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Daycare attendance, breastfeeding, and the development of type 1 diabetes: the diabetes autoimmunity study in the young.

Hall K, Frederiksen B, Rewers M, Norris JM - Biomed Res Int (2015)

Bottom Line: Breastfeeding duration was evaluated as a modifier of the effect of daycare.Breastfeeding duration modified this association, where daycare attendance was associated with increased T1D risk in nonbreastfed children and a decreasing T1D risk with increasing breastfeeding duration (interaction P value=0.02).These preliminary data suggest breastfeeding may modify the effect of daycare on T1D risk.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO 80045, USA.

ABSTRACT

Background: The hygiene hypothesis attributes the increased incidence of type 1 diabetes (T1D) to a decrease of immune system stimuli from infections. We evaluated this prospectively in the Diabetes Autoimmunity Study in the Young (DAISY) by examining daycare attendance during the first two years of life (as a proxy for infections) and the risk of T1D.

Methods: DAISY is a prospective cohort of children at increased T1D risk. Analyses were limited to 1783 children with complete daycare and breastfeeding data from birth to 2 years of age; 58 children developed T1D. Daycare was defined as supervised time with at least one other child at least 3 times a week. Breastfeeding duration was evaluated as a modifier of the effect of daycare. Cox proportional hazards regression was used for analyses.

Results: Attending daycare before the age of 2 years was not associated with T1D risk (HR: 0.89; CI: 0.54-1.47) after adjusting for HLA, first degree relative with T1D, ethnicity, and breastfeeding duration. Breastfeeding duration modified this association, where daycare attendance was associated with increased T1D risk in nonbreastfed children and a decreasing T1D risk with increasing breastfeeding duration (interaction P value=0.02).

Conclusions: These preliminary data suggest breastfeeding may modify the effect of daycare on T1D risk.

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Related in: MedlinePlus

The association between attending daycare in the first 2 years of life and risk of developing T1D in children who were breastfed for 0 months (i.e., not breastfed), 3 months, 6 months, 9 months, and 12 months. The HRs and 95% CIs are calculated from the interaction term, daycare ∗ breastfeeding duration (as a continuous variable), in the model adjusting for HLA, first degree relative with T1D, and ethnicity (interaction P value = 0.02).
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Related In: Results  -  Collection


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fig1: The association between attending daycare in the first 2 years of life and risk of developing T1D in children who were breastfed for 0 months (i.e., not breastfed), 3 months, 6 months, 9 months, and 12 months. The HRs and 95% CIs are calculated from the interaction term, daycare ∗ breastfeeding duration (as a continuous variable), in the model adjusting for HLA, first degree relative with T1D, and ethnicity (interaction P value = 0.02).

Mentions: We a priori hypothesized that breastfeeding would modify the effect of attending daycare on the risk of developing T1D. Our analyses showed that breastfeeding duration interacted with daycare attendance, where daycare attendance was associated with increased risk of T1D in nonbreastfed children and a decreasing risk of T1D with increasing breastfeeding duration (interaction P value = 0.02) (Table 2). To demonstrate this relationship, we calculated HR estimates and 95% CI for daycare attendance for 0, 3, 6, 9, and 12 months of breastfeeding duration (Figure 1). The highest risk of developing T1D was observed in children who attended daycare and were not breastfed (HR: 1.56; CI: 0.77–3.16), and the lowest risk of T1D was observed in children who attended daycare and were breastfed for 12 months (HR: 0.37; CI: 0.13–1.06).


Daycare attendance, breastfeeding, and the development of type 1 diabetes: the diabetes autoimmunity study in the young.

Hall K, Frederiksen B, Rewers M, Norris JM - Biomed Res Int (2015)

The association between attending daycare in the first 2 years of life and risk of developing T1D in children who were breastfed for 0 months (i.e., not breastfed), 3 months, 6 months, 9 months, and 12 months. The HRs and 95% CIs are calculated from the interaction term, daycare ∗ breastfeeding duration (as a continuous variable), in the model adjusting for HLA, first degree relative with T1D, and ethnicity (interaction P value = 0.02).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4389988&req=5

fig1: The association between attending daycare in the first 2 years of life and risk of developing T1D in children who were breastfed for 0 months (i.e., not breastfed), 3 months, 6 months, 9 months, and 12 months. The HRs and 95% CIs are calculated from the interaction term, daycare ∗ breastfeeding duration (as a continuous variable), in the model adjusting for HLA, first degree relative with T1D, and ethnicity (interaction P value = 0.02).
Mentions: We a priori hypothesized that breastfeeding would modify the effect of attending daycare on the risk of developing T1D. Our analyses showed that breastfeeding duration interacted with daycare attendance, where daycare attendance was associated with increased risk of T1D in nonbreastfed children and a decreasing risk of T1D with increasing breastfeeding duration (interaction P value = 0.02) (Table 2). To demonstrate this relationship, we calculated HR estimates and 95% CI for daycare attendance for 0, 3, 6, 9, and 12 months of breastfeeding duration (Figure 1). The highest risk of developing T1D was observed in children who attended daycare and were not breastfed (HR: 1.56; CI: 0.77–3.16), and the lowest risk of T1D was observed in children who attended daycare and were breastfed for 12 months (HR: 0.37; CI: 0.13–1.06).

Bottom Line: Breastfeeding duration was evaluated as a modifier of the effect of daycare.Breastfeeding duration modified this association, where daycare attendance was associated with increased T1D risk in nonbreastfed children and a decreasing T1D risk with increasing breastfeeding duration (interaction P value=0.02).These preliminary data suggest breastfeeding may modify the effect of daycare on T1D risk.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO 80045, USA.

ABSTRACT

Background: The hygiene hypothesis attributes the increased incidence of type 1 diabetes (T1D) to a decrease of immune system stimuli from infections. We evaluated this prospectively in the Diabetes Autoimmunity Study in the Young (DAISY) by examining daycare attendance during the first two years of life (as a proxy for infections) and the risk of T1D.

Methods: DAISY is a prospective cohort of children at increased T1D risk. Analyses were limited to 1783 children with complete daycare and breastfeeding data from birth to 2 years of age; 58 children developed T1D. Daycare was defined as supervised time with at least one other child at least 3 times a week. Breastfeeding duration was evaluated as a modifier of the effect of daycare. Cox proportional hazards regression was used for analyses.

Results: Attending daycare before the age of 2 years was not associated with T1D risk (HR: 0.89; CI: 0.54-1.47) after adjusting for HLA, first degree relative with T1D, ethnicity, and breastfeeding duration. Breastfeeding duration modified this association, where daycare attendance was associated with increased T1D risk in nonbreastfed children and a decreasing T1D risk with increasing breastfeeding duration (interaction P value=0.02).

Conclusions: These preliminary data suggest breastfeeding may modify the effect of daycare on T1D risk.

Show MeSH
Related in: MedlinePlus