Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
Am J Clin Nutr. 2011 Dec;94(6 Suppl):2012S-2017S. doi: 10.3945/ajcn.110.001180. Epub 2011 May 4.
Recently, the American Academy of Pediatrics and the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition published new guidelines on early nutrition and allergy prevention in infants and children. This article reviews epidemiologic evidence from 2 prospective German birth cohort studies, the GINIplus and the LISAplus, regarding maternal diet during pregnancy and feeding patterns in early life and the risk of allergy in light of the new recommendations. The 2 cohorts include a total of 9088 infants who were recruited within different regions of Germany between 1995 and 1999. A subgroup of 2252 infants with a hereditary risk of atopy was enrolled in a double-blind, randomized trial to investigate the effect of feeding regimen in infancy on the development of allergy with the strict recommendation that allergenic solid food be introduced late in the study. The results of the GINIplus and LISAplus studies mainly support the new finding regarding allergy prevention that a delayed introduction of solid foods or the avoidance of highly allergenic foods during the first year does not seem to be beneficial for allergy prevention. A very early introduction of solid foods and a high diversity before week 17 of age may increase the risk of later allergy. We showed that a high intake of margarine, vegetable oils, and some allergenic fruit and vegetables during pregnancy was associated with an increased risk of allergies, especially eczema. Because maternal diet during pregnancy is not reflected in the current recommendations, it should be the focus of future studies.
最近，美国儿科学会和欧洲儿科胃肠病学、肝病学和营养学学会发布了关于婴儿和儿童早期营养和过敏预防的新指南。本文综述了来自两项德国前瞻性出生队列研究（GINIplus 和 LISAplus）的流行病学证据，这些研究涉及母亲在怀孕期间的饮食以及婴儿早期的喂养模式，并根据新建议探讨了它们与过敏风险的关系。这两个队列共纳入了 9088 名 1995 年至 1999 年在德国不同地区招募的婴儿。其中 2252 名具有特应性遗传风险的婴儿被纳入一项双盲、随机试验，以研究婴儿期喂养方案对过敏发展的影响，研究严格建议推迟添加过敏原性固体食物。GINIplus 和 LISAplus 研究的结果主要支持了关于过敏预防的新发现，即固体食物的延迟引入或在第一年避免高度致敏食物似乎对预防过敏没有益处。非常早的引入固体食物和在 17 周龄前的高多样性可能会增加以后过敏的风险。我们发现，怀孕期间摄入大量人造黄油、植物油和一些致敏的水果和蔬菜与过敏的风险增加有关，尤其是湿疹。由于目前的建议没有反映母亲在怀孕期间的饮食情况，因此它应该是未来研究的重点。
