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Nut Products Consumed During Pregnancy Tied to Childhood Asthma Risk 7-15-08
UTRECHT, The Netherlands, June 15 -- If nut products are eaten regularly
during pregnancy, the risk of asthma in the child goes up significantly,
investigators here reported.
The frequency of wheeze, dyspnea, steroid use, and asthma symptoms was
significantly greater in eight-year-olds whose mothers ate nut products (such as
peanut butter) daily versus rarely during pregnancy, Saskia M. Willers, of
Utrecht University, and colleagues reported in the second July issue of the
American Journal of Respiratory and Critical Care Medicine.
No other maternal dietary factors correlated with consumption of nuts or nut
products or with childhood health outcomes, except for a modest protective
effect of fruit consumption against wheeze.
"Maternal diet during pregnancy was strongly associated with the child's diet,"
the authors said. "However, the observed associations between maternal diet
during pregnancy and childhood asthma outcomes were independent from the child's
diet. Including the child's diet did not change the results."
"The findings of this study need to be replicated by other studies before
influencing dietary advice given to pregnant women," they added.
Several lines of evidence support a "fetal programming theory" of impaired fetal
development and long-term physiologic and metabolic outcomes in children. For
example, maternal nutrient status has the potential to impair fetal airway
development or to promote neonatal T-helper cell responses to allergens.
Moreover, in utero allergen exposure may affect development of the fetal immune
system, the authors said, citing evidence of fetal immune responses to allergens
from 22 weeks of gestation. Thus, maternal intake of allergenic foods during
pregnancy might increase fetal risk of sensitization and subsequent development
of allergic disease.
However, inconsistent findings have come from studies of maternal dietary
allergen avoidance during pregnancy, the authors continued.
Prior studies of maternal diet and asthma-related outcomes in children assessed
associations at a specific age. In an attempt to expand the knowledge base,
Willers and her associates investigated the longitudinal influence of material
diet during pregnancy on the prevalence of asthma and asthma-like symptoms in
children followed until age eight.
The study involved 2,832 children for whom complete data on maternal diet during
pregnancy were available. The mothers provided information about intake of
fruit, vegetables, fish, egg, milk and milk products, and nuts and nut products
during pregnancy.
Daily consumption of nut products, but not nuts, was significantly associated
with a higher prevalence of:
* Wheeze, OR 1.42, 95% CI 1.06 to 1.89
* Dyspnea, OR 1.58, 95% CI 1.16 to 2.15
* Steroid use, OR 1.62, 95% CI 1.06 to 2.46
* Asthma symptoms, OR 1.47, 95% CI 1.08 to 1.99
Among other dietary factors, only daily fruit consumption influenced any of the
asthma outcomes assessed in the study. Daily fruit consumption during pregnancy
was associated with an 18% reduction in the prevalence of wheeze in
eight-year-olds. After adjustment for competing influences, the benefit was
smaller and of only borderline significance (OR 0.89, 95% CI 0.75 to 1.04).
The authors acknowledged several limitations of the study, including lack of
information about consumption of specific foods and about portion sizes.
Although the authors did not mention range of consumption for specific types of
foods, only 6% of the mothers reported eating nut products daily, as compared
with 55.9% who rarely ate nut products (never to three times a month) and 36.6%
who reported regular consumption (one to four times a week).
The study was supported by the Netherlands Organization for health Research and
Development, the Netherlands Organization for Scientific Research, the
Netherlands Asthma Fund, the Netherlands Ministry of Spatial Planning, Housing,
and the Environment, and the Netherlands Ministry of Health, Welfare, and Sport.