Nutritional Factors and Preservation of C-Peptide in Youth With Recently Diagnosed Type 1 Diabetes SEARCH Nutrition Ancillary Study

OBJECTIVE-To test the novel hypothesis that nutritional factors previously associated with type 1 diabetes etiology or with insulin secretion are prospectively associated with fasting C-peptide (FCP) concentration among youth recently diagnosed with type 1 diabetes. RESEARCH DESIGN AND METHODS-Included were 1,316 youth with autoantibody-positive type 1 diabetes who participated in the SEARCH for Diabetes in Youth study (baseline disease duration, 9.9 months; SD, 6.3). Nutritional exposures included breastfeeding and age at introduction of complementary foods, baseline plasma long-chain omega-3 fatty acids including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DNA), vitamin D, vitamin E, and, from a baseline food frequency questionnaire, estimated intake of the branched-chain amino acid leucine and total carbohydrate. Multiple linear regression models were conducted to relate each nutritional factor to baseline FCP adjusted for demographics, disease-related factors, and other confounders. Prospective analyses included the subset of participants with preserved beta-cell function at baseline (baseline FCP >= 0.23 ng/mL) with additional adjustment for baseline FCP and time (mean follow-up, 24.3 months; SD, 8.2; n = 656). FCP concentration was analyzed as log(FCP). RESULTS-In adjusted prospective analyses, baseline EPA (P = 0.02), EPA plus DNA (P = 0.03), and leucine (P = 0.03) were each associated positively and significantly with FCP at followup. Vitamin D was unexpectedly inversely associated with FCP (P = 0.002). CONCLUSIONS-Increased intake of branched-chain amino acids and long-chain omega-3 fatty acids may support preservation of beta-cell function. This represents a new direction for research to improve prognosis for type 1 diabetes.