Infectious Disease

Maternal consumption of fermented dairy products may reduce cow’s milk allergy in toddlers

February 10, 2023

2 min read

Source/Disclosures

sources:

Koksal ZG, et al. Ann Allergy Asthma Immunol. 2022;doi:10.1016/j.anai.2022.12.024.

Disclosures:
The authors report no relevant financial disclosures.

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Mothers of toddlers with cow’s milk protein allergy consumed fewer fermented dairy products during pregnancy and lactation than those mothers of toddlers without cow’s milk protein allergy, according to a recent study.

Consumption of diverse fermented dairy products (FDPs) during lactation also may reduce allergy risk, Zeynep Gulec Koksal, MD, of the department of pediatric allergy and immunology at Aydin Adnan Menderes University Faculty of Medicine in Aydin, Turkey, and colleagues wrote in Annals of Allergy, Asthma & Immunology.

The consumption of yogurt and other fermented milk products during pregnancy and lactation may have a protective effect against the development of IgE-mediated cow’s milk protein allergy in children. Source: Adobe Stock

The researchers surveyed the mothers of 160 children aged 1 to 3 years (median age, 28 months) including 80 children with physician-diagnosed, IgE-mediated cow’s milk protein allergy (CMPA; median age at symptom onset, 6 months; range, 3 -7 months) and 80 healthy children matched for age and sex. These children all were exclusively breastfed before the commencement of complementary feeding.

The survey asked these mothers how frequently they consumed FDPs — defined as yogurt, cheese, tarhana and kefir — as well as how many FDPs they consumed to determine how diverse their diets were.

There was no significant difference between the groups in the frequency of maternal FDP consumption during pregnancy, although the mothers in the CMPA group consumed less yogurt (P < .001), tarhana (P < .001) and kefir (P = .009) each week during pregnancy.

During lactation, the mothers in the CMPA group also reported less frequent yogurt (76.3% vs 95%; P = .001), cheese (77.5% vs 93.8%; P = .003) and tarhana (52.5% vs 71.3 %;P=.02) consumption, in addition to lower weekly yogurt (P<.001) and tarhana (P=.001) consumption, compared with the control group. These results appeared comparable when looking at pregnancy and lactation together.

There was no difference between the groups in the diversity of maternal FDP consumption during pregnancy, but the CMPA group reported less diversity during lactation (P = .01).

The researchers found that diversity of FDP during lactation was protective against CMPA (OR = 0.439; 95% CI, 0.272-0.711).

Other factors increasing odds for CMPA among toddlers included maternal weight gain (OR = 1.11; 95% CI, 1.04-1.18), maternal age (OR = 1.2; 95% CI, 1.09-1.31) and gestational age at birth (OR = 1.23 ; 95% CI, 1.03-1.48).

Overall, the researchers found an association between more frequent and diverse maternal FDP consumption, along with higher amounts of consumption during lactation rather than during pregnancy, and the development of IgE-mediated CMPA in their children.

The researchers also suggested that maternal FDP consumption may influence intestinal microbial development and immune modulation in these children, protecting them from developing food allergy.

Comprehensive multicenter cohort studies involving larger populations investigating how maternal consumption of fermented foods affects the development of allergic diseases in children would support these conclusions, the researchers wrote.

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Carina Venter, PhD, RD)

Carina Venter, PhD, RD

I think the results are significant, as data on maternal diet and offspring allergy outcomes are limited. The findings support data from our papers that fermented food intake (yogurt) and diet diversity (in this case fermented food diversity) during pregnancy are associated with reduced offspring allergic outcomes.

Their focus was on cow’s milk allergy. Infant diet diversity and intake of yogurt have also been associated with reduced food allergy in later childhood, but I am unaware of any data focusing on intake of fermented foods of a diverse diet during breastfeeding and offspring allergy outcomes.

Doctors can focus on healthy eating advice for pregnant and breastfeeding women with a focus on diversity of food intake and regular consumption of fermented foods such as yogurt.

Also, we really need randomized controlled trials focusing on a healthy, diverse diet during pregnancy and breastfeeding with offspring allergy as an outcome.

References :

Roduit C, et al. J Allergy Clin Immunol. 2014;doi:10.1016/j.jaci.2013.12.1044.

Venter C, et al. allergy 2021;doi:10.1111/all.14949.

Venter C, et al. J Allergy Clinic Immunol Pract. 2022;doi:10.1016/j.jaip.2022.09.009.

Venter C, et al. J Allergy Clinic Immunol Pract. 2020;doi:10.1016/j.jaip.2020.01.029.

Carina Venter, PhD, RD

Associate Professor of Pediatrics, Section of Allergy/Immunology, Children’s Hospital Colorado and University of Colorado Denver School of Medicine

Disclosures: Venter reports receiving grants from Food Allergy Research and Education, National Peanut Board and Reckitt Benckiser; and personal fees from Abbott Nutrition, Before Brands, Danone, Else Nutrition, Nestle Nutrition Institute and Reckitt Benckiser.

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