Table 4.

Summary of six studies reporting the association between maternal dietary patterns and wheeze in children

Study and location	Sample and study design	Outcome	Dietary pattern	Primary results	Adjusted confounders	Quality score (rating)a
Chatzi et al45 Spain, Greece	n=2,516 pregnant woman-infant pairs; cohort	Wheeze in the first year of life	Mediterranean diet; 100-item FFQ	Adherence to Mediterranean diet during pregnancy was not associated with wheeze in the first year of life	Maternal age; education; maternal history of asthma; smoking during pregnancy; parity; duration of breastfeeding; child’s age at assessment; child’s sex	8 (positive)
Miyake et al49 Japan	n=763 pregnant woman-infant pairs; cohort	Wheeze in toddlers aged 16–24 months	Factor analysis: 3 dietary patterns (“healthy”, “Western” and “Japanese”); 150-item FFQ	Only maternal “Western” dietary pattern was a protective factor of child wheezing (OR 0.59, 95% CI 0.35–0.98)	Maternal age, gestation at baseline, residential municipality at baseline, family income, maternal and parental education, maternal and parental history of asthma, atopic eczema and allergic rhinitis, changes in maternal diet in the previous one month, season at baseline, maternal smoking during pregnancy, baby’s older siblings, baby’s sex, baby’s birth weight, household smoking in the same room as infant, breastfeeding duration, and age of infant at third survey	8 (positive)
Castro-Rodriguez et al46 Spain	n=1,409 pregnant woman-infant pairs (mean age, 16.6±2.5 months); cohort	Ever wheezing during the first year	Mediterranean diet; FFQ (number of item unreported)	Mediterranean diet score (excluding olive oil) was not associated with infants’ ever wheezing during the first year. However, olive oil was protective of ever wheezing (OR 0.57, 95% CI 0.4–0.9)	Sex, exclusive breastfeeding, day care attendance, eczema, maternal asthma, smoking during pregnancy, siblings, mold on household wall, preterm birth, olive oil	8 (positive)
Lange et al48 USA	n=1,376 pregnant woman-child pairs; cohort	Recurrent wheeze at 3 years	Mediterranean diet; Alternate Healthy Eating Index modified for pregnancy; PCA: 2 dietary patterns (“prudent” and “Western”); 166-item FFQ	No maternal dietary pattern was associated with recurrent wheeze in children	Child sex, maternal race, maternal education level, household income, maternal and paternal history of asthma, presence of children <12 years of age at home, maternal prepregnancy BMI, breast-feeding duration, and passive smoke exposure	8 (positive)
Shaheen et al47 UK	n=14,541 pregnant women and 14,062 children; cohort	Early wheezing phenotypes at 2.5 years; wheezing at 3.5 years; asthma, wheezing at 7 years; lung function and bronchial responsiveness at 8–9 years	PCA: 5 dietary patterns (“health conscious”, “traditional”, “processed”, “vegetarian” and “confectionery”); 51-item FFQ	Maternal dietary patterns were not associated with asthma and related outcomes after adjusting for confounding variables	Energy intake, maximum smoked, infections, antibiotics and paracetamol use during pregnancy; maternal education level, housing tenure, financial difficulties, prepregnancy BMI, ethnicity, age, parity, history of asthma, eczema, rhinoconjunctivitis, migraine; child’s sex, gestational age, breast fed in first 6 months, day care at 8 months, multiple pregnancy, pets in infancy, damp/condensation/mold, child exposed to environmental tobacco smoke, season of birth, season of FFQ completion, birth weight, head circumference, birth length	8 (positive)
Chatzi et al38 Spain	n=507 pregnant women and 460 children; cohort	Persistent wheeze, atopic wheeze in children at 6.5 years	Mediterranean diet; 42-item FFQ	Higher adherence of Mediterranean diet was a protective factor of persistent wheeze (OR 0.22, 95% CI0.08–0.58) and atopic wheeze (OR 0.30, 95% CI0.10–0.90) at age 6.5 years	Sex, maternal and paternal asthma, maternal social class and education, BMI, total energy intake, children adherence to Mediterranean diet at age 6.5	8 (positive)

Notes:

^aQuality was scored and rated independently using the American Dietetic Association Quality Criteria Checklist.

Abbreviations: BMI, body mass index; CI, confidence interval; FFQ, food frequency questionnaire; OR, odds ratio; PCA, principal component analysis.