Study Identifies Link Between Maternal Bread Consumption, Risk of Infant Allergies

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There is a consistent association between higher maternal bread consumption and thiamine intake during late pregnancy with risk increases of infant food allergy and eczema, new findings suggest.¹

These data were the conclusions identified in new research—led by Rachelle A. Pretorius from the Telethon Kids Institute at the University of Western Australia—in which investigators sought to explore the influences of a pregnant mother's diet on an infant's immune development. A multi-component approach to dietary analysis was implemented given this type of study’s complexity.

Prior research into 639 mother–infant pairs led to unanticipated data given a link found between higher maternal intake of resistant starch and increased risk of parent-reported and diagnosed eczema.² As such, questions remained that were explored in Pretorius et al’s latest analysis.

“This multi-level nutritional analysis approach will enable a more comprehensive interpretation of any associations found between maternal diet during pregnancy and infant allergy outcomes,” Pretorius and colleagues wrote.¹

Study Design

The investigators enrolled mothers in the study who had been drawn from local antenatal clinics and classes in the timeframe between November 2011 - December 2016. There were a total of 639 mother-infant pairs and these subjects had previously been evaluated with the goal of exploring links between maternal consumption of various fibers—such as resistant starch, total fiber, insoluble fiber, soluble fiber, and prebiotic fiber—and allergic disease outcomes among infants.

Each of the infants featured in the cohort had been born at or following 36 weeks of gestation, with each having at least a single immediate family member who was known to have a history of allergic conditions. Some of these conditions would include allergic rhinitis, asthma, IgE-mediated allergies to foods, or atopic dermatitis.

Utilizing a semi-quantitative food frequency questionnaire (SQFFQ) which was validated in Australia, the investigators designed this cohort to assess various elements of maternal dietary habits in the later period of pregnancy between 32–36 weeks. The research team used information on dietary intake collected using the SQFFQ, to evaluate subjects’ Dietary Inflammatory Index (DII) scores.
Drawing associations between dietary information using a global database that provided estimates for the standard deviation and mean of intakes for dietary components, the team would evaluate the results. There were 23 out of 45 potential food parameters that the team utilized to calculate subjects’ DII score.

Seven such elements, including total fat, energy, protein, cholesterol, carbohydrate, saturated fatty acids, and iron, were noted as being pro-inflammatory. They classified the remaining 16, such as total fiber, several vitamins, minerals, and onion, as being anti-inflammatory.

The investigators noted that higher scores for DII suggested diets which were more pro-inflammatory, whereas a lower, negative score would indicate a more anti-inflammatory diet.

The research team also used SQFFQ to identify specific foods and food groups which had been consumed by mothers in the late pregnancy period, looking specifically at food groups previously connected to occurrence of allergic disease outcomes in children.

Findings

Overall, the investigators reported that pregnant mothers with a higher level of white bread consumption were shown to be more likely to have an infant with IgE-mediated food allergy (aRR 1.14; 95% CI 1.02, 1.28; P = .02) as well as clinician-diagnosed eczema (adjusted relative risk [aRR] 1.16; 95% CI 1.08, 1.24; P < .001).

The research team noted that higher levels of maternal intake of fiber-rich bread (aRR 1.14; 95% CI 1.04, 1.25; P = .01) as well as legumes (aRR 1.11; 95% CI 1.02, 1.21; P = .02) were shown to be linked with infants’ clinician-diagnosed eczema.

Higher maternal intake of thiamine was also found to be associated with rises in parent-reported infant eczema (aRR 1.08; 95% CI 1.03, 1.12; P < .001).

“Future research strategies should consider extending our multi-component dietary analysis approach of food groups, individual foods, and nutrient intakes, including accounting for antenatal vitamin and mineral supplementation use, in larger mother-infant cohorts at general population level risk of allergic disease development,” they wrote.

References

1. ^{Pretorius RA, McKinnon E, Palmer DJ. Higher maternal bread and thiamine intakes are associated with increased infant allergic disease. Pediatr Allergy Immunol. 2024; 35:e14237. doi:10.1111/pai.14237.}
2. ^{Pretorius RA, Bodinier M, Prescott SL, Palmer DJ. Maternal fiber dietary intakes during pregnancy and infant allergic disease. Nutrients. 2019; 11(8): 1767. doi:10.3390/nu11081767.}