Effect of nutrition. On the basis of epidemiological studies it has been pr
oposed that cow milk-based infant formula when introduced within the first
three months of life is associated with an increased risk of later developm
ent of type 1 diabetes. However, other epidemiological case-control studies
, and first prospective trials did not find an association between early ex
posure to cow milk proteins and subsequent type 1 diabetes. In animal model
s however, cow milk proteins were found to be modestly and variably diabete
s promoting. Interestingly, some plant proteins in the diet caused higher r
ates of autoimmune diabetes in the animal models.
Immune reactions. In man and rodents there is increasing evidence that the
gut associated immune system plays a major role in disease development, pro
bably because of disturbed oral tolerance mechanisms. Oral tolerance depend
s on immunological homeostasis and proper maturation of the gut. These para
meters are influenced by growth factors and cytokines from breast milk, pro
per bacterial colonisation, infections and diet. A short duration of breast
feeding and early exposure to foreign dietary proteins may therefore impai
r the development of proper oral tolerance and promote immune reactions to
dietary anti gens which crossreact with beta cell antigens. The concept of
dietary regulation of autoimmunity fits with the observed association of co
eliac disease and type 1 diabetes.