WEDNESDAY, Nov. 10 (HealthDay News) -- Offering your baby a
special formula when weaning off breastfeeding may offer some
protection against the development of the antibodies associated
with type 1 diabetes, if you have a family history of the disease,
new research suggests.
When Finnish researchers randomly assigned 230 babies at high
risk of type 1 diabetes to receive either a regular infant formula,
or one that was extensively hydrolyzed -- which means the proteins
in the formula are already partially broken down and more readily
available for digestion -- they found that the extensively
hydrolyzed formula cut the rate of developing diabetes-linked
antibodies in the blood by about half.
"We observed that early dietary intervention [with extensively hydrolyzed formula] decreased the frequency of diabetes-associated autoantibodies, which are markers of an ongoing disease process, by about 50 percent by the age of 10 years," said the study's lead author, Dr. Michael Knip, a professor of pediatrics at the Hospital for Children and Adolescents in Helsinki, Finland.
The results of the study were published in the Nov. 11 issue of
New England Journal of Medicine.
Type 1 diabetes is an autoimmune disease, which means the body's
immune system mistakenly turns against healthy insulin-producing
cells in the pancreas, instead of a foreign material, such as
bacteria. No one knows for sure what causes this process to begin,
but some research suggests that the initial autoimmunity may begin
early in life.
Five immune system autoantibodies have been linked to type 1
diabetes. Having one of these antibodies isn't a guarantee that
you'll develop type 1 diabetes, but it does indicate an increased
risk for the disease. People who have two or more type 1 antibodies
have between a 50 and 100 percent risk of developing type 1
diabetes, according to background information in the study.
Previous research has suggested that breastfeeding may offer
some protection against the development of these antibodies,
possibly because breastfeeding delays the introduction of infant
formula, which contains complex proteins. Formula may somehow
trigger the development of autoantibodies as these proteins are
broken down for digestion.
The current study was randomized and double-blind (meaning
neither the parents nor the researchers knew who was getting what),
and compared regular baby formula to one that was made easier for
babies to digest because the proteins were broken down (extensively
Babies were offered the formula during the first 6 to 8 months
of life, any time breastfeeding wasn't available. They were then
followed till they were about 10 years old, according to the
After adjusting the data to try to account for the duration of
exposure to one of the study formulas, the researchers found that
the extensively hydrolyzed formula reduced the risk of having one
diabetes autoantibody by 49 percent, and the risk of having two or
more autoantibodies by 53 percent.
How the highly hydrolyzed formula might reduce the risk of
developing diabetes-predictive antibodies is unknown, but the
researchers speculated that it might contribute to reduced gut
permeability or changes in gut microflora, among other things.
According to Knip, the take-home message from the study is that
"it is possible to reduce considerably the initiation of the
diabetes disease process in at-risk children in a simple and safe
way: weaning to an extensively hydrolyzed formula." He added that,
"based on the current results, we think that it is justified to
recommend weaning to a highly hydrolyzed formula for babies in
families with a member affected by type 1 diabetes."
Not everyone agreed with that notion, however.
"The data in this study is not sufficiently strong to support recommending any changes for parents," said the author of an accompanying editorial, Dr. David Harlan, co-director of the Diabetes Center of Excellence at the University of Massachusetts Memorial Medical Center in Worcester.
"I think the authors designed this study to address their hypothesis that proteins present in non-hydrolyzed formula might incite an immune response, and by breaking them down, you might eliminate the immune response. But, there are quite a few steps between that and how the immune system or diabetes are triggered," added Harlan's editorial co-author, Dr. Mary Lee, a professor of pediatrics and cell biology and chief of the pediatric endocrine division at the University of Massachusetts Memorial Medical Center.
"I think this is an important study because we need to understand what causes type 1 diabetes," said Harlan, who added the caveat: "In this study, while there is an apparent signal, there are also some causes for withholding complete faith in the conclusion that the formula caused diabetes."
Both Lee and Harlan stressed that there is currently no
definitive evidence to suggest that the use of standard cow's milk
formulas leads to an increased incidence of diabetes compared to
breastfeeding. The hydrolyzed formula is also considerably more
expensive than standard formula, experts point out.
Learn more about type 1 diabetes from the
American Diabetes Association.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.