Maternal diet during pregnancy and allergic sensitization in the offspring by 5 yrs of age: 
a prospective cohort study

Abstract

Nwaru BI, Ahonen S, Kaila M, Erkkola M, Haapala A‐M, Kronberg‐Kippilä C, Veijola R, Ilonen J, Simell O, Knip M, Virtanen SM. Maternal diet during pregnancy and allergic sensitization in the offspring by 5 yrs of age: a prospective cohort study. Pediatr Allergy Immunol 2010: 21: 29–37. © 2009 John Wiley & Sons A/S To examine the effect of maternal diet during pregnancy on allergic sensitization in the offspring by 5 yrs of age. The Finnish type 1 Diabetes Prediction and Prevention Nutrition Study. A population‐based cohort study with 5‐yr follow‐up. A total of 931 children with human leukocyte antigen‐conferred susceptibility to type 1 diabetes for whom maternal pregnancy food frequency questionnaire data and allergen‐specific immunoglobulin E measurement at 5 yrs were available. Increasing maternal consumption of citrus fruits [odds ratio (OR) = 1.14, 95% confidence interval (CI) = 1.05–1.25] and total fruit (OR = 1.36, 95% CI = 1.09–1.70) were positively associated with sensitization to inhalant allergens, after adjustment for potential confounders. Maternal intake of vitamin D (OR = 0.56, 95% CI = 0.35–0.91) was inversely associated with sensitization to food allergens. Maternal consumption of citrus fruits during pregnancy may increase the risk to allergic sensitization in the offspring, whereas vitamin D intake may have a beneficial effect. Further studies are required to define more closely the putative effect of maternal intake of polyunsaturated fatty acids on development of allergic diseases in the offspring.

Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches

“…Nwaru et al [70] reported more sensitization to inhalant allergens in offspring of mothers who had consumed greater fruit and vegetable intake, particularly citrus fruit during pregnancy and the first three months of lactation. This remained significant after adjustment.…”

Immunomodulatory Effect of Vitamin D in Children with Allergic Diseases

“…Sensitization to food allergen is a precursor and a risk factor for the development of allergic diseases later in life, which is why earliest possible detection and modification of risk indicators for food allergen sensitization might prevent the development of allergic diseases [27][28][29].…”

“…However, there are two pathophysiological mechanisms in the development of atopic dermatitis: first, immunological mechanisms that influence the Th1/Th2 adaptive immune responses; vitamin D receptor agonists have been shown to impact on Th1 and Th2 cell function, suppress allergen-specific IgE synthesis, inhibit dendritic cell maturation and induce tolerogenic dendritic cells, and finally to induce regulatory CD4+CD25+25Foxp3+T cells. Second, injury of the skin barrier function [26,29,31]. Several recent studies have shown that infants with high level of sensitization had a decreased concentration of 25(OH)D levels [27,29,37].…”

“…Second, injury of the skin barrier function [26,29,31]. Several recent studies have shown that infants with high level of sensitization had a decreased concentration of 25(OH)D levels [27,29,37]. What is more, the severity of atopic dermatitis was independently influenced by the serum 25(OH)D levels and by food allergen sensitization.…”

Development of the Immune System - Early Nutrition and Consequences for Later Life

“…Then it is suggested that vitamin D could skew the balance between Th1 and Th2 towards a Th2 phenotype directly or indirectly via monocyte activation, which however may be much more complex in vivo (Adams and Hewison 2008). Low vitamin D levels during pregnancy are suggested to be related in the development of food allergy (Nwaru, Ahonen et al 2010). It was recently shown that active vitamin D can suppress DC maturation and inhibit T cell proliferation.…”