Fruit and vegetable consumption in relation to allergy: Disease-related modification of consumption?

doi:10.1016/j.jaci.2010.11.019

Journal of Allergy and Clinical Immunology

Volume 127, Issue 5, May 2011, Pages 1219-1225

https://doi.org/10.1016/j.jaci.2010.11.019 Get rights and content

Background

Previous largely cross-sectional studies suggest that fruit and vegetable consumption reduces the risk of allergic disease in children, but results are conflicting.

Objective

To investigate the association between current fruit or vegetable intake and allergic disease in 8-year-old Swedish children, and to evaluate the potential effect of disease-related modification of consumption.

Methods

Cross-sectional data were obtained from a Swedish birth cohort study. Information on fruit and vegetable consumption as well as symptoms and diagnoses of allergic diseases was obtained by parental questionnaires at the 8-year follow-up. Allergen-specific IgE levels against food and inhalant allergens were obtained from blood samples collected at age 8 years. In total, 2447 children were included. Data were analyzed with logistic regression.

Results

An inverse relation was observed between total fruit consumption and rhinitis (odds ratio, highest vs lowest quartile, 0.62; 95% CI, 0.45-0.86; P for trend, .002), whereas no association was observed for total vegetable intake. In analyses of individual foods, intake of apples/pears and carrots was inversely associated with rhinitis, asthma, and atopic sensitization. Fifty percent of the children with rhinitis were sensitized against birch pollen, which may cross-react with apples and carrots. After exclusion of children who reported food-related allergic symptoms, most of the observed inverse associations moved toward the null and became nonsignificant.

Conclusion

We confirm the inverse associations between fruit intake and allergic disease in children observed in earlier studies. However, our data also indicate that disease-related modification of consumption contributed to this association.

Section snippets

Study design

A prospective birth cohort of 4089 newborn infants (BAMSE, Swedish abbreviation for Children, Allergy, Milieu, Stockholm, Epidemiology) was established among children born between February 1994 and November 1996, composed of 75% of all eligible children in a predefined area of Stockholm, Sweden. The study design has been described in detail elsewhere.24, 25 In brief, information on various background exposures, allergic heredity, socioeconomy, and other demographic data were obtained through a

Results

Children included in the current study were highly representative compared with the children in the baseline cohort regarding distribution of exposure factors such as sex, parental allergic disease, socioeconomic status, maternal smoking, and breast-feeding (data not shown). The prevalence of asthma (7.4%), rhinitis (15.3%), and eczema (17.1%) at age 8 years in the study group was somewhat higher when compared with the cohort as a whole (6.3%, 13.3%, and 16.3%, respectively) but did not differ

Discussion

In this study of 2447 boys and girls, we observed inverse associations between total fruit consumption during the past year and rhinitis at 8 years of age. When individual food items were analyzed separately, the strongest and most consistent associations were observed for apples/pears and carrots, which were inversely associated with most of the studied outcomes including atopic sensitization. When combining each outcome with the results of the IgE analyses, the inverse associations observed

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Citation Excerpt :
This association remained after adjustment for potential confounding factors, such as maternal age, education, asthma, and allergy. A possible mechanism for the observed results are the immunomodulatory effects of nutrients found in fruits and vegetables, such as vitamin C, β-carotenes, folate, and oligosaccharides, which have been suggested in previous research to influence allergic outcomes because of their effect on inflammatory processes.39-41 That these findings are not allergen or tissue specific (ie, the effect was seen despite all the infants being included in the analysis regardless of what food to which they were reactive) further suggests that the results might be due to modification of the immune response.
After an era of only considering the allergenic properties of the infant diet and allergy outcomes, emerging data suggest that the overall composition of the infant diet might be a more important factor in the development of allergic disease.
We sought to assess the relationship between infant dietary patterns in the first year of life and development of food allergy by age 2 years.
We performed a nested, case-control, within-cohort study. Mothers kept prospective food diaries for the first year of life, with resultant diet data coded in a unique manner to produce new variables, which were then analyzed by using principal component analysis to identify infant feeding patterns within the study subjects.
Principal component analysis of diet diary data from 41 infants given a diagnosis of food allergy based on results of double-blind, placebo-controlled food challenges in the first 2 years of life and their 82 age-matched control subjects provided an early infant diet pattern and an ongoing diet pattern. There was no difference between the study groups for the early infant diet pattern, but for the ongoing diet pattern, there was a significant difference between the groups (P = .001). This ongoing dietary pattern was characterized by higher intake of fruits, vegetables, and home-prepared foods, with control infants having a significantly higher healthy infant diet dietary pattern score than children who had a food allergy.
An infant diet consisting of high levels of fruits, vegetables, and home-prepared foods is associated with less food allergy by the age of 2 years.
Fish consumption in infancy and development of allergic disease up to age 12 y
2013, American Journal of Clinical Nutrition
Fish intake in infancy has been associated with reduced risk of allergic disease in early childhood, but it is unknown whether this effect remains as children grow older.
We studied the possible effect of fish consumption in infancy on prevalent and incident allergic disease up to the age of 12 y.
A total of 3285 children from a prospective Swedish birth cohort (Children, Asthma, Milieu, Stockholm, Epidemiology) were included in the current analyses. At 1, 2, 4, 8, and 12 y, parental questionnaires were used to obtain information on lifestyle factors, environmental exposures, and symptoms of allergic disease. The frequency of fish intake in infancy was assessed in the 1-y questionnaire. Serum immunoglobulin (Ig) E concentrations associated with common allergens were obtained at age 8 y. Generalized estimating equations and multivariate logistic regression were used to examine associations between fish consumption in infancy and prevalent and incident allergic disease at ages 1–12 y, including sensitization and IgE-associated disease at age 8 y.
At 1 y of age, 80% of the children consumed fish regularly (ie, ≥2 times/mo). From 1 to 12 y of age, regular fish consumption in infancy reduced overall risks of prevalent and incident allergic disease [adjusted OR (95% CI) after restriction to children without early symptoms of allergic disease was 0.74 (0.60, 0.90) (P = 0.003) for prevalent rhinitis and 0.78 (0.63, 0.97) (P = 0.028) for prevalent eczema.
Regular fish consumption in infancy may reduce risk of allergic disease up to age 12 y.
Relative validity of an FFQ for pre-school children in the mother-child 'Rhea' birth cohort in Crete, Greece
2015, Public Health Nutrition
Primary, secondary and tertiary prevention of food allergy: current practices and future directions
2024, Allergologia et Immunopathologia
Greater fruit and vegetables consumption, and adherence to a Mediterranean type of diet reduces the risk for asthma in children; a systematic review and meta-analysis
2024, International Journal of Food Sciences and Nutrition
Dietary Polyphenols—Natural Bioactive Compounds with Potential for Preventing and Treating Some Allergic Conditions
2023, Nutrients

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: Supported by the Stockholm County Council, the Heart and Lung Foundation, the Swedish Asthma and Allergy Association, the Swedish Foundation for Health Care Science and Allergy Research, and the Swedish Research Council.

: Disclosure of potential conflict of interest: M. Wickman has received lecture fees from MSD and is a consultant for AstraZeneca. The rest of the authors have declared that they have no conflict of interest.

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Food, drug, insect sting allergy, and anaphylaxisFruit and vegetable consumption in relation to allergy: Disease-related modification of consumption?

Background

Objective

Methods

Results

Conclusion

Section snippets

Study design

Results

Discussion

Nutrition

Nutrition and lung health

Int J Tuberc Lung Dis

Consumption of fresh fruit rich in vitamin C and wheezing symptoms in children. SIDRIA Collaborative Group, Italy (Italian Studies on Respiratory Disorders in Children and the Environment)

Thorax

Effects of early intake of fruit or vegetables in relation to later asthma and allergic sensitization in school-age children

Acta Paediatr

Protective effect of fruits, vegetables and the Mediterranean diet on asthma and allergies among children in Crete

Thorax

Childhood asthma and fruit consumption

Eur Respir J

Diet, wheeze, and atopy in school children in Menorca, Spain

Pediatr Allergy Immunol

Dietary factors associated with wheezing and allergic rhinitis in children

Eur Respir J

Relationship of asthma and rhinoconjunctivitis with obesity, exercise and Mediterranean diet in Spanish schoolchildren

Thorax

Nutrition and respiratory health in children in six Central and Eastern European countries

Thorax

Diet and childhood asthma in a society in transition: a study in urban and rural Saudi Arabia

Thorax

Current asthma and respiratory symptoms among pupils in relation to dietary factors and allergens in the school environment

Indoor Air

Dietary intake in sensitized children with recurrent wheeze and healthy controls: a nested case-control study

Allergy

Diet and asthma in Dutch school children (ISAAC-2)

Thorax

Association of consumption of products containing milk fat with reduced asthma risk in pre-school children: the PIAMA birth cohort study

Thorax

Food, drug, insect sting allergy, and anaphylaxis
Fruit and vegetable consumption in relation to allergy: Disease-related modification of consumption?