Early diet and the risk of allergy: What can we learn from the prospective birth cohort studies GINIplus and LISAplus?

Abstract

Recently, the American Academy of Pediatrics and the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition published new guidelines on early nutrition and allergy prevention in infants and children. This article reviews epidemiologic evidence from 2 prospectiveGermanbirth cohort studies, the GINIplus and the LISAplus, regarding maternal diet during pregnancy and feeding patterns in early life and the risk of allergy in light of the new recommendations. The 2 cohorts include a total of 9088 infants whowere recruited within different regions of Germany between 1995 and 1999. A subgroup of 2252 infants with a hereditary risk of atopy was enrolled in a doubleblind, randomized trial to investigate the effect of feeding regimen in infancy on the development of allergy with the strict recommendation that allergenic solid food be introduced late in the study. The results of the GINIplus and LISAplus studies mainly support the newfinding regarding allergy prevention that a delayed introduction of solid foods or the avoidance of highly allergenic foods during the first year does not seem to be beneficial for allergy prevention. Avery early introduction of solid foods and a high diversity before week 17 of age may increase the risk of later allergy. We showed that a high intake of margarine, vegetable oils, and some allergenic fruit and vegetables during pregnancy was associated with an increased risk of allergies, especially eczema. Because maternal diet during pregnancy is not reflected in the current recommendations, it shouldbe the focus offuture studies. © 2011 American Society for Nutrition.