Abstract
BackgroundJuvenile idiopathic arthritis (JIA) is considered to be an autoimmune disease, but the etiology is unknown. We decided to study the influence of early nutrition on later development of JIA.MethodsAll parents with children born between October 1, 1997 and October 1, 1999 in Southeast Sweden were asked to participate in the ABIS prospective cohort study (All Babies in Southeast Sweden), At 1 year, questionnaires with information on breastfeeding and introduction of foods were completed by 10,565 families. We identified 32 children with JIA and 111 children with non-chronic arthritis with completed questionnaires after delivery and after 1 year. A multivariable logistic regression model, adjusted for relevant factors, was performed to calculate the association between JIA and feeding during the first year of life.ResultsAn increased risk for JIA was found in children who had breast fed for less than 4 months, as opposed to those who were continued on breast milk beyond 4 months of age (aOR 3.5, 95% CI 1.4-8,5; p = 0.006). A short duration of exclusive as well as total breastfeeding was associated with an increased risk of JIA (aOR 1.3, 95% CI 1.1-1.6; p = 0.008 and aOR 1.2, 95% CI 1.1-1.3; p < 0.001). All associations between breastfeeding and JIA persisted after adjustment. There was no relationship between early nutrition and non-chronic arthritis.ConclusionsOur results indicate that there are different disease mechanisms for different types of arthritis in childhood. Longer duration of breastfeeding (both total and exclusive) may protect against development of JIA. Mothers should be encouraged to breast-feed their babies exclusively, if at all possible, for 4 months and continue partial breastfeeding for an extended time when foreign proteins are introduced.
Highlights
Introduction of glutenWe did not observe any significant association between age at introduction of gluten and risk of Juvenile idiopathic arthritis (JIA) or nonchronic arthritis (Fig. 1)
We identified 111 patients in the same cohort with an episode of a transient non-chronic arthritis, with only one joint involved with a maximum duration of 6 weeks. 12% (13/111) of them were diagnosed with reactive arthritis and 88% (95/111) with unspecified arthritis (M02 respective M13 on International Classification of Diseases (ICD) 8-10)
History of Rheumatoid Arthritis (RA)/JIA in first-degree family member was present in only one patient in both the JIA-group (3%) and the group with non-chronic arthritis (1%) compared with 130 controls
Summary
Introduction of glutenWe did not observe any significant association between age at introduction of gluten and risk of JIA or nonchronic arthritis (Fig. 1). Juvenile idiopathic arthritis (JIA) is considered to be an autoimmune disease, but the etiology is unknown. We decided to study the influence of early nutrition on later development of JIA. Juvenile idiopathic arthritis (JIA), the most common chronic rheumatic disease of childhood, is a collection of chronic pediatric arthritis characterized by onset before 16 years of age and the presence of arthritis (inflammation of the synovium with thickening of the synovial lining and accumulation of synovial fluid) for at least 6 weeks [1]. JIA is considered to be an autoimmune disease, which is a result of an immune reaction caused or triggered by. Another study noted a tendency of shorter breastfeeding among children who later developed oligoarticular JIA [7].
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