Effects of diet on the childhood gut microbiome and its implications for atopic dermatitis

• Published in: Journal of allergy and clinical immunology Vol. 143; no. 4; pp. 1636 - 1637.e5
• Main Authors: Mahdavinia, Mahboobeh, Rasmussen, Heather E., Botha, Maresa, Binh Tran, Thi Dong, Van den Berg, Jolice P., Sodergren, Erica, Davis, Erika, Engen, Krista, Gray, Claudia, Lunjani, Nonhlanhla, Hlela, Carol, Preite, Nailliw Z., Basera, Wisdom, Hobane, Lelani, Watkins, Alexandra, Engen, Phillip, Mankahla, Avumile, Gaunt, Ben, Thomas, Facey, Tobin, Mary C., Landay, Alan, Weinstock, George M., Keshavarzian, Ali, Levin, Michael E.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2019; Elsevier Limited
• Subjects: Allergic diseases; Allergic rhinitis; Ascorbic acid; Atopic dermatitis; Breast; Breastfeeding & lactation; Calcium; Child, Preschool; Children; Cow's milk; Deoxyribonucleic acid; Dermatitis; Dermatitis, Atopic; Diet; Dietary intake; DNA; Eggs; Energy; Epigenetics; Fatty acids; Feeding; Female; Food allergies; Gastrointestinal Microbiome; Glucose tolerance; Humans; Intestinal microflora; Intolerance; Iodine; Male; Microbiota; Mucosal immunity; Nutrients; Preschool children; Proteins; Rural areas; Skin tests; South Africa; Sugar; Taxonomy; Thiamine; South Africa; Africa
• ISSN: 0091-6749; 1097-6825; 1097-6825
• DOI: 10.1016/j.jaci.2018.11.034

The composition and diversity of the early gut microbiota has been linked to the development of atopic conditions including AD.1 Although the prevalence of atopic diseases is lower in Africa,2 individuals of African origin who live in Western countries are at a significantly higher risk for atopic conditions like AD and food allergy, and suffer from more severe allergic diseases than do their white counterparts,3 possibly reflecting an enhanced genetic predisposition to allergy that is kept in check by their ancestral environment.2 In certain areas of Africa, people still live in an environment enriched in microbes through close daily contact with animals and plants in natural settings. [...]determining how their natural environment or diet protects these potentially at-risk populations should shed light on causes of the global rise in allergic conditions. High glucose in diet can induce long-lasting activating epigenetic changes in the promoter of the nuclear factor-κB gene8 and result in persistent glucose intolerance.8 These studies show that epigenetic modifications can occur during early development in response to diet and result in reprogramming of the gut mucosal immunity, which can directly impact the gut microbiome.9 Another dietary factor that was linked to AD and lower relative abundance of P copri was higher consumption of saturated fat. Data were entered by registered dietitians, generating key nutrients of interest, including total fat, saturated fat, protein, fiber, and total sugar.Allergic sensitization assessments We evaluated all children by skin prick test for sensitivity to common allergenic foods including cow's milk, eggs, wheat, soy, peanut, fish, and hazelnut. Characteristic With AD (n = 36) Without AD (n = 47) P value Sex .41 Male 19 27 Female 17 20 Age (mo), mean ± SD 21.0 ± 7.3 22.33 ± 6.8 .84 Wheezing 0 1 (3.7) .73 Allergic rhinitis 3 (8.3) 2 (4.2) .14 Food sensitized, n (%) At least 1 food 19 (52.9) 0 .0001 Cow milk 3 (8.3) 0 .03 Egg 11 (30.6) 0 .0001 Peanut 7 (19.4) 0 .0001 Hazelnut 0 0 .21 Wheat 0 0 — Soy 0 0 .17 Fish 0 0 — Polysensitized 2 (5.5) 0 .01 Table E1 Demographic and clinical characteristics of 83 toddlers recruited from rural areas of South Africa Characteristic With AD (n = 36) Without AD (n = 47) P value Breast-feeding at all 76.1% 79.1% .73 Duration of exclusive breast-feeding (mo), mean ± SD 2.93 ± 2.33 3.18 ± 2.43 .67 Total duration of breast-feeding (mo), mean ± SD 5.77 ± 4.8 6.69 ± 7.36 .72 Energy (kcal) 855.8 (436.9) 860.2 (610.0) .976 Carbohydrate, % of energy 61.7 (10.3) 64.8 (15.4) .261 Total fiber intake (g) 5.7 (6.3) 6.2 (7.2) .702 Soluble fiber (g) 0.2 (0.4) 0.2 (0.5) .094 Sugar (g) 47.6 (39.2) 27.2 (35.8) .007 Fat intake (g) 26.9 (10.4) 21.3 (12.3) Fat, % of energy 28.7 (10.1) 25.5 (12.7) .092 Saturated fat (g) 8.5 (12.5) 3.9 (8.9) .003 Omega-3 fatty acids (mg) 205.0 (290.0) 180.0 (330.0) .763 Protein intake (g) 24.0 (13.2) 23.7 (11.5) .67 Protein, % of energy 11.9 (4.0) 11.2 (3.7) .266 Calcium (mg) 632.6 (705.4) 414.4 (613.9) .402 Vitamin C (mg) 47.5 (61.7) 39.4 (52.8) .397 Thiamine (mg) 0.9 (1.0) 0.9 (0.7) .996 Iron (mg) 8.4 (14.8) 10.0 (11.0) .281 Iodine (μg) 14.6 (53.0) 27.6 (87.0) .85 Table E2 Dietary intake and breast-feeding history in 83 toddlers recruited from rural areas of South Africa