PURPOSE OF THE STUDY.
This study evaluated whether the timing of introduction of fish and the amount of fish consumed were associated with asthma-like symptoms at age 48 months.
Patients were recruited from a population-based, multiethnic prospective birth cohort of 7210 children in Rotterdam, Netherlands, who were born between April 2002 and January 2006.
Nutritional data were collected from children at age 14 months by using a semiquantitative food frequency questionnaire, which assesses timing of fish consumption, fat content of fish, and amount of fish consumed. Asthma-like symptoms were evaluated by using the International Study of Asthma and Allergies in Childhood questionnaire at age 36 and 48 months. Confounding variables were considered such as the infant’s gender, gestational age, and birth weight, and maternal factors such as age, body mass index, parity, educational level, ethnicity, marital status, household income, smoking history, fish intake, folic acid supplementation, and any family history of asthma, eczema, food allergy, or allergic rhinitis.
Children with introduction of fish between ages 6 and 12 months had a significantly lower prevalence of wheezing at 48 months compared with children who were not introduced to fish in the first year. In comparison, fish introduction between 0 and 6 months and no introduction in the first year were associated with an increased prevalence of wheezing and shortness of breath at age 48 months. There was no association found between the amount of fish servings and asthma-like symptoms at age 36 and 48 months or type of fish consumption, maternal fish consumption in pregnancy, breastfeeding duration, family history of allergic disease, or history of food allergy or eczema.
Introduction of fish between ages 6 and 12 months, but not type or amount of fish consumed, was associated with lower prevalence of asthma-like symptoms at age 48 months, which may represent a window of opportunity.
This study adds to the growing amount of data which suggest that there may be a critical young age during which the introduction of classically allergenic foods reduces rather than increases the risk of food allergy and perhaps other atopic conditions. Regarding earlier introduction of fish being related to reduced risk of asthma, one theory suggests that the omega-3 fatty acids in fish inhibit the production of specific cellular mediators of atopic responses. It is interesting to see an evolution in our understanding of how specific foods may affect allergic outcomes for a variety of reasons.
- Copyright © 2013 by the American Academy of Pediatrics