Improved maternal diet before conception linked to reduced wheezing in offspring

Five months old baby lying on bed, playing with a crocheted bunny toy: © Bostan Natalia - stock.adobe.com

Editor's note: This article orginally appeared on our sister website, HCP Live.

Examining a nationwide birth cohort of mother-child pairs in Japan has shed light on the impact of maternal diet on children's wheeze trajectories during their early years, revealing compelling findings. The study, led by Hitomi Okubo from the Japan Environment and Children's Study Programme Office at the National Institute for Environmental Studies in Ibaraki, Japan, addresses a less-explored aspect of maternal health and child development.

The investigation, based on the Japan Environment and Children's Study (JECS), focused on over 100,000 expectant mothers registered at 15 centers across different regions in Japan between January 2011 and March 2014. The participating mothers completed surveys during pregnancy and continued with self-administered questionnaires following their children's births.

Analyzing JECS data released in 2019 and 2021, the researchers honed in on 76,014 mother-child pairs, specifically those with a minimum of three wheeze assessments between the ages of 1 and 4 years. Following the exclusion of certain data, the final analysis comprised 70,530 mother-child pairs.

Wheezing patterns in the children were assessed using a modified questionnaire, with the research team determining trajectories through group-based modeling. To evaluate the quality of maternal diets in the 12 months before the first trimester, they employed a food frequency survey and a balanced diet score based on the Japanese Food Guide Spinning Top.

Utilizing Bayesian inference of multinomial logistic regression models, the researchers explored the connection between maternal diet types and early childhood wheeze trajectories. The study protocol received approval from ethics committees, and written informed consent was obtained from all participants.

The study identified four distinct wheezing patterns, with the 'never/infrequent' trajectory being the most prevalent, accounting for 69.1%. This trajectory served as the reference category for the research team. The 'early-childhood onset' group comprised 6.2% of the study population, 'transient early' group 16.5%, and 'persistent' group 8.2%.

After accounting for various influencing variables, the researchers found that a higher maternal balanced diet score in the highest quartile was associated with a reduced risk of being classified under 'transient early' and 'persistent' compared to the 'never/infrequent' trajectory. The lowered risk was approximately 10% for both wheeze patterns. However, no significant link was observed between maternal balanced diet scores and children's membership in the 'early-childhood onset' wheeze trajectory.

Looking ahead, the research team emphasized the importance of continued follow-up on this cohort to elucidate wheeze trajectories throughout childhood and to examine lung function and asthma risk in later life. They concluded, "Although evidence is still limited and inconsistent, improving overall diet quality before pregnancy may reduce asthma-like symptoms and their related healthcare burden in offspring."

References:

1. Okubo, H, Nakayama, SF, Ohya, Y, Japan Environment and Children’s Study Group. Periconceptional maternal diet quality and offspring wheeze trajectories: Japan Environment and Children's Study. Allergy. 2023; 00: 1-11. doi:10.1111/all.15916

2. Hanson C, Rifas-Shiman SL, Shivappa N, et al. Associations of prenatal dietary inflammatory potential with childhood respiratory outcomes in project viva. J Allergy Clin Immunol Pract. 2020; 8(3):945-952. doi:10.1016/j.jaip.2019.10.010