The Impact of Early Nutrition on Incidence of Allergic Manifestations and Common Respiratory Illnesses in Children

Birch, Eileen E.; Khoury, Jane; Berseth, Carol Lynn; Castañeda, Yolanda S.; Couch, Jill M.; Bean, Judy A.; Tamer, Robert; Harris, Cheryl L.; Mitmesser, Susan Hazels; Scalabrin, Deolinda

doi:10.1016/j.jpeds.2010.01.002

Cited by 81 publications

(86 citation statements)

References 29 publications

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“…5 Docosahexaenoic acid (DHA) has been associated with improved immune outcomes and fewer respiratory infections in infants and children. [6][7][8][9] Previous studies of children ,6 years of age in the United States have reported inadequate intake of DHA and corresponding low DHA status. 7,10 In one study, children who consumed a cow' s milk-based formula supplemented with DHA had improved DHA status and fewer respiratory illnesses, compared with children consuming unsupplemented formula.…”

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confidence: 99%

Follow-up Formula Consumption in 3- to 4-Year-Olds and Respiratory Infections: An RCT

Jin

Liu

et al. 2014

Pediatrics

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OBJECTIVE: Children are vulnerable to diet inadequacies, which may affect immune function. Our objective was to determine if a follow-up formula (FUF) containing DHA, the prebiotics PDX and GOS, and yeast β-glucan affects incidence of respiratory infections and diarrheal disease in healthy children. METHODS: In a double-blind, randomized, controlled, prospective trial, 3-4 year old children were fed 3 servings per day of either a FUF with 25 mg DHA, 1.2 g PDX/GOS, and 8.7 mg yeast β-glucan per serving or an unfortified, cow’s milk-based beverage (control) for 28 weeks. Fecal and blood samples were collected to assess immune markers and iron/zinc status. Incidence of acute respiratory infections (ARI), diarrheal disease, and antibiotic treatment were obtained from medical records. RESULTS: The FUF group had fewer episodes and shorter duration of ARI (mean days [SE]; control = 4.3 [0.2]; FUF = 3.5 [0.2]; P = .007), less antibiotic use (n [%]; control = 21 [14%]; FUF = 8 [5%]; P = .01), and fewer missed days of day care due to illness. No diarrheal disease was diagnosed in either group. The FUF group had higher interleukin-10 and white blood cell count at the end of the study. There were no differences in hemoglobin, serum ferritin and zinc, or fecal secretory immunoglobulin A. CONCLUSIONS: Daily consumption of a FUF was associated with fewer episodes and shorter duration of ARI, as well as less antibiotic use. The children who consumed the FUF had increased interleukin-10 and white blood cells, suggesting an antiinflammatory mechanism and/or an increase of effector immune cells.

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confidence: 99%

Follow-up Formula Consumption in 3- to 4-Year-Olds and Respiratory Infections: An RCT

Jin

Liu

et al. 2014

Pediatrics

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“…15 Infants fed formula enriched with DHA and arachidonic acid during the first year of life experienced fewer upper respiratory infections than did the placebo group. 17 Infants who consumed an LCPUFA-supplemented formula had a decreased incidence of bronchiolitis/ bronchitis compared with controls. 9 Term infants who were given formula supplemented with LCPUFA had enhanced presence and function of infant CD3 ϩ and CD44 ϩϩ cells compared with controls.…”

Section: Discussionmentioning

confidence: 93%

“…9,11,[14][15][16][17]38 Children aged 18 to 36 months who were given formula containing DHA for 60 days had a lower occurrence of respiratory illness. 16 Thai schoolchildren aged 9 to 12 years who consumed fish oil-enriched milk for 6 months experienced fewer episodes and shorter duration of illness compared with controls.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6][7][8] Trials in adults and children who received supplementation with fish oil or LCPUFAs have shown inconsistent effects on immune function, inflammation, and morbidity. [9][10][11][12][13][14][15][16][17] Furthermore, the specific clinical effects of n-3 PUFA supplementation in pregnancy on child morbidity are unknown. The determination of these effects is important because the infant immune system begins to develop and become functional in utero and DHA intake is lower than recommended in many populations.…”

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confidence: 99%

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Prenatal Docosahexaenoic Acid Supplementation and Infant Morbidity: Randomized Controlled Trial

2011

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT:Intake of long-chain polyunsaturated fatty acids influences immune cell function; however, the influence on infant morbidity of maternal docosahexaenoic acid (DHA) intake during pregnancy is unknown. In 1 study, allergic responses and immunologic profiles in infants were affected by DHA supplementation during pregnancy in atopic pregnant women. WHAT THIS STUDY ADDS:Maternal DHA supplementation (400 mg/day) during pregnancy decreased the occurrence of colds in infants at 1 month and influenced illness symptom duration at 1, 3, and 6 months. This dose of DHA can be achieved through diet. abstract OBJECTIVE: Long-chain polyunsaturated fatty acids such as docosahexaenoic acid (DHA) influence immune function and inflammation; however, the influence of maternal DHA supplementation on infant morbidity is unknown. We investigated the effects of prenatal DHA supplementation on infant morbidity. METHODS:In a double-blind randomized controlled trial conducted in Mexico, pregnant women received daily supplementation with 400 mg of DHA or placebo from 18 to 22 weeks' gestation through parturition. In infants aged 1, 3, and 6 months, caregivers reported the occurrence of common illness symptoms in the preceding 15 days. RESULTS:Data were available at 1, 3, and 6 months for 849, 834, and 834 infants, respectively. The occurrence of specific illness symptoms did not differ between groups; however, the occurrence of a combined measure of cold symptoms was lower in the DHA group at 1 month (OR: 0.76; 95% CI: 0.58 -1.00). At 1 month, the DHA group experienced 26%, 15%, and 30% shorter duration of cough, phlegm, and wheezing, respectively, but 22% longer duration of rash (all P Յ .01). At 3 months, infants in the DHA group spent 14% less time ill (P Ͻ .0001). At 6 months, infants in the DHA group experienced 20%, 13%, 54%, 23%, and 25% shorter duration of fever, nasal secretion, difficulty breathing, rash, and "other illness," respectively, but 74% longer duration of vomiting (all P Ͻ .05).CONCLUSIONS: DHA supplementation during pregnancy decreased the occurrence of colds in children at 1 month and influenced illness symptom duration at 1, 3, and 6 months. Dr Imhoff-Kunsch contributed to the design of the morbidityspecific aspects of the study, conducted the statistical analysis, and wrote the manuscript. Dr Stein contributed to the study design, reviewed the accuracy of the statistical methods and interpretation of results, and reviewed the initial article and subsequent revisions. Dr

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“…Indeed, there are some promising results from studies demonstrating that high intakes (through diet or supplements) of n-3 LCPUFA during pregnancy by women with a history of atopic disease can reduce the risk and symptoms of asthma (Dunstan et al 2003;Peat et al 2004;Salam et al 2005;Romieu et al 2007;Gunaratne et al 2015) and allergies (Dunstan et al 2003;Mihrshahi et al 2003) in their infants (reviewed by Kremmyda et al 2011). LCPUFA supplementation in the postnatal period has also been reported to have beneficial effects on the occurrence of atopic symptoms both in infants with a family history of atopic diseases (Damsgaard et al 2007;Hwang et al 2007) and without (Birch et al 2010). This epidemiological evidence supports the importance of LCPUFA early in life for immune development.…”

Section: Introductionmentioning

confidence: 99%

Evidence for the essentiality of arachidonic and docosahexaenoic acid in the postnatal maternal and infant diet for the development of the infant’s immune system early in life

Richard

Lewis

Field

2016

Appl. Physiol. Nutr. Metab.

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Long-chain polyunsaturated fatty acids (LCPUFA), especially the balance between arachidonic (AA) and docosahexaenoic (DHA) acids are known to have important immunomodulatory roles during the postnatal period when the immune system is rapidly developing. AA and DHA are required in infant formula in many countries but are optional in North America. The rationale for adding these LCPUFA to full-term formula is based on their presence in breast milk and randomized controlled studies that suggest improved cognitive function in preterm infants, but results are more variable in full-term infants. Recently, the European Food Safety Authority has proposed, based on a lack of functional evidence, that AA is not required in infant formula for full-term infants during the first year of life but DHA should remain mandatory. The purpose of this review is to review the evidence from epidemiological and intervention studies regarding the essentiality of AA and DHA in the postnatal infant and maternal diet (breast-feeding) for the immune system development early in life. Although studies support the essentiality of DHA for the immune system development, more research is needed to rule out the essentiality of AA. Nevertheless, intervention studies have demonstrated improvement in many markers of immune function in infants fed formula supplemented with AA and DHA compared with unsupplemented formula, which appears to consistently result in beneficial health outcomes including reduction in the risk of developing allergic and atopic disease early in life.Key words: nutritional immunology, postnatal diets, early development, arachidonic acid, docosahexaenoic acid, allergy, atopic diseases, infant formula, breast milk. Résumé :Les acides gras polyinsaturés à longue chaîne (AGPLC) et particulièrement la proportion des acides arachidonique (AA) et docosahexaénoïque (DHA) exercent, selon des études, d'importantes fonctions immunomodulatoires durant la période postnatale lorsque le système immunitaire se développe rapidement. La présence de AA et DHA est obligatoire dans les préparations pour nourrissons dans plusieurs pays, mais facultative en Amérique du Nord. On ajoute des AGPLC dans les préparations complètes parce qu'ils sont présents dans le lait maternel et, aussi, que des études randomisées contrôlées rapportent une amélioration de la fonction cognitive chez des enfants prématurés, mais les résultats ne sont pas uniformes chez les enfants nés à terme. Récemment, l'European Food Safety Authority a proposé, faute de résultats probants, que AA ne soit pas obligatoire durant la première année dans les préparations pour nourrissons nés à terme, mais que DHA demeure obligatoire. Cette analyse documentaire a pour objectif de réviser les données probantes dans les études épidémiologiques et interventionnelles traitant de l'essentialité des AA et DHA dans le régime alimentaire postnatal du nourrisson et de la mère allaitante pour le développement du système immunitaire tôt dans la vie. Même si des études plaident en faveur de l'e...

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The Impact of Early Nutrition on Incidence of Allergic Manifestations and Common Respiratory Illnesses in Children

Cited by 81 publications

References 29 publications

Follow-up Formula Consumption in 3- to 4-Year-Olds and Respiratory Infections: An RCT

Follow-up Formula Consumption in 3- to 4-Year-Olds and Respiratory Infections: An RCT

Prenatal Docosahexaenoic Acid Supplementation and Infant Morbidity: Randomized Controlled Trial

Evidence for the essentiality of arachidonic and docosahexaenoic acid in the postnatal maternal and infant diet for the development of the infant’s immune system early in life

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