HOUSTON -- Children born to women who ate a diverse, healthy diet while pregnant had a lower risk for eczema and food allergy than those born to women whose overall diet was poor, according to an analysis of data from the .
For kids born to mothers with a history of allergy, 33% had a diagnosis of eczema and/or food allergy by age 2 years when their mothers ate a poor, less-diverse diet compared with 21% for those whose mothers ate a diverse and healthy diet (odds ratio 1.91, 95% CI 1.17-3.11, P=0.01), reported Carina Venter, PhD, of the University of Colorado and Children's Hospital Colorado in Aurora.
Where no history of allergy was present, an eczema or food allergy diagnosis by the age of 2 was made in 26% for those whose mothers had a poor diet in pregnancy versus 20% for those whose mothers ate a healthy diet, she said here at the American College of Allergy, Asthma & Immunology (ACAAI) annual meeting.
Venter told Ƶ that the study is the first to examine the potential impact of diet diversity during pregnancy on offspring eczema and food allergy risk.
"People have looked at food patterns during pregnancy, such as eating fish, a vegetarian diet, or a Mediterranean diet," she said. "Some of these studies showed some association with a child's risk for wheeze or asthma, but not really with eczema or food allergy."
"What is novel about our study is that we looked at varied dietary intake, not just eating specific foods or diets," she added.
Venter and colleagues assessed diet diversity through a scoring system they created, which gave points for every healthy food a woman ate each day while pregnant. Participants in the Healthy Start Study were asked to record their diet daily during pregnancy.
Foods like fish, fatty fish, nuts, milk, vegetables, fruits, and chicken that wasn't fried were in the "good foods" category, while donuts, cake, pizza, and burgers landed in the "bad foods" category, along with other not-so-healthy foods.
Maternal history of allergic disease was self reported, and recorded cases of eczema and/or food allergy occurring in their offspring before age 2 years was verified by a physician. In all, there were 78 children born to mothers with a poor, less-diverse diet and a history of allergy; 180 born to mothers with a poor diet but no allergy history; 375 born to mothers who ate a diverse and healthy diet and had a history of allergy; and 682 born to mothers with a healthy diet but no allergy history.
The research suggested that eating a variety of healthy foods during pregnancy may protect offspring from eczema and food allergy by enriching infant microbiome composition. Venter explained that infant microbiome composition has been shown to be associated with infant allergy outcomes.
In a related ACAAI study, Venter and colleagues studied fecal samples from 55 children (age 3 months) enrolled in a prospective study of newborns.
DNA was isolated and analyzed using 16S rRNA gene sequencing, and maternal diet was assessed through a validated food frequency questionnaire.
The three-microbiome clusters included a diet rich in phylum Bacteroidetes (cluster 1), a diet rich in phyla Actinobacteria and Proteobacteria (cluster 2) and a diet rich in phylum Firmicutes (cluster 3). Food diversity was highest in cluster 1 and lowest in cluster 3.
Venter told Ƶ that eating a wide variety of healthy foods during pregnancy may positively influence infant microbiome composition in a way that eating a more restricted, healthy diet may not.
"The varied diet affects the variety of microbes in the gut," she said.
Disclosures
Venter disclosed relevant relationships with Abbott, DBV Technologies, the Nestlé Nutrition Institute, Nutricia, and Mead Johnson Nutrition.
Primary Source
American College of Allergy, Asthma & Immunology
Venter C, et al "Maternal diet diversity during pregnancy and eczema and food allergy in offspring: healthy state study" ACAAI 2019; Abstract A306.
Secondary Source
American College of Allergy, Asthma & Immunology
Venter C, et al "Association between maternal diet diversity and infant microbial abundance: IOW 3rd generation cohort" ACAAI, Abstract A500.