Peanut, milk, and wheat intake during pregnancy is associated with reduced allergy and asthma in children

Abstract

Background: Maternal diet during pregnancy may affect childhood allergy and asthma.

Objective: We sought to examine the associations between maternal intake of common childhood food allergens during early pregnancy and childhood allergy and asthma.

Methods: We studied 1277 mother-child pairs from a US prebirth cohort unselected for any disease. Using food frequency questionnaires administered during the first and second trimesters, we assessed maternal intake of common childhood food allergens during pregnancy. In mid-childhood (mean age, 7.9 years), we assessed food allergy, asthma, allergic rhinitis, and atopic dermatitis by questionnaire and serum-specific IgE levels. We examined the associations between maternal diet during pregnancy and childhood allergy and asthma. We also examined the cross-sectional associations between specific food allergies, asthma, and atopic conditions in mid-childhood.

Results: Food allergy was common (5.6%) in mid-childhood, as was sensitization to at least 1 food allergen (28.0%). Higher maternal peanut intake (each additional z score) during the first trimester was associated with 47% reduced odds of peanut allergic reaction (odds ratio [OR], 0.53; 95% CI, 0.30-0.94). Higher milk intake during the first trimester was associated with reduced asthma (OR, 0.83; 95% CI, 0.69-0.99) and allergic rhinitis (OR, 0.85; 95% CI, 0.74-0.97). Higher maternal wheat intake during the second trimester was associated with reduced atopic dermatitis (OR, 0.64; 95% CI, 0.46-0.90). Peanut, wheat, and soy allergy were each cross-sectionally associated with increased childhood asthma, atopic dermatitis, and allergic rhinitis (ORs, 3.6 to 8.1).

Conclusion: Higher maternal intake of peanut, milk, and wheat during early pregnancy was associated with reduced odds of mid-childhood allergy and asthma.

Keywords: Maternal diet; allergic rhinitis; asthma; childhood; food allergy; milk; peanut; pregnancy; sensitization; wheat.

Figure 1. Associations between maternal intake of food allergens during the first trimester and current allergy and asthma outcomes at mid-childhood

Models were adjusted for child age, sex, breastfeeding history, parental atopy, and maternal education. *Food allergy defined as sensitization to the respective food AND EpiPen prescribed, except for peanut allergy, which was more specifically defined by convincing symptoms of a peanut allergic reaction (history of peanut allergy AND a cutaneous, respiratory, cardiovascular, gastrointestinal and/or anaphylactic symptom following peanut ingestion). ^Food sensitization defined as spIgE ≥ 0.35 kU/L to the respective food.

Figure 2. Associations between maternal intake of food allergens during the second trimester and current allergy and asthma outcomes at mid-childhood

Models were adjusted for child age, sex, breastfeeding history, parental atopy, and maternal education. *Food allergy defined as sensitization to the respective food AND EpiPen prescribed, except for peanut allergy, which was more specifically defined by convincing symptoms of a peanut allergic reaction (history of peanut allergy AND a cutaneous, respiratory, cardiovascular, gastrointestinal and/or anaphylactic symptom following peanut ingestion). ^Food sensitization defined as spIgE ≥ 0.35 kU/L to the respective food.

Figure 3. Food allergen sensitization and food allergy among participants of the Project Viva birth cohort

A: Distribution of food allergen specific IgE levels among the 616 participants for whom spIgE levels were measured. B: Percent of study population sensitized with and without allergy. The total height of each bar represents the prevalence of sensitization to each food allergen among the 616 participants for whom spIgE levels were measured. Each bar is then divided into two parts—the red part representing the proportion sensitized to the food allergen and food allergic, and the blue part representing the proportion sensitized to the food allergen and not food allergic.

Figure 4. Prevalences of single and multiple food allergen sensitization

Numbers are percent of study sample with mid-childhood data and spIgE levels (N = 616).

Figure 5. Cross-sectional associations between food allergy and current asthma, current allergic rhinitis, and current atopic dermatitis at mid-childhood

Models were adjusted for child age, sex, breastfeeding history, parental atopy, and maternal education. Association for egg allergy and atopic dermatitis not shown given 0 subjects with both conditions at mid-childhood.