Childhood Diet Research Articles

Changes in the diet of a South Asian transmigratory population may be associated with an increase in incidence of childhood diabetes

Emigrants from Pakistan to Bradford, UK, have moved from an area of low to one of higher incidence of type 1 diabetes. South Asian children in this population have shown a marked rise in diabetes incidence. Changes in diet over the last 40 years were investigated as a potential explanatory factor. Dietary information were collected on (1) South Asian children aged 9 to 11 in Bradford (group 1, n = 204); (2) recalled childhood diet of adult Asians in Bradford aged 10 (group 2, n = 53); and (3) comparative children in Pakistan (group 3, n = 47). For groups 1 and 3, participants were asked to recall all items of food and drink consumed during the previous 24 hours. Nutrient intakes were generated from the raw food data using a computer algorithm. Broad food group consumption and median nutrient intakes were compared between groups. Food intake differed significantly in the Bradford children compared with their counterparts in Pakistan. The childhood diet recalled by adults was similar to that of children currently in Pakistan. Bradford children consumed higher quantities of food that contained more fat, protein, carbohydrate, and sugar than the other 2 groups. Bradford children were more likely to consume meat, fish, and fast food, although fewer vegetables and dairy products than the other groups. The diets of Pakistani children in Bradford differed significantly from their counterparts in Pakistan, both in broad content and nutrient composition. These dietary changes could be responsible for the increase in type 1 diabetes and for the emergence of type 2 diabetes in children.

Post-weaning diet affects genomic imprinting at the insulin-like growth factor 2 (Igf2) locus

IGF2 loss of imprinting (LOI) is fairly prevalent and implicated in the pathogenesis of human cancer and developmental disease; however, the causes of this phenomenon are largely unknown. We determined whether the post-weaning diet of mice affects allelic expression and CpG methylation of Igf2. C57BL/6JxCast/EiJ F1 hybrid mice were weaned onto (1) a standard natural ingredient control diet, (2) a synthetic control diet or (3) a synthetic methyl-donor-deficient diet lacking folic acid, vitamin B(12), methionine and choline. Maternal Igf2 expression in kidney was negligible at birth, but increased to approximately 10% of total expression after 60 days on the natural control diet. By 60 days post-weaning, both synthetic diets caused significant LOI of Igf2 relative to animals weaned onto the natural control diet. Total Igf2 expression was significantly reduced in these groups, however, indicating that the increase in relative maternal Igf2 expression was caused by specific down-regulation of the paternal allele. The LOI induced by the synthetic-deficient diet persisted during a subsequent 100-day 'recuperation' period on natural ingredient diet. There were no group differences in overall or allele-specific CpG methylation in the H19 differentially methylated region (DMR), Igf2 DMR0 or Igf2 DMR1. At 30 and 60 days post-weaning, however, the paternal allele of Igf2 DMR2 was hypermethylated in the kidneys of mice on the control synthetic diet. These results indicate that post-weaning diet can permanently affect expression of Igf2, suggesting that childhood diet could contribute to IGF2 LOI in humans.

Preschool diet and adult risk of breast cancer

Events before puberty may affect adult risk of breast cancer. We examined whether diet during preschool age may affect a woman's risk of breast cancer later in life. We conducted a case-control study including 582 women with breast cancer and 1,569 controls free of breast cancer selected from participants in the Nurses' Health Study and the Nurses' Health Study II. Information concerning childhood diet of the nurses at ages 3-5 years was obtained from the mothers of the participants with a 30-item food-frequency questionnaire. An increased risk of breast cancer was observed among woman who had frequently consumed French fries at preschool age. For one additional serving of French fries per week, the odds ratio (OR) for breast cancer adjusted for adult life breast cancer risk factors was 1.27 (95% confidence interval [CI] = 1.12-1.44). Consumption of whole milk was associated with a slightly decreased risk of breast cancer (covariate-adjusted OR for every additional glass of milk per day = 0.90; 95% CI = 0.82-0.99). Intake of none of the nutrients calculated was related to the risk of breast cancer risk in this study. These data suggest a possible association between diet before puberty and the subsequent risk of breast cancer. Differential recall of preschool diet by the mothers of cases and controls has to be considered as a possible explanation for the observed associations. Further studies are needed to evaluate whether the association between preschool diet and breast cancer is reproducible in prospective data not subject to recall bias.

Racial Differences in Prognostic Value of Adult Height for Biochemical Progression Following Radical Prostatectomy

Adult height, as a surrogate of childhood and adolescent hormone activity and diet, has been associated with the risk for development and death from prostate cancer in predominantly White populations. However, hormonal activity and diets vary between races. We examined whether height was significantly associated with biochemical progression following radical prostatectomy and whether there was an interaction between height and race. Multivariate Cox proportional hazards analysis was used to determine if height significantly predicted biochemical progression among 1,503 men (450 Black and 1,053 White) treated with radical prostatectomy between 1988 and 2003. We examined for possible interactions between height and race. Taller men (>175.3 cm) were significantly younger (P = 0.001), treated in more recent years (P = 0.02), had more clinical stage T(1) disease (P = 0.001), and were less likely to have extraprostatic extension (P = 0.02) than shorter men (< or =175.3 cm). Height was not significantly related to race, preoperative serum prostate-specific antigen concentrations, biopsy or pathologic Gleason sum, positive surgical margins, seminal vesicle invasion, or lymph node metastasis. Height was significantly associated with progression among Black men [relative risk (RR), 1.67; 95% confidence interval (95% CI), 1.00-2.79] but not among White men (RR, 1.03; 95% CI, 0.77-1.38). The interaction between race and height for predicting biochemical progression was statistically significant (P(interaction) = 0.05). There was an interaction between height and race in that height predicted progression for Black men but not for White men. The explanation for these findings is unclear, although lower insulin-like growth factor-binding protein-3 concentrations among Black men may be involved.

What influences diet in early old age? Prospective and cross-sectional analyses of the Boyd Orr cohort

The aim of this study is to identify the socio-economic and health-related factors in childhood and later life associated with healthy eating in early old age. The study is based on surviving members of the Boyd Orr cohort aged 61-80 years. Data are available on household diet and socio-economic position in childhood and on health and social circumstances in later life. A 12-item Healthy Diet Score (HDS) for each subject was constructed from food frequency questionnaire responses. Complete data on all exposures examined were available for 1234 cohort members. Over 50% of study members had inadequacies in at least half of the 12 markers of diet quality. In multivariable models having a childhood diet which was rich in vegetables was associated with a healthy diet in early old age. The HDS for those in the upper quartile of childhood vegetable intake was 0.30 (95% confidence interval -0.01 to 0.61) higher than those with the lowest intake levels (P-trend across quartiles = 0.04). The adult factors that were most strongly associated with a healthy diet were not smoking, being an owner-occupier, and taking anti-hypertensive medication. Our analysis indicates that diet in early old age is influenced by childhood vegetable consumption, current socio-economic position, and smoking. Interventions for improving the diet of older people could usefully focus on both encouragement of healthy diet choices from an early age and higher levels of income or nutritional support for older people.

Cohort Profile: The Boyd Orr cohort—an historical cohort study based on the 65 year follow-up of the Carnegie Survey of Diet and Health (1937–39)

742 of the children on their health and growth were studied. Around 500 children aged 2–14 received supplements and a similar number of non-supplemented children acted as controls.1,3 The initial aim of establishing the Boyd Orr cohort was to investigate the long-term impact of environmental factors in early life on adult coronary heart disease mortality. Whilst the possible impact of poor childhood nutrition on adult health had been the subject of research and policy interest for many years,4–7 specific interest in the influence of early life exposures on adult cardiovascular disease was re-awakened by a series of studies that began in the 1980s by Professor David Barker and colleagues at the University of Southampton.8,9 These studies demonstrated inverse associations of markers of foetal growth with cardiovascular risk factors and mortality. An important strength of the material collected in the Carnegie Survey/Boyd Orr cohort was the availability of detailed measures of childhood diet; most of the research in this field uses proxy measures of pre-natal and childhood nutrition (e.g. birth weight, height).10 Studies on the cohort to date have investigated a range of disease endpoints, particularly coronary heart disease and cancer in relation to infant and childhood diet, the socio-economic conditions experienced by the children, and markers of childhood nutritional status (body mass index, leg length, and height).

Dietary Fat Reduction Improves Relapse-Free Survival in Postmenopausal Women Previously Treated for Early-Stage Breast Cancer: Results from a Phase III Women's Intervention Nutrition Study

pausal status, and therefore the association of fat intake with breast cancer risk may be different in postmenopausal women compared with premenopausal women. • Moreover, dietary patterns in early life have been implicated in the etiology of breast cancer, and dietary fat consumption during adolescence or even in childhood may influence the risk of breast cancer in adulthood.8 As rapid growth and maturation of the breasts occur during adolescence, a woman’s diet as an adolescent could potentially affect her risk of developing breast cancer more than her diet would as an adult.8,9 Although case-controlled studies generally do not support an association between childhood diet and risk of breast cancer,10,11 most studies suffer

Dietary Fruit, Vegetable, and Dairy Intake Leads to Lasting Blood Pressure Changes

Source: Moore LL, Singer MR, Bradlee ML, et al. Intake of fruits, vegetables, and dairy products in early childhood and subsequent blood pressure change. Epidemiology. 2005;16:4–11.Diets with high intake of fruits, vegetables, and low-fat dairy products have been shown to reduce blood pressure in adults.1 Similar effects of childhood diets have not been previously demonstrated. Investigators from Boston University used 8 years of follow-up data from 95 children who were initially enrolled at 3–6 years of age in the prospective Framingham Children’s Study in 1986. Diet was assessed with sets of 3-day food diaries repeated frequently through the study. Blood pressure was measured 5 times at each annual clinic visit following a standard procedure using an automated device. The 5 blood pressure readings were averaged. Children who consumed 4 or more servings of fruits and vegetables per day or 2 or more servings of dairy products per day during preschool age had smaller yearly gains in systolic blood pressure (SBP) throughout childhood. By early adolescence, children with higher intakes of fruits and vegetables and dairy products had an adjusted mean SBP of 106 ± 2.9 mm Hg SD, while those with lower intakes in both food groups had a mean SBP of 113 ± 1.5 mm Hg SD. Subjects who had either higher fruit and vegetable intake alone or higher dairy intake alone had intermediate levels of SBP in adolescence. Effects on diastolic BP were weaker than for systolic. Controlling for body mass index led to a small attenuation of the effects, which suggests that a small part of the protective effect of diet may be explained by body size differences. The authors suggest that a diet rich in fruits, vegetables, and dairy products may have beneficial effects on blood pressure during childhood.Dr. Neuspiel has disclosed no financial relationships relevant to this commentary.These investigators used a prospective cohort study design to demonstrate a beneficial effect of early childhood diet on blood pressure during adolescence. The mechanisms of this effect are uncertain, and may reflect either specific amounts of dietary minerals (eg, calcium, magnesium, potassium), peptides from milk proteins,2 or lower body weight for height. This current study was not of sufficient size to tease out these effects. Vegetarian diets in adults have been shown to lower blood pressure.3,4 In its ability to demonstrate causation, a prospective cohort study is the strongest observational design, and is only surpassed by a randomized clinical trial, which would not be feasible to study this question. A longer period of cohort follow-up would be helpful to determine if the benefit of early diet persists into adulthood.

Potential early-life predictors of dietary behaviour in adulthood: a retrospective study

Unnecessary dietary restraint (ie in the absence of a need to lose weight) and chronic overeating are both very unhealthy activities. As a precursor to a more involved longitudinal study, we sought to identify potential early-life predictors that merit scrutiny in this context. Four retrospective questionnaire studies were conducted (Study 1, N=242; Study 2, N=297; Study 3, N=175; Study 4, N=261). Female participants (18-30 y) completed measures of current dietary restraint and overeating. They also recalled experiences between 5 and 10 years of age. All were staff or students at Loughborough University (UK). After considering obvious sources of systematic bias, we report evidence that (i) dietary restraint is related to memories of maternal weight and dietary behaviour, and (ii) overeating and meal-size selection are both associated with memories of receiving a high-energy diet. The role of maternal factors in dietary restraint is consistent with previous research exploring the early onset of this behaviour. However, the relationship between childhood diet and overeating has not been suggested elsewhere. This is particularly important because it suggests a previously unreported correspondence between childhood experience and behaviours associated with obesity in adulthood.

Cross-Sectional Associations of Diet and Insulin-Like Growth Factor Levels in 7- to 8-Year-Old Children

AbstractBackground: The insulin-like growth factors (IGF) are polypeptide hormones which are associated with several adult diseases including cancer and coronary heart disease. The dietary determinants of circulating levels of components of the IGF system are of interest, as these may mediate some of the effects of diet on later health. However, few studies have examined the relationship between diet and IGF levels in children.Objective: To investigate associations between diet and IGF-I and IGFBP-3 levels in 7- to 8-year-old children.Methods: This study used subjects participating in the Avon Longitudinal Study of Parents and Children. Diet was assessed using a 3-day unweighed food diary. Confounding variables considered were maternal education, housing tenure, birthweight, and body mass index.Results: Complete information on dietary intakes, IGF levels, and all confounding variables were available for 521 children (287 boys). IGF-I was positively associated with intakes of protein, magnesium, zinc, calcium, potassium, and phosphorus, and IGFBP-3 was positively associated with energy. The IGF-I/IGFBP-3 ratio was positively associated with intakes of protein, zinc, and phosphorus. There was some evidence that the dietary determinants of the IGF system differed between the sexes. None of the foods examined were strongly associated with IGF levels, in particular, there was no association with red meat or vegetable intake.Conclusion: These data suggest that the IGF axis in children is affected by diet. This may provide a mechanism whereby childhood diet could have a long-term effect on risk of chronic disease.

Change in nutrient intake between adolescence and adulthood: a 21‐year longitudinal study

Summary The period between adolescence and adulthood is a time of great change, mentally, physically and socially. Such changes can have a profound impact on nutrient intake. Yet whilst some short‐term studies have attempted to assess dietary change during adolescence, few have considered how diet changes over the longer term, spanning the transition between adolescence and adulthood. This article describes the findings of the first British study to assess the change in macronutrient and micronutrient intake from early adolescence into adulthood. The study sample comprised 202 participants of a dietary survey carried out on Northumberland 12 years olds in 1979–80 who were followed up at 33 years old. At both time‐points dietary intake was measured using two 3‐day food diaries with follow‐up interviews to record estimated portion size. The most notable findings were that between 12 and 33 years old, for both males and females, % food energy intakes of fat, total sugars and carbohydrate had fallen and protein intakes had risen, whilst absolute intakes of unavailable carbohydrate and all micronutrients considered (vitamin C, iron, calcium, vitamin D), with the exception of retinol equivalents, had increased. These changes in intake were generally consistent in direction between males and females. In conclusion, nutrient intake undergoes considerable change between adolescence and adulthood and, in most respects, this is in a direction in line with dietary recommendations. This does not imply that efforts should not be made to improve childhood and adolescent diet given the importance of diet on health in adolescence and later in life and evidence that dietary intake is, to some extent, established at an early age.

The role of changing childhood diets in the prehistoric evolution of food production: An isotopic assessment.

Earlier weaning has often been suggested as a cause for population growth after the evolution of food production. However, evidence for weaning-time reduction is largely circumstantial. Collagen stable nitrogen- and carbon-isotope ratios from juvenile and adult burials from four sites in eastern North America were measured to estimate weaning onsets and durations before and after the appearance of intensive food production. Two preagricultural Late Archaic sites (Indian Knoll and Carlston Annis) are compared with two highly agricultural Middle Mississippian sites (Angel and Tinsley Hill). Isotopic data and paleodemographic measures of birth rates provide no evidence for changes in weaning behavior or fertility with the development of food production in the prehistoric Lower Ohio Valley. Birth rates and weaning behavior appear to have been roughly the same at all four sites. These results indicate that models attributing population growth after the appearance of food production to earlier weaning are not universally applicable.

Longitudinal changes in diet from childhood into adulthood with respect to risk of cardiovascular diseases: The Cardiovascular Risk in Young Finns Study.

To assess nutrient intakes relevant in the prevention of cardiovascular diseases (CVD) among young adults in Finland and to find past and present determinants of quality of diet. Prospective study, 21 years of follow-up. The Cardiovascular Risk in Young Finns Study, Finland. At baseline in 1980: 3569 children aged 3-18 y participated (83% of those invited), and every second of them (1780) were selected to the dietary study. At follow-ups in 1986 and 2001: 1200 and 1037 of the original sample, respectively, participated. Food consumption was assessed using 48-h dietary recall. Intakes in 2001 were compared with those obtained in 1980 and 1986. Nutrients selected for further examination were those implicated in the risk of CVD: saturated, monounsaturated, polyunsaturated and n-3 fatty acids, fibre and salt. An index describing the quality of adulthood diet was constructed. Multivariate logistic regression was used to identify independent childhood and adulthood determinants of the quality index. The average intakes showed substantial changes since 1980. Intakes of fat and saturated fat had decreased, while the consumption of vegetables and fruit had increased. However, a great disparity was present between the recommended levels and actual intakes for many of the nutrients, particularly salt, saturated fat and fibre. Intake of fat and consumption of vegetables in childhood and physical activity in adulthood were important health behavioural determinants of the cardiovascular quality of the adult diet. Socio-demographic factors, including education of the subject and their parents, had no significant associations with diet. While intakes of energy and nutrients have changed favourably in Finnish young adults between 1980 and 2001 with regard to the risk of CVD, they are still far from recommended levels. Childhood diet is a significant determinant of adult diet even after 21 y. This study was supported by the Academy of Finland (grant 77841) and Juho Vainio Foundation.

The association of socio‐economic position across the life course and age at menopause: the British Women's Heart and Health Study

To assess the association of indicators of adverse socio-economic position from across the life course with age at menopause. Cross sectional study as part of the British Women's Heart and Health Study. 23 British towns. Three thousand and five hundred and thirteen women aged 60-79 years from a total cohort of 4286. Women who underwent a hysterectomy or oophorectomy prior to their 'natural' menopause or who were taking hormone replacement therapy around the perimenopausal period and for whom a biological age at menopause could not be calculated were excluded from this study. Age at menopause. Most of the 10 indicators of adverse socio-economic position from childhood through to adulthood were linearly associated with a younger age at menopause. In age adjusted analyses, women from manual social classes in childhood began their menopause on average 0.68 years (95% confidence interval [CI] 0.11, 1.3) earlier than those from non-manual social classes. Those who lived in a house as a child without a bathroom began their menopause 0.47 years (95% CI 0.12, 0.82) earlier than those with a bathroom. Those who shared a bedroom began 0.36 years (95% CI 0.03, 0.70) earlier than those who had their own bedroom and finally those who lived in a household with no access to a car as a child began their menopause 0.47 years (95% CI 0.02, 0.95) earlier than those with access to a car. Adult indicators of adverse socio-economic position were similarly associated with earlier age at menopause. Age at completing full time education was not substantively associated with age at menopause. The inverse associations between each of the indicators of both childhood and adult socio-economic position and age at menopause were not importantly affected by adjustment for other reproductive factors but they attenuated by between 6% and 21% with adjustment for adult smoking and body mass index. The inverse associations between each of the childhood indicators of socio-economic position only and age at menopause attenuated markedly (between 12% and 70%) with adjustment for adult leg length. There was a cumulative effect of disadvantage across the life course demonstrated by a strong linear trend between a composite score of the 10 socio-economic indicators and young age at menopause. The age at onset of menopause for women who had 9 or 10 adverse socio-economic indicators was on average 1.70 years (95% CI 0.36, 3.0) younger than that of women with none or only one indicator. Adverse socio-economic circumstances in childhood, as well as in adulthood, are associated with an earlier age at menopause. The association between childhood deprivation and early menopause may at least in part be mediated via exposures, such as childhood diet, which affect both linear growth and age at menopause.

Stable carbon and nitrogen isotope values of bone and teeth reflect weaning age at the Medieval Wharram Percy site, Yorkshire, UK.

We report on the measurements of carbon and nitrogen stable isotopes of both bone and teeth from a single site and population (Medieval Wharram Percy), undertaken to explore variations due to weaning in a past population. There have been a number of recent studies of weaning using delta(15)N values of ribs, and we indicate a number of assumptions that must be met before the results of such studies can be correctly interpreted. We found that rib collagen delta(15)N values decrease to adult levels after age 2 years, indicating that weaning occurred at or before this age. Rib collagen delta(13)C values are also more enriched than adult delta(13)C values before age 2 years, and we argue that this is due to the so-called "carnivore" effect in delta(13)C. We measured teeth and rib delta(15)N values from the same individuals and found that for individuals up to age 11 years, tooth dentine delta(15)N is higher than adult rib delta(15)N values, indicating that the dentine was formed during breast-feeding and that there was almost no turnover of dentine since. We observed some decrease in delta(13)C and delta(15)N rib values, compared to adult rib and teeth values, for the few years after weaning that may relate to a theoretically predicted physiological nitrogen imbalance during this period of rapid growth, but this is more likely due to a childhood diet (up to age 9) which was isotopically different from later diet, possibly consisting of a greater proportion of plant foods.

Leg and trunk length at 43 years in relation to childhood health, diet and family circumstances; evidence from the 1946 national birth cohort

This is a study of the associations of adult leg and trunk length with early life height and weight, diet, socioeconomic circumstances, and health, and parental height, divorce and death. The data used were collected in a longitudinal study of the health, development and ageing of a British national birth cohort (N = 2879 in this analysis) studied since birth in 1946. Multiple regression models were used to investigate the relationships. Adult leg and trunk length were each positively associated with parental height, birthweight, and weight at 4 years. Leg length was associated positively with breastfeeding and energy intake at 4 years. Trunk length was associated negatively with serious illness in childhood and possibly also parental divorce, but not with the dietary data. Adult leg length is particularly sensitive to environmental factors and diet in early childhood because that is the period of most rapid leg growth. Trunk growth is faster than leg growth after infancy and before puberty, and may be associated with the effects of serious illness and parental separation because of the child's growing sensitivity to stressful circumstances, as well as the result of the biological effects of illness.

Leg and trunk length at 43 years in relation to childhood health, diet and family circumstances; evidence from the 1946 national birth cohort

Background This is a study of the associations of adult leg and trunk length with early life height and weight, diet, socioeconomic circumstances, and health, and parental height, divorce and death. Method The data used were collected in a longitudinal study of the health, development and ageing of a British national birth cohort (N = 2879 in this analysis) studied since birth in 1946. Multiple regression models were used to investigate the relationships. Results Adult leg and trunk length were each positively associated with parental height, birthweight, and weight at 4 years. Leg length was associated positively with breastfeeding and energy intake at 4 years. Trunk length was associated negatively with serious illness in childhood and possibly also parental divorce, but not with the dietary data. Conclusion Adult leg length is particularly sensitive to environmental factors and diet in early childhood because that is the period of most rapid leg growth. Trunk growth is faster than leg growth after infancy and before puberty, and may be associated with the effects of serious illness and parental separation because of the child's growing sensitivity to stressful circumstances, as well as the result of the biological effects of illness.

Vitamin and mineral nutrition for the health and development of the children of Europe

Most European countries are now affected by demographic transition and changing epidemiology of disease; the nutrition of children is increasingly recognised as crucial for present and future health. Adequate dietary intake and nutritional status among children are important for their own growth, development and function but there is now increasing evidence that childhood nutrition also influences adult health. Intrauterine nutrition influences adult morbidity and mortality, but the childhood diet and nutritional status modify the increased risk of being born small. Thus, childhood diet needs to be taken more seriously in order to improve a nation's health as well as producing bright, active children. A key factor is the recognition that nutritional interventions at different stages of the life cycle are necessary if childhood nutrition is to improve. The mosaic pattern of the geography and social structure of communities in Europe produces 'poverty' and 'consumer' related nutrition patterns - often side by side. At one extreme, there is an urgent need to prevent obesity; while at the other extreme serious attention is required towards the prevention of deficiency disorders, mostly related to poverty and social exclusion. Few European governments take childhood nutrition at all seriously. This paper reviews a number of micronutrient issues and makes the case for the development of evidence-based policies and programmes for improving the nutrition of children in Europe.

Relation of childhood diet and body size to menarche and adolescent growth in girls.

Adolescent growth and development may be affected by factors such as dietary intake and body size from much earlier in childhood. In a longitudinal study of 67 Caucasian girls in Boston, Massachusetts, data were collected prospectively from birth during the 1930s and 1940s. Heights and weights were measured semiannually, and dietary history interviews were conducted with mothers. Stepwise linear regression methods were used to seek factors which best predicted age at menarche, adolescent peak height growth velocity, and the age at which peak growth velocity occurred. Girls who consumed more (energy-adjusted) animal protein and less vegetable protein at ages 3-5 years had earlier menarche, and girls aged 1-2 years with higher dietary fat intakes and girls aged 6-8 years with higher animal protein intakes became adolescents with earlier peak growth. Controlling for body size, girls who consumed more calories and animal protein 2 years before peak growth had higher peak growth velocity. These findings may have implications regarding adult diseases whose risks are associated with adolescent growth and development factors.

Cow's milk consumption, HLA-DQB1 genotype, and type 1 diabetes: a nested case-control study of siblings of children with diabetes. Childhood diabetes in Finland study group.

The evidence for the putative role of cow's milk in the development of type 1 diabetes is controversial. We studied infant feeding patterns and childhood diet by structured questionnaire (n = 725) and HLA-DQB1 genotype by a polymerase chain reaction-based method (n = 556) in siblings of affected children and followed them for clinical type 1 diabetes. In a nested case-control design in a population who had both dietary and genetic data available, we selected as cases those siblings who progressed to clinical diabetes during the follow-up period (n = 33). For each case, we chose as matched control subjects siblings who fulfilled the following criteria: same sex, age within 1 year, not from the same family, the start of the follow-up within 6 months of that of the respective case, and being at risk for type 1 diabetes at the time the case presented with that disease (n = 254). The median follow-up time was 9.7 years (range 0.2-11.3). Early age at introduction of cow's milk supplements was not significantly associated with progression to clinical type 1 diabetes (relative risk adjusted for matching factors, maternal education, maternal and child's ages, childhood milk consumption, and genetic susceptibility markers was 1.60 [95% CI 0.5-5.1]). The estimated relative risk of childhood milk consumption for progression to type 1 diabetes was 5.37 (1.6-18.4) when adjusted for the matching and aforementioned sociodemographic factors, age at introduction of supplementary milk feeding, as well as for genetic susceptibility markers. In conclusion, our results provide support for the hypothesis that high consumption of cow's milk during childhood can be diabetogenic in siblings of children with type 1 diabetes. However, further studies are needed to assess the possible interaction between genetic disease susceptibility and dietary exposures in the development of this disease.