Quick Take: Association of Cereal, Gluten, and Dietary Fiber Intake With Islet Autoimmunity and Type 1 Diabetes

Type 1 diabetes (T1D) is thought to result from a combination of genetic and environmental factors. An increased intake of dietary fiber and gluten has been hypothesized to contribute to the development of T1D, though supporting data is scarce. In this cohort study, 6,081 infants with human leukocyte antigen (HLA)-conferred susceptibility to T1D were followed up to study the association between cereal, gluten, and dietary fiber intake with the development of islet autoimmunity (IA) and T1D. During the 6-year follow-up period, 4.4% of children developed IA at a median age of 2.5 years (IQR 1.3 to 3.6 years). Of the 5714 children with food record data available, 1.6% developed T1D at a median age of 3.8 years (2.9 to 4.8 years). Researchers found that, after adjusting for energy intake, a high intake of oats, (HR 1.08, 95% CI 1.03 to 1.13, p=0.002), wheat (HR 1.09, 95% CI 1.03 to 1.15, p=0.002), rye (HR 1.13, 95% CI 1.03 to 1.23, p-0.01), gluten-containing cereals (HR 1.07, 95% CI, 1.03 to 1.11, p<0.001), gluten without avenin from oats (HR 2.23, 95% CI 1.40 to 3.57, p<0.001), gluten with avenin (HR 2.06, 95% CI 1.45 to 2.92, p<0.001), and dietary fiber (HR 1.41, 95% CI 1.10 to 1.81, p=0.01) was associated with an increased risk of developing IA (HRs for 1 g/MJ increase in intake). The intake of rice and barley was not associated with risk of IA. After adjusting for energy intake, only the intake of oats (HR 1.10, 95% CI 1.00 to 1.21, p=0.04) and rye (HR 1.20, 95% CI 1.03 to 1.41, p=0.02) was associated with an increased risk of developing T1D. However, after multiple testing correction, neither of these associations were statistically significant. In summary, findings from this study suggest that a high intake of oats, gluten-containing cereals, gluten, and dietary fiber may increase the risk of developing islet autoimmunity, but not necessarily that of developing type 1 diabetes.

Click to read the study in JAMA Pediatrics 

Image: PD

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