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Maternal unhealthy diet affecting food allergy in infant

Published online: March 28, 2019

The increasing incidence of food allergy (FA) can be attributed to interactions between genes and the environment, but these interactions are not yet defined clearly. Maternal diet during pregnancy and breastfeeding are considered important environmental factors in allergy programming. Genetic variants associated with FA are largely unknown because the prevalence of FA is lower than those of asthma and atopic dermatitis (AD) and because the phenotypic heterogeneity of FA makes diagnosis difficult.

In a recent study in The Journal of Allergy and Clinical Immunology: In Practice, Kim et al. aimed to evaluate the interaction between infant genetic variations and maternal dietary patterns to identify risk factors in the development of FA using a prospective birth-cohort study in Korea called COCOA (COhort for Childhood Origin of Asthma and allergic diseases). A total of 1628 infants born between 2007 and 2015 were assessed, and cord blood samples from the infants were genotyped at 12 loci which were reported as candidate loci in the development of allergic disease. FA was defined as definite allergic symptoms typical of IgE-mediated reactions. Maternal dietary intake was assessed at 26 weeks using a food frequency questionnaire and clustered as 5 dietary patterns following “Korean traditional,” “confectionery,” “meat”, “processed,” and “coffee and milk” patterns.

Among 1628 infants, 147 (9.0%) were diagnosed with FA. A maternal confectionery diet characterized by a higher intake of baked and sugary products during pregnancy was associated with a higher prevalence of FA [adjusted odds ratio (OR) = 1.517, P = 0.02]; this dietary pattern tended to be higher in trans-fat (r = 0.498, P < 0.001). Development of FA was associated with longer periods of breastfeeding (adjusted OR = 1.792, P = 0.03), and this dietary pattern was more significantly related to the development of FA in infants with the homozygous TT genotype of CD14 (rs2569190) and more than one copy of GSTM1 and GSTT1.

Maternal dietary patterns that involve high intake of baked and sugary products during pregnancy and breastfeeding may lead to the development of FA in the infant. This type of FA may reflect the harmful effects of trans-fat produced during industrial food processing. Polymorphisms of CD14 that play a role in increasing the proinflammatory response as well as polymorphisms in GST that play a role in detoxification pathways may increase the susceptibility to FA in infants whose mothers’ diets are rich in baked and sugary products. Maternal dietary interventions involving reducing the consumption of baked and sugary products during the perinatal period may be a way to prevent FA development, especially in genetically susceptible children.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.