Researchers in Finland have uncovered a relationship between baby milk formula and the development of antibodies to type 1 diabetes in at-risk children. However, the study was too small, and the connection is so far too unclear, to say that changing babies’ diets might prevent them developing type 1.
The research team studied 230 babies who had been identified as having a genetic risk of type 1 diabetes at birth, by analysis of their cord blood. They all also had at least one family member with type 1.
The babies’ mothers were encouraged to breastfeed as usual, but when breast milk was not available, one group of the babies were given a standard cow’s milk infant formula, and the other group were given a special formula containing casein hydrolysate. This is a milk-derived product in which complex dairy proteins have been reduced to their constituent amino acids.
The babies were given the formula up to the age of eight months, after which both groups were monitored until they were 10 years old. By that time, 4% of children in the intervention group had been diagnosed with type 1 diabetes, compared to 8% in the control group, which is not a statistically significant difference.
However, there were significant differences in the number of children who developed antibodies that are associated with type 1: 16% of the babies who had cow’s milk formula tested positive for at least two of five significant antibodies, compared to 7% of the children who had been given the casein hydrolysate.
Professor Mikael Knip of the Hospital for Children and Adolescents and
University of Helsinki, who led the study, says: ‘The study showed that the safe
and simple dietary intervention applied in this pilot trial was capable of
reducing the emergence of diabetes-predictive autoantibodies by about 50%
by age 10 in the participants carrying increased disease risk.
‘The current
study population does not provide sufficient statistical power to
definitely conclude whether an intervention of this type will reduce the
frequency of clinical type 1 diabetes, although the preliminary data are
promising.’
A full-scale trial – TRIGR (Trial to Reduce IDDM in the Genetically at R
isk) – is currently running in 77 study centers
in 15 countries to provide a conclusive answer to the question of whether
weaning to a highly hydrolyzed formula will reduce the cumulative
incidence of clinical type 1 diabetes. A total of 2,160 children have been
randomized for TRIGR, and the first results are expected in 2013.
The researchers do not know exactly what the difference is between the
casein hydrolysate and regular cow’s milk-based formulas; it is thought that a highly hydrolyzed formula might have a beneficial effect on gut microflora.
The full press release from the University of Helsinki can be read here, and an abstract of the paper in the New England Journal of Medicine appears here.
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