Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom.
PLoS One. 2020 May 14;15(5):e0232170. doi: 10.1371/journal.pone.0232170. eCollection 2020.
The global prevalence of childhood eczema has increased over the last few decades, with a marked increase in high-income countries. Differences in prevalence of childhood eczema between countries and ethnicities suggest that genetic and early modifiable environmental factors, such as dietary intake, may underlie this observation. To investigate the association between pregnancy diet and infant eczema in a consortium of prospective Canadian birth cohorts predominantly comprised of white Europeans and South Asians.
We evaluated the association of maternal dietary patterns reported during pregnancy (assessed at 24-28 weeks gestation using a semi-quantitiative food-frequency questionnaire) with parent-reported physician-diagnosed infant eczema at 1-year from 2,160 mother-infant pairs. Using three dietary patterns ("Western", "plant-based", and "Balanced") previously derived in this cohort using principal component analysis, we used multivariable logistic regression to determine the association of these dietary patterns with infant eczema, adjusted for potential confounders.
We observed a lower odds of eczema in the full sample combining white Europeans and South Asians with greater adherence to a plant-based (OR = 0.65; 95% CI: 0.55, 0.76; <0.001) and Western dietary pattern (OR = 0.73; 95% CI: 0.60, 0.89; P<0.01), after adjusting for other known predictors of eczema, including ethnicity, which was not significant. No associations were observed for the balanced diet. An interaction between the Western diet and ethnicity was observed (P<0.001). Following stratification by ethnicity, a protective association between the plant-based diet and infant eczema was confirmed in both white Europeans (OR = 0.59; 95% CI: 0.47, 0.74; P<0.001) and South Asians (OR = 0.77; 95% CI: 0.61, 0.97; P = 0.025). In white Europeans only, a Western diet was associated with a lower odds of infant eczema (OR = 0.69; 95% CI: 0.56, 0.87; P = 0.001) while a balanced diet increased the odds of infant eczema (OR = 1.23; 95% CI: 1.02, 1.49; P = 0.03). Beyond a plant-based diet, no significant associations with other dietary patterns were observed in South Asians.
A plant-based diet during pregnancy is associated with a lowered odds of infant eczema at 1 year in all participants. Future studies of the components of plant-based diet which underlie the lower risk of eczema are needed.
过去几十年，全球儿童湿疹的患病率有所上升，高收入国家的上升幅度尤为明显。不同国家和种族之间儿童湿疹的患病率差异表明，遗传和早期可改变的环境因素（如饮食摄入）可能是导致这一观察结果的原因。本研究旨在调查加拿大主要由白种欧洲人和南亚人组成的前瞻性出生队列研究联盟中，孕妇饮食与婴儿湿疹之间的关联。
我们评估了孕妇在妊娠 24-28 周时（使用半定量食物频率问卷评估）报告的饮食模式与 2160 对母婴对中，1 岁时由医生诊断的婴儿湿疹之间的关联。使用先前在该队列中使用主成分分析得出的三种饮食模式（“西方”、“植物性”和“均衡”），我们使用多变量逻辑回归来确定这些饮食模式与婴儿湿疹之间的关联，同时调整了潜在的混杂因素。
我们观察到，在纳入了白种欧洲人和南亚人的全样本中，与更遵循植物性饮食模式（OR=0.65；95%CI：0.55，0.76；<0.001）和西方饮食模式（OR=0.73；95%CI：0.60，0.89；P<0.01）相关的婴儿湿疹发生几率较低，且调整了其他已知的湿疹预测因素，包括种族因素，这一因素无统计学意义。对于均衡饮食模式，没有观察到相关性。观察到西方饮食模式与种族之间存在交互作用（P<0.001）。在按种族分层后，在白种欧洲人和南亚人中均证实了植物性饮食与婴儿湿疹之间的保护关联：在白种欧洲人中（OR=0.59；95%CI：0.47，0.74；<0.001），在南亚人中（OR=0.77；95%CI：0.61，0.97；P=0.025）。仅在白种欧洲人中，西方饮食与婴儿湿疹发生几率较低相关（OR=0.69；95%CI：0.56，0.87；P=0.001），而均衡饮食则增加了婴儿湿疹的发生几率（OR=1.23；95%CI：1.02，1.49；P=0.03）。在南亚人中，除了植物性饮食外，与其他饮食模式之间没有观察到显著的关联。
在所有参与者中，妊娠期间的植物性饮食与 1 岁时婴儿湿疹的发病几率降低有关。需要进一步研究构成植物性饮食的成分，以确定其降低湿疹风险的机制。
