RENO, NEV. — Infants—especially breast-fed infants—at an increased risk for type 1 diabetes aren't getting the recommended levels of vitamin D in their diets, despite efforts to publicize the relationship between type 1 diabetes and insufficient vitamin D, according to a poster presented at the annual meeting of the American College of Nutrition.
Given the reported association between low intake of vitamin D and higher risk for type 1 diabetes, researchers with the Environmental Determinants of Diabetes in the Young (TEDDY) study decided to assess the vitamin D intake of children aged 3–12 months who possess a genetic predisposition to the autoimmunity associated with type 1 diabetes.
The dietary intake of the infants was compared with recommendations for vitamin D intake from the American Academy of Pediatrics (AAP).
The researchers analyzed vitamin D intake for 342 infants from the TEDDY centers in Colorado, Georgia, and Florida. Fewer than half of the children in the study (49%) met AAP guidelines for vitamin D intake at 3 months, and 56% met guidelines at 6 months. But compliance with the AAP recommendations increased over time. By 9 months of age, the percentage of infants meeting AAP recommendations for vitamin D intake increased to 73% and continued to rise to 79% by 12 months.
The current AAP recommendation calls for infants to receive 200 IU of vitamin D daily within the first 2 months of life. Infants and children who consume at least 500 mL per day of vitamin D-fortified formula or milk should meet the recommended intake, but vitamin D supplementation is necessary in breast-fed infants, according to the AAP (Pediatrics 2003;111:908–10).
The TEDDY researchers found that infants with very low intakes of vitamin D were generally those infants who were predominantly breast fed. Many infants who were primarily formula-fed had vitamin D intakes that were twofold higher than the AAP recommendations. And some formula-fed infants with very large energy intakes were receiving three- to fourfold more than the AAP's recommended daily intake of vitamin D, the researchers wrote.
These preliminary results are based on dietary intake data collected between September 2004 and July 2006. The researchers collected 24-hour diet recall and 3-day food diaries from the primary caretakers. The 3-day records were averaged to obtain daily intake, and nutrient values were calculated. The data collection is ongoing.
The TEDDY study is funded by the National Institutes of Health, the Centers for Disease Control and Prevention, and the Juvenile Diabetes Research Foundation.