Division of Allergy and Clinical Immunology, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60614, USA.
Curr Opin Allergy Clin Immunol. 2010 Apr;10(2):139-44. doi: 10.1097/ACI.0b013e32833667a8.
Prenatal and early life dietary factors may influence asthma and allergic disease development. We review recent studies and consensus statements regarding the effects of prenatal/early life dietary exposures on atopic disease.
The American Academy of Pediatrics consensus statement highlighted the inadequacy of evidence for pregnancy antigen avoidance diets or delay of infant complementary foods beyond 4-6 months. Recent studies raise the question of whether early food introduction may promote tolerance, though controlled trials are pending. A recent meta-analysis suggested that antioxidants may protect against the development of atopy. Furthermore, some of the conflicting results on the effects of vitamin E may be related to variability in the isoforms prevalent in local diet. Recent studies of vitamin D similarly suggest that it may be protective, though this remains controversial. Finally, prenatal methyl donor exposure promoted the development of allergy in an animal model.
There are conflicting data on the effects of most prenatal and early childhood dietary exposures on childhood atopic disease. Longitudinal prenatal/birth cohort studies with prospective measurements and clinical supplementation trials of promising dietary factors will be needed to make reliable recommendations in this vulnerable population of pregnant women and their infants.
产前和生命早期的饮食因素可能会影响哮喘和过敏性疾病的发展。我们回顾了最近关于产前/生命早期饮食暴露对特应性疾病影响的研究和共识声明。
美国儿科学会的共识声明强调了妊娠抗原回避饮食或婴儿补充食物延迟至 4-6 个月以上的证据不足。最近的研究提出了这样一个问题，即早期食物引入是否可以促进耐受，但仍需要进行对照试验。最近的一项荟萃分析表明，抗氧化剂可能有助于预防特应性疾病的发生。此外，维生素 E 效果的一些相互矛盾的结果可能与当地饮食中普遍存在的同型异构体的可变性有关。最近关于维生素 D 的研究也表明它可能具有保护作用，但这仍然存在争议。最后，动物模型研究表明，产前甲基供体暴露促进了过敏的发展。
大多数产前和儿童早期饮食暴露对儿童特应性疾病的影响存在相互矛盾的数据。需要进行前瞻性测量的纵向产前/出生队列研究和对有前途的饮食因素进行临床补充试验，以便为孕妇及其婴儿这一脆弱人群提供可靠的建议。
