1. Children whose mothers reported the highest consumption of peanuts and tree nuts (P/TN) while pregnant had the lowest risk of developing P/TN allergy on subsequent analysis.
Evidence grade: 2 (Good)
Study Rundown: Peanut and tree nut (P/TN) allergies are an ever present worry amongst mothers. Most of these allergies develop early in a child’s life. To date, there is little evidence about the effects of peripregnancy consumption of P/TN and its relation to the offspring developing allergies to P/TN. This study demonstrated that children whose mothers reported the highest consumption of P/TN had the lowest risk of developing P/TN allergy.
Strengths of the study include a lack of recall bias since the participants filled out their food consumption questionnaires in real time, rather than retrospectively. There was also a stringent verification of the offspring’s allergy status. Weaknesses include the fact that a significant number of mothers did not record their P/TN consumption status in the peripregnancy period, but these women did note that their diets during the peripregnancy period did not deviate significantly from their baseline. In addition, there are a number of behavioral and environmental factors that cannot be controlled, and thus can confound the relationship determined by the authors.
In-Depth [prospective cohort study]: This prospective cohort study’s population was derived from the Nurses’ Health Study II (NHSII) and their offspring, Growing Up Today Study II (GUTSII). From the large cohort, 140 cases of P/TN allergies in the offspring were found and their allergy status was validated by two pediatricians after reviewing their medical charts. The peripregnancy diet information was derived from the questionnaire the mothers filled out at the inception of the study (this was periodically updated every 4yrs).
In multivariable analysis of the odds of P/TN allergy in the offspring, the children whose mothers reported the highest consumption of P/TN during the peripregnancy period had the lowest risk of P/TN allergy (OR = 0.58; 95% CI, 0.34-0.99; P = 0.04). Children whose non-allergic mothers were in the highest quartile of P/TN consumption (≥5 times/wk) had the lowest risk of P/TN allergy (OR: 0.31; 95% CI, 0.13-0.75; P = 0.04).
By Anees Daud and James Jiang
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