University of Oulu

Syrjälä, E., Nevalainen, J., Peltonen, J. et al. A Joint Modeling Approach for Childhood Meat, Fish and Egg Consumption and the Risk of Advanced Islet Autoimmunity. Sci Rep 9, 7760 (2019).

A joint modeling approach for childhood meat, fish and egg consumption and the risk of advanced islet autoimmunity

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Author: Syrjälä, Essi1; Nevalainen, Jaakko1; Peltonen, Jaakko2;
Organizations: 1Health Sciences/Faculty of Social Sciences, Tampere University, Tampere, FI-33014, Finland
2Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, FI-33014, Finland
3Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, FI-00271, Finland
4Department of Pediatrics, Medical Research Center, PEDEGO Research Unit, Oulu University Hospital and University of Oulu, Oulu, FI-90014, Finland
5Immunogenetics Laboratory, Institute of Biomedicine, University of Turku, Turku, FI-20520, Finland
6Department of Clinical Microbiology, Turku University Hospital, Turku, FI-20520, Finland
7Department of Pediatrics, Turku University Hospital, Turku, FI-20521, Finland
8Department of Physiology, Institute of Biomedicine, University of Turku, Turku, FI-20520, Finland
9Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, FI-00281, Finland
10Research Programs Unit - Diabetes and Obesity, University of Helsinki, Helsinki, FI-00290, Finland
11Tampere Center for Child Health Research, Tampere University Hospital, Tampere, FI-33521, Finland
12Folkhälsan Research Center, Helsinki, FI-00290, Finland
13Tampere University Hospital, Research, Development and Innovation Center, Tampere, FI-33521, Finland
14Center for Child Health Research, Tampere University and Tampere University Hospital, Tampere, FI-33014, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.2 MB)
Persistent link:
Language: English
Published: Springer Nature, 2019
Publish Date: 2020-04-14


Several dietary factors have been suspected to play a role in the development of advanced islet autoimmunity (IA) and/or type 1 diabetes (T1D), but the evidence is fragmentary. A prospective population-based cohort of 6081 Finnish newborn infants with HLA-DQB1-conferred susceptibility to T1D was followed up to 15 years of age. Diabetes-associated autoantibodies and diet were assessed at 3- to 12-month intervals. We aimed to study the association between consumption of selected foods and the development of advanced IA longitudinally with Cox regression models (CRM), basic joint models (JM) and joint latent class mixed models (JLCMM). The associations of these foods to T1D risk were also studied to investigate consistency between alternative endpoints. The JM showed a marginal association between meat consumption and advanced IA: the hazard ratio adjusted for selected confounding factors was 1.06 (95% CI: 1.00, 1.12). The JLCMM identified two classes in the consumption trajectories of fish and a marginal protective association for high consumers compared to low consumers: the adjusted hazard ratio was 0.68 (0.44, 1.05). Similar findings were obtained for T1D risk with adjusted hazard ratios of 1.13 (1.02, 1.24) for meat and 0.45 (0.23, 0.86) for fish consumption. Estimates from the CRMs were closer to unity and CIs were narrower compared to the JMs. Findings indicate that intake of meat might be directly and fish inversely associated with the development of advanced IA and T1D, and that disease hazards in longitudinal nutritional epidemiology are more appropriately modeled by joint models than with naive approaches.

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Series: Scientific reports
ISSN: 2045-2322
ISSN-E: 2045-2322
ISSN-L: 2045-2322
Volume: 9
Article number: 7760
DOI: 10.1038/s41598-019-44196-1
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3123 Gynaecology and paediatrics
Funding: This work was supported by the Academy of Finland (Grants 63672, 68292, 79685, 79686, 80846, 114666, 126813, 129492, 139391, 201988, 210632, 276475, 308066); European Foundation for the Study of Diabetes; the Finnish Diabetes Association; the Finnish Diabetes Research Foundation; the Juho Vainio Foundation; the Juvenile Diabetes Research Foundation International (Grants 4-1998-274, 4-1999-731, 4-2001-435); the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital (Grants 9E082, 9F089, 9G087, 9H092, 9J147, 9K149, 9L042, 9L117, 9M036, 9M1140, 9N086, 9P057, 9R055, 9S074); Oulu University Hospital Research Funds; Turku University Hospital Governmental Grant; the European Union (Grant BMH4-CT98-3314); the Novo Nordisk Foundation; the Academy of Finland (Center of Excellence in Molecular Systems Immunology and Physiology Research 2012–2017, Decision No. 250114); Special Research Funds for University Hospitals in Finland; and the Sigrid Juselius Foundation.
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