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A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (15 July 2019) | Viewed by 100850

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Prof. Dr. Diego Peroni

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Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Via Roma 67, 56126 Pisa, Italy
Interests: allergy; atopy; sensitization; child; cow's milk allergy; mechanisms; asthma; diagnosis
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Dr. Pasquale Comberiati

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Guest Editor

1. Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
2. Department of Clinical Immunology and Allergology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
Interests: asthma; food allergy; atopic dermatitis; quality of life; children; adolescents
Special Issues, Collections and Topics in MDPI journals

Dr. Daniel Munblit

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Guest Editor

Department of Paediatrics, Imperial College London, London, UK; Department of Paediatrics & Infectious diseases, Sechenov University, Moscow, Russian Federation
Interests: allergy (prevention); systematic review; breastfeeding; epigenetic regulation; fatty acids; folic acid; human milk; microbiome; nutrition; oligosaccharides; pregnancy; probiotics and prebiotics

Special Issue Information

Dear Colleagues,

In the last decade, substantial progress has been made in our understanding of the impact that early life environmental and nutritional changes can have on the future health of all organ systems. In particular, there is accumulating evidence to show that early-life dietary exposures significantly contribute to the rise in childhood allergic diseases. Many studies have addressed the effect of diet and specific nutrients during pregnancy and the early postnatal period, including prebiotics, oligosaccharides, symbiotic, polyunsaturated fatty acids, antioxidants, folate and vitamin D, on the development of allergies and have documented effects on immune function, as well as metabolic programming. In addition, there is increasing interest on the role of breastfeeding habits as well as breastmilk composition in relation to the development of allergic sensitisation and allergic disease and modulation of intestinal microbiota. An improved understanding of nutritional programming of immune health, nutritional epigenetics modification of gene expression and subsequent disease risk, and the metabolic processes sensitive to nutritional exposures in early life may lead to effective dietary prevention strategies that can reduce the burden of allergic diseases.

This Special Issue, “Nutrition, Diet and Allergic Diseases”, provides an overview of recent developments related to nutrition and diet during pregnancy and the early childhood and the development and management of allergic diseases.

Prof. Diego Peroni
Dr. Pasquale Comberiati
Dr. Daniel Munblit
Guest Editors

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Keywords

Allergy
Asthma
Atopic Dermatitis
Breastfeeding
Epigenetic Regulation
Fatty Acids
Folic Acid
Food Allergy
Human Milk
Immune Programming
Metabolic Programming
Microbiome
Nutrition
Oligosaccharides
Pregnancy
Probiotics
Prebiotics
Vitamin D

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Published Papers (11 papers)

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15 pages, 657 KiB

Open AccessArticle

Statistical Approaches in the Studies Assessing Associations between Human Milk Immune Composition and Allergic Diseases: A Scoping Review

by Oleg Blyuss, Ka Yan Cheung, Jessica Chen, Callum Parr, Loukia Petrou, Alina Komarova, Maria Kokina, Polina Luzan, Egor Pasko, Alina Eremeeva, Dmitrii Peshko, Vladimir I. Eliseev, Sindre Andre Pedersen, Meghan B. Azad, Kirsi M. Jarvinen, Diego G. Peroni, Valerie Verhasselt, Robert J. Boyle, John O. Warner, Melanie R. Simpson and Daniel Munblit Show full author list Hide full author list

Nutrients 2019, 11(10), 2416; https://doi.org/10.3390/nu11102416 - 10 Oct 2019

Cited by 4 | Viewed by 5004

Abstract

A growing number of studies are focusing on the associations between human milk (HM) immunological composition and allergic diseases. This scoping review aims to identify statistical methods applied in the field and highlight pitfalls and unmet needs. A comprehensive literature search in MEDLINE and Embase retrieved 13,607 unique records. Following title/abstract screening, 29 studies met the selection criteria and were included in this review. We found that definitions of colostrum and mature milk varied across the studies. A total of 17 out of 29 (59%) studies collected samples longitudinally, but only 12% of these used serial (longitudinal) analyses. Multivariable analysis was used in 45% of the studies, but statistical approaches to modelling varied largely across the studies. Types of variables included as potential confounding factors differed considerably between models. Discrimination analysis was absent from all studies and only a single study reported classification measures. Outcomes of this scoping review highlight lack of standardization, both in data collection and handling, which remains one of the main challenges in the field. Improved standardization could be obtained by a consensus group of researchers and clinicians that could recommend appropriate methods to be applied in future prospective studies, as well as already existing datasets. Full article

(This article belongs to the Special Issue Nutrition, Diet, and Allergic Diseases)

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12 pages, 1042 KiB

Open AccessArticle

Testing the Cow’s Milk-Related Symptom Score (CoMiSS^TM) for the Response to a Cow’s Milk-Free Diet in Infants: A Prospective Study

by Silvia Salvatore, Elisabetta Bertoni, Federica Bogni, Valentina Bonaita, Chiara Armano, Alex Moretti, Mario Baù, Chiara Luini, Enza D’Auria, Maddalena Marinoni, GianVincenzo Zuccotti and Massimo Agosti

Nutrients 2019, 11(10), 2402; https://doi.org/10.3390/nu11102402 - 8 Oct 2019

Cited by 32 | Viewed by 4456

Abstract

The diagnosis of cow’s milk allergy (CMA) is particularly challenging in infants, especially with non-Immunoglobulin E (IgE)-mediated manifestations, and inaccurate diagnosis may lead to unnecessary dietary restrictions. The aim of this study was to assess the accuracy of the cow’s milk-related symptom score (CoMiSS^TM) in response to a cow’s milk-free diet (CMFD). We prospectively recruited 47 infants (median age three months) who had been placed on a CMFD due to persisting unexplained gastrointestinal symptoms. We compared data with 94 healthy controls (median age three months). The CoMiSS^TM score was completed at recruitment and while on the exclusion diet. In 19/47 (40%) cases a response to the diet occurred. At recruitment CoMiSS^TM was significantly higher in cases compared to controls (median score 8 vs. 3; p-value: <0.05), 9 cases had a score ≥12 and 8/9 normalized on CMFD. An oral milk challenge was performed in all 19 responders and six of these had a positive reaction to cow’s milk (CM). In eight infants IgE allergy tests were positive. The receiver operation characteristic (ROC) curve identified a CoMISS^TM score of 9 to be the best cut-off value (84% sensitivity, 85% specificity, 80% positive (PPV) and 88% negative predictive value (NPV)) for the response to CMFD. We found CoMiSS^TM to be a useful tool to help identify infants with persisting gastrointestinal symptoms and suspected CMA that would benefit from CMFD. Full article

(This article belongs to the Special Issue Nutrition, Diet, and Allergic Diseases)

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15 pages, 2432 KiB

Open AccessArticle

Oral Tolerance Induction to Newly Introduced Allergen is Favored by a Transforming Growth Factor-β-Enriched Formula

by Sébastien Holvoet, Marie Perrot, Nanda de Groot, Guénolée Prioult, Takashi Mikogami, Valérie Verhasselt and Sophie Nutten

Nutrients 2019, 11(9), 2210; https://doi.org/10.3390/nu11092210 - 13 Sep 2019

Cited by 10 | Viewed by 4828

Abstract

Food allergies have become a major healthcare concern, hence preventive efforts to ensure oral tolerance induction to newly introduced antigens are particularly relevant. Given that transforming growth factor-β (TGF-β) plays a key role in immune tolerance, we tested whether an infant formula enriched with TGF-β would improve oral tolerance induction. A partially hydrolyzed whey protein-based formula was enriched with cow’s-milk-derived TGF-β (TGF-β-enriched formula) by adding a specific whey protein isolate (WPI). The manufacturing process was optimized to achieve a concentration of TGF-β within the range of human breast milk concentrations. Protection from allergic sensitization and immune response was assessed in a mouse model. Adult mice received the TGF-β-enriched formula, a control non-enriched formula, or water ad libitum for 13 days before sensitization and suboptimal tolerization to ovalbumin (OVA). When compared to non-tolerized mice, suboptimally-tolerized mice supplemented with the TGF-β-enriched formula showed significantly lower levels of total immunoglobulin-E (IgE) and OVA-specific (IgG1). Mouse mast-cell protease-1 (mMCP-1) and cytokine levels were also significantly decreased in suboptimally-tolerized mice fed the TGF-β-enriched formula. In conclusion, oral supplementation with cow’s-milk-derived TGF-β decreased allergic responses to newly introduced allergens and thus reduced the risk of developing food allergy. Full article

(This article belongs to the Special Issue Nutrition, Diet, and Allergic Diseases)

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8 pages, 1191 KiB

Open AccessArticle

Soluble CD14 in Breast Milk and Its Relation to Atopic Manifestations in Early Infancy

by Bahrul Fikri, Yumi Tani, Kazue Nagai, Masumi Sahara, Chisako Mitsuishi, Yaei Togawa, Taiji Nakano, Fumiya Yamaide, Hiroshi Ohno and Naoki Shimojo

Nutrients 2019, 11(9), 2118; https://doi.org/10.3390/nu11092118 - 5 Sep 2019

Cited by 9 | Viewed by 4276

Abstract

Soluble CD14 (sCD14) is one of the immunomodulatory factors in breast milk (BM). Although it may be involved in the prevention of atopic symptoms and sensitization to both food and inhalant allergens, conflicting evidence exists concerning its protective effects. In this study, we investigated the relationship between sCD14 in colostrum and 1-month BM, and the development of atopic dermatitis (AD) and sensitization to food and aeroallergens at 9 months of age in infants who were exclusively or almost exclusively breastfed up to 4 months of age. BM samples were collected from lactating mothers who participated in a 2 × 2 factorial, randomized, nontreatment controlled trial study set in Tokyo, which looked at the efficacy of emollients and synbiotics in preventing AD and food allergy in children during the first year of life. A total of 258 colostrum samples and 269 1-month BM samples were analyzed. We found that one-month BM sCD14 levels in the AD group were significantly lower than in the non-AD group. Levels of sCD14 in 1-month BM were not related to allergen sensitization in the overall analysis, but egg white sensitization correlated inversely with 1-month BM sCD14 in infants without AD. The results suggest that sCD14 in BM may be involved in atopic manifestations in early infancy. Full article

(This article belongs to the Special Issue Nutrition, Diet, and Allergic Diseases)

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16 pages, 718 KiB

Open AccessArticle

Fish Consumption at One Year of Age Reduces the Risk of Eczema, Asthma and Wheeze at Six Years of Age

by Torbjørn Øien, Astrid Schjelvaag, Ola Storrø, Roar Johnsen and Melanie Rae Simpson

Nutrients 2019, 11(9), 1969; https://doi.org/10.3390/nu11091969 - 21 Aug 2019

Cited by 16 | Viewed by 13110

Abstract

Background: The role of dietary fish and n-3 polyunsaturated fatty acids (n-PUFAs) in the primary prevention of allergic diseases remains uncertain. The aim of this study was to investigate associations between the consumption of fish and cod liver oil (rich in n-PUFAs) from pregnancy to the first two years of life, and parental reported allergic diseases at six years of age. Methods: We used data from the Prevention of Allergy among Children in Trondheim study and included mother-infant pairs who had submitted questionnaires detailing both maternal or infant diet and allergic disease at six years of age. Results: Eating fish at least once a week at one year of age was associated with a 28%, 40% and 34% reduction in the odds of current eczema, asthma, and wheeze at six years of age. Cod liver oil consumption at least four times per week at one year of age tended to be associated with a lower risk of allergy-related outcomes at six years. We found no consistent associations between allergy-related outcomes and fish or cod liver oil consumption by mothers. Conclusion: The preventive effect of fish consumption is best achieved by increasing dietary fish in the first year of life. Full article

(This article belongs to the Special Issue Nutrition, Diet, and Allergic Diseases)

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12 pages, 500 KiB

Open AccessArticle

Pre-Conception Maternal Food Intake and the Association with Childhood Allergies

by Jessica A. Grieger, Anita M. Pelecanos, Cameron Hurst, Andrew Tai and Vicki L. Clifton

Nutrients 2019, 11(8), 1851; https://doi.org/10.3390/nu11081851 - 9 Aug 2019

Cited by 11 | Viewed by 4661

Abstract

Background: Periconceptional nutrition may have an important function in programming the immune function and allergies, however, there is a lack of studies assessing pre-conception food intake and childhood allergic disorders. The aim of the current study was to identify maternal pre-conception dietary components that may be associated with allergic disorders in children up to 3 years of age. Methods: Pregnant women attending their first antenatal visit and who were aged >18 years were invited to participate. Pre-conception food frequency data was retrospectively collected at 18 weeks’ gestation. Childhood eczema, current wheeze, and rhinitis was assessed at 36 months of age using a questionnaire and doctor diagnosis (n = 234). Linear discriminant analysis (LDA) was used to explore the combination of dietary food components that best discriminated between allergy status in children. Results: Maternal pre-conception food intake such as low and high fat dairy, fresh fruit, unsaturated spreads, and take-away foods, were protective for any allergy assessed. Non-oily fish was protective for eczema and current wheeze; saturated spreads (e.g., butter) was protective for eczema, current wheeze, and rhinitis; poultry and fruit juice were adversely associated with each allergy. Conclusions: Pre-conception food intakes demonstrate inconsistent and somewhat contrary relationships to the development of child allergies. Whether and how maternal food intake impacts the underlying fetal programming and the mechanisms of childhood allergy warrants further investigation. Full article

(This article belongs to the Special Issue Nutrition, Diet, and Allergic Diseases)

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14 pages, 408 KiB

Open AccessArticle

Maternal Fiber Dietary Intakes during Pregnancy and Infant Allergic Disease

by Rachelle A. Pretorius, Marie Bodinier, Susan L. Prescott and Debra J. Palmer

Nutrients 2019, 11(8), 1767; https://doi.org/10.3390/nu11081767 - 1 Aug 2019

Cited by 24 | Viewed by 6659

Abstract

Maternal diet during pregnancy plays a likely role in infant immune development through both direct nutrient specific immunomodulatory effects and by modulating the composition and metabolic activity of the maternal gut microbiome. Dietary fibers, as major substrates for microbial fermentation, are of interest in this context. This is the first study to examine maternal intakes of different fiber sub-types and subsequent infant allergic disease. In an observational study of 639 mother–infant pairs (all infants had a family history of allergic disease) we examined maternal intakes of total fiber, soluble fiber, insoluble fiber, resistant starch, and prebiotic fiber, by a semi-quantitative food frequency questionnaire at 36–40 weeks’ gestation. Infants attended an allergy clinical assessment at 12 months of age, including skin prick testing to common allergens. Higher maternal dietary intakes of resistant starch were associated with reduced doctor diagnosed infant wheeze, adjusted odds ratio (aOR) 0.68 (95% CI 0.49, 0.95, p = 0.02). However, in contrast, higher maternal intakes of resistant starch were associated with higher risk of parent reported eczema aOR 1.27 (95% CI 1.09, 1.49, p < 0.01) and doctor diagnosed eczema aOR 1.19 (95% CI 1.01, 1.41, p = 0.04). In conclusion, maternal resistant starch consumption was differentially associated with infant phenotypes, with reduced risk of infant wheeze, but increased risk of eczema. Full article

(This article belongs to the Special Issue Nutrition, Diet, and Allergic Diseases)

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19 pages, 2614 KiB

Open AccessArticle

Influence of Socio-Economic and Psychosocial Profiles on the Human Breast Milk Bacteriome of South African Women

by Anna Ojo-Okunola, Shantelle Claassen-Weitz, Kilaza S. Mwaikono, Sugnet Gardner-Lubbe, Dan J. Stein, Heather J. Zar, Mark P. Nicol and Elloise du Toit

Nutrients 2019, 11(6), 1390; https://doi.org/10.3390/nu11061390 - 20 Jun 2019

Cited by 14 | Viewed by 5178

Abstract

The human breast milk (HBM) bacteriome is an important, continuous source of microbes to the neonate in early life, playing an important role in shaping the infant’s intestinal bacteriome. Study of the composition of the HBM bacteriome is an emerging area of research, with little information available, particularly from low- and middle-income countries. The aim of this study was to characterize the diversity of bacterial communities in HBM samples collected between 6–10 weeks postpartum from lactating South African women and to study potential influencing factors of the bacteriome. Using 16S rRNA gene sequencing of samples from 554 women, we demonstrated that the HBM bacteriome was largely dominated by the phyla Firmicutes (mean relative abundance: 71.1%) and Actinobacteria (mean relative abundance: 16.4%). The most abundant genera identified from the HBM bacteriome were Streptococcus (mean relative abundance: 48.6%), Staphylococcus (mean relative abundance: 17.8%), Rothia (mean relative abundance: 5.8%), and Corynebacterium (mean relative abundance: 4.3%). “Core” bacterial genera including Corynebacterium, Streptococcus, Staphylococcus, Rothia, Veillonella, Gemella, Acinetobacter, Micrococcus and a genus belonging to the Enterobacteriaceae family were present in 80% of samples. HBM samples were classified, according to their bacteriome, into three major clusters, dominated by the genera Staphylococcus (cluster 1), a combination of Staphylococcus and Streptococcus (cluster 2), and Streptococcus (cluster 3). The cluster groups differed significantly for Shannon and chao1 richness indices. Bacterial interactions were studied using co-occurrence networks with positive associations observed between the abundances of Staphylococcus and Corynebacteria (members of the skin microflora) and between Streptococcus, Rothia, Veillonella, and Gemella (members of the oral microflora). HBM from older mothers had a higher Shannon diversity index. The study site was associated with differences in HBM bacteriome composition (permutational multivariate analysis of variance using distance matrices (PERMANOVA), p < 0.05). No other tested socio-demographic or psychosocial factors were associated with HBM bacterial composition. Full article

(This article belongs to the Special Issue Nutrition, Diet, and Allergic Diseases)

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13 pages, 548 KiB

Open AccessCommunication

Timing of Food Introduction and the Risk of Food Allergy

by Valentina Ferraro, Stefania Zanconato and Silvia Carraro

Nutrients 2019, 11(5), 1131; https://doi.org/10.3390/nu11051131 - 21 May 2019

Cited by 32 | Viewed by 14918

Abstract

Given that the prevalence of pediatric IgE-mediated food allergies (FA) has followed a substantive increase in recent decades, nowadays, a research challenge is to establish whether the weaning strategy can have a role in FA prevention. In recent decades, several studies have demonstrated that delayed exposure to allergenic foods did not reduce the risk of FA, leading to the publication of recent guidelines which recommend against delaying the introduction of solid foods after 4–6 months of age, both in high- and low-risk infants, in order to prevent food allergy. In the present review, focusing on cow’s milk protein, hen’s eggs, peanuts, soy, wheat and fish, we describe the current scientific evidence on the relationship between timing of these foods’ introduction in infants’ diet and allergy development. Full article

(This article belongs to the Special Issue Nutrition, Diet, and Allergic Diseases)

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26 pages, 2855 KiB

Open AccessReview

Prebiotics: Mechanisms and Preventive Effects in Allergy

by Carole Brosseau, Amandine Selle, Debra J. Palmer, Susan L. Prescott, Sébastien Barbarot and Marie Bodinier

Nutrients 2019, 11(8), 1841; https://doi.org/10.3390/nu11081841 - 8 Aug 2019

Cited by 55 | Viewed by 11990

Abstract

Allergic diseases now affect over 30% of individuals in many communities, particularly young children, underscoring the need for effective prevention strategies in early life. These allergic conditions have been linked to environmental and lifestyle changes driving the dysfunction of three interdependent biological systems: microbiota, epithelial barrier and immune system. While this is multifactorial, dietary changes are of particular interest in the altered establishment and maturation of the microbiome, including the associated profile of metabolites that modulate immune development and barrier function. Prebiotics are non-digestible food ingredients that beneficially influence the health of the host by 1) acting as a fermentable substrate for some specific commensal host bacteria leading to the release of short-chain fatty acids in the gut intestinal tract influencing many molecular and cellular processes; 2) acting directly on several compartments and specifically on different patterns of cells (epithelial and immune cells). Nutrients with prebiotic properties are therefore of central interest in allergy prevention for their potential to promote a more tolerogenic environment through these multiple pathways. Both observational studies and experimental models lend further credence to this hypothesis. In this review, we describe both the mechanisms and the therapeutic evidence from preclinical and clinical studies exploring the role of prebiotics in allergy prevention. Full article

(This article belongs to the Special Issue Nutrition, Diet, and Allergic Diseases)

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16 pages, 262 KiB

Open AccessReview

Cow’s Milk Substitutes for Children: Nutritional Aspects of Milk from Different Mammalian Species, Special Formula and Plant-Based Beverages

by Elvira Verduci, Sofia D’Elios, Lucia Cerrato, Pasquale Comberiati, Mauro Calvani, Samuele Palazzo, Alberto Martelli, Massimo Landi, Thulja Trikamjee and Diego G Peroni

Nutrients 2019, 11(8), 1739; https://doi.org/10.3390/nu11081739 - 27 Jul 2019

Cited by 132 | Viewed by 24686

Abstract

Cow’s milk and dairy are commonly consumed foods in the human diet and contribute to maintaining a healthy nutritional state, providing unique sources of energy, calcium, protein, and vitamins, especially during early childhood. Milk formula is usually made from cow’s milk and represents the first food introduced into an infant’s diet when breastfeeding is either not possible or insufficient to cover nutritional needs. Very recently, increased awareness of cow’s milk protein allergy and intolerance, and higher preference to vegan dietary habits have influenced parents towards frequently choosing cows’ milk substitutes for children, comprising other mammalian milk types and plant-based milk beverages. However, many of these milk alternatives do not necessarily address the nutritional requirements of infants and children. There is a strong need to promote awareness about qualitative and quantitative nutritional compositions of different milk formulas, in order to guide parents and medical providers selecting the best option for children. In this article, we sought to review the different compositions in terms of macronutrients and micronutrients of milk from different mammalian species, including special milk formulas indicated for cow’s milk allergy, and of plant-based milk alternatives. Full article

(This article belongs to the Special Issue Nutrition, Diet, and Allergic Diseases)

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