Infant Feeding, Vitamin D and IgE Sensitization to Food Allergens at 6 Years in a Longitudinal Icelandic Cohort

Abstract

Nordic Nutrition Recommendations (NNR) recommend exclusive breastfeeding until 6 months, partial breastfeeding until 1 year or longer and irrespective of breastfeeding, avoiding solid foods before 4 months. Strong evidence was found for benefits of breastfeeding regarding growth and infections but limited/inconclusive evidence regarding atopic disease and asthma. Vitamin D is of special interest in the Nordic diet. The aim of this prospective study was to compare infant feeding and vitamin D between immunoglobulin E (IgE) sensitized (n = 14) and non-sensitized (n = 130) children at 6 years. Information on diet and vitamin D supplement use were collected with dietary recall (<5 months), 1-d food records (5 and 6 months) and 3-d weighed food records (12 months and 6 years). Serum-specific IgE-antibodies against milk, egg, cod, wheat, soy and peanut (cut-off specific IgE ≥ 0.35 kUA/L) were measured at 6 years and serum 25-hydroxyvitamin D at 12 months and 6 years. At 4 months, 57% of IgE sensitized vs. 23% of non-sensitized children (p < 0.01) had received solid food. At 12 months, IgE sensitized children had a lower intake of vitamin D (median (25th, 75th percentiles): 3.9 μg/d (3.2, 7.2) vs. 8.1 μg/d (4.4, 12.3), p = 0.03) and at 6 years, fewer used vitamin D supplements regularly (23% vs. 56%, p = 0.03). Introduction of solid foods prior to 4 months increased the odds of IgE-sensitization, OR = 4.9 (95%, CI = 1.4–16.6) and vitamin D supplement at 6 years decreased the odds of IgE-sensitization, OR = 0.2 (95%, CI = 0.1–0.98), adjusting for maternal smoking. These observations support the NNR in their recommendation against introducing complementary solid foods before the age of 4 months. Furthermore, they support encouraging vitamin D intake for young children at northern latitudes.

Role of Vitamin D in Prevention of Food Allergy in Infants

“…At 6 years, less IgE-sensitized children used vitamin D supplements regularly. Equally, vitamin D integration at 6 years decreased the ratio of IgE sensitization ( 52 ). Nonetheless, the authors did not record a difference in mean serum 25(OH)D 3 between IgE-sensitized and non-sensitized children, nor at 12 months (96.8 ± 33.6 vs. 99.3 ± 32.2 nmol/L, respectively) or 6 years (59.3 ± 15.9 vs. 56.0 ± 16.7 nmol/L, respectively).…”

Associations between child filaggrin mutations and maternal diet with the development of allergic diseases in children

“…Furthermore, we did not adjust our data for childhood vitamin D intake as current information on vitamin D intake in infancy and childhood and its association with allergy outcomes provides a confusing picture. [25][26][27][28][29][30][31][32] This may be due to various factors that can influence vitamin D levels such as sun exposure, country of residence, ethnicity, age, diet intake, vitamin D supplementation (timing, formulation and dose), genetic polymorphisms affecting vitamin D metabolism, epigenetic changes that contribute to vitamin D levels, vitamin D binding protein, interaction with disease-associated genetic polymorphisms, definition of vitamin D insufficiency/deficiency, and time-points for the assessment of vitamin D status. 33 We acknowledge that are data suggesting that vitamin D intake in childhood may increase the risk of asthma.…”

Vitamina D y alergia respiratoria: estado del arte

“…Se ha propuesto que la suficiencia prenatal de vitamina D en el tercer trimestre y la administración de suplementos a dosis altas desde los primeros meses de embarazo pueden atenuar el riesgo de RA infantil y sensibilización a aeroalérgenos, especialmente en aquellos niños con antecedentes de atopia materna, por lo que la suplementación prenatal con vitamina D parece ser benéfica para reducir el riesgo de su desarrollo en la descendencia. 37,38,39,40 Por otro lado, existen estudios en los que no se ha encontrado disminución del riesgo de presentar esta enfermedad en los niños con relación a la suplementación prenatal. Los niveles séricos de 25-OH-D de la madre o en el cordón umbilical no funcionan como predictores de la enfermedad alérgica de los hijos.…”