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Magnusson J, Kull I, Rosenlund H, Håkansson N, Wolk A, Melén E, Wickman M, Bergström A. Fish consumption in infancy and development of allergic disease up to age 12 y. Am J Clin Nutr 2013; 97:1324-30. [PMID: 23576046 DOI: 10.3945/ajcn.112.045377] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Fish intake in infancy has been associated with reduced risk of allergic disease in early childhood, but it is unknown whether this effect remains as children grow older. OBJECTIVE We studied the possible effect of fish consumption in infancy on prevalent and incident allergic disease up to the age of 12 y. DESIGN A total of 3285 children from a prospective Swedish birth cohort (Children, Asthma, Milieu, Stockholm, Epidemiology) were included in the current analyses. At 1, 2, 4, 8, and 12 y, parental questionnaires were used to obtain information on lifestyle factors, environmental exposures, and symptoms of allergic disease. The frequency of fish intake in infancy was assessed in the 1-y questionnaire. Serum immunoglobulin (Ig) E concentrations associated with common allergens were obtained at age 8 y. Generalized estimating equations and multivariate logistic regression were used to examine associations between fish consumption in infancy and prevalent and incident allergic disease at ages 1-12 y, including sensitization and IgE-associated disease at age 8 y. RESULTS At 1 y of age, 80% of the children consumed fish regularly (ie, ≥2 times/mo). From 1 to 12 y of age, regular fish consumption in infancy reduced overall risks of prevalent and incident allergic disease [adjusted OR (95% CI) after restriction to children without early symptoms of allergic disease was 0.74 (0.60, 0.90) (P = 0.003) for prevalent rhinitis and 0.78 (0.63, 0.97) (P = 0.028) for prevalent eczema. CONCLUSION Regular fish consumption in infancy may reduce risk of allergic disease up to age 12 y.
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Affiliation(s)
- Jessica Magnusson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Goksör E, Alm B, Pettersson R, Möllborg P, Erdes L, Aberg N, Wennergren G. Early fish introduction and neonatal antibiotics affect the risk of asthma into school age. Pediatr Allergy Immunol 2013; 24:339-44. [PMID: 23577718 PMCID: PMC3712479 DOI: 10.1111/pai.12078] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/12/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND The early introduction of fish has been reported to reduce the risk of wheezing disorder in early childhood, while broad-spectrum antibiotics in the first week have been associated with an increased risk. However, it is uncertain whether the effects remain into school age. The aim was to explore these risk factors for doctor-diagnosed asthma at 8 years. METHODS Data were obtained from a prospective, longitudinal study of a cohort of children born in western Sweden. The parents answered questionnaires at 6 months and 1, 4.5 and 8 years of age. The response rate at 8 years was 80% of the questionnaires distributed (4051/5044), that is, 71% of the families entering the study (4051/5654). RESULTS At 8 years, 5.7% reported current doctor-diagnosed asthma. Of these, 65% had atopic asthma and 35% non-atopic asthma. In the multivariate analysis, atopic heredity, male gender and own allergic disease during infancy were risk factors for doctor-diagnosed asthma at 8 years. In addition, the introduction of fish before the age of 9 months independently reduced the risk (adjusted OR 0.6; 95% CI 0.4-0.96), while broad-spectrum antibiotics in the first week independently increased the risk of current asthma at school age (aOR 2.3; 1.2-4.2). Regarding types of asthma, the effects were significant in atopic asthma but not in non-atopic asthma. CONCLUSION The early introduction of fish and neonatal antibiotic treatment influence the risk of asthma into school age. The significant effect on atopic asthma is of particular importance, as this phenotype is of major clinical significance.
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Affiliation(s)
- Emma Goksör
- Department of Paediatrics, Queen Silvia Children's Hospital, University of Gothenburg, Gothenburg, Sweden.
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Abstract
The prevalence of food allergy has continued to rise over the last 10-15 years, with building concern over the underlying causes and the best strategies to reverse this. Although it is still not clear if infant feeding practices play any significant role in either the aetiology of this epidemic or in its prevention, these have nonetheless been core to many previous prevention strategies. Early 'allergen avoidance' strategies have not only failed, but have instead been increasingly associated with increased risk of allergic disease. Together with other observations in humans and animals, this suggests that earlier introduction of allergenic foods may be a more logical preventive strategy. Based on this, there are several randomised controlled trials world-wide assessing the merits of early introduction of complementary feeding and/or allergenic foods. Until the results of these studies are available it is difficult to provide definitive recommendations regarding the role of early feeding in the induction of oral tolerance and prevention of food allergy.
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Nwaru BI, Takkinen HM, Niemelä O, Kaila M, Erkkola M, Ahonen S, Tuomi H, Haapala AM, Kenward MG, Pekkanen J, Lahesmaa R, Kere J, Simell O, Veijola R, Ilonen J, Hyöty H, Knip M, Virtanen SM. Introduction of complementary foods in infancy and atopic sensitization at the age of 5 years: timing and food diversity in a Finnish birth cohort. Allergy 2013; 68:507-16. [PMID: 23510377 DOI: 10.1111/all.12118] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2012] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To study the associations between timing and diversity of introduction of complementary foods during infancy and atopic sensitization in 5-year-old children. METHODS In the Finnish DIPP (type 1 diabetes prediction and prevention) birth cohort (n = 3781), data on the timing of infant feeding were collected up to the age of 2 years and serum IgE antibodies toward four food and four inhalant allergens measured at the age of 5 years. Logistic regression was used for the analyses. RESULTS Median duration of exclusive and total breastfeeding was 1.4 (interquartile range: 0.2-3.5) and 7.0 (4.0-11.0) months, respectively. When all the foods were studied together and adjusted for confounders, short duration of breastfeeding decreased the risk of sensitization to birch allergen; introduction of oats <5.1 months and barley <5.5 months decreased the risk of sensitization to wheat and egg allergens, and oats additionally associated with milk, timothy grass, and birch allergens. Introduction of rye <7.0 months decreased the risk of sensitization to birch allergen. Introduction of fish <6 months and egg ≤11 months decreased the risk of sensitization to all the specific allergens studied. The introduction of <3 food items at 3 months was associated with sensitization to wheat, timothy grass, and birch allergens; the introduction of 1-2 food items at 4 months and ≤4 food items at 6 months was associated with all endpoints, but house dust mite. These results were particularly evident among high-risk children when the results were stratified by atopic history, indicating the potential for reverse causality. CONCLUSIONS The introduction of complementary foods was consecutively done, and with respect to the timing of each food, early introduction of complementary foods may protect against atopic sensitization in childhood, particularly among high-risk children. Less food diversity as already at 3 months of age may increase the risk of atopic sensitization.
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Affiliation(s)
- B. I. Nwaru
- School of Health Sciences; University of Tampere; Tampere; Finland
| | - H.-M. Takkinen
- School of Health Sciences; University of Tampere; Tampere; Finland
| | - O. Niemelä
- Department of Laboratory Medicine and Medical Research Unit; Seinäjoki Central Hospital and University of Tampere; Tampere; Finland
| | | | - M. Erkkola
- Division of Nutrition; Department of Food and Environmental Sciences; University of Helsinki; Finland
| | | | - H. Tuomi
- Department of Laboratory Medicine and Medical Research Unit; Seinäjoki Central Hospital and University of Tampere; Tampere; Finland
| | - A.-M. Haapala
- Center for Laboratory Medicine; Pirkanmaa Hospital District; Finland
| | - M. G. Kenward
- Faculty of Epidemiology and Population Health; London School of Hygiene & Tropical Medicine; London; UK
| | | | - R. Lahesmaa
- Turku Centre for Biotechnology; University of Turku; Finland
| | | | - O. Simell
- Department of Pediatrics; University of Turku; Finland
| | - R. Veijola
- Department of Pediatrics; University of Oulu; Finland
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de Cássia Ribeiro Silva R, Assis AMO, Cruz AA, Fiaccone RL, Dinnocenzo S, Barreto ML, da Silva LA, Rodrigues LC, Alcantara-Neves NM. Dietary Patterns and Wheezing in the Midst of Nutritional Transition: A Study in Brazil. PEDIATRIC ALLERGY, IMMUNOLOGY, AND PULMONOLOGY 2013; 26:18-24. [PMID: 23555072 PMCID: PMC3609612 DOI: 10.1089/ped.2012.0182] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 11/12/2012] [Indexed: 11/12/2022]
Abstract
To assess the influence of dietary patterns on the prevalence of wheezing in the child and adolescent population in Northeastern Brazil. This is a cross-sectional study of male and female students, 6-12 years old, from the public elementary schools of São Francisco do Conde, Bahia, Northeastern Brazil. The report of wheezing in the past 12 months was collected using a questionnaire from the International Study of Asthma and Allergies in Childhood Program phase III, adapted to Portuguese. Consumption patterns were derived from principal component analysis based on the frequency of consumption of 97 food items by the food frequency questionnaire. We also obtained the anthropometric status, level of physical activity, pubertal development, and socioeconomic information, for each participant. Multivariate logistic regression analyses were used to assess the associations of interest. Of the children surveyed, 10.6% reported having wheezing. We identified 2 dietary patterns named Western and Prudent. We found a positive statistically significant association of the Western pattern with wheeze (odds ratio=1.77, 95% confidence interval: 1.10-2.84) after adjustment for total energy intake and controlling for potential confounders. The results showed that the Western dietary pattern was associated with wheezing. Our result is according with previous findings reported in several other studies.
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Hageman JHJ, Hooyenga P, Diersen-Schade DA, Scalabrin DMF, Wichers HJ, Birch EE. The impact of dietary long-chain polyunsaturated fatty acids on respiratory illness in infants and children. Curr Allergy Asthma Rep 2012; 12:564-73. [PMID: 23001718 PMCID: PMC3492691 DOI: 10.1007/s11882-012-0304-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Increasing evidence suggests that intake of long-chain polyunsaturated fatty acids (LCPUFA), especially omega-3 LCPUFA, improves respiratory health early in life. This review summarizes publications from 2009 through July 2012 that evaluated effects of fish, fish oil or LCPUFA intake during pregnancy, lactation, and early postnatal years on allergic and infectious respiratory illnesses. Studies during pregnancy found inconsistent effects in offspring: two showed no effects and three showed protective effects of omega-3 LCPUFA on respiratory illnesses or atopic dermatitis. Two studies found that infants fed breast milk with higher omega-3 LCPUFA had reduced allergic manifestations. Earlier introduction of fish improved respiratory health or reduced allergy in four studies. Three randomized controlled trials showed that providing LCPUFA during infancy or childhood reduced allergy and/or respiratory illness while one found no effect. Potential explanations for the variability among studies and possible mechanisms of action for LCPUFA in allergy and respiratory disease are discussed.
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Affiliation(s)
- Jeske H. J. Hageman
- Human Nutrition Department, Wageningen University, Bornse Weilanden 9, 6708 WG Wageningen, the Netherlands
| | - Pieter Hooyenga
- Mead Johnson Nutrition, Middenkampweg 2, 6545 CJ Nijmegen, the Netherlands
| | | | | | - Harry J. Wichers
- Wageningen University Food & Biobased Research, Bornse Weilanden 9, 6708 WG Wageningen, the Netherlands
| | - Eileen E. Birch
- Retina Foundation of the Southwest, 9900 North Central Expressway, Suite 400, Dallas, TX 75231 USA
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Kiefte-de Jong JC, de Vries JH, Franco OH, Jaddoe VWV, Hofman A, Raat H, de Jongste JC, Moll HA. Fish consumption in infancy and asthma-like symptoms at preschool age. Pediatrics 2012; 130:1060-8. [PMID: 23147966 DOI: 10.1542/peds.2012-0875] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess whether timing of introduction of fish and the amount of fish consumption in infancy were associated with asthmalike symptoms at preschool age. METHODS This study was embedded in the Generation R study (a population-based birth cohort in Rotterdam, Netherlands). At the age of 12 and 14 months, timing of introduction of fish into the infant's diet was assessed. The amount of fish consumption at 14 months was assessed by a semiquantitative food frequency questionnaire. Presence of asthmalike symptoms in the past year was assessed at the child's age of 36 and 48 months. RESULTS Relative to no introduction in the first year of life, introduction between age 6 and 12 months was significantly associated with a lower risk of wheezing at 48 months (odds ratio [OR]: 0.64; 95% CI: 0.43-0.94). When compared with introduction between 6 and 12 months, no introduction in the first year and introduction between 0 and 6 months were associated with an increased risk of wheezing at 48 months (OR: 1.57; 95% CI: 1.07-2.31 and OR: 1.53; 95% CI: 1.07-2.19, respectively). The amount of fish at age 14 months was not associated with asthmalike symptoms (P > .15). CONCLUSIONS Introduction of fish between 6 and 12 months but not fish consumption afterward is associated with a lower prevalence of wheezing. A window of exposure between the age of 6 and 12 months might exist in which fish might be associated with a reduced risk of asthma.
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Nwaru BI, Takkinen HM, Niemelä O, Kaila M, Erkkola M, Ahonen S, Haapala AM, Kenward MG, Pekkanen J, Lahesmaa R, Kere J, Simell O, Veijola R, Ilonen J, Hyöty H, Knip M, Virtanen SM. Timing of infant feeding in relation to childhood asthma and allergic diseases. J Allergy Clin Immunol 2012. [PMID: 23182171 DOI: 10.1016/j.jaci.2012.10.028] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Emerging evidence questions current recommendations on the timing of infant feeding for the prevention of childhood allergies. The evidence for asthma is inconclusive. OBJECTIVE We sought to investigate the associations between the duration of breast-feeding and timing of introduction of complementary foods and the development of asthma and allergies by the age of 5 years. METHODS Data were analyzed for 3781 consecutively born children. The dietary exposures were categorized into thirds and analyzed as time-dependent variables. Asthma, allergic rhinitis, and atopic eczema end points were assessed by using the International Study of Asthma and Allergies in Childhood questionnaire, whereas IgE antibodies were analyzed from serum samples at the age of 5 years. Cox proportional hazard and logistic regressions were used for the analyses. RESULTS The median duration of exclusive and total breast-feeding was 1.4 months (interquartile range, 0.2-3.5 months) and 7.0 months (interquartile range, 4.0-11.0 months), respectively. Total breast-feeding of 9.5 months or less was associated with an increased risk of nonatopic asthma. Introduction of wheat, rye, oats, or barley at 5 to 5.5 months was inversely associated with asthma and allergic rhinitis, whereas introduction of other cereals at less than 4.5 months increased the risk of atopic eczema. Introduction of egg at 11 months or less was inversely associated with asthma, allergic rhinitis, and atopic sensitization, whereas introduction of fish at 9 months or less was inversely associated with allergic rhinitis and atopic sensitization. CONCLUSION Early introduction of wheat, rye, oats, and barley cereals; fish; and egg (respective to the timing of introduction of each food) seems to decrease the risk of asthma, allergic rhinitis, and atopic sensitization in childhood. Longer duration of total breast-feeding, rather than its exclusivity, was protective against the development of nonatopic but not atopic asthma, suggesting a potential differing effect of breast-feeding on different asthma phenotypes.
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Affiliation(s)
- Bright I Nwaru
- School of Health Sciences, University of Tampere, Tampere, Finland.
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Keet CA, Matsui EC, Savage JH, Neuman-Sunshine DL, Skripak J, Peng RD, Wood RA. Potential mechanisms for the association between fall birth and food allergy. Allergy 2012; 67:775-82. [PMID: 22515802 DOI: 10.1111/j.1398-9995.2012.02823.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND Season of birth has been reported as a risk factor for food allergy, but the mechanisms by which it acts are unknown. METHODS Two populations were studied: 5862 children from the National Health and Nutrition Examination Survey (NHANES) III and 1514 well-characterized food allergic children from the Johns Hopkins Pediatric Allergy Clinic (JHPAC). Food allergy was defined as self-report of an acute reaction to a food (NHANES), or as milk, egg, and peanut allergy. Logistic regression compared fall or nonfall birth between (i) food allergic and nonallergic subjects in NHANES, adjusted for ethnicity, age, income, and sex, and (ii) JHPAC subjects and the general Maryland population. For NHANES, stratification by ethnicity and for JHPAC, eczema were examined. RESULTS Fall birth was more common among food allergic subjects in both NHANES (OR, 1.91; 95% CI, 1.31-2.77) and JHPAC/Maryland (OR, 1.31; 95% CI, 1.18-1.47). Ethnicity interacted with season (OR, 2.34; 95% CI, 1.43-3.82 for Caucasians; OR, 1.19; 95% CI, 0.77-1.86 for non-Caucasians; P = 0.04 for interaction), as did eczema (OR, 1.47; 95% CI, 1.29-1.67 with eczema; OR, 1.00; 95% CI, 0.80-1.23 without eczema; P = 0.002 for interaction). CONCLUSIONS Fall birth is associated with increased risk of food allergy, and this risk is greatest among those most likely to have seasonal variation in vitamin D during infancy (Caucasians) and those at risk for skin barrier dysfunction (subjects with a history of eczema), suggesting that vitamin D and the skin barrier may be implicated in seasonal associations with food allergy.
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Affiliation(s)
- C. A. Keet
- Division of Allergy and Immunology; Department of Pediatrics; Johns Hopkins University School of Medicine; Baltimore; MD; USA
| | - E. C. Matsui
- Division of Allergy and Immunology; Department of Pediatrics; Johns Hopkins University School of Medicine; Baltimore; MD; USA
| | - J. H. Savage
- Division of Allergy and Clinical Immunology; Department of Medicine; Johns Hopkins University School of Medicine; Baltimore; MD; USA
| | - D. L. Neuman-Sunshine
- Division of Allergy and Clinical Immunology; Department of Medicine; Johns Hopkins University School of Medicine; Baltimore; MD; USA
| | - J. Skripak
- ENT and Allergy Associates; Hoboken; NJ; USA
| | - R. D. Peng
- Department of Biostatistics; Johns Hopkins Bloomberg School of Public Health; Baltimore; MD; USA
| | - R. A. Wood
- Division of Allergy and Clinical Immunology; Department of Medicine; Johns Hopkins University School of Medicine; Baltimore; MD; USA
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Goksör E, Alm B, Thengilsdottir H, Pettersson R, Åberg N, Wennergren G. Preschool wheeze - impact of early fish introduction and neonatal antibiotics. Acta Paediatr 2011; 100:1561-6. [PMID: 21767307 DOI: 10.1111/j.1651-2227.2011.02411.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
AIM The aim of this study was to analyse the risk factors for preschool wheeze with special reference to the early introduction of fish and early antibiotic treatment. To avoid reverse causation regarding antibiotics, we focused on the influence of broad-spectrum antibiotics given during the first week of life. METHODS Data were obtained from a prospective, longitudinal study of a cohort of children born in western Sweden where 50% of the birth cohort was randomly selected. The parents answered questionnaires at 6 and 12 months and at 4.5 years of age. The response rate at 4.5 years was 83% (4496 of 5398 questionnaires distributed). RESULTS In the multivariate analysis, broad-spectrum antibiotics in the first week increased the risk of recurrent wheeze (≥ 3 episodes) during the last 12 months at age 4.5 years (adjusted OR 2.2; 95% CI 1.3-3.8) and multiple-trigger wheeze (aOR, 2.8; 1.3-6.1). The introduction of fish before the age of 9 months reduced the risk of recurrent wheeze (aOR, 0.6; 0.4-0.8). CONCLUSION Treatment with broad-spectrum antibiotics during the first week of life increased the risk of recurrent wheeze and multiple-trigger wheeze at preschool age. The early introduction of fish reduced the risk of recurrent wheeze.
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Affiliation(s)
- Emma Goksör
- Department of Paediatrics, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden.
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West CE, D'Vaz N, Prescott SL. Dietary immunomodulatory factors in the development of immune tolerance. Curr Allergy Asthma Rep 2011; 11:325-33. [PMID: 21538229 DOI: 10.1007/s11882-011-0200-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Emerging evidence suggests that exposures during pregnancy and the early postnatal period can modify gene expression and disease propensity. Diet is a major environmental exposure, and dietary factors, including polyunsaturated fatty acids, probiotics, oligosaccharides, antioxidants, folate, and other vitamins, have effects on immune function. Some also have been implicated in reduced risk of allergy in observational studies. Intervention trials with polyunsaturated fatty acids, probiotics, and oligosaccharides suggest preliminary but as-of-yet-unconfirmed benefits. Food allergen avoidance during pregnancy, lactation, or infancy has provided no consistent evidence in allergy prevention and is no longer recommended. Rather, there is now a focus on food allergens in tolerance induction. Specific nutrients can induce changes in gene expression during early development and have been implicated in potentially heritable "epigenetic" changes in disease predisposition. Collectively, these observations emphasize that early exposures may modify tolerance development and that further research on these exposures should remain a priority.
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Affiliation(s)
- Christina E West
- Department of Clinical Sciences, Pediatrics, Umeå University, SE-901 87, Umeå, Sweden.
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Abstract
Over the past several decades, the incidence of atopic diseases such as asthma, atopic dermatitis and food allergies has increased dramatically. Although atopic diseases have a clear genetic basis, environmental factors, including early infant nutrition, may have an important influence on their development. Therefore, attempts have been made to reduce the risk of the development of allergy using dietary modifications, mainly focused on longer breast-feeding and delayed introduction or elimination of foods identified as potentially most allergenic. Recently, there is also an increasing interest in the active prevention of atopy using specific dietary components. Many studies have shown that breast-feeding may have the protective effect against future atopic dermatitis and early childhood wheezing. Concerning complementary feeding, there is evidence that the introduction of complementary foods before 4 months of age may increase the risk for atopic dermatitis. However, there is no current convincing evidence that delaying introduction of solids after 6 months of age has a significant protective effect on the development of atopic disease regardless of whether infants are fed cow's milk protein formula or human subject's milk, and this includes delaying the introduction of foods that are considered to be highly allergic, such as fish, eggs and foods containing peanut protein. In conclusion, as early nutrition may have profound implications for long-term health and atopy later in life, it presents an opportunity to prevent or delay the onset of atopic diseases.
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Johansson S, Wold AE, Sandberg AS. Low breast milk levels of long-chain n-3 fatty acids in allergic women, despite frequent fish intake. Clin Exp Allergy 2011; 41:505-15. [PMID: 21338426 PMCID: PMC3085074 DOI: 10.1111/j.1365-2222.2010.03678.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Long-chain n-3 polyunsaturated fatty acids (PUFAs) have immune regulating and anti-inflammatory effects. However, their role in allergic disease is unclear. Allergic diseases are immunologically heterogeneous, and we hypothesized that n-3 fatty acid composition in serum and breast milk may vary according to clinical manifestations. Further, animal studies have shown reduction of serum-PUFA levels during allergic inflammation. OBJECTIVE To investigate fatty acid composition in breast milk and serum from women with different atopic disease manifestations. Secondly, to determine whether low PUFA levels reflected insufficient intakes. METHODS Fatty acids were analysed in breast milk and serum of women with atopic eczema and respiratory allergy (n=16), only respiratory allergy (n=7), as well as healthy women (n=22). Dietary intake of foods expected to affect long-chain n-3 PUFA levels were estimated by food-frequency questionnaire. The fatty acid pattern was related to diagnostic group and intake of relevant food items using a multivariate pattern recognition method (partial least squares projections to latent structures and discriminant analysis). Results Women with a combination of eczema and respiratory allergy had lower breast milk levels of several PUFAs (arachidonic acid, eicosapentaenoic acid, EPA, docosahexaenoic acid, DHA, and docosapentaenoic acid, DPA), and a lower ratio of long-chain n-3 PUFAs/n-6 PUFAs. Their PUFA levels differed not only from that of healthy women, but also from that of women with only respiratory allergy. The latter had a fatty acid pattern similar to that of healthy women. Despite low EPA, DHA and DPA levels women with eczema and respiratory allergy consumed no less fish than did healthy women. CONCLUSION & CLINICAL RELEVANCE Our data suggest that reduced levels of long-chain n-3 fatty acids in serum and breast milk characterize women with extensive allergic disease including eczema, and are not related to low fish intake. Consumption of PUFAs during the allergic process may explain these findings.
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Affiliation(s)
- S Johansson
- Food Science, Department of Chemical and Biological Engineering, Chalmers University of Technology, Göteborg, Sweden.
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