Dietary Diversity during Early Infancy Increases Microbial Diversity and Prevents Egg Allergy in High-Risk Infants

Abstract

We aimed to investigate associations of dietary diversity (DD) with gut microbial diversity and the development of hen's egg allergy (HEA) in infants. We enrolled 68 infants in a high-risk group and 32 infants in a control group based on a family history of allergic diseases. All infants were followed from birth until 12 months of age. We collected infant feeding data, and DD was defined using 3 measures: the World Health Organization definition of minimum DD, food group diversity, and food allergen diversity. Gut microbiome profiles and expression of cytokines were evaluated by bacterial 16S rRNA sequencing and real-time reverse transcriptase-polymerase chain reaction. High DD scores at 3 and 4 months were associated with a lower risk of developing HEA in the high-risk group, but not in the control group. In the high-risk group, high DD scores at 3, 4, and 5 months of age were associated with an increase in Chao1 index at 6 months. We found that the gene expression of IL-4, IL-5, IL-6, and IL-8 were higher among infants who had lower DD scores compared to those who had higher DD scores in high-risk infants. Additionally, high-risk infants with a higher FAD score at 5 months of age showed a reduced gene expression of IL-13. Increasing DD within 6 months of life may increase gut microbial diversity, and thus reduce the development of HEA in infants with a family history of allergic diseases.

The future of food allergy: Challenging existing paradigms of clinical practice

“…A Korean study reported that higher diet diversity scores at 3, 4 and 5 months of age were associated with increased microbial diversity at 6 months. Gene expression of pro‐inflammatory and Th2‐cytokines and chemokines, IL‐4, IL‐5, IL‐6 and IL‐8, were higher among infants with lower diet diversity scores than those with higher diet diversity scores 89 . High‐risk infants with a higher food allergen diversity score at 5 months of age showed a reduced gene expression of IL‐13 89 .…”

“…89 High-risk infants with a higher food allergen diversity score at 5 months of age showed a reduced gene expression of IL-13. 89 A recent study in pregnant women showed that increased healthy diet diversity in pregnancy was associated with reduced offspring allergy outcomes defined as 'all allergies excluding wheeze' by 4 years, but microbiome data were not available. 90 Data regarding diet diversity in the adult population and food allergy are lacking.…”

“…Gene expression of pro-inflammatory and Th2-cytokines and chemokines, IL-4, IL-5, IL-6 and IL-8, were higher among infants with lower diet diversity scores than those with higher diet diversity scores. 89 High-risk infants with a higher food allergen diversity score at 5 months of age showed a reduced gene expression of IL-13. 89 A recent study in pregnant women showed that increased healthy diet diversity in pregnancy was associated with reduced offspring allergy outcomes defined as 'all allergies excluding wheeze' by 4 years, but microbiome data were not available.…”

Food allergy prevention: where are we in 2023?

“…reported that reduction in food diversity at 12 months of age was significantly associated with an increased risk of parent-reported food allergy by 2 years of age. A research group from Korea [ 89 ] reported higher DD based on food group consumption, number of food allergens consumed, and the WHO definition of diversity at 3 and 4 months were associated with a lower prevalence of hen’s egg allergy in the high-risk group. No associations were seen in the control group.…”

“…Recently, the EAT study showed that the introduction of 6 major allergenic foods leads to a significant increase in microbial diversity, measured by the Shannon index and increase of Prevotellaceae and Proteobacteria, compared with exclusively breastfed infants [ 111 ]. A Korean research group reported data on DD in infancy, gut microbial composition and development of hen’s egg allergy [ 89 ]. DD was defined according to the WHO definition of minimum DD, food group diversity, and food allergen diversity.…”