Mediterranean diet in pregnancy is protective for wheeze and atopy in childhood

Abstract

Introduction: Dietary intake of specific nutrients or food groups during pregnancy could play a role in the risk of asthma and atopy in offspring, but specific dietary patterns have not been implicated. The authors evaluated the impact of maternal (during pregnancy) and child adherence to a Mediterranean diet on asthma and atopy in childhood. Methods: Women presenting for antenatal care at all general practices in Menorca, a Mediterranean island in Spain, over a 12 month period starting in mid-1997 were recruited. 460 children were included in the analysis after 6.5 years of follow-up. Maternal dietary intake during pregnancy and children's dietary intake at age 6.5 years were assessed by food frequency questionnaires, and adherence to a Mediterranean diet was evaluated by a priori defined scores. During follow-up, parents completed questionnaires on the child's respiratory and allergic symptoms. Children underwent skin prick tests with six common aeroallergens. Results: The prevalence rates of persistent wheeze, atopic wheeze and atopy at age 6.5 years were 13.2%, 5.8% and 17.0%, respectively. One-third (36.1%) of mothers had a low quality Mediterranean diet during pregnancy according to the Mediterranean Diet Score, while the rest had a high score. A high Mediterranean Diet Score during pregnancy (at two levels, using ''low'' score as the reference) was found to be protective for persistent wheeze (OR 0.22; 95% CI 0.08 to 0.58), atopic wheeze (OR 0.30; 95% CI 0.10 to 0.90) and atopy (OR 0.55; 95% CI 0.31 to 0.97) at age 6.5 years after adjusting for potential confounders. Childhood adherence to a Mediterranean diet was negatively associated with persistent wheeze and atopy although the associations did not reach statistical significance. Conclusion: These results support a protective effect of a high level of adherence to a Mediterranean diet during pregnancy against asthma-like symptoms and atopy in childhood.

Prenatal Fish Oil Supplementation and Allergy: 6-Year Follow-up of a Randomized Controlled Trial

“…Although more children reported allergic disease symptoms, there appears to be a dilution of the protective effects on sensitization seen in RCTs that assessed symptoms of atopic disease in infancy. 7,8,18 Our results did not support findings from cohort studies observing an association with increased maternal dietary n-3 LCPUFA (mainly from fish) intake during pregnancy and reduced incidence of asthma or wheeze 9,11,12,30 at 5 to 7 years of age and hay fever at 5 years of age. 31 There was some comparability, however, with 2 studies reporting a reduction in sensitization to HDM at 6 years of age.…”

“…[4][5][6][7][8] Several observational studies have reported protective associations between increased fish intake in pregnancy and allergic disease symptoms in offspring from infancy to 6 years of age. [9][10][11][12][13][14] However, these observational studies are unable to establish causality because of the difficulty in adjusting for complex confounding factors. 15 Randomized controlled trials (RCTs) of n-3 LCPUFA supplementation during pregnancy have reported protective effects; however, apart from 1 16-year registry based follow-up, 16 all reported allergic disease outcomes are in early childhood (between 1 and 3 years of age).…”

“…31 There was some comparability, however, with 2 studies reporting a reduction in sensitization to HDM at 6 years of age. 9,12 We used 2 common species of HDM in our SPT allergen extract panel, D. farinae and D. pteronyssinus, yet there was a significant reduction in sensitization to D. farinae only. This inconsistency in results is unexplainable, and the possibility of a chance finding cannot be excluded.…”

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

“…Chatzi et al [56] found no difference between the cereal content of mothers' diets and persistent or atopic wheeze in their 6.5 year old children.…”

“…Chatzi et al [56] reported that a lower Mediterranean dietary score in pregnant women was associated with more atopy at 6.5 years of age (defined as sensitization or positive skin prick testing to aeroallergens). Chatzi et al scored the diet of 482 pregnant women by assigning positive scores to beneficial components (vegetables, legumes, fruits, nuts, cereal, fish and dairy products) if maternal intake was above the median; a detrimental component (meat) was scored positively if intake was below the median.…”