Journal article
Dietary factors during pregnancy and atopic outcomes in childhood: A systematic review from the European Academy of Allergy and Clinical Immunology.
- Venter C Section of Allergy and Immunology, University of Colorado School of Medicine, Denver, CO, USA.
- Agostoni C Pediatria Media Intensità di Cura Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinic, Milan, Italy.
- Arshad SH Clinical & Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
- Ben-Abdallah M Children's Hospital Colorado, Aurora, CO, USA.
- Du Toit G Department of Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, London, UK.
- Fleischer DM Section of Allergy and Immunology, University of Colorado School of Medicine, Denver, CO, USA.
- Greenhawt M Section of Allergy and Immunology, University of Colorado School of Medicine, Denver, CO, USA.
- Glueck DH Department of Pediatrics, University of Colorado School of Medicine, Denver, CO, USA.
- Groetch M Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Lunjani N University of Zurich, Davos, Switzerland.
- Maslin K University of Plymouth, Plymouth, UK.
- Maiorella A University of Chicago, Chicago, IL, USA.
- Meyer R Imperial College, London, UK.
- Antonella M Centro di Specializzazione Regionale per lo Studio e la Cura delle Allergie e delle Intolleranze Alimentari presso l'Azienda Ospedaliera, Università di Padova, Padova, Italy.
- Netting MJ Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
- Ibeabughichi Nwaru B Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
- Palmer DJ Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.
- Palumbo MP Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Colorado, USA.
- Roberts G The David Hide Asthma and Allergy Centre, Isle of Wight, UK.
- Roduit C University Children's Hospital Zurich, Switzerland.
- Smith P School of Medicine, Griffith University, Southport, Australia.
- Untersmayr E Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
- Vanderlinden LA Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA.
- O'Mahony L Departments of Medicine and Microbiology, APC Microbiome Ireland, National University of Ireland, Cork, Ireland.
- 2020-06-12
Published in:
- Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. - 2020
AD
allergic diseases
allergic rhinitis
allergic rhinoconjunctivitis
asthma
children
eczema
food allergy
hay fever
infants
maternal diet
pregnancy
prevention
seasonal allergies
wheeze
English
RATIONALE
Allergic diseases are an increasing public health concern, and early life environment is critical to immune development. Maternal diet during pregnancy has been linked to offspring allergy risk. In turn, maternal diet is a potentially modifiable factor, which could be targeted as an allergy prevention strategy. In this systematic review, we focused on non-allergen-specific modifying factors of the maternal diet in pregnancy on allergy outcomes in their offspring.
METHODS
We undertook a systematic review of studies investigating the association between maternal diet during pregnancy and allergic outcomes (asthma/wheeze, hay fever/allergic rhinitis/seasonal allergies, eczema/atopic dermatitis (AD), food allergies, and allergic sensitization) in offspring. Studies evaluating the effect of food allergen intake were excluded. We searched three bibliographic databases (MEDLINE, EMBASE, and Web of Science) through February 26, 2019. Evidence was critically appraised using modified versions of the Cochrane Collaboration Risk of Bias tool for intervention trials and the National Institute for Clinical Excellence methodological checklist for cohort and case-control studies and meta-analysis performed from RCTs.
RESULTS
We identified 95 papers: 17 RCTs and 78 observational (case-control, cross-sectional, and cohort) studies. Observational studies varied in design and dietary intakes and often had contradictory findings. Based on our meta-analysis, RCTs showed that vitamin D supplementation (OR: 0.72; 95% CI: 0.56-0.92) is associated with a reduced risk of wheeze/asthma. A positive trend for omega-3 fatty acids was observed for asthma/wheeze, but this did not reach statistical significance (OR: 0.70; 95% CI: 0.45-1.08). Omega-3 supplementation was also associated with a non-significant decreased risk of allergic rhinitis (OR: 0.76; 95% CI: 0.56-1.04). Neither vitamin D nor omega-3 fatty acids were associated with an altered risk of AD or food allergy.
CONCLUSIONS
Prenatal supplementation with vitamin D may have beneficial effects for prevention of asthma. Additional nutritional factors seem to be required for modulating the risk of skin and gastrointestinal outcomes. We found no consistent evidence regarding other dietary factors, perhaps due to differences in study design and host features that were not considered. While confirmatory studies are required, there is also a need for performing RCTs beyond single nutrients/foods.
Allergic diseases are an increasing public health concern, and early life environment is critical to immune development. Maternal diet during pregnancy has been linked to offspring allergy risk. In turn, maternal diet is a potentially modifiable factor, which could be targeted as an allergy prevention strategy. In this systematic review, we focused on non-allergen-specific modifying factors of the maternal diet in pregnancy on allergy outcomes in their offspring.
METHODS
We undertook a systematic review of studies investigating the association between maternal diet during pregnancy and allergic outcomes (asthma/wheeze, hay fever/allergic rhinitis/seasonal allergies, eczema/atopic dermatitis (AD), food allergies, and allergic sensitization) in offspring. Studies evaluating the effect of food allergen intake were excluded. We searched three bibliographic databases (MEDLINE, EMBASE, and Web of Science) through February 26, 2019. Evidence was critically appraised using modified versions of the Cochrane Collaboration Risk of Bias tool for intervention trials and the National Institute for Clinical Excellence methodological checklist for cohort and case-control studies and meta-analysis performed from RCTs.
RESULTS
We identified 95 papers: 17 RCTs and 78 observational (case-control, cross-sectional, and cohort) studies. Observational studies varied in design and dietary intakes and often had contradictory findings. Based on our meta-analysis, RCTs showed that vitamin D supplementation (OR: 0.72; 95% CI: 0.56-0.92) is associated with a reduced risk of wheeze/asthma. A positive trend for omega-3 fatty acids was observed for asthma/wheeze, but this did not reach statistical significance (OR: 0.70; 95% CI: 0.45-1.08). Omega-3 supplementation was also associated with a non-significant decreased risk of allergic rhinitis (OR: 0.76; 95% CI: 0.56-1.04). Neither vitamin D nor omega-3 fatty acids were associated with an altered risk of AD or food allergy.
CONCLUSIONS
Prenatal supplementation with vitamin D may have beneficial effects for prevention of asthma. Additional nutritional factors seem to be required for modulating the risk of skin and gastrointestinal outcomes. We found no consistent evidence regarding other dietary factors, perhaps due to differences in study design and host features that were not considered. While confirmatory studies are required, there is also a need for performing RCTs beyond single nutrients/foods.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1111/pai.13303
- PMID 32524677
- Persistent URL
- https://sonar.ch/global/documents/284134
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