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Revisión sistemática

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Maternal Omega-3 Supplementation During Pregnancy, But Not Childhood Supplementation, Reduces the Risk of Food Allergy Diseases in Offspring.

Revista The journal of allergy and clinical immunology. In practice
Año 2023
Enlaces Pubmed DOI

Este artículo incluye 12 Estudios primarios 7 Estudios primarios (12 referencias)

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BACKGROUND: Omega-3 supplementation has been reported to modulate immune responses and prevent food allergies among children; however, findings are inconsistent, and the timing of supplementation, which is critical, has not been thoroughly investigated. OBJECTIVE: To assess optimal timing (maternal vs. childhood intake) of omega-3 supplementation for reducing food allergy risk among children in two periods (the first three years and beyond three years of age). METHODS: We performed a meta-analysis to assess the effects of maternal or childhood omega-3 supplementation on preventing the development of infant food allergies and food sensitizations. The PubMed/MEDLINE, EMBASE, Scopus, and Web of Science databases were searched for related studies published until October 30, 2022. We conducted dose-response and subgroup analyses to investigate the effects of omega-3 supplementation. RESULTS: We found that maternal omega-3 supplementation during pregnancy and lactation was significantly associated with decreased risks of infant egg sensitization (relative risk [RR]: 0.58, 95% confidence interval [95% CI]: 0.47 to 0.73, p < 0.01) and peanut sensitization (RR: 0.62, 95% CI: 0.47 to 0.80, p < 0.01) among children. Similar results were found in subgroup analyses for food allergy, egg sensitization, and peanut sensitization during the first 3 years of age and peanut sensitization and cashew nut sensitization beyond 3 years of age. Dose-response analysis showed a linear relationship between maternal omega-3 supplementation and infant egg sensitization risk during early life. By contrast, intake of omega-3 polyunsaturated fatty acid during childhood did not appear to significantly protect against food allergies. CONCLUSION: Maternal omega-3 supplementation during pregnancy and lactation, rather than childhood intake, reduces the risk of infant food allergy and food sensitization.

Revisión sistemática

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The Effect of Dietary Components of the Mediterranean Diet on Food Allergies: A Systematic Review.

Revista Nutrients
Año 2023
Enlaces Pubmed DOI PubMed Central

Este artículo incluye 9 Estudios primarios 9 Estudios primarios (9 referencias)

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Allergies are a common and increasing health problem affecting millions of people worldwide. This increase is attributed to genetic predisposition, air pollution, climate change, lack of physical activity, and alterations in eating habits. The Mediterranean diet (MD), which includes a lot of fruits and vegetables, whole grains, legumes, nuts, olive oil, and fish, has been linked to a variety of health benefits, including a lower risk of chronic and allergic disease. This paper explores the effects of the dietary components of the MD on food allergies. Electronic databases PubMed, Scopus, Science Direct, and EBSCO were used to conduct this systematic review. Out of 696 studies initially identified, five human and four animal studies were included. Risk of bias was determined using the Office of Health Assessment and Translation tool. In human studies, when the intervention was given during pregnancy and lactation, a beneficial effect was observed. When the intervention was given during pregnancy and until birth or to the infant for six months, no effect was observed. The animal studies indicated a beneficial effect between the food components of the MD and food allergies. Although the results are promising, the limited number of studies highlights the need for more research.

Revisión sistemática

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Enteral long-chain polyunsaturated fatty acids and necrotizing enterocolitis: A systematic review and meta-analysis.

Revista The American journal of clinical nutrition
Año 2023
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Este artículo incluye 15 Estudios primarios 15 Estudios primarios (15 referencias)

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BACKGROUND: Preterm infants are at risk of long-chain polyunsaturated fatty acid (LCPUFA) deficiency. Recent studies on high-dose DHA; n-3 LCPUFA in preterm infants suggested potential positive effects on cognitive outcomes but raised concerns about some increased neonatal morbidities. These studies and recent recommendations for DHA supplementation generated controversy owing to the lack of balance between DHA and arachidonic acid (ARA; n-6 LCPUFA). OBJECTIVES: To identify the effect of enteral supplementation of DHA, with and without ARA, on necrotizing enterocolitis (NEC) in very preterm infants. METHODS: A systematic review of randomized and controlled trials compared enteral LCPUFAs with placebo or no supplementation in very preterm infants. We searched PubMed, Ovid-MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and CINHAL databases from inception to July 2022. Data were extracted in duplicate using a structured proforma. A meta-analysis and metaregression with random-effects models were used. The interventions evaluated were DHA alone vs. that combined with ARA, source of DHA, dose, and supplement delivery methods. Methodological qualities and risk of bias were assessed using the Cochrane risk-of-bias tool. RESULTS: Fifteen randomized clinical trials (RCTs) included 3963 very preterm infants with 217 cases of NEC. Supplementation with DHA alone increased NEC (2620 infants; RR: 1.56; 95% CI: 1.02, 2.39) with no evidence of heterogeneity (I2 = 0.0%, P = 0.46). Multiple metaregression revealed significant reduction in NEC when ARA was supplemented with DHA (aRR 0.42; 95% CI: 0.21, 0.88). The source of DHA, dose, and feeding type revealed no associations with NEC. Two RCTs supplemented high-dose DHA to lactating mothers. There was a significant increase in risk of NEC with this approach (1148 infants; RR: 1.92; 95% CI: 1.02, 3.61) with no evidence of heterogeneity (I2 = 0.0, P = 0.81). CONCLUSIONS: Supplementation with DHA alone may increase risk of NEC. Concurrent supplementation with ARA needs to be considered when adding DHA to preterm infants' diet.

Revisión sistemática

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Effect of Prenatal Omega-3 Polyunsaturated Fatty Acid Supplementation on Childhood Eczema: A Systematic Review and Meta-Analysis.

Autores Jia Y , Huang Y , Wang H , Jiang H
Revista International archives of allergy and immunology
Año 2023
Enlaces Pubmed DOI

Este artículo incluye 6 Estudios primarios 6 Estudios primarios (6 referencias)

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It is uncertain about the effect of omega-3 polyunsaturated fatty acid (ω-3 PUFA) supplementation during pregnancy on the incidence of eczema among children. The aim of this review was to test if there is an effect of ω-3 PUFA supplementation during pregnancy on the risk of eczema among children of different ages. Two authors independently carried out the selection of published works, data extraction, and evaluation of the likelihood of bias. The PubMed, Medline, the Cochrane Library, Web of Science, and Embase databases updated to the date of March 2021 have been researched thoroughly for literature review. Quality Assessment of studies was evaluated using the updated tool (Rob2) provided by the Cochrane collaboration group. Six unique randomized controlled trials from 7 studies including 1,646 mother-infant pairs were contained in this review. Pooled data showed no pronounced decline in the incidence of eczema (RR = 1.09, 95% CI = 0.82~1.46, p = 0.54) or IgE-associated eczema (RR = 0.67; 95% CI = 0.29~1.57; p = 0.34). However, the subgroup analyses on "IgE-associated eczema" showed a significant decrease among the "≤3-year-old children" (RR = 0.70; 95% CI = 0.50~0.96; p = 0.03) in the ω-3 PUFAs group compared with the placebo. Supplementing the maternal diet with ω-3 PUFAs during pregnancy cannot reduce the danger of eczema or IgE-associated eczema among all children; however, there may be a subgroup-specific effect on 3-year-old or even younger children in reducing the incidence of IgE-associated eczema.

Revisión sistemática

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Influence of Maternal Fish Oil Supplementation on the Risk of Asthma or Wheeze in Children: A Meta-Analysis of Randomized Controlled Trials

Autores Wu S , Li C
Revista Frontiers in pediatrics
Año 2022
Enlaces Pubmed DOI PubMed Central

Este artículo incluye 10 Estudios primarios 11 Estudios primarios (10 referencias)

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BACKGROUND: Previous studies evaluating the influences of maternal fish oil supplementation on the risk of asthma or wheeze in children showed inconsistent results. We performed a meta-analysis or randomized controlled trials (RCTs) to systematically evaluate the efficacy of maternal fish oil supplementation for asthma or wheeze. METHODS: Relevant RCTs were obtained by search of PubMed, Embase, and Cochrane's Library databases. A random-effects model incorporating the potential publication bias was used to pool the results. RESULTS: Ten RCTs with 3,676 infants were included. Compared to control, maternal supplementation with fish oil was not associated with a reduced risk of asthma or wheeze [odds ratio (OR): 0.91, 95% confidence interval (CI): 0.72-1.14, P = 0.40] with mild heterogeneity (I 2 = 28%). Subgroup analyses showed that maternal fish oil supplementation significantly reduced the risk of asthma (OR: 0.56, 95% CI: 0.35-0.91, P = 0.02; I 2 = 0%), but not the risk of wheeze (OR: 1.12, 95% CI: 0.90-1.41, P = 0.32; I 2 = 0%). In addition, maternal fish oil supplementation was associated with reduced risk of asthma or wheeze in high-dose studies (≥1,200 mg/d, OR: 0.65, 95% CI: 0.48-0.87, P = 0.003; I 2 = 0%), but not in low-dose studies (<1,200 mg/d, OR: 1.10, 95% CI: 0.88-1.38, P = 0.39; I 2 = 0%, P for subgroup difference = 0.005). Study characteristics such as the risk of the infants, timing of supplementation, and follow-up duration did not significantly affect the results. CONCLUSIONS: Maternal fish oil supplementation may reduce the risk of clinically diagnosed asthma in children, particularly with high-dose fish oil.

Revisión sistemática

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Supplementation with long chain n-3 fatty acids during pregnancy, lactation, or infancy in relation to risk of asthma and atopic disease during childhood: a systematic review and meta-analysis of randomized controlled clinical trials

Revista Food & nutrition research
Año 2022
Enlaces Pubmed DOI PubMed Central

Este artículo incluye 18 Estudios primarios 9 Estudios primarios (18 referencias)

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OBJECTIVE: To assess whether supplementation with long chain n-3 fatty acids during pregnancy, lactation, or infancy reduces the risk of developing asthma or atopic disease during childhood. METHODS: Searches were performed in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus up to 2021-09-20, for randomized controlled trials (RCTs) that investigated the effect of supplemental long chain n-3 fatty acids during pregnancy, lactation, or infancy for the prevention of childhood asthma or allergy. Article selection, data extraction, and risk of bias assessment (Cochrane's Risk of Bias 2.0) were independently conducted by two assessors. The evidence was synthesized qualitatively according to the criteria of the World Cancer Research Fund and meta-analyzed. RESULTS: A total of nine RCTs met inclusion criteria; six were conducted during pregnancy, two during infancy, and one during both pregnancy and infancy. Meta-analysis showed that long chain n-3 fatty acid supplementation during pregnancy significantly reduced the risk of asthma/wheeze in the child (RR 0.62 [95% confidence interval 0.34-0.91], P = 0.005, I 2 = 67.4%), but not other outcomes. Supplementation during lactation of infancy showed no effects on any outcome. The strength of evidence that long chain n-3 fatty acid supplementation during pregnancy reduces risk of asthma/wheeze in the offspring was considered limited - suggestive. No conclusion could be made for the effects of long chain n-3 fatty acid supplementation during pregnancy for other atopic diseases, or for supplementation during lactation or infancy for any outcome. CONCLUSION: The intake of long chain n-3 fatty acid supplements during pregnancy may reduce the risk of asthma and/or wheeze in the offspring, but the strength of evidence is low. There is inconclusive evidence for the effects of long chain n-3 fatty acid supplements during pregnancy for other outcomes, as well as for supplementation during lactation or infancy.

Revisión sistemática

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A dose-response meta-analysis of the association between the maternal omega-3 long-chain polyunsaturated fatty acids supplement and risk of asthma/wheeze in offspring.

Autores Jia Y , Huang Y , Wang H , Jiang H
Revista BMC pediatrics
Año 2022
Enlaces Pubmed DOI PubMed Central

Este artículo incluye 9 Estudios primarios 8 Estudios primarios (9 referencias)

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BACKGROUND: Prenatal exposure to omega-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFA) in oily fish may prevent asthma or wheeze in childhood. OBJECTIVE: By limiting n-3 LC-PUFA capsules interventions commenced in pregnancy, this systematic review aimed to find more clear evidence on the relationship between the supplement with n-3 LC-PUFA during pregnancy and the risk of asthma/wheeze in offspring and to improve the life satisfaction of children with asthma. METHODS: The Cochrane library, Embase, Medline, Web of Science, and PubMed were searched from origin to March 2021 in the above-mentioned databases. Studies selection, data of characteristics extraction, and risk of bias assessment were conducted by two authors, independently. A total of 3037 mother-infant pairs from eight randomized controlled trials were ultimately analyzed. The primary outcome was the risk of "asthma and/or wheeze", and the secondary outcome was "Allergic asthma" in this dose-response meta-analysis. Sensitivity analysis and subgroup analysis were conducted. The robust-error meta-regression model was used for dose-response analysis. RESULTS: This meta-analysis showed that n-3 LC-PUFA during pregnancy did not obviously reduce the risk of asthma/wheeze (RR 0.93; 95% CI 0.82 to 1.04, p = 0.21) and allergic asthma (RR 0.66, 95% CI 0.24 to 1.86, p = 0.44). The risk of asthma/wheeze in offspring was significantly decreased in the subgroup analysis when:: (1) studies conducted in Europe (RR 0.69; 95% CI 0.53 to 0.89); (2) daily supplementary dose of n-3 LC-PUFA was at least 1200 mg (RR 0.69; 95% CI 0.55 to 0.88); (3) supplementation lasts from pregnancy to lactation period (RR 0.69; 95% CI 0.51 to 0.95). Furthermore, the risk of asthma/wheeze reduce 2% when daily supplemental dose of n-3 LC-PUFA was increased by 100 mg in the linear dose-response analysis model. CONCLUSIONS: Perinatal supplementation with n-3 LC-PUFA can reduce the incidence of asthma/wheeze and allergic asthma in children under certain conditions, and higher doses indicate better protective effects. Further studies are required to confirm the hypothesis of an association between n-3 LC-PUFA intake and childhood asthma/wheeze prevention.

Revisión sistemática

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Effects of supplementation with omega-3 fatty acids during pregnancy on asthma or wheeze of children: A Systematic Rev and meta-analysis.

Autores Lin J , Zhang Y , Zhu X , Wang D , Dai J
Revista The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
Año 2020
Enlaces Pubmed DOI

Este artículo incluye 7 Estudios primarios 6 Estudios primarios (7 referencias)

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OBJECTIVE: To evaluate the effects of omega-3 fatty acids during pregnancy on the incidence of wheeze and asthma of children. METHODS: A search was conducted in PubMed, Embase and CENTRAL until September 2017. Randomized controlled trials (RCTs) assessing the effects of omega-3 fatty acids during pregnancy on wheeze/asthma of children were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. Outcomes of relative risks were pooled. Subgroup analyses were conducted. RESULTS: Seven RCTs involving 2047 children were included. The pooled data revealed the supplementation during pregnancy reduced the incidence of wheeze/asthma (risk ratio (RR) 0.81; 95% CI 0.66-0.99; p 0.04), but the incidence of childhood asthma was not significantly reduced (RR 0.89; 95%CI 0.67-1.17; p 0.40). Subgroup analyses indicated that the risk of childhood wheeze/asthma was significantly decreased 1) in studies located in Europe (RR 0.67 95% CI 0.51 0.88), 2) in children whose first-degree relatives were diagnosed with allergic disease (RR 0.65 95% CI 0.49 0.85), 3) when a dose of omega - 3 fatty acids ≥ 2000mg/d was applied (RR 0.61 95% CI 0.45 0.81), 4) in wheeze/asthma without sensitivity (RR 0.71 95% CI 0.54 0.94). CONCLUSION: The available low-quality evidence indicated that omega-3 fatty acids supplementation during pregnancy may reduce the incidence of wheeze/asthma of children, but incidence of asthma was not reduced after omega-3 fatty acids supplementation during pregnancy. More well-designed RCTs with large sample sizes need to be conducted to better understand the effectiveness of omega-3 fatty acids supplementation during pregnancy with asthma in childhood.

Revisión sistemática

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Preventing food allergy in infancy and childhood: systematic review of randomised controlled trials.

Revista Pediatric allergy and immunology
Año 2020
Enlaces Pubmed DOI

Este artículo está incluido en 2 Síntesis amplias 45 Síntesis amplias (2 referencias)

Este artículo incluye 46 Estudios primarios 45 Estudios primarios (46 referencias)

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BACKGROUND: This systematic review of ways to prevent immediate-onset/IgE-mediated food allergy will inform guidelines by the European Academy of Allergy and Immunology (EAACI). METHODS: The GRADE approach was used. Eleven databases were searched from 1946 to October 2019 for randomised controlled trials (and large prospective cohort studies in the case of breastfeeding). The studies included heterogeneous interventions, populations and outcomes so were summarised narratively. RESULTS: Forty-six studies examined interventions to reduce the risk of food allergy in infancy (up to one year) or early childhood. The following interventions for pregnant or breastfeeding women and/or infants may have little to no effect on preventing food allergy but the evidence is very uncertain: dietary avoidance of food allergens, vitamin supplements, fish oil, probiotics, prebiotics, synbiotics and emollients. Breastfeeding, hydrolysed formulas and avoiding cow's milk formula may not reduce the risk of cow's milk protein allergy, however temporary supplementation with cow's milk formula in the first week of life may increase the risk of cow's milk allergy. Introducing well-cooked egg, but not pasteurised raw egg, from four to six months probably reduces the risk of hen's egg allergy. Introducing regular peanut consumption into the diet of an infant at increased risk beginning from four to 11 months probably results in a large reduction in peanut allergy in countries with a high prevalence. These conclusions are based on moderate certainty evidence, from single trials in high-income countries. CONCLUSIONS: Sixty percent of the included studies were published in the last ten years, but much still remains to be understood about preventing food allergy. In particular, there is a need to validate the potential benefits of early introduction of food allergens in a wider range of populations.

Revisión sistemática

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Dietary factors during pregnancy and atopic outcomes in childhood: A systematic review from the European Academy of Allergy and Clinical Immunology.

Revista Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
Año 2020
Enlaces Pubmed DOI PubMed Central

Este artículo incluye 95 Estudios primarios 67 Estudios primarios (95 referencias)

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RATIONALE: Allergic diseases are an increasing public health concern, and early life environment is critical to immune development. Maternal diet during pregnancy has been linked to offspring allergy risk. In turn, maternal diet is a potentially modifiable factor, which could be targeted as an allergy prevention strategy. In this systematic review, we focused on non-allergen-specific modifying factors of the maternal diet in pregnancy on allergy outcomes in their offspring. METHODS: We undertook a systematic review of studies investigating the association between maternal diet during pregnancy and allergic outcomes (asthma/wheeze, hay fever/allergic rhinitis/seasonal allergies, eczema/atopic dermatitis (AD), food allergies, and allergic sensitization) in offspring. Studies evaluating the effect of food allergen intake were excluded. We searched three bibliographic databases (MEDLINE, EMBASE, and Web of Science) through February 26, 2019. Evidence was critically appraised using modified versions of the Cochrane Collaboration Risk of Bias tool for intervention trials and the National Institute for Clinical Excellence methodological checklist for cohort and case-control studies and meta-analysis performed from RCTs. RESULTS: We identified 95 papers: 17 RCTs and 78 observational (case-control, cross-sectional, and cohort) studies. Observational studies varied in design and dietary intakes and often had contradictory findings. Based on our meta-analysis, RCTs showed that vitamin D supplementation (OR: 0.72; 95% CI: 0.56-0.92) is associated with a reduced risk of wheeze/asthma. A positive trend for omega-3 fatty acids was observed for asthma/wheeze, but this did not reach statistical significance (OR: 0.70; 95% CI: 0.45-1.08). Omega-3 supplementation was also associated with a non-significant decreased risk of allergic rhinitis (OR: 0.76; 95% CI: 0.56-1.04). Neither vitamin D nor omega-3 fatty acids were associated with an altered risk of AD or food allergy. CONCLUSIONS: Prenatal supplementation with vitamin D may have beneficial effects for prevention of asthma. Additional nutritional factors seem to be required for modulating the risk of skin and gastrointestinal outcomes. We found no consistent evidence regarding other dietary factors, perhaps due to differences in study design and host features that were not considered. While confirmatory studies are required, there is also a need for performing RCTs beyond single nutrients/foods.