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Associations Between the Maternal Diet Index and Childhood Asthma: The NorthPop and Healthy Start Cohorts
Stina Bodén1,2, Carina Venter2,3, Kaci Pickett-Nairne4
1Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
Insights
The Maternal Diet Index (MDI) did not predict childhood asthma in a Swedish cohort, unlike in a US study. This suggests the MDI may not be universally applicable for assessing pregnancy diet and offspring asthma risk.
Area of Science:
- Reproductive Health
- Pediatrics
- Nutritional Science
Background:
- A novel Maternal Diet Index (MDI) was developed and validated in the US Healthy Start cohort to assess maternal dietary intake during pregnancy.
- The MDI characterizes intake associated with offspring asthma and allergies.
Purpose of the Study:
- To externally validate the asthma-related findings of the MDI in the Swedish NorthPop Birth Cohort Study.
- To characterize the dietary patterns and demographics of both the NorthPop and Healthy Start cohorts.
Main Methods:
- The MDI was calculated using seven dietary components, with specific foods weighted for their association with offspring asthma/allergies.
- Childhood asthma incidence was determined via doctor diagnoses.
- Time-to-event analysis (Weibull) was used to evaluate the association between the MDI and offspring asthma.
Main Results:
- The NorthPop cohort exhibited significantly different mean MDI values compared to Healthy Start (p < 0.001).
- In NorthPop, a Maternal Diet Index (MDI) above the median was not a significant independent predictor of childhood asthma after full adjustment (HR 0.84; p = 0.428).
- The original Healthy Start cohort showed a significant association between a higher MDI and reduced asthma risk (HR 0.41; p < 0.0001).
Conclusions:
- The Maternal Diet Index (MDI) did not demonstrate utility as an independent predictor of offspring asthma in the NorthPop cohort, which has different demographics and dietary patterns.
- Further validation in diverse populations is required to establish the generalizability of the MDI.
Background:
A novel maternal diet index (MDI), characterizing offspring asthma- and allergy-associated maternal intake during pregnancy was constructed and validated in Healthy Start, USA. This study aims to (1) externally validate the asthma findings from Healthy Start in the NorthPop Birth Cohort Study (NorthPop) in Sweden; and (2) characterize the diet and demographics of the two cohorts.
Methods:
The MDI was computed as a weighted combination of seven components associated with offspring allergies and asthma, including vegetables and yogurt (associated with decreased odds) and cold cereals, fried potatoes, juice, red meat, and rice (associated with increased odds). Doctor diagnoses provided childhood asthma incidence and timing. Parametric Weibull time-to-event analysis evaluated associations between the MDI, dichotomized at the median (72.2) for Healthy Start, and offspring asthma.
Results:
The NorthPop and Healthy Start mean MDI values differed significantly (p < 0.001) and in NorthPop, only 6.1% had MDI < 72.2. Data from 6446 mother-child dyads in NorthPop yielded a crude hazard ratio (HR) for asthma of 0.70 (95% confidence interval [CI] 0.50-0.98, p = 0.037) and a fully adjusted HR of 0.84 (0.55-1.29; p = 0.428) for MDI > 72.2 versus < 72.2 (n = 4655). The fully adjusted HR for 945 Healthy Start dyads was significant at HR 0.41 (0.29-0.57; p < 0.0001).
Conclusions:
Results show that in a population with different maternal dietary patterns and demographics compared to the source population, MDI > 72.2 was not an independent predictor of offspring asthma. Further proof of the utility and generalizability of the MDI needs to be tested in other populations.
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