I have got to know quite a lot of kids with type 1 diabetes (T1D) over the years and I have seen first-hand, how tough it is to live with this autoimmune disease and to manage it well. I am also passionate about gut health and its link with autoimmunity. This is why I got so excited when new research came out last month linking T1D and gut health. Even though it is early days I am hoping that this wealth of information might help to prevent this disease and at the very least may help children with T1D manage this complex condition better.
Type 1 Diabetes has been a huge part of my life as my mum developed this shortly after giving birth to my brother. My norm growing up was mum’s daily injections, blood glucose monitoring and counting carbohydrates and her huge box of daily medications. Her uncle died of this awful disease at only 14 months old and my extended family are riddled with autoimmune diseases including the closely linked Coeliac disease and Hashimoto’s thyroiditis. When I discovered that I shared the gene that can trigger one, or all of these autoimmune diseases, I knew I had to take this more seriously as I had strong signs I was on the same health road as mum.
Even though genes play a major role in whether you or your child develops an autoimmune disease such as type 1 diabetes there is more research emerging that may help with its prevention and treatment. This information is building a picture and better understanding of T1D that may also help you and your child cope with it better on a daily basis until a cure is found.
When I stumbled upon a very exciting piece of research a team at the University of Utrecht last month this got me buzzing. Early-Life Nutritional Factors and Mucosal Immunity in the Development of Autoimmune Diabetes is a meta study looking at the link between different areas of gut health and the risk of a child developing type 1 diabetes.
There are four main areas of gut health that this team researched and this study has established these as being potential risk factors for developing T1D. Links between gut health and autoimmunity have been known about for a long time and Dr Tim Spector and his team at The British Gut Project are pioneers in this area of research.
It is now thought that if gut function is working at its best, general health can also improve and that is something that we all want for us and our families. This study is looking at risk factors rather than at potential interventions. However, if you know which areas of the gut are out of sync, then this gives you information on where the issues lie and a clearer idea on where to look for help.
It is always important to look at a child’s individual gut health and a private comprehensive stool analysis organised by a nutritional therapist or another health practitioner would be able to establish whether any of these markers are applicable to your child’s gut health. Testing takes the guess work out and ensures any changes you make are appropriate to your child’s situation.
Even though no proof has been shown that dietary interventions can help a child’s outcome, this research points towards areas of gut health that can be worked upon and some of which can be supported by positive dietary changes. I will attempt to translate this gut health research into practical and positive steps that you can make that might help your child even if this is in a small way. This is certainly not medical advice and it is important to discuss any diet changes with your diabetes consultant. Here are the four main areas of gut health that this researched looked at and my take on it:
“The microbiomes of diabetic children are less diverse and more unstable in nature”
Gut bacteria diversity is emerging as one of the most important areas of gut health that protects us from disease. If your child has a low diversity of gut flora then this means that you will probably need to work much harder on building up and maintaining their beneficial bacteria in both the short and longer term.
Ways to increase gut flora include feeding your child a very diverse wholefood diet with plenty of different fruits, vegetables, salads, whole grains, nuts, seeds and beans. Fresh air and lots of outdoor play (especially in the mud) can also help with exposure to different bacteria. It is thought that adding in probiotic rich foods such as kefir, yoghurt and sauerkraut may also give them an extra boost of beneficial bacteria. It may also be helpful to add in a good quality probiotic to support gut health until things are more stable and when the immune system is more challenged such as during the winter months.
“Intestinal permeability plays a pathogenic role in the onset and development of T1D”
It is thought the health of the tight junctions of the villi in the small intestine play a significant role in whether a child develops type 1 diabetes. Several human studies demonstrate that the intestinal permeability (or leaky gut) is increased in people predisposed or already diagnosed with T1D established by sugar permeability tests. If you have a leaky gut then this means your immune system is on constant alert and you can switch into auto-immune mode much more readily.
Bone broth (AKA chicken stock simmered for at least twelve hours) is a traditional gut healing food that has been used to help leaky gut, so this is an easy and yummy way to potentially help your child. I know of several eminent paediatric gastroenterologists, who are now recommending bone broth to their little patients. It is good to make lots of home-made soups and slow cooked stews for your child with T1D. You can also cook grains and lentils in bone broth and add it to bolognaise if your child is not a big fan of soups or stews.
Short Chain Fatty Acids (SCFAs) may protect against T1D
SCFAs are bacterial metabolites that are produced in the colon and can directly shape the pancreatic immune environment and autoimmune diabetes development. The SCFA butyrate, has been shown to be particularly crucial in regulating the epithelial barrier function and preventing leaky gut. Butyrate is often very low in kids with type 1 diabetes and dietary sources include: butter, ghee (clarified butter), leafy greens and whole grains such as buckwheat, quinoa, millet and amaranth. Apples, oranges and kiwi fruits are also rich in butyrate as well as legumes such as peas and beans. I have always given my kids lots of lovely organic butter on their veggies, and I use the wholegrains in my baking and in porridges to top them up with butyrate rich foods every day.
“The Role of Human Milk in the Protection Against T1D”
The protective effect of breastfeeding against T1D has been theorised since the early 1980s. A more recent study has shown that the duration of breastfeeding (whether exclusive or not) as well as the age of introduction of solid food seem to affect the development of T1D. One study involving 1,390 pre-schoolers established that receiving breast milk for at least the first five months protects against T1D.
Exposure to gluten and other cereals early in life have been linked with an increased risk of developing T1D and that breastfeeding is suggested to play a role in protection at the time of cereal introduction. It is therefore good to continue breastfeeding whilst you are introducing grains into your baby’s diet at the time of weaning. You could consider using non-gluten grains in their first couple of years if you have not been able to breast feed for this length of time. If you do think that gluten is an issue for your child then blood tests (such as Cyrex and testing for the HLA DQ gene) can be organised through a Nutritional Therapist to establish whether they have autoimmune antibodies to gluten, or whether they have this genetic predisposition.
I hope you share your enthusiasm about this research as much as me. The first thing I learned when I started studying nutrition is that all disease starts in the gut, and it is wonderful to see that scientists are now finding strong links with gut health and autoimmunity. Let’s hope this brilliant research leads to some breakthroughs in preventing and finding a cure for juvenile type 1 diabetes.
This blog was inspired by learning more about Jubie Wigan’s work with Sugarplum Children, a charity dedicated to supporting children with type 1 diabetes. This incredible charity are now selling the most beautiful sweatshirts raising money for more research and support for these wonderful kids.