Prenatal and childhood nutrition and the development of asthma and allergy in children

Abstract

Since the 1960’s of the last century the prevalence of asthma and allergic disease has increased considerably, especially in the Western world. Prosperity related changes in diet have possibly contributed to this increase. However, the evidence from epidemiological studies for a relation between nutrition and allergic disease is still inconsistent. The SEATON birth cohort in Scotland was set up to investigate associations between maternal diet during pregnancy and childhood asthma and allergic disease. 2,000 healthy pregnant women and their newborn children have been followed up for 5 years. Children of mothers who ate 4 apples or more during their pregnancy had a significant lower risk of wheeze and asthma at 5 years of age compared to children of mothers who ate less than one apple a week. Fish consumption at least once a week significantly lowered the risk of eczema and hay fever. There were no associations for the other investigated foods. Within the Dutch PIAMA birth cohort, associations between maternal diet during pregnancy and childhood asthma were investigated longitudinally. 3,963 children were annually followed up until 8 years of age. Longitudinal analyses were used to assess associations between maternal dietary consumption of fruit, vegetables, fish, milk, milk products, nuts and nut products such as peanut butter during pregnancy and childhood asthma from 1 to 8 years of age simultaneously. There were no consistent associations between the investigated foods and symptoms of asthma, except for nut products. Daily versus rare nut product consumption during pregnancy was consistently significantly positively associated with childhood wheeze, dyspnea, inhaled steroid use, and doctor-diagnosed asthma. The PIAMA birth cohort study annually assessed the child’s dietary habits. The stability of dietary habits from early to later age was investigated by tracking analyses. Daily fruit and vegetable consumption decreased considerably over time. Highest tracking was seen for butter consumption. Tracking of fruit, cooked vegetables, fish, margarine and semi-skimmed milk consumption were relatively moderate to low. In conclusion, the assumption that dietary consumption estimated at a certain time point reflects the habitual intake during childhood is not valid for all foods. Furthermore, we investigated whether the child’s diet at early age was stronger associated with asthma or atopy at 8 years of age than the child’s diet at later age. We were also interested in effects of long-term dietary habits. There were no associations between early, late or long-term dietary consumption and asthma or atopy at 8 years of age, except for fruit. Long-term high fruit consumption was borderline inversely associated with inhaled steroid use, asthma symptoms, and sensitisation to inhalant allergens. We observed a beneficial association between high fruit consumption and asthma symptoms at later age, but not at early age. Maternal diet during pregnancy has possibly a stronger influence on the development of allergic disease than the child’s diet. Longitudinal studies can provide more insight in the relation between nutrition and allergic disease. If our results are confirmed, dietary recommendations may help to reduce the risk of developing allergic disease during childhood.