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Omega-3 polyunsaturated fatty acid intake and islet autoimmunity in children at increased risk for type 1 diabetes.

Authors: Norris JM, Yin X, Lamb MM, Barriga K, Seifert J, Hoffman M, Orton HD, Barón AE, Clare-Salzler M, Chase HP, Szabo NJ, Erlich H, Eisenbarth GS, Rewers M.
  • Journals: JAMA
  • Pages: 1420-8.
  • Volume: 298(12)
  • Year: 2007
CONTEXT: Cod liver oil supplements in infancy have been associated with a decreased risk of type 1 diabetes mellitus in a retrospective study. OBJECTIVE: To examine whether intakes of omega-3 and omega-6 fatty acids are associated with the development of islet autoimmunity (IA) in children. DESIGN; SETTING; AND PARTICIPANTS: A longitudinal; observational study; the Diabetes Autoimmunity Study in the Young (DAISY); conducted in Denver; Colorado; between January 1994 and November 2006; of 1770 children at increased risk for type 1 diabetes; defined as either possession of a high diabetes risk HLA genotype or having a sibling or parent with type 1 diabetes. The mean age at follow-up was 6.2 years. Islet autoimmunity was assessed in association with reported dietary intake of polyunsaturated fatty acids starting at age 1 year. A case-cohort study (N = 244) was also conducted in which risk of IA by polyunsaturated fatty acid content of erythrocyte membranes (as a percentage of total lipids) was examined. MAIN OUTCOME MEASURE: Risk of IA; defined as being positive for insulin; glutamic acid decarboxylase; or insulinoma-associated antigen-2 autoantibodies on 2 consecutive visits and still autoantibody positive or having diabetes at last follow-up visit. RESULTS: Fifty-eight children developed IA. Adjusting for HLA genotype; family history of type 1 diabetes; caloric intake; and omega-6 fatty acid intake; omega-3 fatty acid intake was inversely associated with risk of IA (hazard ratio [HR]; 0.45; 95% confidence interval [CI]; 0.21-0.96; P = .04). The association was strengthened when the definition of the outcome was limited to those positive for 2 or more autoantibodies (HR; 0.23; 95% CI; 0.09-0.58; P = .002). In the case-cohort study; omega-3 fatty acid content of erythrocyte membranes was also inversely associated with IA risk (HR; 0.63; 95% CI; 0.41-0.96; P = .03). CONCLUSION: Dietary intake of omega-3 fatty acids is associated with reduced risk of IA in children at increased genetic risk for type 1 diabetes.