Proinflammatory Diet During Pregnancy Linked to Childhood Wheeze

A proinflammatory diet during pregnancy may be associated with early transient wheeze during childhood, according to longitudinal cohort study results published in The Journal of Allergy and Clinical Immunology: In Practice.

Project Viva (ClinicalTrials.gov Identifier: NCT02820402) was a study conducted in mother and child pairs enrolled between 1999 and 2002, at initial prenatal visits at Atrius Harvard Vanguard Medical Associates in Eastern Massachusetts. Recognizing that inflammation during pregnancy may be a factor in the development of asthma and wheeze in childhood, investigators sought to examine the associations between the inflammatory potential of a prenatal diet with respiratory outcomes in early and mid-childhood.

In the 1424 mother-child pairs in Project Viva, the associations of Dietary Inflammatory Index (DII) scores in the first trimester, second trimester, and average of the first and second trimesters were explored with respect to the following factors: (1) ever asthma and wheezing in the prior year (ie, early childhood and mid-childhood); (2) current asthma and lung function (mid-childhood); and (3) wheeze trajectory (from 1 to 9 years).

Results of the study showed that consumption of a more proinflammatory diet was associated with an early vs never wheeze trajectory (first and second trimester average fourth vs first quartile: odds ratio, 1.89; 95% CI, 1.14-3.13). Furthermore, a more proinflammatory diet during a woman’s pregnancy also was linked to lower forced expiratory flow (FEF_25-75) in mid-childhood (first and second trimester average fourth vs first quartile: -132 mL; 95% CI, -249 to -14 mL).

Results were apparent for the first but not the second trimester DII and wheeze trajectory and mid-childhood FEF_25-75. Other childhood respiratory outcomes, such as ever asthma, were not associated with any DII measure during pregnancy.

The investigators concluded that consuming a proinflammatory diet during pregnancy is linked to wheeze trajectory during early childhood and to decrements in small airways caliber in mid-childhood, but not to other respiratory outcomes in offspring.  Although recommending an anti-inflammatory diet during pregnancy may be helpful, the researchers noted that more studies are warranted to identify the mechanisms that link maternal nutrition to wheeze and asthma in offspring.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Hanson C, Rifas-Shiman SL, Shivappa N, et al. Associations of prenatal dietary inflammatory potential with childhood respiratory outcomes in Project Viva [published online October 31, 2019]. J Allergy Clin Immunol Pract. doi:10.1016/j.jaip.2019.10.010