懷孕期間的飲食多樣性和兒童過敏性疾病的風險

The global rise of atopic diseases, including atopic dermatitis, asthma, and allergic rhinitis, necessitates the exploration of preventive strategies. Nutritional factors, particularly maternal diet modifications during pregnancy, are gaining interest for their potential to influence allergy development in offspring. However, the impact of maternal dietary diversity on infant atopic diseases remains unclear. This study addresses this critical gap by investigating the association between a mother's dietary diversity during pregnancy and the development of atopic diseases in their children during the first three years of life. We further explore the potential mediating role of the gut microbiome in this relationship. Utilizing a cohort of 1,381 mother-infant pairs from the Taipei Maternal Infant Nutrition Cohort (TMINC), we assessed maternal dietary diversity using the Minimum Dietary Diversity for Women (MDD-W) indicator. Atopic diseases were documented at 12-, 24-, and 36-months postpartum follow-ups. Gut microbiome samples were collected at 2 months to explore its mediating effect. Survival analysis were employed to analyze the impact of maternal diet diversity on offspring's atopic diseases. Our findings showed that high maternal dietary diversity during pregnancy protected against atopic dermatitis and allergic conjunctivitis in offspring. While maternal diet diversity did not significantly impact the overall diversity (alpha and beta diversity) of the infant gut microbiome, it did influence specific bacterial composition. In infants from the maternal low dietary diversity group, the genera Rothia and Parabacteroides were associated with a decreased risk of atopic dermatitis, but not allergic conjunctivitis. A higher abundance of Parabacteroides was linked to maternal intake of Vitamin A-rich fruits and vegetables. In addition, further investigation into specific dietary components revealed contrasting results for fish consumption. Fish intake during pregnancy was associated with a light increased risk of asthma (OR = 1.02) and allergic conjunctivitis (OR = 1.05). However, fish oil supplementation during pregnancy showed a protective effect against allergic rhinitis (OR = 0.90). To strengthen the evidence on omega-3s, we conducted meta-analyses of randomized controlled trials. These analyses revealed that maternal omega-3 supplementation during pregnancy and lactation significantly reduced the risk of infant egg (RR = 0.58; 95% CI = 0.47-0.73) and peanut sensitization (RR = 0.62; 95% CI = 0.47-0.80). Subgroup analyses confirmed similar protective effects for food allergies and sensitizations beyond three years of age. Notably, a dose-response relationship was observed between maternal omega-3 intake and a reduced risk of infant egg sensitization. In conclusion, this study adds to the growing body of evidence suggesting that a mother's diet during pregnancy can influence the development of atopic diseases in her children. Our findings highlight the potential benefits of a diverse diet rich in omega-3s and Vitamin A-rich fruits and vegetables for preventing certain atopic diseases. While the gut microbiome may be involved in this relationship, further research is needed to elucidate its specific mechanisms. Overall, this study paves the way for developing dietary recommendations for pregnant women with the aim of potentially reducing the risk of atopic diseases in their offspring.