Vegetable intake during childhood may reduce the risk of subsequent asthma. We verified the effect of maternal intake during pregnancy on asthma risk in offspring, which has rarely been studied.
In a hospital-based birth cohort study conducted in Tokyo, we administered a food frequency questionnaire at two periods during the respondents’ pregnancy: early and mid to late periods. In addition, a questionnaire including the International Study of Asthma and Allergies in Childhood questionnaire was conducted when the offspring were 2 years old. Multivariate Poisson regression adjusting for maternal baseline demographics was used to elucidate the association between maternal vegetable intake and the incidence of wheeze in the offspring.
Among 310 singletons, 82 (26.5%) experienced wheeze at 2 years of age. Women with the highest intake of cruciferous, and folate-rich vegetables during early pregnancy reported a significantly lower prevalence of wheeze in their child at 2 years of age in comparison with those who reported the lowest intake (adjusted risk ratio: 0.48 and 0.47, 95% confidence interval: 0.26–0.89, and 0.25–0.87, respectively). In trend analysis, a higher maternal intake of cruciferous, folate-rich vegetables, and total vegetables during early pregnancy was less likely to be associated with wheeze in the offspring at 2 years old (p for trend: 0.038, <0.001, and 0.028, respectively). Maternal vegetable intake during mid to late pregnancy was not associated with wheeze in the offspring.
Maternal vegetable intake during early pregnancy may have a protective effect against asthma in offspring at 2 years of age.
Access optionsAccess options
Subscribe to Journal
Get full journal access for 1 year
only $53.83 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
Ebisawa M, Nishima S, Ohnishi H, Kondo N. Pediatric allergy and immunology in Japan. Pediatr Allergy Immunol. 2013;24:704–14. https://doi.org/10.1111/pai.12117.
Eder W, Ege MJ, von Mutius E. The asthma epidemic. N Engl J Med. 2006;355:2226–35. https://doi.org/10.1056/NEJMra054308.
Dick S, Friend A, Dynes K, AlKandari F, Doust E, Cowie H, et al. A systematic review of associations between environmental exposures and development of asthma in children aged up to 9 years. BMJ Open. 2014;4:e006554 https://doi.org/10.1136/bmjopen-2014-006554.
Weitzman M, Gortmaker S, Walker DK, Sobol A. Maternal smoking and childhood asthma. Pediatrics. 1990;85:505–11.
Lau S, Illi S, Sommerfeld C, Niggemann B, Bergmann R, von Mutius E, et al. Early exposure to house-dust mite and cat allergens and development of childhood asthma: a cohort study. Multicentre Allergy Study Group. Lancet. 2000;356:1392–7.
Marra F, Lynd L, Coombes M, Richardson K, Legal M, Fitzgerald JM, et al. Does antibiotic exposure during infancy lead to development of asthma?: a systematic review and metaanalysis. Chest. 2006;129:610–8.
Nagel G, Weinmayr G, Kleiner A, Garcia-Marcos L, Strachan DP. Effect of diet on asthma and allergic sensitisation in the International Study on Allergies and Asthma in Childhood (ISAAC) Phase Two. Thorax. 2010;65:516–22. https://doi.org/10.1136/thx.2009.128256.
Chatzi L, Torrent M, Romieu I, Garcia-Esteban R, Ferrer C, Vioque J, et al. Diet, wheeze, and atopy in school children in Menorca, Spain. Pediatr Allergy Immunol. 2007;18:480–5. https://doi.org/10.1111/j.1399-3038.2007.00596.x.
Erkkola M, Nwaru BI, Kaila M, Kronberg-Kippila C, Ilonen J, Simell O, et al. Risk of asthma and allergic outcomes in the offspring in relation to maternal food consumption during pregnancy: a Finnish birth cohort study. Pediatr Allergy Immunol. 2012;23:186–94. https://doi.org/10.1111/j.1399-3038.2012.01272.x.
Fitzsimon N, Fallon U, O’Mahony D, Loftus BG, Bury G, Murphy AW, et al. Mothers’ dietary patterns during pregnancy and risk of asthma symptoms in children at 3 years. Ir Med J. 2007;100:27–32.
Miyake Y, Sasaki S, Tanaka K, Hirota Y. Consumption of vegetables, fruit, and antioxidants during pregnancy and wheeze and eczema in infants. Allergy. 2010;65:758–65. https://doi.org/10.1111/j.1398-9995.2009.02267.x.
Willers SM, Devereux G, Craig LC, McNeill G, Wijga AH, Abou El-Magd W, et al. Maternal food consumption during pregnancy and asthma, respiratory and atopic symptoms in 5-year-old children. Thorax. 2007;62:773–9.
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;178:124–31.
Chu S, Yu H, Chen Y, Chen Q, Wang B, Zhang J. Periconceptional and gestational exposure to antibiotics and childhood asthma. PLoS ONE. 2015;10:e0140443
Haberg SE, London SJ, Stigum H, Nafstad P, Nystad W. Folic acid supplements in pregnancy and early childhood respiratory health. Arch Dis Child. 2009;94:180–4. https://doi.org/10.1136/adc.2008.142448.
Veeranki SP, Gebretsadik T, Mitchel EF, Tylavsky FA, Hartert TV, Cooper WO, et al. Maternal folic acid supplementation during pregnancy and early childhood asthma. Epidemiology. 2015;26:934–41.
Hashimoto K, Ogawa K, Horikawa R, Ikeda N, Kato K, Kamide A. et al. Gross motor function and general development of babies born after assisted reproductive technology. J Obstet Gynaecol Res. 2016;42:266–72. https://doi.org/10.1111/jog.12898.
Tsugane S, Kobayashi M, Sasaki S. Validity of the self-administered food frequency questionnaire used in the 5-year follow-up survey of the JPHC Study Cohort I: comparison with dietary records for main nutrients. J Epidemiol. 2003;13(1 Suppl):S51–56.
Ogawa K, Jwa SC, Kobayashi M, Morisaki N, Sago H, Fujiwara T. Validation of a food frequency questionnaire for Japanese pregnant women with and without nausea and vomiting in early pregnancy. J Epidemiol. 2017;27:201–8.
Kobayashi M, Jwa SC, Ogawa K, Morisaki N, Fujiwara T. Validity of a food frequency questionnaire to estimate long-chain polyunsaturated fatty acid intake among Japanese women in early and late pregnancy. J Epidemiol. 2017;27:30–35. https://doi.org/10.1016/j.je.2016.07.001.
Office for Resources Policy Division, Science and Technology Policy Bureau, Ministry of Education, Culture, Sports, Science and Technology. Standard tables of food composition in Japan, Sixth edition: Tokyo, Japan, 2010 (in Japanese).
Jenkins MA, Clarke JR, Carlin JB, Robertson CF, Hopper JL, Dalton MF, et al. Validation of questionnaire and bronchial hyperresponsiveness against respiratory physician assessment in the diagnosis of asthma. Int J Epidemiol. 1996;25:609–16.
Willet WC. Nutritional Epidemiology, 2nd ed. New York: Oxford Univercity Press; 1998.
Nurmatov U, Nwaru BI, Devereux G, Sheikh A. Confounding and effect modification in studies of diet and childhood asthma and allergies. Allergy. 2012;67:1041–59. https://doi.org/10.1111/j.1398-9995.2012.02858.x.
Sadler TW. Langman’s medical embryology, Thirteenth edition: Lippincott Williams & Wilkins: Baltimore, USA, 2014.
Hecht SS. Inhibition of carcinogenesis by isothiocyanates. Drug Metab Rev. 2000;32:395–411. https://doi.org/10.1081/dmr-100102342.
Murillo G, Mehta RG. Cruciferous vegetables and cancer prevention. Nutr Cancer. 2001;41:17–28. https://doi.org/10.1080/01635581.2001.9680607.
Liu RH. Health benefits of fruit and vegetables are from additive and synergistic combinations of phytochemicals. Am J Clin Nutr. 2003;78(3 Suppl):517s–520s.
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;127:724–33. https://doi.org/10.1016/j.jaci.2010.11.001.
Maslova E, Hansen S, Strom M, Halldorsson TI, Olsen SF. Maternal intake of vitamins A, E and K in pregnancy and child allergic disease: a longitudinal study from the Danish National Birth Cohort. Br J Nutr. 2014;111:1096–108. https://doi.org/10.1017/s0007114513003395.
Canfield LM, Davy LA, Thomas GL. Anti-oxidant/pro-oxidant reactions of vitamin K. Biochem Biophys Res Commun. 1985;128:211–9.
Jwa SC, Ogawa K, Kobayashi M, Morisaki N, Sago H, Fujiwara T. Validation of a food-frequency questionnaire for assessing vitamin intake of Japanese women in early and late pregnancy with and without nausea and vomiting. J Nutr Sci. 2016;5:e27 https://doi.org/10.1017/jns.2016.14.
Sherriff A, Peters TJ, Henderson J, Strachan D. Risk factor associations with wheezing patterns in children followed longitudinally from birth to 3(1/2) years. Int J Epidemiol. 2001;30:1473–84.
We are deeply grateful to all participants in this study, and to the hospital staff for their cooperation. We would like to thank Mr. James R. Valera and Ms. Emma Barber of the Department of Education for Clinical Research of the National Center for Child Health and Development for their assistance with editing this manuscript.
This work was partially supported by grants from the Research Development Grant for Child Health and Development from the National Center for Child Health and Development (25–4). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
About this article
European Journal of Clinical Nutrition (2019)
Reply to Shakira et al.: Validation of a food frequency questionnaire for Japanese pregnant women in mid to late pregnancy
European Journal of Clinical Nutrition (2019)