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Periconceptional maternal diet quality and offspring wheeze trajectories: Japan Environment and Children's Study
Hitomi Okubo1,2, Shoji F Nakayama1, Yukihiro Ohya3,4
1Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Ibaraki, Japan.
Insights
Improving maternal diet quality before conception may reduce the risk of transient early and persistent wheeze in children. This study identified distinct childhood wheeze patterns and their link to maternal diet.
Area of Science:
- Pediatric Allergy and Immunology
- Nutritional Epidemiology
- Developmental Pediatrics
Background:
- The link between prenatal diet and childhood asthma risk remains unclear, potentially due to diverse wheezing patterns.
- Identifying distinct wheeze trajectories in early childhood is crucial for understanding environmental influences.
- Periconceptional maternal diet quality is a modifiable factor that may impact early childhood respiratory health.
Purpose of the Study:
- To identify distinct wheeze trajectories in early childhood.
- To investigate the association between periconceptional maternal diet quality and identified wheeze trajectories.
- To inform public health strategies regarding preconception nutrition for preventing childhood respiratory issues.
Main Methods:
- Analysis of data from 70,530 mother-child pairs in the Japan Environment and Children's Study.
- Wheezing patterns were tracked yearly from ages 1 to 4 using caregiver reports and analyzed via group-based trajectory modeling.
- Maternal diet quality was assessed using a validated food frequency questionnaire and the balanced diet score; associations were examined using Bayesian logistic regression.
Main Results:
- Four distinct wheeze trajectories were identified: 'never/infrequent' (69.1%), 'early-childhood onset' (6.2%), 'transient early' (16.5%), and 'persistent' (8.2%).
- Higher maternal balanced diet scores were associated with a 10% reduced risk of 'transient early' and 'persistent' wheeze trajectories.
- No significant association was found between maternal diet quality and the 'early-childhood onset' wheeze trajectory.
Conclusions:
- Maternal diet quality in the periconceptional period is associated with specific childhood wheeze trajectories.
- Improving maternal diet quality before conception may be a viable strategy to mitigate the risk of transient and persistent wheeze.
- Further research should explore the mechanisms linking preconception nutrition to early childhood respiratory health outcomes.
Background:
The role of prenatal diet on childhood wheezing and subsequent risk of asthma is inconclusive, which may be partly due to the heterogeneity in wheezing phenotypes. We aimed to identify wheeze trajectories in early childhood and to examine their associations with periconceptional maternal diet quality.
Methods:
Data from 70,530 mother-child pairs of liveborn singletons from the Japan Environment and Children's Study were analysed. Wheezing was reported by caregivers using a modified International Study of Asthma and Allergies in Childhood questionnaire yearly from 1 to 4 years of age, from which trajectories were derived using group-based trajectory modelling. Maternal diet in the year preceding the first trimester of pregnancy was assessed using a validated food frequency questionnaire; overall diet quality was determined using the balanced diet score based on the Japanese Food Guide Spinning Top. Bayesian inference of multinomial logistic regression models was performed to examine the association between maternal diet quality and wheeze trajectory in early childhood.
Results:
We identified four wheeze trajectories: 'never/infrequent' (69.1%; reference group), 'early-childhood onset' (6.2%), 'transient early' (16.5%) and 'persistent' (8.2%). After adjustment for confounders, a higher quartile of maternal balanced diet score was associated with a lower risk of belonging to the 'transient early' and 'persistent' wheeze trajectories compared with the 'never/infrequent' wheeze trajectory by 10% of both. Maternal balanced diet score was not associated with belonging to the 'early-childhood onset' wheeze trajectory.
Conclusion:
Improving maternal diet quality prior to conception may reduce certain wheeze phenotypes in early childhood.
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