論文No2343
Mediterranean diet during pregnancy and childhood respiratory and atopic outcomes: birth cohort study
Annabelle Bédard, Kate Northstone, A. John Henderson, Seif O. Shaheen
European Respiratory Journal 55 (3) 1901215; DOI: 10.1183/13993003.01215-2019 Published 12 March 2020
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＜背景＞
妊娠中の地中海式食事と小児喘息、アレルギー、関連したアウトカムとの関連は様々である。
小児を学童期までフォローしたコホートはほとんどなく、肺機能へ言及したものはない。
＜方法＞
Avon親子縦断研究において、我々は妊娠中の母親の地中海式食事
（前もって定義したスコア（頻度少ない０から多い７まで）質問票を使用して食事の頻度で評価）と
7-9歳の8907名の小児の現在の医師診断の喘息、喘鳴、花粉症、アトピー、肺機能との関連を解析した。
母親の地中海式食事と妊娠中の母親の喫煙との相互関係を検討した。
＜結果＞
妊娠中の母親の地中海式食事スコアは喘息や他のアレルギー性アウトカムと関連しなかった。
母親の地中海式食事スコアと小児期の最大呼気中間流速(FVCの25-75％の流速(FEF 25-75%）を交絡因子で補正）
には弱い正の相関を認めた。
地中海式食事スコアが高値だと年齢、身長、性別で補正後にFEF25-75% z-score増加と関連した
(β 0.06, 95% CI 0.01–0.12; p=0.03, comparing a score of 4–7 versus a score of 0–3)。
妊娠中の母親の喫煙で層別化すると、FEF25-75%の関連は母親が非喫煙者／受動喫煙者のみで認められた。
しかし、統計的に有意な相互関係はなかった。
＜感想＞
妊娠中に地中海式食事を多くとると、子供の細気管支の機能が若干よくなる可能性があったようですが、
喘息や他のアレルギー性疾患のリスク減少とはいかなかったようです。
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Evidence for associations between Mediterranean diet during pregnancy and childhood asthma, allergy and related outcomes is conflicting. Few cohorts have followed children to school age, and none have considered lung function.
In the Avon Longitudinal Study of Parents and Children, we analysed associations between maternal Mediterranean diet score during pregnancy (estimated by a food frequency questionnaire, using an a priori defined score adapted to pregnant women; score ranging from 0 (low adherence) to 7 (high adherence)) and current doctor-diagnosed asthma, wheeze, eczema, hay fever, atopy and lung function in 8907 children at 7–9 years. Interaction between maternal Mediterranean diet and maternal smoking in pregnancy was investigated.
The maternal Mediterranean diet score was not associated with asthma or other allergic outcomes. Weak positive associations were found between maternal Mediterranean diet score and childhood maximal mid-expiratory flow (forced expiratory flow at 25–75% of forced vital capacity (FEF25–75%)) after controlling for confounders. Higher Mediterranean diet scores were associated with increased FEF25–75% z-scores adjusted for age, height and sex (β 0.06, 95% CI 0.01–0.12; p=0.03, comparing a score of 4–7 versus a score of 0–3). Stratifying associations by maternal smoking during pregnancy showed that associations with FEF25–75% were only seen in children of never-/passive-smoking mothers, but no evidence for a statistically significant interaction was found.
Results suggest adherence to a Mediterranean diet during pregnancy may be associated with increased small airway function in childhood, but we found no evidence for a reduced risk of asthma or other allergic outcomes.