Predigested Formula May Prevent Diabetes in at-Risk Infants

50% Fewer Kids Fed Nutramigen Get Marker of Type 1 Diabetes in Pilot Study

Nov. 11, 2010 ? For the first time, a study suggests that a change in diet can influence the process leading to type 1 diabetes in infants at high risk for the disease.

There's no proof that the dietary change -- using a predigested infant formula instead of normal formula when a mother stops breastfeeding -- actually prevents type 1 diabetes.?

But compared to babies fed normal formula, those who got the special formula were 50% less likely to develop the kind of antibodies that predict diabetes, reports Mikael Knip, MD, PhD, of the University of Helsinki, Finland.

Predigested formula -- also called hydrolyzed formula -- is a formula in which the protein content has been broken down into smaller proteins that can be digested more easily, according to the American Academy of Pediatrics.

The study findings apply only to infants that carry genetic factors indicating high diabetes risk, and not to children in the general population.

"My interpretation is that the dietary intervention reduces the initiation of the disease process leading to type 1 diabetes," Knip tells WebMD.

Not so fast, warn University of Massachusetts diabetes experts David M. Harlan, MD, and Mary M. Lee, MD. While they praise Knip's team for a carefully conducted study, they note that this small pilot study was far from definitive.

"It is very difficult to draw conclusions from this data," Lee, a pediatric endocrinologist, tells WebMD. "Their conclusion that there is a suggestion that the [predigested] formula might be protective is exactly that: a suggestion."

"Just by chance, those kids randomized to the [predigested] formula got that formula a little bit later. They were consuming breast milk a little bit longer, and maybe that explains it," Harlan tells WebMD. "This study adds further interest to the association between early diet and diabetes, but it is not the final answer. I don't want anybody to draw the conclusion that this formula prevents diabetes."

Sixteen of the study's 230 children went on to develop diabetes over a median follow-up period of 7.5 years. Seven of these kids were in the group scheduled to receive the predigested formula. But Knip notes that only four of them actually got the special formula.

Knip is more positive about the findings than either Harlan or Lee.

"I think that if you have a diabetic family member and have a newborn baby, the first recommendation is to breastfeed as long as possible," Knip says. "But then our recommendation is you should use a [predigested] formula. But I would not recommend this to the general population -- only to children with a first-degree relative who has type 1 diabetes."

Harlan and Lee agree with only part of this advice: That parents from families at higher risk of diabetes should breastfeed for as long as possible.

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Could Baby Formula Help Prevent Childhood Diabetes?

Researchers said they found some evidence that keeping babies off cow's milk may help prevent the development of type 1 diabetes in children with an inherited risk of the disease.

The children will have to be followed for years to be sure, but the Finnish researchers found indirect evidence that giving the babies a special formula may have helped.

The study of 230 Finnish infants who had stopped receiving breast milk was a preliminary test of the treatment. A much larger study of 2,160 babies, now ongoing in 15 countries, is expected to provide a definitive answer to the question in 2017.

The goal is to prevent type 1 diabetes, which typically strikes in childhood and requires a lifetime of careful management, including regular insulin injections. It is believed to be caused when the body's immune system mistakenly attacks insulin-producing cells in the pancreas.

This study involved infants who only got the formula when breast milk was not available.

Instead of a standard cow's milk formula, about half the babies were given a special formula in which the proteins found in the casein portion of the milk had been broken down into components too small to activate the immune system, a process called hydrolyzation.

Results of the pilot test, reported in the New England Journal of Medicine, showed that babies fed this hydrolyzed formula were less likely to develop telltale antibodies that are believed to pave the way for diabetes.

"Our results indicate that a preventive dietary intervention aimed at decreasing the risk of type 1 diabetes may be feasible," the researchers, led by Dr. Mikael Knip of the University of Helsinki, wrote.

Children given the cow's milk were twice as likely as the other children to develop one or more diabetes-related antibodies. The antibodies took anywhere from three months to 10 years to appear.

However, the pilot study was not large enough to tell if avoiding cow's milk reduced the actual risk of diabetes. Eight percent of the cow's milk recipients developed type 1 diabetes, compared to 6 percent who got the special formula, a difference that was not statistically significant.

"We did not expect a 100 percent prevention of clinical disease," Knip said in an e-mail.

All of the babies in the test -- and those in the larger study now underway -- have a genetic susceptibility to diabetes and had at least one family member with type 1 diabetes. They were followed until their 10th birthday.

Finland has one of the highest rates of type 1 diabetes in the world, with 64 new cases per year among every 100,000 children under 15.

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Spice in curry could prevent liver damage

ScienceDaily (Oct. 30, 2010) ? Curcumin, a chemical that gives curry its zing, holds promise in preventing or treating liver damage from an advanced form of a condition known as fatty liver disease, new Saint Louis University research suggests.

Curcurmin is contained in turmeric, a plant used by the Chinese to make traditional medicines for thousands of years. SLU's recent study highlights its potential in countering an increasingly common kind of fatty liver disease called non-alcoholic steatohepatitis (NASH). Linked to obesity and weight gain, NASH affects 3 to 4 percent of U.S. adults and can lead to a type of liver damage called liver fibrosis and possibly cirrhosis, liver cancer and death.

"My laboratory studies the molecular mechanism of liver fibrosis and is searching for natural ways to prevent and treat this liver damage," said Anping Chen, Ph.D., corresponding author and director of research in the pathology department of Saint Louis University.

"While research in an animal model and human clinical trials are needed, our study suggests that curcumin may be an effective therapy to treat and prevent liver fibrosis, which is associated with non-alcoholic steatohepatitis (NASH)."

High levels of blood leptin, glucose and insulin are commonly found in human patients with obesity and type 2 diabetes, which might contribute to NASH-associated liver fibrosis.

Chen's most recent work tested the effect of curcumin on the role of high levels of leptin in causing liver fibrosis in vitro, or in a controlled lab setting.

"Leptin plays a critical role in the development of liver fibrosis," he said.

High levels of leptin activate hepatic stellate cells, which are the cells that cause overproduction of the collagen protein, a major feature of liver fibrosis. The researchers found that among other activities, curcumin eliminated the effects of leptin on activating hepatic stellate cells, which short-circuited the development of liver damage.

The findings were published in the September issue of Endocrinology.

Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Saint Louis University, via EurekAlert!, a service of AAAS.

Note: If no author is given, the source is cited instead.

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