The maternal diet index in pregnancy is associated with offspring allergic diseases: the Healthy Start study

Allergy. 2022 Jan;77(1):162-172. doi: 10.1111/all.14949. Epub 2021 Jun 9.


Background: A systematic review showed limited associations between pregnancy diet and offspring allergy. We developed a maternal diet index during pregnancy that was associated with offspring allergy outcomes.

Methods: Data came from Healthy Start, a Colorado pre-birth cohort of mother/offspring dyads. Food propensity questionnaires were completed during pregnancy. Offspring allergic rhinitis, atopic dermatitis, asthma, wheeze, and food allergy diagnosis up to age four were verified from electronic medical records. Data were randomized into test and replication sets. The index included the weighted combination of variables that best predicted a combined outcome of any allergy in the test set. Index utility was verified in the replication set. Separate adjusted and unadjusted logistic models estimated associations between the index and each offspring allergy diagnosis in the full sample.

Results: The index included weighted measures of intake of vegetables, yogurt, fried potatoes, rice/grains, red meats, pure fruit juice, and cold cereals. Vegetables and yogurt were associated with the prevention of any allergy, while other components were associated with increased disease. In adjusted models, a one-unit increase in the index was significantly associated with reduced odds of offspring allergic rhinitis (odds ratio (CI) 0.82 [0.72-0.94]), atopic dermatitis (0.77 [0.69-0.86]), asthma (0.84 [0.74-0.96]), and wheeze (0.80 [0.71-0.90]), but not food allergy (0.84 [0.66-1.08]).

Conclusions: This is the first study that has shown associations between an index of maternal dietary intake during pregnancy and multiple offspring allergic diseases. The results give hope for prevention of allergic diseases in utero.

Keywords: allergic rhinitis; asthma; atopic dermatitis; food allergy; maternal diet index in pregnancy.

Publication types

  • Research Support, N.I.H., Extramural
  • Systematic Review

MeSH terms

  • Asthma* / epidemiology
  • Asthma* / etiology
  • Dermatitis, Atopic* / epidemiology
  • Dermatitis, Atopic* / etiology
  • Diet
  • Female
  • Food Hypersensitivity* / epidemiology
  • Food Hypersensitivity* / prevention & control
  • Humans
  • Pregnancy
  • Respiratory Sounds