‘Inflammatory’ diet during pregnancy may raise child’s diabetes type 1 risk

A diet high in foods with the potential to promote low-grade inflammation during pregnancy may raise that child’s risk of developing type 1 diabetes, suggests Danish research published online in the Journal of Epidemiology & Community Health.

This dietary pattern was associated with a 16% heightened risk for every unit increase in a dietary measure of inflammatory food intake, the findings show.

Type 1 diabetes is an autoimmune disorder characterized by the destruction of insulin-producing β-cells in the pancreas, necessitating lifelong insulin treatment.

New cases of type 1 diabetes have been rising steadily, increasing by an average of 3–4% every year, especially in developed nations, strongly suggesting a major role for environmental factors, note the researchers.

And since the immune system develops and establishes in early life, and to a certain degree before birth, there is a strong case for exploring the role of the mother’s diet during her pregnancy, especially as mounting evidence suggests that diet is a modifiable contributory factor to low-grade systemic inflammation, they explain.

To explore this further, the researchers drew on pregnant women in the Danish National Birth Cohort (DNBC) (January 1996 to October 2002).

They calculated a score based on the inflammatory potential of the mother’s usual dietary intake (EDII score) in mid-pregnancy from a comprehensive food frequency questionnaire, covering 38 food groups (360 separate items), which was completed at around 25 weeks of pregnancy.

Foods that are often reported to have inflammatory properties include: red/processed meats; sugar-sweetened drinks; commercial baked goods; refined grain products, such as white bread and pasta; deep-fried foods; foods high in added sugar; and trans fats found in non-dairy creamers and some margarines.

In all, 67,701 mother-child pairs were included in the final analysis.

Information on type 1 diabetes diagnoses in the children was obtained through registry linkage to the Danish Registry of Childhood and Adolescent Diabetes. Some 281 (nearly 0.5%) developed the condition during an average tracking period of 17 years. Their average age at diagnosis was 10.

The mothers’ average EDII scores ranged from −5.3 to 4.1, with higher scores indicating higher dietary intake of inflammatory foods.

Higher EDII scores were associated with younger maternal age, lower alcohol consumption, shorter breastfeeding period, and less favorable socioeconomic circumstances. They were also associated with higher BMI (weight) and a tendency to smoke beyond the first 12 weeks of pregnancy.

There was no significant difference in total energy intake between those women with the highest and lowest EDII scores. But a higher daily intake of red meats, low-fat dairy, pizza, margarine, potatoes, low energy drinks, French fries, and savory snacks was reflected in higher EDII scores.

On the other hand, higher daily intake of alliums (onions and garlic), tomatoes, whole grains, coffee, green leafy vegetables, fruit juice, dark meat fish, tea, and fruits was reflected in lower EDII scores.

The risk of a child’s type 1 diabetes was associated with their mother’s EDII score, rising by 16% for each unit increase in score up to the age of 18, after accounting for potentially influential factors. Put simply, 1 unit of EDII, which is one standard deviation of the distribution of EDII, corresponds approximately to going from the bottom 3rd to the top 3rd of the population.

This risk wasn’t affected by the child’s sex or weight at birth, but it did seem to be affected by the mother’s intake of gluten, and whether she smoked during her pregnancy.

A 10 g increase in estimated intake of gluten was associated with a 36% increase in risk.

This is an observational study, and as such, can’t establish cause and effect. And the researchers weren’t able to account for the child’s diet.

But they write, “A low-grade inflammatory state secondary to an altered immune cell profile, which triggers pro-inflammatory pathways, is increasingly acknowledged as a critical early-life factor influencing offspring health.”

They caution: “The precise mechanisms by which diet modulates the immune response remain elusive, although some clues can be offered for specific dietary components.”

They add, “Of particular note is the fact that three factors during mid-pregnancy, a pro-inflammatory dietary pattern, gluten, and smoking, seemed to independently predict the child’s risk of type 1 diabetes. This suggests that mid-pregnancy may be a critical period during which the fetus is particularly susceptible to maternal lifestyle influences in relation to the individual’s later risk for developing type 1 diabetes during childhood or adolescence.”

A diet high in foods with the potential to promote low-grade inflammation during pregnancy may raise that child’s risk of developing type 1 diabetes, suggests Danish research published online in the Journal of Epidemiology & Community Health.

This dietary pattern was associated with a 16% heightened risk for every unit increase in a dietary measure of inflammatory food intake, the findings show.

Type 1 diabetes is an autoimmune disorder characterized by the destruction of insulin-producing β-cells in the pancreas, necessitating lifelong insulin treatment.

New cases of type 1 diabetes have been rising steadily, increasing by an average of 3–4% every year, especially in developed nations, strongly suggesting a major role for environmental factors, note the researchers.

And since the immune system develops and establishes in early life, and to a certain degree before birth, there is a strong case for exploring the role of the mother’s diet during her pregnancy, especially as mounting evidence suggests that diet is a modifiable contributory factor to low-grade systemic inflammation, they explain.

To explore this further, the researchers drew on pregnant women in the Danish National Birth Cohort (DNBC) (January 1996 to October 2002).

They calculated a score based on the inflammatory potential of the mother’s usual dietary intake (EDII score) in mid-pregnancy from a comprehensive food frequency questionnaire, covering 38 food groups (360 separate items), which was completed at around 25 weeks of pregnancy.

Foods that are often reported to have inflammatory properties include: red/processed meats; sugar-sweetened drinks; commercial baked goods; refined grain products, such as white bread and pasta; deep-fried foods; foods high in added sugar; and trans fats found in non-dairy creamers and some margarines.

In all, 67,701 mother-child pairs were included in the final analysis.

Information on type 1 diabetes diagnoses in the children was obtained through registry linkage to the Danish Registry of Childhood and Adolescent Diabetes. Some 281 (nearly 0.5%) developed the condition during an average tracking period of 17 years. Their average age at diagnosis was 10.

The mothers’ average EDII scores ranged from −5.3 to 4.1, with higher scores indicating higher dietary intake of inflammatory foods.

Higher EDII scores were associated with younger maternal age, lower alcohol consumption, shorter breastfeeding period, and less favorable socioeconomic circumstances. They were also associated with higher BMI (weight) and a tendency to smoke beyond the first 12 weeks of pregnancy.

There was no significant difference in total energy intake between those women with the highest and lowest EDII scores. But a higher daily intake of red meats, low-fat dairy, pizza, margarine, potatoes, low energy drinks, French fries, and savory snacks was reflected in higher EDII scores.

On the other hand, higher daily intake of alliums (onions and garlic), tomatoes, whole grains, coffee, green leafy vegetables, fruit juice, dark meat fish, tea, and fruits was reflected in lower EDII scores.

The risk of a child’s type 1 diabetes was associated with their mother’s EDII score, rising by 16% for each unit increase in score up to the age of 18, after accounting for potentially influential factors. Put simply, 1 unit of EDII, which is one standard deviation of the distribution of EDII, corresponds approximately to going from the bottom 3rd to the top 3rd of the population.

This risk wasn’t affected by the child’s sex or weight at birth, but it did seem to be affected by the mother’s intake of gluten, and whether she smoked during her pregnancy.

A 10 g increase in estimated intake of gluten was associated with a 36% increase in risk.

This is an observational study, and as such, can’t establish cause and effect. And the researchers weren’t able to account for the child’s diet.

But they write, “A low-grade inflammatory state secondary to an altered immune cell profile, which triggers pro-inflammatory pathways, is increasingly acknowledged as a critical early-life factor influencing offspring health.”

They caution: “The precise mechanisms by which diet modulates the immune response remain elusive, although some clues can be offered for specific dietary components.”

They add, “Of particular note is the fact that three factors during mid-pregnancy, a pro-inflammatory dietary pattern, gluten, and smoking, seemed to independently predict the child’s risk of type 1 diabetes. This suggests that mid-pregnancy may be a critical period during which the fetus is particularly susceptible to maternal lifestyle influences in relation to the individual’s later risk for developing type 1 diabetes during childhood or adolescence.”