The protective effect of cheese consumption at 18 months on allergic diseases in the first 6 years

Abstract

BackgroundThe effect of exposure to microorganisms on allergic diseases has been well studied. The protective effect of early food diversity against allergic diseases was previously shown in the PASTURE cohort study. The consumption of cheese, a food potentially rich in microbial diversity, deserves further examination. We aimed to evaluate whether cheese consumption is associated with allergic diseases.MethodsIn the PASTURE study (birth cohort in 5 European countries), data on feeding practices, environmental factors, and allergic diseases were collected by questionnaires from birth to 6 years (N = 931). Cheese consumption at 18 months of age was quantified in terms of frequency and diversity (ie, number of consumed types among 6 types: hard pressed, semipressed, soft, blue, fresh cheese, and cheese from the farm). Multiple logistic regressions were performed to evaluate the effect of cheese consumption on atopic dermatitis (AD), food allergy (FA), allergic rhinitis, asthma, and atopic sensitization at 6 years after adjustment for confounders of atopy.ResultsCheese consumption (vs. nonconsumption) had a significant protective effect on AD (OR = 0.51 [0.29‐0.90], P = 0.02) and FA (OR = 0.32, [0.15‐0.71], P = 0.004), but no effect on atopic sensitization, allergic rhinitis, and asthma at 6 years. This effect on AD and FA may be related to the diversity of consumed cheeses (OR = 0.64 [0.48‐0.85] per cheese type, P = 0.002; OR = 0.55 [0.33‐0.92], P = 0.02, respectively).ConclusionAlthough reverse causality cannot totally be ruled out, cheese diversity at 18 months had a protective effect against AD and FA at 6 years in addition to the protective effect of diversity of other foods.

New Perspectives in Food Allergy

“…In addition, current FA guidelines advocate early introduction of peanut between the ages of 4 to 6 months to infants who are considered at high risk of developing a peanut allergy, introduction of peanut-containing foods to children with mild to moderate eczema around 6 months of age and to children with no eczema or food allergy freely into the diet, in accordance with family preferences and cultural practices [6].There are currently no precise guidelines for early introduction of egg and milk in the diet of infants at risk, although egg introduction at 4 to 6 months and cow's milk within the first 14 days of life are suggested [128]. The early introduction of food allergens into the diet could, therefore, representa promising prevention strategy [129][130][131][132][133][134]. Furthermore, the maternal consumption of common food allergens (mainly milk and peanuts) during pregnancy and a greater food diversity in childhood diet could be further useful tools for reducing allergic risk [117,118,135].…”

EAACI position paper on diet diversity in pregnancy, infancy and childhood: Novel concepts and implications for studies in allergy and asthma

“…"Food biodiversity is defined as the diversity of plants, animals and other organisms used as food, covering the genetic resources within species, between species and provided by ecosystems" Food biodiversity therefore measures food intake based on their scientific classifications and may be useful to determine nutritional intake. 44 Microbial diversity of food: Studying foods with a high biodiversity of microbial content such as unpasteurized milk (atopic dermatitis and atopy) 130 and fermented foods such as cheese or yoghurt (food allergy and atopic dermatitis) 131 as an indicator of intake of microbial diversity, and a source of short chain fatty acids, gives an indication that these foods may be associated with allergy prevention. Studies focusing on Westernized diets 116,117,132 (also high in advanced glycation end products, soda, fruit juice, 133,134 cured meats 135 and fast food 136 ) suggest that increased intake of advanced glycation end products(AGEs) is associated with reduced diet diversity and increased allergy outcomes.…”

“…Microbial diversity of food: Studying foods with a high biodiversity of microbial content such as unpasteurized milk (atopic dermatitis and atopy) and fermented foods such as cheese or yoghurt (food allergy and atopic dermatitis) as an indicator of intake of microbial diversity, and a source of short chain fatty acids, gives an indication that these foods may be associated with allergy prevention.…”

Diet Diversity Through the Life-Course as an Opportunity Toward Food Allergy Prevention

“…Most recently, Venter et al ( 65 ) have examined four different (but internationally recognized) measurements' methods to define diet diversity and found that, regardless of the method applied, FA outcomes over the first 10 years of life were always reduced in children with higher diet diversity scores in the first year of life. Additional information on the importance of diet diversity in the prevention of FA derives from a paper by Nicklaus et al, who reported that increased diversity of cheese consumed at 18 months might have a protective effect on the development of FA (as well as AD) by the age of 6 years ( 66 ). An overview of the studies is presented in Table 1 .…”