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Dietary vitamin C intake and the risk of islet autoimmunity and type 1 diabetes : The Environmental Determinants of Diabetes in the Young (TEDDY) Study

Mattila, Markus ; Mramba, Lazarus K ; Niinistö, Sari ; Erlund, Iris ; Liu, Xiang ; Uusitalo, Ulla ; Andrén Aronsson, Carin LU orcid ; Hummel, Sandra ; Frohnert, Brigitte I and Parikh, Hemang M LU , et al. (2026) In European Journal of Nutrition 65(7). p.1-11
Abstract

PURPOSE: We explored the associations between vitamin C intake and the risk of islet autoimmunity (IA) and/or type 1 diabetes in genetically at-risk children. Furthermore, we explored associations between vitamin C metabolism-related single nucleotide polymorphisms (SNPs) and type 1 diabetes outcomes.

METHODS: The current study within Environmental Determinants of Diabetes in the Young (TEDDY) cohort included 8478 children followed up every 3-6 months for relevant autoantibodies and diet. Dietary vitamin C intake was assessed longitudinally throughout childhood using age-specific dietary assessment methods and analysed using repeated measurements. Cox regression was used for the primary analyses and Bayesian joint... (More)

PURPOSE: We explored the associations between vitamin C intake and the risk of islet autoimmunity (IA) and/or type 1 diabetes in genetically at-risk children. Furthermore, we explored associations between vitamin C metabolism-related single nucleotide polymorphisms (SNPs) and type 1 diabetes outcomes.

METHODS: The current study within Environmental Determinants of Diabetes in the Young (TEDDY) cohort included 8478 children followed up every 3-6 months for relevant autoantibodies and diet. Dietary vitamin C intake was assessed longitudinally throughout childhood using age-specific dietary assessment methods and analysed using repeated measurements. Cox regression was used for the primary analyses and Bayesian joint longitudinal-survival models as sensitivity analyses.

RESULTS: A total of 777 (9.2%) children developed IA, including 292 (3.4%) with IAA-first and 337 (4.0%) with GADA-first autoimmunity; 319 (41.0%) progressed to type 1 diabetes. Mean (SD) vitamin C intake was 60.7 (38.8) mg/1000 kcal. Higher vitamin C intake was associated with an increased risk of IAA-first autoimmunity (adjusted hazard ratio 1.04; 95% confidence interval 1.00-1.07, per 10 mg/1000 kcal increase) while lowest and highest tertiles of intake were associated with increased risk of GADA-first autoimmunity as compared to mid-tertile [(1.65; 1.20-2.27) and (1.42; 1.02-1.98), respectively]. Sensitivity analyses using Bayesian joint longitudinal-survival models supported the primary findings and suggested nonlinear associations between vitamin C intake and the risks of IA and multiple IA. Associations between vitamin C-related SNPs and study outcomes did not withstand correction for multiple testing.

CONCLUSION: Vitamin C intake was not consistently associated with IA or progression to type 1 diabetes. However, the observed nonlinear association, with lowest risk for moderate intakes, merits further investigation.

TRIAL REGISTRATION: NCT00279318, 06/09/2004.

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publication status
published
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keywords
Child, Child, Preschool, Female, Humans, Male, Ascorbic Acid/administration & dosage, Autoantibodies/blood, Autoimmunity, Cohort Studies, Diabetes Mellitus, Type 1/epidemiology, Diet/methods, Islets of Langerhans/immunology, Longitudinal Studies, Polymorphism, Single Nucleotide, Risk Factors, Social Determinants of Health
in
European Journal of Nutrition
volume
65
issue
7
article number
262
pages
1 - 11
publisher
Springer
external identifiers
  • pmid:42782404
ISSN
1436-6215
DOI
10.1007/s00394-026-04116-2
language
English
LU publication?
yes
additional info
© 2026. The Author(s).
id
7d417eaa-b120-4506-a01e-210c699b22c5
date added to LUP
2026-09-26 15:28:52
date last changed
2026-09-28 07:35:22
@article{7d417eaa-b120-4506-a01e-210c699b22c5,
  abstract     = {{<p>PURPOSE: We explored the associations between vitamin C intake and the risk of islet autoimmunity (IA) and/or type 1 diabetes in genetically at-risk children. Furthermore, we explored associations between vitamin C metabolism-related single nucleotide polymorphisms (SNPs) and type 1 diabetes outcomes.</p><p>METHODS: The current study within Environmental Determinants of Diabetes in the Young (TEDDY) cohort included 8478 children followed up every 3-6 months for relevant autoantibodies and diet. Dietary vitamin C intake was assessed longitudinally throughout childhood using age-specific dietary assessment methods and analysed using repeated measurements. Cox regression was used for the primary analyses and Bayesian joint longitudinal-survival models as sensitivity analyses.</p><p>RESULTS: A total of 777 (9.2%) children developed IA, including 292 (3.4%) with IAA-first and 337 (4.0%) with GADA-first autoimmunity; 319 (41.0%) progressed to type 1 diabetes. Mean (SD) vitamin C intake was 60.7 (38.8) mg/1000 kcal. Higher vitamin C intake was associated with an increased risk of IAA-first autoimmunity (adjusted hazard ratio 1.04; 95% confidence interval 1.00-1.07, per 10 mg/1000 kcal increase) while lowest and highest tertiles of intake were associated with increased risk of GADA-first autoimmunity as compared to mid-tertile [(1.65; 1.20-2.27) and (1.42; 1.02-1.98), respectively]. Sensitivity analyses using Bayesian joint longitudinal-survival models supported the primary findings and suggested nonlinear associations between vitamin C intake and the risks of IA and multiple IA. Associations between vitamin C-related SNPs and study outcomes did not withstand correction for multiple testing.</p><p>CONCLUSION: Vitamin C intake was not consistently associated with IA or progression to type 1 diabetes. However, the observed nonlinear association, with lowest risk for moderate intakes, merits further investigation.</p><p>TRIAL REGISTRATION: NCT00279318, 06/09/2004.</p>}},
  author       = {{Mattila, Markus and Mramba, Lazarus K and Niinistö, Sari and Erlund, Iris and Liu, Xiang and Uusitalo, Ulla and Andrén Aronsson, Carin and Hummel, Sandra and Frohnert, Brigitte I and Parikh, Hemang M and Rich, Stephen S and Hagopian, William and Toppari, Jorma and Lernmark, Åke and Ziegler, Anette G and Rewers, Marian and Krischer, Jeffrey P and Hakola, Leena and Norris, Jill M and Virtanen, Suvi M}},
  issn         = {{1436-6215}},
  keywords     = {{Child; Child, Preschool; Female; Humans; Male; Ascorbic Acid/administration & dosage; Autoantibodies/blood; Autoimmunity; Cohort Studies; Diabetes Mellitus, Type 1/epidemiology; Diet/methods; Islets of Langerhans/immunology; Longitudinal Studies; Polymorphism, Single Nucleotide; Risk Factors; Social Determinants of Health}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{7}},
  pages        = {{1--11}},
  publisher    = {{Springer}},
  series       = {{European Journal of Nutrition}},
  title        = {{Dietary vitamin C intake and the risk of islet autoimmunity and type 1 diabetes : The Environmental Determinants of Diabetes in the Young (TEDDY) Study}},
  url          = {{http://dx.doi.org/10.1007/s00394-026-04116-2}},
  doi          = {{10.1007/s00394-026-04116-2}},
  volume       = {{65}},
  year         = {{2026}},
}