Hey, here's an idea - never introduce cereal AT ALL!

Dori Zook
Denver, CO

Age of Introducing Cereal to At-Risk Infants Impacts Diabetes Risk

(DENVER) Sept. 29, 2003 - Researchers at the
University of Colorado Health Sciences Center have
found that age matters when introducing cereal to the
diet of an infant at risk for diabetes. Appearing in
the Oct. 1 issue of The Journal of the American
Medical Association, the study showed that while
cereal introduction before four months of age
increased the risk for diabetes autoimmunity, a
pre-cursor to type 1 diabetes, children who were not
exposed until after six months of age were also more
likely to develop diabetes autoimmunity.

Type 1 diabetes develops when the body’s immune system
mistakenly targets the pancreas, killing the cells
that make insulin. Children who have an immediate
relative with type 1 diabetes or who have specific
genetic susceptibility markers are considered at risk
for the disease.

For this study, 1,183 children at risk for type 1
diabetes were followed from birth for an average of
four years. Parents were surveyed once every three
months to log what kinds of foods and amounts were
being introduced and at what age. Children were tested
for specific antibodies in the blood that marked the
destruction of the cells that make insulin.

Of the children followed, those who were given cereal
before four months of age were four times as likely to
develop diabetes autoimmunity than those first given
cereal between four and six months. In addition,
children who were not given cereal until after six
months of age were five times as likely to develop
diabetes autoimmunity, as children introduced to
cereal between four and six months of age.

The team, which included researchers from CU’s
Department of Preventive Medicine and Biometrics and
the Barbara Davis Center for Childhood Diabetes, could
only hypothesize why there may be a window for initial
cereal exposure in those susceptible to diabetes.

“What happens in the first year of life has a large
impact on the development of children and their immune
systems,” said Dr. Jill Norris, lead author of the
study and an associate professor of Preventive
Medicine and Biometrics at the CU-Health Sciences
Center. “At a very young age, an infant’s system may
not be ready for the new food. However, when foods are
introduced at a much older age the larger portions
given to older babies at that time may be too much for
their systems to handle.”

The study findings support the current American
Academy of Pediatrics recommended guidelines of
introducing solid food between the ages of four to six
months. The team found no difference in the risk
depending on the type of cereal introduced – rice, or
gluten-containing cereals such as wheat, oat, barley
and rye.

The findings came from a National Institutes of
Health-funded study called DAISY, for Diabetes
Autoimmunity Study in the Young. DAISY became the
focus of international attention in 1996, when the
team found there was no increased risk to children
from early consumption of cow’s milk as had been
reported in Europe.

“We will soon begin an international study modeled
after DAISY that will allow us to understand what
cultural, dietary and environmental factors may be at
work to cause international inconsistencies in these
research findings,” said Dr. Marian Rewers, clinical
director of the Barbara Davis Center and the lead
investigator for DAISY.

Other researchers on the DAISY cereal study team
include: Katherine Barriga, MSPH; Georgeanna
Klingensmith, MD; Michelle Hoffman, RN; George S.
Eisenbarth, MD, PhD; and Henry A. Erlich, MD, PhD.
The University of Colorado Health Sciences Center is
one of four campuses in the University of Colorado
system. Located in Denver and Aurora, Colo., the
center includes schools of medicine, nursing,
pharmacy, and dentistry, a graduate school and a
teaching hospital. For more information, visit the Web
site at www.uchsc.edu.

The Barbara Davis Center is the largest center
dedicated to Type 1 diabetes in the U.S., caring for
more than 5,000 children and young adults with the
disease from all over the world.

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