Lack of association between early exposure to cow's milk protein and beta-cell autoimmunity. Diabetes Autoimmunity Study in the Young (DAISY)

JAMA. 1996 Aug 28;276(8):609-14. doi: 10.1001/jama.1996.03540080031025.


Objective: To examine whether infant dietary exposure to cow's milk is associated with beta-cell autoimmunity (BCA), an early predictor of insulin-dependent diabetes mellitus (IDDM).

Setting: Denver, Colo.

Design: Cross-sectional with retrospective analysis.

Participants: Between January 1994 and December 1995, 253 children from 171 families of persons with IDDM were screened for BCA. All children were between the ages of 9 months and 7 years.

Main outcome measures: BCA was defined as elevated levels of insulin autoantibody, glutamic acid decarboxylase autoantibody, or insulinoma-associated islet tyrosine phosphatases autoantibody (IA-2) above the 99th percentile of 198 normal subjects.

Results: Eighteen cases of BCA were detected; 153 unrelated autoantibody-negative children were selected from the cohort as controls. There were no differences in the proportion of cases and controls who were exposed to cow's milk or foods containing cow's milk or to cereal, fruit and vegetable, or meat protein by 3 months or by 6 months of age. Children with BCA were breast-fed for a slightly longer duration than controls (median duration 10 vs 8 months, P=.07).

Conclusions: These data suggest that early exposure to cow's milk or other dietary protein is not associated with BCA. This calls into question the importance of cow's milk avoidance as a preventive measure for IDDM.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Animals
  • Autoantibodies / analysis*
  • Autoantibodies / immunology
  • Autoimmunity* / immunology
  • Breast Feeding
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / etiology
  • Diabetes Mellitus, Type 1 / immunology*
  • Dietary Proteins
  • Female
  • Glutamate Decarboxylase / immunology
  • HLA Antigens / analysis
  • Humans
  • Infant
  • Infant Food
  • Insulin Antibodies / analysis
  • Insulin Antibodies / immunology
  • Islets of Langerhans / immunology*
  • Logistic Models
  • Male
  • Milk / immunology*
  • Milk Proteins / immunology*
  • Multivariate Analysis
  • Protein Tyrosine Phosphatase, Non-Receptor Type 1
  • Protein Tyrosine Phosphatases / immunology
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis


  • Autoantibodies
  • Dietary Proteins
  • HLA Antigens
  • Insulin Antibodies
  • Milk Proteins
  • islet cell antibody
  • Protein Tyrosine Phosphatase, Non-Receptor Type 1
  • Protein Tyrosine Phosphatases
  • Glutamate Decarboxylase