Food protein induced allergic proctocolitis: The effect of maternal
Mediterranean diet during pregnancy and breastfeeding
Abstract
Background: The aim of the current investigation was to explore
predisposing factors for food protein induced allergic proctocolitis
(FPIAP) in Greek infants relevant in the maternal diet, during pregnancy
and breastfeeding, as relevant knowledge is limited. Methods: A
multicenter retrospective case-control study was conducted in 6 regions
in Greece, with 96 mothers of infants with and 141 mothers of infants
without a history of FPIAP. Maternal dietary habits during pregnancy and
breastfeeding were evaluated with validated questionnaires: a) The
Mediterranean Diet (MedDiet) Score, and b) The Mediterranean Oriented
Culture Specific Semi-Quantitative Food Frequency Questionnaire.
Statistical tests, modeling and exploration of the FPIAP risk in
relation to the maternal diet using elastic net regression models were
performed with R software and Studio. Results: FPIAP was
associated with cow’s milk (83.6%), egg (7.3 %), and wheat, beef
(6.4%) in the maternal diet. Adherence to MedDiet was similar among the
mothers, but mothers of FPIAP infants consumed more vegetables (p=0.018)
and olive oil (p=0.003). Elastic net prediction models showed that, in
this Mediterranean population, increased consumption during pregnancy
and lactation of common allergens, whole grain products, homemade food,
fish and shellfish, fruit offered protection; conversely, high intake of
vegetables, sugar and total fat, and non-stick/grilled cooking,
increased the risk of FPIAP, as did high intake of salt and white flour
during lactation. Conclusions: Components of a maternal
Mediterranean diet can protect against FPIAP when traditional cooking
methods are adopted and fish, fruit and whole wheat products are
consumed frequently.