{"doi":"10.1155/2023/3945064","title":"Dietary Intake and Body Mass Index Influence the Risk of Islet Autoimmunity in Genetically At-Risk Children: A Mediation Analysis Using the TEDDY Cohort","abstract":"Background/Objective. Growth and obesity have been associated with increased risk of islet autoimmunity (IA) and progression to type 1 diabetes. We aimed to estimate the effect of energy-yielding macronutrient intake on the development of IA through BMI. Research Design and Methods. Genetically at-risk children (n = 5,084) in Finland, Germany, Sweden, and the USA, who were autoantibody negative at 2 years of age, were followed to the age of 8 years, with anthropometric measurements and 3-day food records collected biannually. Of these, 495 (9.7%) children developed IA. Mediation analysis for time-varying covariates (BMI z-score) and exposure (energy intake) was conducted. Cox proportional hazard method was used in sensitivity analysis. Results. We found an indirect effect of total energy intake (estimates: indirect effect 0.13 [0.05, 0.21]) and energy from protein (estimates: indirect effect 0.06 [0.02, 0.11]), fat (estimates: indirect effect 0.03 [0.01, 0.05]), and carbohydrates (estimates: indirect effect 0.02 [0.00, 0.04]) (kcal/day) on the development of IA. A direct effect was found for protein, expressed both as kcal/day (estimates: direct effect 1.09 [0.35, 1.56]) and energy percentage (estimates: direct effect 72.8 [3.0, 98.0]) and the development of GAD autoantibodies (GADA). In the sensitivity analysis, energy from protein (kcal/day) was associated with increased risk for GADA, hazard ratio 1.24 (95% CI: 1.09, 1.53), <a:math xmlns:a=\"http://www.w3.org/1998/Math/MathML\" id=\"M1\"> <a:mi>p</a:mi> <a:mo>=</a:mo> <a:mn>0.042</a:mn> </a:math> . Conclusions. This study confirms that higher total energy intake is associated with higher BMI, which leads to higher risk of the development of IA. A diet with larger proportion of energy from protein has a direct effect on the development of GADA.","journal":"Pediatric Diabetes","year":2023,"id":343980,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.891,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":391573,"name":"Roy Tamura","orcid":null,"position":1,"is_corresponding":false},{"id":95834,"name":"Kendra Vehik","orcid":"0000-0001-6243-6772","position":2,"is_corresponding":false},{"id":500513,"name":"Ulla Uusitalo","orcid":"0000-0001-9132-7727","position":3,"is_corresponding":false},{"id":536208,"name":"Jimin Yang","orcid":"0000-0002-9829-6916","position":4,"is_corresponding":false},{"id":356520,"name":"Michael J. Haller","orcid":"0000-0002-2803-1824","position":5,"is_corresponding":false},{"id":95830,"name":"Jorma Toppari","orcid":"0000-0003-2228-334X","position":6,"is_corresponding":false},{"id":95829,"name":"William Hagopian","orcid":"0000-0003-2979-0475","position":7,"is_corresponding":false},{"id":678216,"name":"Richard McIndoe","orcid":"0000-0002-3040-3631","position":8,"is_corresponding":false},{"id":95828,"name":"Marian Rewers","orcid":"0000-0003-3829-9207","position":9,"is_corresponding":false},{"id":71711,"name":"Anette‐G. Ziegler","orcid":null,"position":10,"is_corresponding":false},{"id":16102,"name":"Beena Akolkar","orcid":"0000-0002-2351-5942","position":11,"is_corresponding":false},{"id":5970,"name":"Jeffrey P. Krischer","orcid":"0000-0003-4526-888X","position":12,"is_corresponding":false},{"id":230361,"name":"Jill M. Norris","orcid":"0000-0001-8674-2598","position":13,"is_corresponding":false},{"id":344341,"name":"Suvi Μ. Virtanen","orcid":"0000-0001-8928-0878","position":14,"is_corresponding":false},{"id":414044,"name":"Helena Elding Larsson","orcid":"0000-0003-3306-1742","position":15,"is_corresponding":false},{"id":703786,"name":"Carin Andrén Aronsson","orcid":"0000-0003-0256-9367","position":0,"is_corresponding":true}],"reference_count":50,"raw_metadata":null,"created_at":"2026-07-19T01:11:26.556051Z","pmid":"37614409","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}