Dietary Intake and Body Mass Index Influence the Risk of Islet Autoimmunity in Genetically At-Risk Children: A Mediation Analysis Using the TEDDY Cohort
Authors' conclusion
This study confirms that higher total energy intake is associated with higher BMI, which leads to higher risk of the development of IA. A diet with larger proportion of energy from protein has a direct effect on the development of GADA.
Study context
- Population
- Genetically at-risk children in Finland, Germany, Sweden and the USA, autoantibody negative at 2 years, followed to age 8 years (TEDDY cohort)495 developed islet autoimmunity (IA)
- Participants
- 5,084 children
- Exposure
- Energy-yielding macronutrient intake, mediated through BMI z-score, and development of islet autoimmunity
- Outcome
- Effect of energy-yielding macronutrient intake on development of islet autoimmunity (IA) through BMI
- Follow-up
- To age 8 years
Methodological detailsmediation analysis, mediation analysis for time-varying covariates and exposure, Cox proportional hazard sensitivity analysis, multinational
- Mediation analysis
- Mediation analysis for time-varying covariates and exposure
- Cox proportional hazard sensitivity analysis
- Multinational
Main finding
As reported in the abstract
Development of IA (indirect effect via BMI)
Indirect effect of total energy intake (kcal/day)
0.13
0.05, 0.21
Indirect effect of energy from protein (kcal/day)
0.06
0.02, 0.11
Indirect effect of energy from fat (kcal/day)
0.03
0.01, 0.05
Indirect effect of energy from carbohydrates (kcal/day)
0.02
0.00, 0.04
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| GADA risk per energy from protein (kcal/day), sensitivity analysisCox sensitivity analysis · sensitivity analysis | 1.24 (1.09–1.53) | P = 0.042 | |
| 0.512Hazard ratio (log scale) |
Development of GAD autoantibodies (GADA) (direct effect of protein)
- Direct effect of protein, kcal/day
- 1.09 [0.35, 1.56]
- Direct effect of protein, energy percentage
- 72.8 [3.0, 98.0]
Original publication
Dietary Intake and Body Mass Index Influence the Risk of Islet Autoimmunity in Genetically At-Risk Children: A Mediation Analysis Using the TEDDY Cohort. Pediatr Diabetes. Published 17 February 2023. doi:10.
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