Journal Home > Volume 12 , Issue 3

To investigate the role of nutrients intake during pregnancy with longitudinal development of rhinitis, asthma, eczema, wheeze, and food allergy in offspring. The PubMed, Embase, and Cochrane library were searched for articles published throughout May 2022. The pooled effect estimate were presented using relative risk and calculated by the random-effects model. Twenty-three prospective cohort studies enrolling 210817 individuals were included. The risk of wheeze in offspring were lowered when high vitamin D, vitamin E, zinc, and milk intakes during pregnancy, whereas high meat intake during pregnancy could induce additional risk of wheeze in offspring. Moreover, high β-carotene and magnesium intakes during pregnancy were related to lower eczema risk in offspring, whereas eczema risk in offspring was increased for pregnant women with high intake of butter and margarine. Finally, the asthma risk in offspring could protect against for pregnant women with high intake of vitamin D and apple, whereas high folic acid during pregnancy could produce excess asthma risk in offspring. This study provides the summary evidences regarding the role of nutrients intake during pregnancy and subsequent risk of rhinitis, asthma, eczema, wheeze, and food allergy, and further effective intervention strategies should be employed to improve childhood allergic diseases.


menu
Abstract
Full text
Outline
About this article

Association of nutrients intake during pregnancy with the risk of allergic disease in offspring: a meta-analysis of prospective cohort studies

Show Author's information Hua Fenga,bYan ChencXiujuan XiongdQunying XubZhongwei ZhangbQinghua XibYongning Wua,c( )Yuanan Lue( )
State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330006, China
School of Public Health, Nanchang University, Nanchang 330006, China
Research Unit of Food Safety (2019RU014), Chinese Academy of Medical Sciences; NHC Key Laboratory of Food Safety Risk Assessment, China National Center for Food Safety Risk Assessment (CFSA), Beijing 100022, China
Department of Pathology, School of Basic Medical Sciences, Nanchang University, Nanchang 330006, China
Environmental Health Laboratory, Department of Public Health Sciences, University of Hawaii, Honolulu 96822, US

Peer review under responsibility of KeAi Communications Co., Ltd.

Abstract

To investigate the role of nutrients intake during pregnancy with longitudinal development of rhinitis, asthma, eczema, wheeze, and food allergy in offspring. The PubMed, Embase, and Cochrane library were searched for articles published throughout May 2022. The pooled effect estimate were presented using relative risk and calculated by the random-effects model. Twenty-three prospective cohort studies enrolling 210817 individuals were included. The risk of wheeze in offspring were lowered when high vitamin D, vitamin E, zinc, and milk intakes during pregnancy, whereas high meat intake during pregnancy could induce additional risk of wheeze in offspring. Moreover, high β-carotene and magnesium intakes during pregnancy were related to lower eczema risk in offspring, whereas eczema risk in offspring was increased for pregnant women with high intake of butter and margarine. Finally, the asthma risk in offspring could protect against for pregnant women with high intake of vitamin D and apple, whereas high folic acid during pregnancy could produce excess asthma risk in offspring. This study provides the summary evidences regarding the role of nutrients intake during pregnancy and subsequent risk of rhinitis, asthma, eczema, wheeze, and food allergy, and further effective intervention strategies should be employed to improve childhood allergic diseases.

Keywords: Pregnancy, Allergy, Nutrients, Offspring, Immune disease

References(69)

[1]

M.I. Asher, S. Montefort, B. Björkstén, et al., Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys, Lancet 368 (2006) 733-743. https://doi.org/10.1016/s0140-6736(06)69283-0.

[2]

R.A. Waterland, K.B. Michels, Epigenetic epidemiology of the developmental origins hypothesis, Annu. Rev. Nutr. 27 (2007) 363-388. https://doi.org/10.1146/annurev.nutr.27.061406.093705.

[3]

M.J. Netting, P.F. Middleton, M. Makrides, Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches, Nutrition 30 (2014) 1225-1241. https://doi.org/10.1016/j.nut.2014.02.015.

[4]

D.R. Miller, S.W. Turner, D. Spiteri-Cornish, et al., Maternal vitamin D and E intakes during early pregnancy are associated with airway epithelial cell responses in neonates, Clin. Exp. Allergy 45 (2015) 920-927. https://doi.org/10.1111/cea.12490.

[5]

T. Keil, A. Bockelbrink, A. Reich, et al., The natural history of allergic rhinitis in childhood, Pediatr. Allergy Immunol. 21 (2010) 962-969. https://doi.org/10.1111/j.1399-3038.2010.01046.x.

[6]

N. Ballardini, I. Kull, T. Lind, et al., Development and comorbidity of eczema, asthma and rhinitis to age 12: data from the BAMSE birth cohort, Allergy 67 (2012) 537-544. https://doi.org/10.1111/j.1398-9995.2012.02786.x.

[7]

M. Wickman, A. Asarnoj, H. Tillander, et al., Childhood-to-adolescence evolution of IgE antibodies to pollens and plant foods in the BAMSE cohort, J. Allergy Clin. Immunol. 133 (2014) 580-582. https://doi.org/10.1016/j.jaci.2013.09.009.

[8]

M. Westman, P. Stjärne, A. Bergström, et al., Chronic rhinosinusitis is rare but bothersome in adolescents from a Swedish population-based cohort, J. Allergy Clin. Immunol. 136 (2015) 512-514.e6. https://doi.org/10.1016/j.jaci.2015.02.019.

[9]

U. Nurmatov, G. Devereux, A. Sheikh, Nutrients and foods for the primary prevention of asthma and allergy: systematic review and meta-analysis, J. Allergy Clin. Immunol. 127 (2011) 724-733.e1-30. https://doi.org/10.1016/j.jaci.2010.11.001.

[10]

K.S. Crider, A.M. Cordero, Y.P. Qi, et al., Prenatal folic acid and risk of asthma in children: a systematic review and meta-analysis, Am. J. Clin. Nutr. 98 (2013) 1272-1281. https://doi.org/10.3945/ajcn.113.065623.

[11]

A.A. Beckhaus, L. Garcia-Marcos, E. Forno, et al., Maternal nutrition during pregnancy and risk of asthma, wheeze, and atopic diseases during childhood: a systematic review and meta-analysis, Allergy 70 (2015) 1588-1604. https://doi.org/10.1111/all.12729.

[12]

Z. Wei, J. Zhang, X. Yu, Maternal vitamin D status and childhood asthma, wheeze, and eczema: a systematic review and meta-analysis, Pediatr. Allergy Immunol. 27 (2016) 612-619. https://doi.org/10.1111/pai.12593.

[13]

Y.H. Kim, K.W. Kim, M.J. Kim, et al., Vitamin D levels in allergic rhinitis: a systematic review and meta-analysis, Pediatr. Allergy Immunol. 27 (2016) 580-590. https://doi.org/10.1111/pai.12599.

[14]

G.Q. Zhang, B. Liu, J. Li, et al., Fish intake during pregnancy or infancy and allergic outcomes in children: a systematic review and meta-analysis, Pediatr. Allergy Immunol. 28 (2017) 152-161. https://doi.org/10.1111/pai.12648.

[15]

M. Vahdaninia, H. Mackenzie, S. Helps, et al., Prenatal intake of vitamins and allergic outcomes in the offspring: a systematic review and meta-analysis, J. Allergy Clin. Immunol. Pract. 5 (2017) 771-778.e5. https://doi.org/10.1016/j.jaip.2016.09.024.

[16]

Z. Aryan, N. Rezaei, C.A. Camargo, Jr., Vitamin D status, aeroallergen sensitization, and allergic rhinitis: a systematic review and meta-analysis, Int. Rev. Immunol. 36 (2017) 41-53. https://doi.org/10.1080/08830185.2016.1272600.

[17]

J.J. Yepes-Nuñez, J.L. Brożek, A. Fiocchi, et al., Vitamin D supplementation in primary allergy prevention: systematic review of randomized and non-randomized studies, Allergy 73 (2018) 37-49. https://doi.org/10.1111/all.13241.

[18]

R.M. Pacheco-González, L. García-Marcos, E. Morales, Prenatal vitamin D status and respiratory and allergic outcomes in childhood: a meta-analysis of observational studies, Pediatr. Allergy Immunol. 29 (2018) 243-253. https://doi.org/10.1111/pai.12876.

[19]

V. Garcia-Larsen, D. Ierodiakonou, K. Jarrold, et al., Diet during pregnancy and infancy and risk of allergic or autoimmune disease: a systematic review and meta-analysis, PLoS Med. 15 (2018) e1002507. https://doi.org/10.1371/journal.pmed.1002507.

[20]

D. Moher, A. Liberati, J. Tetzlaff, et al., Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement, PLoS Med. 6 (2009) e1000097. https://doi.org/10.1371/journal.pmed.1000097.

[21]

A. Stang, Critical evaluation of the Newcastle–Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses, Eur. J. Epidemiol. 25(9) (2010) 603–605. http://doi.org/10.1007/s10654-010-9491-z.

[22]

R. DerSimonian, N. Laird, Meta-analysis in clinical trials. Control Clin. Trials 7 (1986) 177-188. https://doi.org/10.1016/0197-2456(86)90046-2.

[23]

A.E. Ades, G. Lu, J.P. Higgins, The interpretation of random-effects meta-analysis in decision models. Med. Decis. Making 25 (2005) 646-654. https://doi.org/10.1177/0272989x05282643.

[24]
J. Higgins, Cochrane handbook for systematic reviews of interventions (Version 5.0.1), The Cochrane Collaboration, 2008.
DOI
[25]

J.P. Higgins, S.G. Thompson, J.J. Deeks, et al., Measuring inconsistency in meta-analyses, BMJ 327 (2003) 557-560. https://doi.org/10.1136/bmj.327.7414.557.

[26]

J.P. Higgins, S.G. Thompson, Quantifying heterogeneity in a meta-analysis, Stat Med. 21 (2002) 1539-1558. https://doi.org/10.1002/sim.1186.

[27]
A. Tobias, Assessing the influence of a single study in the meta-anyalysis estimate, 1999.
[28]

R.R. Huxley, M. Woodward, Cigarette smoking as a risk factor for coronary heart disease in women compared with men: a systematic review and meta-analysis of prospective cohort studies, Lancet 378 (2011) 1297-1305. https://doi.org/10.1016/s0140-6736(11)60781-2.

[29]

M. Egger, G. Davey Smith, M. Schneider, et al., Bias in meta-analysis detected by a simple, graphical test, BMJ 315 (1997) 629-634. https://doi.org/10.1136/bmj.315.7109.629.

[30]

C.B. Begg, M. Mazumdar, Operating characteristics of a rank correlation test for publication bias, Biometrics 50 (1994) 1088-1101.

[31]

S. Duval, R. Tweedie, A nonparametric “Trim and Fill” method of accounting for publication bias in meta-analysis, J. Am. Stat. Assoc. 95 (2000) 89-98. https://doi.org/10.1080/01621459.2000.10473905.

[32]

S. Martindale, G. McNeill, G. Devereux, et al., Antioxidant intake in pregnancy in relation to wheeze and eczema in the first two years of life, Am. J. Respir. Crit. Care. Med. 171 (2005) 121-128. https://doi.org/10.1164/rccm.200402-220OC.

[33]

G. Devereux, S.W. Turner, L.C. Craig, et al., Low maternal vitamin E intake during pregnancy is associated with asthma in 5-year-old children, Am. J. Respir. Crit. Care. Med. 174 (2006) 499-507. https://doi.org/10.1164/rccm.200512-1946OC.

[34]

A.A. Litonjua, S.L. Rifas-Shiman, N.P. Ly, et al., Maternal antioxidant intake in pregnancy and wheezing illnesses in children at 2 y of age, Am. J. Clin. Nutr. 84 (2006) 903-911. https://doi.org/10.1093/ajcn/84.4.903.

[35]

C.A. Camargo, Jr., S.L. Rifas-Shiman, A.A. Litonjua, et al., Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age, Am. J. Clin. Nutr. 85 (2007) 788-795. https://doi.org/10.1093/ajcn/85.3.788.

[36]

G. Devereux, A.A. Litonjua, S.W. Turner, et al., Maternal vitamin D intake during pregnancy and early childhood wheezing, Am. J. Clin. Nutr. 85 (2007) 853-859. https://doi.org/10.1093/ajcn/85.3.853.

[37]

S.M. Willers, G. Devereux, L.C. Craig, et al., Maternal food consumption during pregnancy and asthma, respiratory and atopic symptoms in 5-year-old children, Thorax 62 (2007) 773-779. https://doi.org/10.1136/thx.2006.074187.

[38]

N. Fitzsimon, U. Fallon, D. O'Mahony, et al., Mothers' dietary patterns during pregnancy and risk of asthma symptoms in children at 3 years, Ir. Med. J. 100 (Suppl) (2007) 27-32.

[39]

L. Chatzi, M. Torrent, I. Romieu, et al., Mediterranean diet in pregnancy is protective for wheeze and atopy in childhood, Thorax 63 (2008) 507-513. https://doi.org/10.1136/thx.2007.081745.

[40]

S.M. Willers, A.H. Wijga, B. Brunekreef, et al., Maternal food consumption during pregnancy and the longitudinal development of childhood asthma, Am. J. Respir. Crit. Care. Med. 178 (2008) 124-131. https://doi.org/10.1164/rccm.200710-1544OC.

[41]

M. Erkkola, M. Kaila, B.I. Nwaru, et al., Maternal vitamin D intake during pregnancy is inversely associated with asthma and allergic rhinitis in 5-year-old children, Clin. Exp. Allergy 39 (2009) 875-882. https://doi.org/10.1111/j.1365-2222.2009.03234.x.

[42]

S.O. Shaheen, K. Northstone, R.B. Newson, et al., Dietary patterns in pregnancy and respiratory and atopic outcomes in childhood, Thorax 64 (2009) 411-417. https://doi.org/10.1136/thx.2008.104703.

[43]

Y. Miyake, S. Sasaki, K. Tanaka, et al., Dairy food, calcium and vitamin D intake in pregnancy, and wheeze and eczema in infants, Eur. Respir. J. 35 (2010) 1228-1234. https://doi.org/10.1183/09031936.00100609.

[44]

S. Sausenthaler, J. Heinrich, S. Koletzko, Early diet and the risk of allergy: what can we learn from the prospective birth cohort studies GINIplus and LISAplus? Am. J. Clin. Nutr. 94 (2011) 2012s-2017s. https://doi.org/10.3945/ajcn.110.001180.

[45]

C.E. West, J. Dunstan, S. McCarthy, et al., Associations between maternal antioxidant intakes in pregnancy and infant allergic outcomes, Nutrients 4 (2012) 1747-1758. https://doi.org/10.3390/nu4111747.

[46]

F. Pelé, E. Bajeux, H. Gendron, et al., Maternal fish and shellfish consumption and wheeze, eczema and food allergy at age two: a prospective cohort study in Brittany, France. Environ. Health 12 (2013) 102. https://doi.org/10.1186/1476-069x-12-102.

[47]

E. Maslova, S. Hansen, C.B. Jensen, et al., Vitamin D intake in mid-pregnancy and child allergic disease: a prospective study in 44 825 Danish mother-child pairs. BMC Pregnancy Childb. 13 (2013) 199. https://doi.org/10.1186/1471-2393-13-199.

[48]

Y. Miyake, K. Tanaka, H. Okubo, et al., Maternal fat intake during pregnancy and wheeze and eczema in Japanese infants: the Kyushu Okinawa Maternal and Child Health Study, Ann. Epidemiol. 23 (2013) 674-680. https://doi.org/10.1016/j.annepidem.2013.08.004.

[49]

L. Chatzi, R. Garcia, T. Roumeliotaki, et al., Mediterranean diet adherence during pregnancy and risk of wheeze and eczema in the first year of life: INMA (Spain) and RHEA (Greece) mother-child cohort studies, Br. J. Nutr. 110 (2013) 2058-2068. https://doi.org/10.1017/s0007114513001426.

[50]

E.T. Leermakers, A.M. Sonnenschein-van der Voort, D.H. Heppe, et al., Maternal fish consumption during pregnancy and risks of wheezing and eczema in childhood: the Generation R Study, Eur. J. Clin. Nutr. 67 (2013) 353-359. https://doi.org/10.1038/ejcn.2013.36.

[51]

L.N. Anderson, Y. Chen, J.A. Omand, et al., Vitamin D exposure during pregnancy, but not early childhood, is associated with risk of childhood wheezing, J. Dev. Orig. Hlth. Dis. 6 (2015) 308-316.

[52]

C.L. Parr, M.C. Magnus, Ø. Karlstad, et al., Maternal folate intake during pregnancy and childhood asthma in a population-based cohort, Am. J. Respir. Crit. Care. Med. 195 (2017) 221-228. https://doi.org/10.1164/rccm.201604-0788OC.

[53]

K. Viljoen, R. Segurado, J. O'Brien, et al., Pregnancy diet and offspring asthma risk over a 10-year period: the Lifeways Cross Generation Cohort Study, Ireland. BMJ Open 8 (2018) e017013. https://doi.org/10.1136/bmjopen-2017-017013.

[54]

K. Ogawa, K. Pak, K. Yamamoto-Hanada, et al., Association between maternal vegetable intake during pregnancy and allergy in offspring: Japan environment and children's study, PLoS ONE 16 (2021) e0245782. https://doi.org/10.1371/journal.pone.0245782.

[55]

M.D. Griffin, N. Xing, R. Kumar, Vitamin D and its analogs as regulators of immune activation and antigen presentation, Annu. Rev. Nutr. 23 (2003) 117-145. https://doi.org/10.1146/annurev.nutr.23.011702.073114.

[56]

R. Lin, J.H. White, The pleiotropic actions of vitamin D, Bioessays 26 (2004) 21-28. https://doi.org/10.1002/bies.10368.

[57]

S. Gregori, N. Giarratana, S. Smiroldo, et al., A 1 alpha,25-dihydroxy vitamin D3 analog enhances regulatory T-cells and arrests autoimmune diabetes in NOD mice, Diabetes 51 (2002) 1367-1374. https://doi.org/10.2337/diabetes.51.5.1367.

[58]

S. Islam, V. Narra, G.M. Coté, et al., Prenatal vitamin E treatment improves lung growth in fetal rats with congenital diaphragmatic hernia, J. Pediatr. Surg. 34 (1999) 172-177. https://doi.org/10.1016/s0022-3468(99)90251-8.

[59]

S.O. Shaheen, R.B. Newson, A.J. Henderson, et al., Umbilical cord trace elements and minerals and risk of early childhood wheezing and eczema, Eur. Respir. J. 24 (2004) 292-297. https://doi.org/10.1183/09031936.04.00117803.

[60]

S. Cunningham-Rundles, D.F. McNeeley, A. Moon, Mechanisms of nutrient modulation of the immune response, J. Allergy Clin. Immunol. 115 (2005) 1119-1128. https://doi.org/10.1016/j.jaci.2005.04.036.

[61]

E. Ho, Zinc deficiency, DNA damage and cancer risk, J. Nutr. Biochem. 15 (2004) 572-578. https://doi.org/10.1016/j.jnutbio.2004.07.005.

[62]
S. Tricon, S. Willers, H.A. Smit, et al., Nutrition and allergic disease, 2006, pp. 117-188.
DOI
[63]

J. Riedler, C. Braun-Fahrländer, W. Eder, et al., Exposure to farming in early life and development of asthma and allergy: a cross-sectional survey, Lancet 358 (2001) 1129-1133. https://doi.org/10.1016/s0140-6736(01)06252-3.

[64]

P.J. Vuillermin, L. Macia, R. Nanan, et al., The maternal microbiome during pregnancy and allergic disease in the offspring, Semin. Immunopathol. 39 (2017) 669-675. https://doi.org/10.1007/s00281-017-0652-y.

[65]

P. Jakszyn, A. Agudo, R. Ibáñez, et al., Development of a food database of nitrosamines, heterocyclic amines, and polycyclic aromatic hydrocarbons, J. Nutr. 134 (2004) 2011-2014. https://doi.org/10.1093/jn/134.8.2011.

[66]

S.K. Weiland, E. von Mutius, A. Hüsing, et al., Intake of trans fatty acids and prevalence of childhood asthma and allergies in Europe. ISAAC Steering Committee, Lancet 353 (1999) 2040-2041. https://doi.org/10.1016/s0140-6736(99)01609-8.

[67]

M. Davalos Bichara, R.D. Goldman, Magnesium for treatment of asthma in children, Can. Fam. Physician. 55 (2009) 887-889.

[68]

A. Soutar, A. Seaton, K. Brown, Bronchial reactivity and dietary antioxidants, Thorax 52 (1997) 166-170. https://doi.org/10.1136/thx.52.2.166.

[69]

S. Sausenthaler, S. Koletzko, B. Schaaf, et al., Maternal diet during pregnancy in relation to eczema and allergic sensitization in the offspring at 2 y of age, Am. J. Clin. Nutr. 85 (2007) 530-537. https://doi.org/10.1093/ajcn/85.2.530.

Publication history
Copyright
Acknowledgements
Rights and permissions

Publication history

Received: 27 April 2022
Revised: 12 May 2022
Accepted: 02 July 2022
Published: 15 October 2022
Issue date: May 2023

Copyright

© 2023 Beijing Academy of Food Sciences. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co., Ltd.

Acknowledgements

Acknowledgements

This study was supported by CAMS Innovation Fund for Medical Science (CIFMS 2019-I2M-5-024).

Rights and permissions

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Return