Increased food diversity in the first year of life is inversely associated with allergic outcomes in the second year

Abstract

Background The evidence on the relationship between diet diversity in early life and allergic outcomes was few and inconsistent. We sought to determine the association of food diversity in the first year of life with allergic outcomes in the second year. Methods Two thousand two hundred fifty‐one mother‐infant pairs from Tongji Maternal and Child Health Cohort (TMCHC) were involved in the study. Information on complementary foods introduction was obtained by telephone interview at 6‐ and 12‐month postpartum follow‐up. Any doctor‐diagnosed allergic diseases in the second year were recorded at 2‐year postpartum follow‐up. Food allergies in infancy were assessed and self‐reported by mothers at each postpartum follow‐up. Multivariable logistic regression was used to examine the effect of food diversity at 6 and 12 months of age on later allergic diseases and food allergy. Results A total of 135 (6.0%) infants reported allergic diseases at between 1 and 2 years of age. Independent of food allergy history of infants and other potential confounders, less food diversity at 6 months of age was associated with increased risk of later allergic diseases (OR 2.17, 95% CI 1.04–4.50 for 0 vs. 3–6 food groups). By 12 months of age, significant inverse associations with later allergic diseases (OR 2.35, 95% CI 1.03–5.32 for 1–5 vs. 8–11 food groups, and OR 1.98, 95% CI 1.16–3.37 for 6–7 vs. 8–11 food groups) and food allergy (OR 2.10, 95% CI 1.29–3.42 for 1–5 vs. 8–11 food groups) were observed. Children with higher food diversity in both periods had the lowest risk of allergic diseases during the second year of life. Conclusions A more diverse diet within the first year of life was associated with reduced risk of allergic diseases at 1–2 years of age. Introducing higher diversity of foods from 6 to 12 months of age might be an effective strategy to improve the allergy outcomes of infants in later life.

The associations between diet diversity during infancy and atopic disease in later life : Systematic review

“…For example, in Zhong, Stampfli, and other studies, almost all infants at 12 months of age were introduced to vegetables, fruits, and meat, but a small number of people ate only peanuts and other nuts. 13,14 Stampfli found that the group with a high food diversity consumed more dairy products, eggs, and other foods than the group with a low level of food diversity. After adjustment, it was found that eating dairy products may have a protective effect on allergic diseases.…”

“…12,26 Zhong et al found that food diversity at 6 months old had a preventive effect on skin-related atopic disease, while there was no protective effect on food allergy, but food diversity at 12 months old had a preventive effect on food allergy and atopic dermatitis. 14 Stampfli et al reported that even if food diversity is high in the first year of life, insufficient food diversity in the second year remains a risk factor for developing allergic disease later in life. 13 It can be seen that only a variety of foods in a specific period may have a protective effect on atopic diseases, and this protective effect may be time-sensitive and requires the continuous intake of diverse foods.…”

“…Stampfli et al found that in the second year after birth, each additional food was associated with a reduced risk of asthma by 25% (OR=0.75, 95% CI=0.58-0.98) 13 . Zhong et al showed that after adjusting for food allergy history and other potential confounding factors, food diversity at 12 months showed a significant dose-response negative correlation with respiratory tract allergic diseases, that is, people with insufficient food diversity had an increased risk of developing asthma (OR=2.69, 95% Cl=1.22-5.59) 14 . Three other studies did not observe a clear association between food diversity in infancy and asthma.…”

“…26 Although Zhong et al did not draw a significant conclusion at 6 months (p>0.05), they showed that low food diversity at 12 months increased the risk of food allergy (OR=2.78, 95% CI=1.80-4.32). 14…”

General Review of the Impact and Peculiarities of the Introduction of Complete Food to Children in the First Years of Life

“…С другой стороны, слишком раннее введение прикорма (до 4-6 месяцев), наоборот, может стать предиктором развития аллергических реакций [14,15]. Упоминаемое выше разнообразие продуктов важно не только для формирования правильного пищевого поведения, но и для предупреждения развития аллергии [16], что подтверждается исследованиями, в которых однообразное питание приводило к большему риску аллергических реакций в возрасте 1-2 лет [17].…”