Nutritional Factors and Preservation of C-Peptide in Youth With Recently Diagnosed Type 1 Diabetes
SEARCH Nutrition Ancillary Study
- Elizabeth J. Mayer-Davis, PHD1⇑,
- Dana Dabelea, MD, PHD2,
- Jamie L. Crandell, PHD3,
- Tessa Crume, PHD2,
- Ralph B. D’Agostino Jr., PHD4,
- Lawrence Dolan, MD5,
- Irena B. King, PHD6,
- Jean M. Lawrence, SCD, MPH, MSSA7,
- Jill M. Norris, PHD2,
- Catherine Pihoker, MD8 and
- Natalie The, PHD9
- 1Department of Nutrition and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- 2Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado
- 3School of Nursing and Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- 4Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- 5Cincinnati Children’s Hospital and Medical Center, Cincinnati, Ohio
- 6Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico
- 7Department of Research and Evaluation, Kaiser Permanente, Southern California, Pasadena, California
- 8Department of Pediatric Endocrinology and Diabetes, Children’s Hospital and Regional Medical Center, Seattle, Washington
- 9Department of Health Sciences, Furman University, Greenville, South Carolina
- Corresponding author: Elizabeth J. Mayer-Davis,
OBJECTIVE To test the novel hypothesis that nutritional factors previously associated with type 1 diabetes etiology or with insulin secretion are prospectively associated with fasting C-peptide (FCP) concentration among youth recently diagnosed with type 1 diabetes.
RESEARCH DESIGN AND METHODS Included were 1,316 youth with autoantibody-positive type 1 diabetes who participated in the SEARCH for Diabetes in Youth study (baseline disease duration, 9.9 months; SD, 6.3). Nutritional exposures included breastfeeding and age at introduction of complementary foods, baseline plasma long-chain omega-3 fatty acids including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), vitamin D, vitamin E, and, from a baseline food frequency questionnaire, estimated intake of the branched-chain amino acid leucine and total carbohydrate. Multiple linear regression models were conducted to relate each nutritional factor to baseline FCP adjusted for demographics, disease-related factors, and other confounders. Prospective analyses included the subset of participants with preserved β-cell function at baseline (baseline FCP ≥0.23 ng/mL) with additional adjustment for baseline FCP and time (mean follow-up, 24.3 months; SD, 8.2; n = 656). FCP concentration was analyzed as log(FCP).
RESULTS In adjusted prospective analyses, baseline EPA (P = 0.02), EPA plus DHA (P = 0.03), and leucine (P = 0.03) were each associated positively and significantly with FCP at follow-up. Vitamin D was unexpectedly inversely associated with FCP (P = 0.002).
CONCLUSIONS Increased intake of branched-chain amino acids and long-chain omega-3 fatty acids may support preservation of β-cell function. This represents a new direction for research to improve prognosis for type 1 diabetes.
This article contains Supplementary Data online at http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc12-2084/-/DC1.
The findings and conclusions in this report are those of the authors and do not represent the views of the funding agencies.
- Received October 11, 2012.
- Accepted February 6, 2013.
- © 2013 by the American Diabetes Association.
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