Tags

Type your tag names separated by a space and hit enter

Dietary factors during pregnancy and atopic outcomes in childhood: A systematic review from the European Academy of Allergy and Clinical Immunology.
Pediatr Allergy Immunol. 2020 11; 31(8):889-912.PA

Abstract

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.

Authors+Show Affiliations

Section of Allergy and Immunology, University of Colorado School of Medicine, Denver, CO, USA. Children's Hospital Colorado, Aurora, CO, USA.Pediatria Media Intensità di Cura Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinic, Milan, Italy.Clinical & Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK. The David Hide Asthma and Allergy Centre, Isle of Wight, UK.Children's Hospital Colorado, Aurora, CO, USA.Department of Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, London, UK. Evelina London, Guy's & St Thomas' Hospital, London, UK.Section of Allergy and Immunology, University of Colorado School of Medicine, Denver, CO, USA. Children's Hospital Colorado, Aurora, CO, USA.Section of Allergy and Immunology, University of Colorado School of Medicine, Denver, CO, USA. Children's Hospital Colorado, Aurora, CO, USA.Department of Pediatrics, University of Colorado School of Medicine, Denver, CO, USA.Icahn School of Medicine at Mount Sinai, New York, NY, USA.University of Zurich, Davos, Switzerland. University of Cape Town, Cape Town, South Africa.University of Plymouth, Plymouth, UK.University of Chicago, Chicago, IL, USA.Imperial College, London, UK.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.Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia. Discipline of Pediatrics, University of Adelaide, Adelaide, SA, Australia.Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Colorado, USA.The David Hide Asthma and Allergy Centre, Isle of Wight, UK. Department of Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, London, UK. NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK. Faculty of Medicine, Human Development in Health Academic Units, University of Southampton, Southampton, UK.University Children's Hospital Zurich, Switzerland. Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.School of Medicine, Griffith University, Southport, Australia.Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA.Departments of Medicine and Microbiology, APC Microbiome Ireland, National University of Ireland, Cork, Ireland.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

32524677

Citation

Venter, Carina, et al. "Dietary Factors During Pregnancy and Atopic Outcomes in Childhood: a Systematic Review From the European Academy of Allergy and Clinical Immunology." Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology, vol. 31, no. 8, 2020, pp. 889-912.
Venter C, Agostoni C, Arshad SH, et al. Dietary factors during pregnancy and atopic outcomes in childhood: A systematic review from the European Academy of Allergy and Clinical Immunology. Pediatr Allergy Immunol. 2020;31(8):889-912.
Venter, C., Agostoni, C., Arshad, S. H., Ben-Abdallah, M., Du Toit, G., Fleischer, D. M., Greenhawt, M., Glueck, D. H., Groetch, M., Lunjani, N., Maslin, K., Maiorella, A., Meyer, R., Antonella, M., Netting, M. J., Ibeabughichi Nwaru, B., Palmer, D. J., Palumbo, M. P., Roberts, G., ... O'Mahony, L. (2020). Dietary factors during pregnancy and atopic outcomes in childhood: A systematic review from the European Academy of Allergy and Clinical Immunology. Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology, 31(8), 889-912. https://doi.org/10.1111/pai.13303
Venter C, et al. Dietary Factors During Pregnancy and Atopic Outcomes in Childhood: a Systematic Review From the European Academy of Allergy and Clinical Immunology. Pediatr Allergy Immunol. 2020;31(8):889-912. PubMed PMID: 32524677.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary factors during pregnancy and atopic outcomes in childhood: A systematic review from the European Academy of Allergy and Clinical Immunology. AU - Venter,Carina, AU - Agostoni,Carlo, AU - Arshad,S Hasan, AU - Ben-Abdallah,Miriam, AU - Du Toit,George, AU - Fleischer,David M, AU - Greenhawt,Matthew, AU - Glueck,Deborah H, AU - Groetch,Marion, AU - Lunjani,Nonhlanhla, AU - Maslin,Kate, AU - Maiorella,Alexander, AU - Meyer,Rosan, AU - Antonella,Muraro, AU - Netting,Merryn J, AU - Ibeabughichi Nwaru,Bright, AU - Palmer,Debra J, AU - Palumbo,Micheala P, AU - Roberts,Graham, AU - Roduit,Caroline, AU - Smith,Pete, AU - Untersmayr,Eva, AU - Vanderlinden,Lauren A, AU - O'Mahony,Liam, Y1 - 2020/08/06/ PY - 2020/03/13/received PY - 2020/05/06/revised PY - 2020/05/20/accepted PY - 2020/6/12/pubmed PY - 2020/6/12/medline PY - 2020/6/12/entrez KW - AD KW - allergic diseases KW - allergic rhinitis KW - allergic rhinoconjunctivitis KW - asthma KW - children KW - eczema KW - food allergy KW - hay fever KW - infants KW - maternal diet KW - pregnancy KW - prevention KW - seasonal allergies KW - wheeze SP - 889 EP - 912 JF - Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology JO - Pediatr Allergy Immunol VL - 31 IS - 8 N2 - 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. SN - 1399-3038 UR - https://www.unboundmedicine.com/medline/citation/32524677/Dietary_factors_during_pregnancy_and_atopic_outcomes_in_childhood:_A_systematic_review_from_the_European_Academy_of_Allergy_and_Clinical_Immunology_ L2 - https://doi.org/10.1111/pai.13303 DB - PRIME DP - Unbound Medicine ER -