prospective birth cohort study in five European rural settings. Children of 1133 mothers recruited during pregnancy were followed from birth with measurement of serum vitamin E levels at year 1 and repeated assessments of serum immunoglobulin E antibodies (year 1, 4.5, 6), atopic dermatitis, wheezing symptoms, and asthma (year 1, 1.5, 2, 3, 4, 5, 6). RESULTS: At 6 years of age, 66% and 82% of the original 1133 subjects underwent blood test for IgE and answered the questionnaire, respectively. We did not observe any statistically significant associations between serum vitamin E concentrations at year 1 and the endpoints, but borderline inverse associations between alpha tocopherol and wheezing without cold (OR 0.45, 95% CI 0.19-1.09) and any wheezing symptom (OR 0.52, 95% CI 0.27-1.02). CONCLUSIONS: Serum vitamin E concentrations at year 1 were not associated with allergies or asthma by 6 years of age. While further prospective studies with repeated assessments of vitamin E during early life may clarify its putative role in the development of the diseases, it is also possible that the antioxidant hypothesis in the development of allergies and asthma does not hold.


Asunto(s)
Asma/sangre , Asma/epidemiología , Dermatitis Atópica/sangre , Dermatitis Atópica/epidemiología , Hipersensibilidad Inmediata/sangre , Hipersensibilidad Inmediata/epidemiología , Ruidos Respiratorios , Vitamina E/sangre , Niño , Preescolar , Europa (Continente)/epidemiología , Humanos , Incidencia , Lactante , Oportunidad Relativa , Prevalencia , Estudios Prospectivos , Riesgo , Factores de Riesgo , Población Rural
5.
Diabetes Metab Res Rev ; 30(8): 749-60, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24692218

RESUMEN

BACKGROUND: Vitamin D has immunomodulatory properties, such as regulation of FOXP3 expression and regulatory T-cell activity. Our aim was to investigate whether plasma 25-hydroxyvitamin D [25(OH)D] concentrations associate with the development of ß-cell autoimmunity and the transcriptional activity of FOXP3 or vitamin D3 convertase gene (CYP27B1) in CD4+ memory T cells. METHODS: We studied 83 Finnish and 32 Estonian children participating in the DIABIMMUNE and DIPP studies. Twenty-nine Finnish and six Estonian children tested positive for at least one diabetes-associated autoantibody. The plasma concentrations of 25(OH)D and 1,25(OH)2D were analysed with an enzyme immunoassay. Gene expression of FOXP3 and CYP27B1 in the isolated CD4+ memory T cells was studied with reverse transcription quantitative polymerase chain reaction. RESULTS: Vitamin D status did not differ between subjects positive and negative for ß-cell autoantibodies. Finnish children had higher vitamin D status than Estonian children (p < 0.001). FOXP3 expression was higher in Estonian CD4+ memory T-cell samples than in Finnish samples (p < 0.01) even when including in both groups only children with serum 25(OH)D concentrations in the range of 50-80 nmol/L (p < 0.001). CONCLUSIONS: These findings do not support a crucial role of circulating 25(OH)D as a regulator of ß-cell autoimmunity or FOXP3 expression.


Asunto(s)
25-Hidroxivitamina D 2/sangre , Autoinmunidad , Calcifediol/sangre , Fenómenos Fisiológicos Nutricionales Infantiles , Diabetes Mellitus Tipo 1/etiología , Células Secretoras de Insulina/inmunología , Deficiencia de Vitamina D/fisiopatología , 25-Hidroxivitamina D3 1-alfa-Hidroxilasa/sangre , 25-Hidroxivitamina D3 1-alfa-Hidroxilasa/genética , 25-Hidroxivitamina D3 1-alfa-Hidroxilasa/metabolismo , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD4-Positivos/metabolismo , Niño , Preescolar , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/inmunología , Estonia/epidemiología , Femenino , Finlandia/epidemiología , Factores de Transcripción Forkhead/sangre , Factores de Transcripción Forkhead/genética , Factores de Transcripción Forkhead/metabolismo , Regulación del Desarrollo de la Expresión Génica , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Humanos , Incidencia , Masculino , Estado Nutricional
6.
Allergy ; 68(4): 507-16, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23510377

RESUMEN

OBJECTIVE: To study the associations between timing and diversity of introduction of complementary foods during infancy and atopic sensitization in 5-year-old children. METHODS: In the Finnish DIPP (type 1 diabetes prediction and prevention) birth cohort (n = 3781), data on the timing of infant feeding were collected up to the age of 2 years and serum IgE antibodies toward four food and four inhalant allergens measured at the age of 5 years. Logistic regression was used for the analyses. RESULTS: Median duration of exclusive and total breastfeeding was 1.4 (interquartile range: 0.2-3.5) and 7.0 (4.0-11.0) months, respectively. When all the foods were studied together and adjusted for confounders, short duration of breastfeeding decreased the risk of sensitization to birch allergen; introduction of oats <5.1 months and barley <5.5 months decreased the risk of sensitization to wheat and egg allergens, and oats additionally associated with milk, timothy grass, and birch allergens. Introduction of rye <7.0 months decreased the risk of sensitization to birch allergen. Introduction of fish <6 months and egg ≤11 months decreased the risk of sensitization to all the specific allergens studied. The introduction of <3 food items at 3 months was associated with sensitization to wheat, timothy grass, and birch allergens; the introduction of 1-2 food items at 4 months and ≤4 food items at 6 months was associated with all endpoints, but house dust mite. These results were particularly evident among high-risk children when the results were stratified by atopic history, indicating the potential for reverse causality. CONCLUSIONS: The introduction of complementary foods was consecutively done, and with respect to the timing of each food, early introduction of complementary foods may protect against atopic sensitization in childhood, particularly among high-risk children. Less food diversity as already at 3 months of age may increase the risk of atopic sensitization.


Asunto(s)
Hipersensibilidad Inmediata/inmunología , Alimentos Infantiles , Factores de Edad , Alérgenos/inmunología , Lactancia Materna , Preescolar , Dieta , Femenino , Finlandia , Hipersensibilidad a los Alimentos/inmunología , Humanos , Inmunoglobulina E/sangre , Inmunoglobulina E/inmunología , Lactante , Recién Nacido , Masculino , Oportunidad Relativa , Estudios Prospectivos , Factores de Tiempo
7.
Acta Paediatr ; 101(8): e337-43, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22578184

RESUMEN

AIM: To explore the association between maternal dietary fat and fatty acid (FA) intake during lactation, and the risk of asthma in the offspring by the age of 5 years. METHODS: The subjects comprised 1798 mother-child pairs from the Type 1 Diabetes Prediction and Prevention (DIPP) Nutrition Study. Dietary intake was assessed by a validated 181-item food frequency questionnaire, which covered the third month of lactation. The cumulative incidence of asthma was assessed at the age of 5 years with a questionnaire modified from the International Study of Asthma and Allergies in Childhood (ISAAC). Cox proportional hazards regression was used for statistical analysis. RESULTS: The maternal use of margarines during lactation was associated with a marginally increased risk of asthma [hazard ratio (HR) for user vs. nonuser 1.96, 95% confidence interval (CI) 1.01-3.82, p = 0.047] after adjusting for putative confounders. The maternal intakes of n-3 polyunsaturated FA (PUFA) and fish during lactation were not associated with the risk of asthma. CONCLUSION: Maternal use of margarines during lactation was weakly associated with an increased risk of asthma in the offspring at the age of 5 years. Other fats or FAs during lactation were not associated with the risk of asthma. However, the nonadherence to dietary recommendations regarding especially fats of our study population may restrict the generalizability of our results.


Asunto(s)
Asma/etiología , Lactancia Materna , Dieta/efectos adversos , Grasas de la Dieta/efectos adversos , Lactancia , Fenómenos Fisiologicos Nutricionales Maternos , Adulto , Preescolar , Estudios de Cohortes , Encuestas sobre Dietas , Ácidos Grasos Omega-3 , Femenino , Humanos , Margarina/efectos adversos , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Factores de Riesgo
8.
Diabetologia ; 54(3): 627-33, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21153533

RESUMEN

AIMS/HYPOTHESIS: The Trial to Reduce IDDM in the Genetically at Risk (TRIGR) study was designed to establish whether weaning to a highly hydrolysed formula in infancy subsequently reduces the risk of type 1 diabetes. METHODS: The study population comprises newborn infants who have first-degree relatives with type 1 diabetes and meet the increased risk HLA inclusion, but not exclusion criteria. The study is being performed in 15 countries in three continents. First-degree relatives of patients with type 1 diabetes were identified from diabetes clinics, diabetes registries, and from other endocrinology or obstetrics offices and websites. HLA typing was performed at birth from cord or heel stick blood, and the results sent to the study's Data Management Unit within 2 weeks for communication of eligibility to the clinical study centre. All mothers recruited were encouraged to breastfeed. The intervention lasted for 6 to 8 months, and weaning formulas based on hydrolysed casein and standard cow's milk were compared. RESULTS: TRIGR recruited 5,606 infants, of whom 2,160 were enrolled as eligible participants, 6% more than the target of 2,032. Of those enrolled, 80% were exposed to the study formula. The overall retention rate over the first 5 years is 87%, with protocol compliance at 94%. The randomisation code will be opened when the last recruited child turns 10 years of age, i.e. in 2017. CONCLUSIONS/INTERPRETATION: The TRIGR experience demonstrates the feasibility and successful implementation of an international dietary intervention study. TRIGR is the first ever primary prevention trial for type 1 diabetes and, if completed successfully, will provide a definite answer to the research question. TRIAL REGISTRATION: ClinicalTrials.gov NCT00179777 FUNDING: The study was funded by the National Institute of Child Health and Development (NICHD) and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH) (grant numbers HD040364, HD042444 and HD051997), Canadian Institutes of Health Research, the Juvenile Diabetes Research Foundation International and the Commission of the European Communities (specific RTD programme 'Quality of Life and Management of Living Resources', contract number QLK1-2002-00372 'Diabetes Prevention'. Other funding came from the EFSD/JDRF/Novo Nordisk Focused Research Grant, Academy of Finland, Dutch Diabetes Research Foundation and Finnish Diabetes Research Foundation).


Asunto(s)
Diabetes Mellitus Tipo 1/prevención & control , Fórmulas Infantiles/administración & dosificación , Proyectos de Investigación , Animales , Lactancia Materna , Caseínas/química , Humanos , Fórmulas Infantiles/química , Recién Nacido , Leche
9.
Diabet Med ; 28(8): 965-71, 2011 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21418094

RESUMEN

AIMS: 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.


Asunto(s)
Autoanticuerpos/aislamiento & purificación , Autoinmunidad/genética , Diabetes Mellitus Tipo 1/inmunología , Predisposición Genética a la Enfermedad/genética , Verduras/metabolismo , Autoanticuerpos/inmunología , Lactancia Materna , Niño , Preescolar , Diabetes Mellitus Tipo 1/genética , Femenino , Antígenos HLA-DQ/genética , Antígenos HLA-DQ/inmunología , Humanos , Lactante , Islotes Pancreáticos/inmunología , Masculino , Estudios Prospectivos , Factores de Riesgo , Destete
10.
Pediatr Diabetes ; 12(2): 95-9, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21352426

RESUMEN

BACKGROUND: Evidence for a putative role of maternal diet during pregnancy in the development of ß-cell autoimmunity in the child is scarce. The authors study the association of food consumption during pregnancy and the development of ß-cell autoimmunity in the offspring. SUBJECTS AND METHODS: A prospective Finnish birth cohort of 4297 infants with human leukocyte antigen (HLA)-DQB1-conferred susceptibility to type 1 diabetes and their mothers. Blood samples were collected from the children at 3-12 months intervals to measure type 1 diabetes-associated antibodies: antibodies against islet cells (ICA), insulin, glutamate dehydroxylase, and islet antigen 2. The mothers completed a validated food frequency questionnaire. The end-point was repeated positivity for ICA together with at least one of the other three antibodies. Piecewise-exponential survival models were used. The effective sample size was 3723, with 138 end-points. The median follow-up time was 4.4 years. RESULTS: Maternal consumption of butter, low-fat margarines, berries, and coffee were inversely associated with the development of advanced ß-cell autoimmunity in the offspring, adjusted for genetic risk group and familial diabetes. These associations for low-fat margarines (use vs. non-use HR 0.60, 95% CI: 0.38-0.93, p = 0.02), berries (continuous variable HR 0.90, 95% CI: 0.83-0.98, p = 0.02) and coffee (highest quarter vs. lowest HR 0.62, 95% CI: 0.40-0.97, p = 0.04), remained significant when adjusting for potential confounding sociodemographic, perinatal, and other dietary factors. CONCLUSIONS: In this study assessing total food consumption of the mother during pregnancy, only few among the 27 food groups tested were weakly related to the development of advanced ß-cell autoimmunity in Finnish children.


Asunto(s)
Autoinmunidad/fisiología , Diabetes Mellitus Tipo 1/etiología , Ingestión de Alimentos/fisiología , Células Secretoras de Insulina/inmunología , Fenómenos Fisiologicos Nutricionales Maternos , Efectos Tardíos de la Exposición Prenatal/inmunología , Autoanticuerpos/análisis , Autoanticuerpos/sangre , Mantequilla , Café , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 1/epidemiología , Diabetes Mellitus Tipo 1/inmunología , Progresión de la Enfermedad , Femenino , Frutas , Humanos , Recién Nacido , Margarina , Encuestas Nutricionales , Embarazo , Efectos Tardíos de la Exposición Prenatal/sangre , Efectos Tardíos de la Exposición Prenatal/epidemiología , Factores de Riesgo
11.
Acta Paediatr ; 100(4): 557-64, 2011 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-21114527

RESUMEN

AIM: The international Trial to Reduce IDDM in the Genetically at Risk (TRIGR) was launched to determine whether weaning to a highly hydrolysed formula in infancy reduces the incidence of type 1 diabetes in children at increased genetic disease susceptibility. We describe here the findings on feasibility and compliance from the pilot study. METHODS: The protocol was tested in 240 children. The diet of the participating children was assessed by self-administered dietary forms, a structured questionnaire and a food record. Blood samples were taken and weight and height measured at birth and at 3, 6, 9, 12, 18 and 24 months. RESULTS: A majority of the subjects (84%) were exposed to the study formula at least for 2 months. Linear growth or weight gain over the first 2 years of life was similar in the two study groups. The levels of IgA and IgG antibodies to cow's milk and casein were higher in the cow's milk-based formula group than in the hydrolysed formula group during the intervention period (p<0.05), reflecting the difference in the intake of cow's milk protein. CONCLUSION: This randomized trial on infant feeding turned out to be feasible, and dietary compliance was acceptable. Valuable experience was gained for the planning and sample size estimation of the study proper.


Asunto(s)
Diabetes Mellitus Tipo 1/prevención & control , Fórmulas Infantiles/administración & dosificación , Cooperación del Paciente/estadística & datos numéricos , Prevención Primaria/métodos , Animales , Caseínas/análisis , Diabetes Mellitus Tipo 1/genética , Estudios de Factibilidad , Predisposición Genética a la Enfermedad , Humanos , Inmunoglobulina A/inmunología , Inmunoglobulina G/inmunología , Lactante , Fórmulas Infantiles/química , Fenómenos Fisiológicos Nutricionales del Lactante , Leche/química , Proyectos Piloto
12.
Diabetologia ; 53(8): 1599-607, 2010 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-20369220

RESUMEN

AIMS/HYPOTHESIS: We evaluated the intake of vitamin D by pregnant Finnish women and examined associations between maternal intake of vitamin D and the development of advanced beta cell autoimmunity and type 1 diabetes in their offspring. METHODS: The research was carried out within the Diabetes Prediction and Prevention study (DIPP), which is a population-based birth cohort of infants at genetic risk of type 1 diabetes. Mothers of 3,723 infants born between 1997 and 2002 completed a validated 181-item food frequency questionnaire, which included questions on dietary supplements. The offspring were observed at 3 to 12 month intervals for the appearance of autoantibodies associated with type 1 diabetes and for the development of clinical type 1 diabetes. RESULTS: Maternal mean daily intake of vitamin D was 5.1 microg from food and 1.3 microg from supplements. The maternal intake of vitamin D, either from food or from supplements, was not associated with the risk of advanced beta cell autoimmunity/type 1 diabetes in offspring (HR [95% CI] for intake of vitamin D from food 1.25 [0.80-1.95], for vitamin D intake from supplements 1.05 [0.95-1.16]), or with the risk of type 1 diabetes alone (HR [95% CI] for intake of vitamin D from food 0.84 [0.41-1.72], for vitamin D intake from supplements 1.09 [0.99-1.20]). CONCLUSIONS/INTERPRETATION: Maternal intake of vitamin D either from food or supplements during pregnancy is not associated with advanced beta cell autoimmunity/type 1 diabetes or with type 1 diabetes alone in Finnish offspring carrying increased genetic susceptibility to type 1 diabetes.


Asunto(s)
Autoanticuerpos/inmunología , Diabetes Mellitus Tipo 1/inmunología , Células Secretoras de Insulina/inmunología , Intercambio Materno-Fetal , Vitamina D/administración & dosificación , Autoinmunidad/inmunología , Distribución de Chi-Cuadrado , Diabetes Mellitus Tipo 1/etiología , Suplementos Dietéticos , Femenino , Finlandia , Humanos , Lactante , Embarazo , Modelos de Riesgos Proporcionales , Encuestas y Cuestionarios , Vitamina D/inmunología
13.
Cancer Causes Control ; 21(12): 2223-9, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20859673

RESUMEN

OBJECTIVE: To assess the association between dietary acrylamide intake and the risk of cancer among male smokers. METHODS: The study consisted of 27,111 male smokers, aged 50-69 years, without history of cancer. They were participants of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study in Finland. The men completed a validated dietary questionnaire and a questionnaire on general background characteristics (including smoking habits) at baseline. Incident cases of cancer were identified through the national Finnish Cancer Registry. RESULTS: During an average 10.2 year follow-up, 1,703 lung cancers, 799 prostate cancers, 365 urothelial cancers, 316 colorectal cancers, 224 stomach cancers, 192 pancreatic cancers, 184 renal cell cancers, and 175 lymphomas were diagnosed. Dietary acrylamide intake was positively associated with the risk of lung cancer; relative risk (RR) in the highest versus the lowest quintile in the multivariable-adjusted model was 1.18 ((95% confidence interval (CI) 1.01-1.38, p for trend 0.11). Other cancers were not associated with acrylamide intake. CONCLUSIONS: High acrylamide intake is associated with increased risk of lung cancer but not with other cancers in male smokers.


Asunto(s)
Acrilamida/efectos adversos , Dieta/efectos adversos , Neoplasias/etiología , Fumar/efectos adversos , Fumar/epidemiología , Acrilamida/administración & dosificación , Anciano , Suplementos Dietéticos , Método Doble Ciego , Ingestión de Alimentos/fisiología , Finlandia/epidemiología , Estudios de Seguimiento , Contaminación de Alimentos , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/epidemiología , Neoplasias/prevención & control , Placebos , Riesgo , alfa-Tocoferol/administración & dosificación , beta Caroteno/administración & dosificación
14.
Clin Exp Allergy ; 39(6): 875-82, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19522996

RESUMEN

BACKGROUND: Vitamin D is known to have a number of immunological effects and it may play a role in preventing allergic diseases. Objectives To study the effect of maternal intake of vitamin D during pregnancy on the emergence of asthma, allergic rhinitis (AR), and atopic eczema by the age of 5 years in children with HLA-DQB1-conferred susceptibility for type 1 diabetes. METHODS: Children (1669) participating in the population-based birth cohort study were followed for asthma, AR, and atopic eczema assessed by validated questionnaire at 5 years. Maternal diet was assessed by a food-frequency questionnaire. RESULTS: The mean maternal intake of vitamin D was 5.1 (SD 2.6) microg from food and 1.4 (2.6) microg from supplements. Only 32% of the women were taking vitamin D supplements. When adjusted for potential confounders, maternal intake of vitamin D from food was negatively related to risk of asthma [hazard ratio (HR) 0.80; 95% confidence interval (CI) 0.64-0.99] and AR [HR 0.85; 95% CI 0.75-0.97]. Vitamin D supplements alone were not associated with any outcome. Adjustment for maternal intake of other dietary factors did not change the results. CONCLUSION: Maternal vitamin D intake from foods during pregnancy may be negatively associated with risk of asthma and AR in childhood.


Asunto(s)
Asma/epidemiología , Suplementos Dietéticos/efectos adversos , Rinitis Alérgica Perenne/epidemiología , Rinitis Alérgica Estacional/epidemiología , Vitamina D/efectos adversos , Adulto , Asma/genética , Asma/inmunología , Preescolar , Estudios de Cohortes , Dermatitis Atópica/epidemiología , Dermatitis Atópica/genética , Dermatitis Atópica/inmunología , Femenino , Finlandia/epidemiología , Estudios de Seguimiento , Antígenos HLA-DQ/inmunología , Cadenas beta de HLA-DQ , Humanos , Estimación de Kaplan-Meier , Masculino , Embarazo , Rinitis Alérgica Perenne/genética , Rinitis Alérgica Perenne/inmunología , Rinitis Alérgica Estacional/genética , Rinitis Alérgica Estacional/inmunología , Encuestas y Cuestionarios , Vitamina D/administración & dosificación , Vitamina D/inmunología
15.
Eur J Clin Nutr ; 62(12): 1432-9, 2008 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17700648

RESUMEN

BACKGROUND/OBJECTIVES: Data on associations between marine n-3 fatty acids and glucose metabolism are inconsistent. Therefore, we explored effects of the Pro12Ala polymorphism in peroxisome proliferator-activated receptor (PPAR)-gamma2 gene on associations of fish intake and dietary and plasma eicosapentaenoic and docosahexaenoic acid with glucose metabolism. The design comprises of the cross-sectional analysis. SUBJECTS/METHODS: The Pro12Ala variant in the PPAR-gamma2 (PPARG) gene was genotyped in 571 non-diabetic relatives of subjects with type II diabetes. The dietary intake was measured by a 3-day food record, and the plasma cholesterol ester fatty acid composition was analysed with gas chromatography. Associations of dietary and plasma variables with insulin resistance and fasting and 2-h glucose and free fatty acid concentrations were analysed with multiple linear regression analysis. RESULTS: In men, there was a significant interaction between PPARG polymorphism and plasma docosahexaenoic acid on fasting free fatty acid concentration (P=0.036), and genotype-stratified models showed an inverse association in Pro homozygotes only (P=0.028). In women, the proportion of plasma eicosapentaenoic acid was higher in Ala-allele carriers compared to Pro homozygotes (1.67 vs 1.44% respectively, P=0.006). A significant interaction between PPARG polymorphism and fish intake on 2-h glucose was found in women (P=0.021), and genotype-stratified models suggested an inverse association in Ala-allele carriers only (P=0.039). CONCLUSIONS: The findings suggest that PPARG polymorphism might affect the plasma proportion of eicosapentaenoic acid and modulate the associations of fish intake and marine n-3 fatty acids with glucose metabolism and fasting free fatty acids.


Asunto(s)
Alelos , Glucemia/metabolismo , Diabetes Mellitus Tipo 2/sangre , Ácidos Grasos no Esterificados/sangre , Ácidos Grasos Omega-3/administración & dosificación , PPAR gamma/genética , Polimorfismo Genético , Alanina , Estudios Transversales , Diabetes Mellitus Tipo 2/genética , Registros de Dieta , Ácidos Docosahexaenoicos/administración & dosificación , Ácidos Docosahexaenoicos/sangre , Ácido Eicosapentaenoico/administración & dosificación , Ácido Eicosapentaenoico/sangre , Ácidos Grasos Omega-3/sangre , Femenino , Genotipo , Heterocigoto , Homocigoto , Humanos , Insulina/sangre , Resistencia a la Insulina/genética , Lípidos/sangre , Masculino , Persona de Mediana Edad , Prolina , Factores Sexuales
16.
Pediatr Obes ; 12 Suppl 1: 26-37, 2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-27378525

RESUMEN

BACKGROUND: Maternal diet during pregnancy may contribute to the risk of offspring adiposity. OBJECTIVES: The objective of the study is to explore the associations between maternal antenatal dietary fatty acid intake and the risk of offspring overweight and obesity at the ages of 2 to 7 years. METHODS: In a prospective Finnish birth cohort with 3807 mother-child pairs, maternal diet in late pregnancy was assessed with a food frequency questionnaire. Intakes of total fatty acids and individual saturated, monounsaturated and polyunsaturated fatty acids (PUFAs) were calculated. Generalized estimating equation models were used to study the associations of maternal dietary variables with repeatedly measured offspring overweight and obesity. RESULTS: In girls, maternal intake ratio of n-6:n-3 PUFAs had a U-shaped association with obesity (adjusted OR for the lowest 2.0 [95% CI 1.27-3.20] and the highest 1.7 [1.03-2.73] vs. the two middle quartiles of n-6:n-3 PUFAs, p = 0.01). In boys, arachidonic acid (20:4n-6): docosahexaenoic acid + eicosapentaenoic acid ratio was associated with obesity (adjusted OR for the lowest 1.0 [0.60-1.57] and the highest 0.5 [0.26-0.88] vs. the two middle quartiles, p = 0.02). Saturated fatty acids and monounsaturated fatty acids were not associated with overweight or obesity in either sex. CONCLUSIONS: Maternal intakes of PUFAs in late pregnancy were associated with risk of later obesity differently in girls and boys.


Asunto(s)
Adiposidad/fisiología , Ácidos Grasos/administración & dosificación , Sobrepeso/etiología , Obesidad Infantil/etiología , Antropometría , Niño , Preescolar , Estudios de Cohortes , Dieta , Ácidos Grasos/efectos adversos , Conducta Alimentaria , Femenino , Finlandia , Humanos , Masculino , Madres , Sobrepeso/epidemiología , Obesidad Infantil/epidemiología , Embarazo , Estudios Prospectivos , Medición de Riesgo , Encuestas y Cuestionarios
17.
Eur J Clin Nutr ; 71(12): 1449-1454, 2017 12.
Artículo en Inglés | MEDLINE | ID: mdl-28901336

RESUMEN

BACKGROUND/OBJECTIVES: Vitamin D and probiotics are nutrients of interest in the context of type 1 diabetes (T1D). We assessed the prevalence of and factors associated with vitamin D and probiotic supplementations among young children with genetic risk of T1D. SUBJECTS/METHODS: Use of supplements during the first 2 years of life was collected prospectively from 8674 children in The Environmental Determinants of Diabetes in the Young (TEDDY) study. RESULTS: Single and/or multivitamin/mineral (MVM) supplements were reported by 81% of the children. The majority of participants in Finland, Germany and Sweden (97-99%) and 50% in the United States received vitamin D supplements that were mostly MVMs. Probiotics use varied from 6% in the United States to 60% in Finland and was primarily from probiotics-only preparations. More than 80% of the vitamin D and probiotics supplementation was initiated during infancy, and more than half of the uses lasted longer than a year. Being the first child, longer duration of breastfeeding, born in a later year, older maternal age and higher maternal education level were associated with both vitamin D and probiotics use. Shorter gestational age and mother not smoking during pregnancy were associated with a higher likelihood of probiotics supplementation only. CONCLUSIONS: Vitamin D and probiotics supplementations are popular in children 0-2 years old and are associated with common factors. Data documented here will allow evaluation of the relationship between early childhood dietary intake and the development of islet autoimmunity and progression to T1D.


Asunto(s)
Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/prevención & control , Suplementos Dietéticos , Predisposición Genética a la Enfermedad , Probióticos/administración & dosificación , Vitamina D/administración & dosificación , Adulto , Peso al Nacer , Preescolar , Diabetes Mellitus Tipo 1/sangre , Femenino , Finlandia , Alemania , Humanos , Lactante , Masculino , Micronutrientes/administración & dosificación , Micronutrientes/sangre , Estudios Prospectivos , Factores de Riesgo , Encuestas y Cuestionarios , Suecia , Estados Unidos , Vitamina D/sangre , Adulto Joven
18.
Eur J Clin Nutr ; 60(11): 1317-22, 2006 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-16775583

RESUMEN

OBJECTIVE: To study the total daily intake of vitamin D from food and supplements among Finnish children aged 3 months to 3 years, the dietary sources of vitamin D and the association between vitamin D intake and sociodemographic factors. SUBJECTS AND METHODS: The subjects are participants in the Finnish Type I Diabetes Prediction and Prevention Nutrition Study born between October 1997 and October 1998. At the age of 3 and 6 months, 1, 2 and 3 years, 342 (72% of the invited families), 298 (63%), 267 (56%), 233 (49%) and 209 (44%) families, respectively, participated in the present study. Food consumption was assessed by a 3-day food record. A structured questionnaire was used to record the parents' socioeconomic status. RESULTS: The mean dietary vitamin D intake exceeded the recommendation (10 microg/day) at the age of 3 (11.0 microg) and 6 months (12.0 microg), but decreased thereafter being 9.8, 5.0 and 4.1 microg at 1, 2 and 3 years of age, respectively. Among the children 91, 91, 81, 42 and 26% used vitamin D supplements at the age of 3 and 6 months, and 1, 2 and 3 years, respectively. In children not using vitamin D supplements, vitamin D intake was less than 10 microg/day at all ages. Vitamin D intake from food did not differ in children who used and did not use vitamin D supplements. Vitamin D supplements were the main source of vitamin D intake in all age groups studied, followed by vitamin D-fortified infant formula in 3-month-olds and infant formula and baby foods in 6-month-olds. After the age of 1 year, the most important food sources of vitamin D were margarine, fish, baby foods, low-fat milk and eggs. Sociodemographic factors, especially the number of children in the family and maternal age, were associated with the total vitamin D intake and vitamin D supplement use. CONCLUSION: Vitamin D supplements are not used according to the dietary recommendations in a substantial proportion of Finnish children.


Asunto(s)
Dieta , Suplementos Dietéticos/estadística & datos numéricos , Escolaridad , Vitamina D/administración & dosificación , Adulto , Distribución por Edad , Preescolar , Estudios de Cohortes , Diabetes Mellitus Tipo 1/prevención & control , Registros de Dieta , Composición Familiar , Femenino , Finlandia , Conocimientos, Actitudes y Práctica en Salud , Humanos , Lactante , Masculino , Edad Materna , Padres/educación , Padres/psicología , Clase Social , Factores Socioeconómicos , Encuestas y Cuestionarios
19.
Eur J Clin Nutr ; 70(5): 554-9, 2016 05.
Artículo en Inglés | MEDLINE | ID: mdl-26757832

RESUMEN

BACKGROUND/OBJECTIVES: Diet during pregnancy and lactation may have a role in the development of allergic diseases. There are few human studies on the topic, especially focusing on food allergies. We sought to study the associations between maternal diet during pregnancy and lactation and cow's milk allergy (CMA) in offspring. SUBJECTS/METHODS: A population-based birth cohort with human leukocyte antigen-conferred susceptibility to type 1 diabetes was recruited in Finland between 1997 and 2004 (n=6288). Maternal diet during pregnancy and lactation was assessed by a validated, 181-item semi-quantitative food frequency questionnaire. Register-based information on diagnosed CMA was obtained from the Social Insurance Institution and completed with parental reports. The associations between maternal food consumption and CMA were assessed using logistic regression, comparing the highest and the lowest quarters to the middle half of consumption. RESULTS: Consumption of milk products in the highest quarter during pregnancy was associated with a lower risk of CMA in offspring (odds ratio (OR) 0.56, 95% confidence interval (CI) 0.37-0.86; P<0.01). When stratified by maternal allergic rhinitis and asthma, there was evidence of an inverse association between high use of milk products and CMA in offspring of non-allergic mothers (OR 0.30, 95% CI 0.13-0.69, P<0.001). Cord blood IgA correlated positively with the consumption of milk products during pregnancy, indicating exposure to CMA and activation of antigen-specific immunity in the infant during pregnancy. CONCLUSIONS: High maternal consumption of milk products during pregnancy may protect children from developing CMA, especially in offspring of non-allergic mothers.


Asunto(s)
Dieta/efectos adversos , Lactancia/fisiología , Hipersensibilidad a la Leche/etiología , Leche/efectos adversos , Efectos Tardíos de la Exposición Prenatal/etiología , Adulto , Animales , Preescolar , Encuestas sobre Dietas , Femenino , Sangre Fetal/inmunología , Finlandia , Humanos , Inmunoglobulina A/análisis , Lactante , Modelos Logísticos , Masculino , Fenómenos Fisiologicos Nutricionales Maternos/fisiología , Hipersensibilidad a la Leche/prevención & control , Embarazo
20.
Diabetes ; 49(10): 1657-65, 2000 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-11016449

RESUMEN

Type 1 diabetes is considered to be a T-cell-mediated autoimmune disease in which insulin-producing beta-cells are destroyed. Immunity to insulin has been suggested to be one of the primary autoimmune mechanisms leading to islet cell destruction. We have previously shown that the first immunization to insulin occurs by exposure to bovine insulin (BI) in cow's milk (CM) formula. In this study, we analyzed the development of insulin-specific T-cell responses by proliferation test, emergence of insulin-binding antibodies by enzyme immunoassay, and insulin autoantibodies by radioimmunoassay in relation to CM exposure and family history of type 1 diabetes in infants with a first-degree relative with type 1 diabetes and increased genetic risk for the disease. The infants were randomized to receive either an adapted CM-based formula or a hydrolyzed casein (HC)-based formula after breast-feeding for the first 6-8 months of life. At the age of 3 months, both cellular and humoral responses to BI were higher in infants exposed to CM formula than in infants fully breast-fed (P = 0.015 and P = 0.007). IgG antibodies to BI were higher in infants who received CM formula than in infants who received HC formula at 3 months of age (P = 0.01), but no difference in T-cell responses was seen between the groups. T-cell responses to BI at 9 months of age (P = 0.05) and to human insulin at 12 (P = 0.014) and 24 months of age (P = 0.009) as well as IgG antibodies to BI at 24 months of age (P = 0.05) were lower in children with a diabetic mother than in children with a diabetic father or a sibling, suggesting possible tolerization to insulin by maternal insulin therapy. The priming of insulin-specific humoral and T-cell immunity occurs in early infancy by dietary insulin, and this phenomenon is influenced by maternal type 1 diabetes.


Asunto(s)
Diabetes Mellitus Tipo 1/inmunología , Dieta , Predisposición Genética a la Enfermedad , Inmunización , Insulina/inmunología , Leche , Animales , Formación de Anticuerpos , Autoanticuerpos/sangre , Autoinmunidad , Caseínas , Bovinos , Diabetes Mellitus Tipo 1/genética , Femenino , Humanos , Inmunidad Celular , Técnicas para Inmunoenzimas , Lactante , Alimentos Infantiles , Insulina/administración & dosificación , Linfocitos T/inmunología
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