Literature Review: Pregnant and breastfeeding ... - Eat For Health

Reference Lamb 2008Dietary patterns Cereals: Gluten-containing foods (brownies, cookies, cakes, cereals, oats, other grains, bread, muffins, hamburgers, hot dogs, meat sandwiches,pancakes, pasta, pie, pizza, pastries, beer, bran and wheat germ); non-gluten containing cereals (rice and corn)Study typePart of a longitudinal prospective birth cohort studyLevel of evidence II (aetiology)SettingDenver, Colorado, US (part of the Diabetes Autoimmunity Study in the Young (the DAISY))FundingNational Institutes of Health, Diabetes Endocrine Research CenterParticipants642 newborns at increased risk for type 1 diabetes (based on HLA genotype and family history), enrolled in the study from 1993 to 2004; 27 casesdefined as testing positive for islet autoantibodies at two consecutive blood draws and still positive (diabetic) at last follow-upBaseline comparisons See confounding belowDietary assessment FFQTimingFrom 1997 to 2004, mothers of infants enrolled in DAISY completed FFQ soon after birth, reflecting diet in the last trimester of pregnancy (but couldsubmit FFQ before child reached one year of age)ComparisonMonthly servings of gluten-containing foods and non-gluten cereal grainsOutcomes Islet autoimmunity in children (a precursor of type 1 diabetes) at 9 months, 15 months, 2 years and annually thereafter up to the age of 15ResultsGluten-containing foods:aHR (for one standard deviation change in reported consumption) 0.89 95% CI 0.50 to 1.58 (127 mean monthly servings)Non-gluten cereal grains:aHR (for one standard deviation change in reported consumption) 0.98 95% CI 0.64 to 1.51 (12 mean monthly servings)FollowupConfoundingRisk of biasRelevanceOther commentsUp to 15 yearsSize for gestational age, ethnicity, maternal education, household income, exposure to type 1 diabetes or GDM in utero, gender of child, maternal ageat birth, total calories of maternal dietModerate risk of bias: subset of DAISY only (later enrolments); and women were not reminded to submit FFQ, leading to possible selection bias; of the661 FFQs returned, 5 were excluded because incomplete, and 14 for implausible dietary intakes, leaving 642 FFQs for analysis; child’s diet notcontrolled forLikely to be relevant to some Australian women, although women in this study may have been at higher risk of diabetesCereal117