Maternal and pediatric nutrition

Maternal diet during pregnancy and lactation and cow’s milk allergy in offspring

Subjects

Abstract

Background/Objectives:

Diet during pregnancy and lactation may have a role in the development of allergic diseases. There are few human studies on the topic, especially focusing on food allergies. We sought to study the associations between maternal diet during pregnancy and lactation and cow’s milk allergy (CMA) in offspring.

Subjects/Methods:

A population-based birth cohort with human leukocyte antigen-conferred susceptibility to type 1 diabetes was recruited in Finland between 1997 and 2004 (n=6288). Maternal diet during pregnancy and lactation was assessed by a validated, 181-item semi-quantitative food frequency questionnaire. Register-based information on diagnosed CMA was obtained from the Social Insurance Institution and completed with parental reports. The associations between maternal food consumption and CMA were assessed using logistic regression, comparing the highest and the lowest quarters to the middle half of consumption.

Results:

Consumption of milk products in the highest quarter during pregnancy was associated with a lower risk of CMA in offspring (odds ratio (OR) 0.56, 95% confidence interval (CI) 0.37–0.86; P<0.01). When stratified by maternal allergic rhinitis and asthma, there was evidence of an inverse association between high use of milk products and CMA in offspring of non-allergic mothers (OR 0.30, 95% CI 0.13–0.69, P<0.001). Cord blood IgA correlated positively with the consumption of milk products during pregnancy, indicating exposure to CMA and activation of antigen-specific immunity in the infant during pregnancy.

Conclusions:

High maternal consumption of milk products during pregnancy may protect children from developing CMA, especially in offspring of non-allergic mothers.

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References

  1. 1

    Nurmatov U, Devereux G, Sheikh A . Nutrients and foods for the primary prevention of asthma and allergy: systematic review and meta-analysis. J Allergy Clin Immunol 2011; 127: 724–733.

    Article  Google Scholar 

  2. 2

    Ushiyama Y, Matsumoto K, Shinohara M, Wakiguchi H, Sakai K, Komatsu T et al. Nutrition during pregnancy may be associated with allergic diseases in infants. J Nutr Sci Vitaminol (Tokyo) 2002; 48: 345–351.

    CAS  Article  Google Scholar 

  3. 3

    Kramer MS, Kakuma R Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child. Cochrane Database Syst Rev 2006; (3): CD000133.

  4. 4

    Sala-Vila A, Miles EA, Calder PC . Fatty acid composition abnormalities in atopic disease: evidence explored and role in the disease process examined. Clin Exp Allergy 2008; 38: 1432–1450.

    CAS  Article  Google Scholar 

  5. 5

    Willers SM, Wijga AH, Brunekreef B, Kerkhof M, Gerritsen J, Hoekstra MO et al. Maternal food consumption during pregnancy and the longitudinal development of childhood asthma. Am J Respir Crit Care Med 2008; 178: 124–131.

    Article  Google Scholar 

  6. 6

    Miyake Y, Sasaki S, Tanaka K, Hirota Y . Consumption of vegetables, fruit, and antioxidants during pregnancy and wheeze and eczema in infants. Allergy 2010; 65: 758–765.

    CAS  Article  Google Scholar 

  7. 7

    Chatzi L, Torrent M, Romieu I, Garcia-Esteban R, Ferrer C, Vioque J et al. Mediterranean diet in pregnancy is protective for wheeze and atopy in childhood. Thorax 2008; 63: 507–513.

    CAS  Article  Google Scholar 

  8. 8

    Nwaru BI, Ahonen S, Kaila M, Erkkola M, Haapala AM, Kronberg-Kippila C et al. Maternal diet during pregnancy and allergic sensitization in the offspring by 5 yrs of age: a prospective cohort study. Pediatr Allergy Immunol 2009; 21: 29–37.

    Article  Google Scholar 

  9. 9

    Sausenthaler S, Koletzko S, Schaaf B, Lehmann I, Borte M, Herbarth O 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 2007; 85: 530–537.

    CAS  Article  Google Scholar 

  10. 10

    Miyake Y, Sasaki S, Tanaka K, Hirota Y . Dairy food, calcium, and vitamin D intake in pregnancy and wheeze and eczema in infants. Eur Respir J 2009; 35: 1228–1234.

    Article  Google Scholar 

  11. 11

    Saito K, Yokoyama T, Miyake Y, Sasaki S, Tanaka K, Ohya Y et al. Maternal meat and fat consumption during pregnancy and suspected atopic eczema in Japanese infants aged 3-4 months: The Osaka Maternal and Child Health Study. Pediatr Allergy Immunol 2009; 21: 38–46.

    Article  Google Scholar 

  12. 12

    Maslova E, Halldorsson TI, Strom M, Olsen SF . Low-fat yoghurt intake in pregnancy associated with increased child asthma and allergic rhinitis risk: a prospective cohort study. J Nutr Sci 2012; 1: e5.

    Article  Google Scholar 

  13. 13

    Orivuori L, Loss G, Roduit C, Dalphin JC, Depner M, Genuneit J et al. Soluble immunoglobulin A in breast milk is inversely associated with atopic dermatitis at early age: the PASTURE cohort study. Clin Exp Allergy 2014; 44: 102–112.

    CAS  Article  Google Scholar 

  14. 14

    Hoppu U, Rinne M, Salo-Väänänen P, Lampi AM, Piironen V, Isolauri E . Vitamin C in breast milk may reduce the risk of atopy in the infant. Eur J Clin Nutr 2005; 59: 123–128.

    CAS  Article  Google Scholar 

  15. 15

    Palmer DJ, Makrides M . Diet of lactating women and allergic reactions in their infants. Curr Opin Clin Nutr Metab Care 2006; 9: 284–288.

    CAS  Article  Google Scholar 

  16. 16

    Kajosaari M . Food allergy in Finnish children aged 1 to 6 years. Acta Paediatr Scand 1982; 71: 815–819.

    CAS  Article  Google Scholar 

  17. 17

    Saarinen KM, Juntunen-Backman K, Järvenpää AL, Kuitunen P, Lope L, Renlund M et al. Supplementary feeding in maternity hospitals and the risk of cow's milk allergy: a prospective study of 6209 infants. J Allergy Clin Immunol 1999; 104: 457–461.

    CAS  Article  Google Scholar 

  18. 18

    Pyrhönen K, Näyhä S, Kaila M, Hiltunen L, Läärä E . Occurrence of parent-reported food hypersensitivities and food allergies among children aged 1–4 yr. Pediatr Allergy Immunol 2009; 20: 328–338.

    Article  Google Scholar 

  19. 19

    Pediatric Society of Finland. Food allergy among children. Duodecim 2009; 125: 1992–1993.

    Google Scholar 

  20. 20

    Kupila A, Muona P, Simell T, Arvilommi P, Savolainen H, Hamalainen AM et al. Feasibility of genetic and immunological prediction of type I diabetes in a population-based birth cohort. Diabetologia 2001; 44: 290–297.

    CAS  Article  Google Scholar 

  21. 21

    Erkkola M, Karppinen M, Javanainen J, Räsänen L, Knip M, Virtanen SM . Validity and reproducibility of a food frequency questionnaire for pregnant Finnish women. Am J Epidemiol 2001; 154: 466–476.

    CAS  Article  Google Scholar 

  22. 22

    Prasad M, Lumia M, Erkkola M, Tapanainen H, Kronberg-Kippila C, Tuokkola J et al. Diet composition of pregnant Finnish women: changes over time and across seasons. Public Health Nutr 2010; 13: 939–946.

    Article  Google Scholar 

  23. 23

    Tuokkola J, Kaila M, Pietinen P, Simell O, Knip M, Virtanen SM . Agreement between parental reports and patient records in food allergies among infants and young children in Finland. J Eval Clin Pract 2008; 14: 984–989.

    Article  Google Scholar 

  24. 24

    Tuokkola J, Luukkainen P, Kaila M, Tapanainen H, Klaukka T, Veijola R et al. Validation of a questionnaire on cow's milk allergy: parental reports and physicians diagnosis. Acta Paediatr 2010; 99: 1273–1275.

    CAS  Article  Google Scholar 

  25. 25

    Nwaru BI, Lumia M, Kaila M, Luukkainen P, Tapanainen H, Erkkola M et al. Validation of the Finnish ISAAC questionnaire on asthma against anti-asthmatic medication reimbursement database in 5-year-old children. Clin Respir J 2011; 5: 211–218.

    Article  Google Scholar 

  26. 26

    Hoppu U, Kalliomäki M, Isolauri E . Cow's milk allergy—a matter of fat. Allergy 2002; 57: 61–62.

    CAS  Article  Google Scholar 

  27. 27

    Katz Y, Rajuan N, Goldberg MR, Eisenberg E, Heyman E, Cohen A et al. Early exposure to cow's milk protein is protective against IgE-mediated cow's milk protein allergy. J Allergy Clin Immunol 2010; 126: 77–82.

    CAS  Article  Google Scholar 

  28. 28

    Loibichler C, Pichler J, Gerstmayr M, Bohle B, Kisst H, Urbanek R et al. Materno-fetal passage of nutritive and inhalant allergens across placentas of term and pre-term deliveries perfused in vitro. Clin Exp Allergy 2002; 32: 1546–1551.

    CAS  Article  Google Scholar 

  29. 29

    Polte T, Hennig C, Hansen G . Allergy prevention starts before conception: maternofetal transfer of tolerance protects against the development of asthma. J Allergy Clin Immunol 2008; 122: 1022–1030.

    CAS  Article  Google Scholar 

  30. 30

    Fusaro AE, Brito CA, Victor JR, Rigato PO, Goldoni AL, Duarte AJ et al. Maternal-fetal interaction: preconception immunization in mice prevents neonatal sensitization induced by allergen exposure during pregnancy and breastfeeding. Immunology 2007; 122: 107–115.

    CAS  Article  Google Scholar 

  31. 31

    Edelbauer M, Loibichler C, Nentwich I, Gerstmayr M, Urbanek R, Szepfalusi Z . Maternally delivered nutritive allergens in cord blood and in placental tissue of term and preterm neonates. Clin Exp Allergy 2004; 34: 189–193.

    CAS  Article  Google Scholar 

  32. 32

    Vance GH, Lewis SA, Grimshaw KE, Wood PJ, Briggs RA, Thornton CA et al. Exposure of the fetus and infant to hens' egg ovalbumin via the placenta and breast milk in relation to maternal intake of dietary egg. Clin Exp Allergy 2005; 35: 1318–1326.

    CAS  Article  Google Scholar 

  33. 33

    Sicherer SH, Wood RA, Stablein D, Lindblad R, Burks AW, Liu AH et al. Maternal consumption of peanut during pregnancy is associated with peanut sensitization in atopic infants. J Allergy Clin Immunol 2010; 126: 1191–1197.

    CAS  Article  Google Scholar 

  34. 34

    Metsala J, Lundqvist A, Kaila M, Gissler M, Klaukka T, Virtanen SM . Maternal and perinatal characteristics and the risk of cow's milk allergy in infants up to 2 years of age: a case-control study nested in the Finnish population. Am J Epidemiol 2010; 171: 1310–1316.

    Article  Google Scholar 

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Acknowledgements

We are extremely grateful to all the families who took part in this study. We also acknowledge the excellent collaboration of the Diabetes Prediction and Prevention research nurses, doctors, nutritionists and laboratory staff over the years. We especially thank Mirka Puputti for her work in the laboratory. The study was supported by the Academy of Finland (grants 63672, 79685, 79686, 80846, 201988, 210632, 129492 and 126813), the Finnish Paediatric Research Foundation, the Juho Vainio Foundation, the Yrjö Jahnsson Foundation, the Competitive Research Funding of the Tampere University Hospital, Medical Research Funds of Turku and Oulu University Hospitals, the Juvenile Diabetes Research Foundation (grants 197032, 4-1998-274, 4-1999-731 and 4-2001-435), the Novo Nordisk Foundation and EU Biomed 2 (BMH4-CT98-3314), Doctoral Programs for Public Health, Foundation for Allergy Research, Research Foundation of Orion Corporation, Tampere Tuberculosis Foundation and the Jalmari and Rauha Ahokas Foundation.

Author contributions

SMV, JT, MKa and OV were responsible for the current study concept and design; JI, MKn and OS designed the DIPP study; SMV designed the nutrition study within DIPP; JT, SMV and OV conducted research; LV provided registry data from the Social Insurance Institute; OV was responsible for laboratory analyses of β-casein-specific IgA antibodies; MGK designed and HT carried out the statistical analysis; RV was responsible for the clinical work in Oulu; JT wrote the first version of the manuscript; PL, MKa, SMV and OV participated in the writing process; SMV had primary responsibility for the final content; all the authors contributed to the critical revision of the manuscript.

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Correspondence to J Tuokkola.

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Tuokkola, J., Luukkainen, P., Tapanainen, H. et al. Maternal diet during pregnancy and lactation and cow’s milk allergy in offspring. Eur J Clin Nutr 70, 554–559 (2016). https://doi.org/10.1038/ejcn.2015.223

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