Effects of maternal dietary egg intake during early lactation on human milk ovalbumin concentration: a randomized controlled trial
Metcalfe JR, Marsh JA, D'Vaz N, Geddes DT, Lai CT, Prescott SL, Palmer DJ
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 46 citations
How it was studied
- Design
- Randomized controlled trial (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
- Intake measured by
- Not stated
Who paid for it
- Funding
- Independent funding
- Nonprofit
- Princess Margaret Hospital Foundation
- Government
- Medical Research Council
- Government
- National Health and Medical Research Council
- Grants
- National Health and Medical Research Council (1046036)
Based on 3 listed funder(s).
Publication
- Published
- 2016-08-26 · Clin Exp Allergy · vol. 46 · issue 12 · pp. 1605–1613
- Publisher
- Wiley
- Cited
- 62 citations · more than 92% of similar papers · 3.5× the field average
- Impact
- Top 10% most cited in its field
- References
- 18 works
- Access
- Open access (repository copy) · OTHER-OA
- Research areas
- Food Allergy and Anaphylaxis Research · Infant Nutrition and Health · Breastfeeding Practices and Influences
- Keywords
- Ovalbumin, Lactation, Ingestion, Sensitization, Egg allergy, Medicine, Oral food challenge, Breast feeding, Animal science, Internal medicine, Endocrinology, Biology, Allergy, Immunology, Pregnancy, Food allergy, Immune system
- MeSH
- milk, human, animals, humans, food hypersensitivity, ovalbumin, immunoglobulin e, immunoglobulin g, allergens, diet, risk factors, antibody specificity, breast feeding, lactation, pregnancy, eggs, adult, infant, infant, newborn, female, male
7 authors
From AU
- Jessica R. MetcalfeThe University of Western Australia
- Julie A. MarshThe Kids Research Institute Australia; The University of Western Australia
- Nina D’VazThe Kids Research Institute Australia; The University of Western Australia
- Donna Tracy GeddesThe University of Western Australia
- Ching Tat LaiThe University of Western Australia
- Susan L. PrescottThe Kids Research Institute Australia; The University of Western Australia
Abstract
Background
There is limited understanding of how maternal diet affects breastmilk food allergen concentrations, and whether exposure to allergens through this route influences the development of infant oral tolerance or sensitization.
Objective
To investigate how maternal dietary egg ingestion during early lactation influences egg protein (ovalbumin) levels detected in human breastmilk.
Methods
In a randomized controlled trial, women were allocated to a dietary group for the first six weeks of lactation: high-egg diet (> 4 eggs per week), low-egg diet (one-three eggs per week) or an egg-free diet. Breastmilk samples were collected at 2, 4 and 6 weeks of lactation for the measurement of ovalbumin. The permeability of the mammary epithelium was assessed by measuring the breastmilk sodium : potassium ratio. Egg-specific IgE and IgG4 were measured in infant plasma at 6 weeks, and prior to the introduction of egg in solids at 16 weeks.
Results
Average maternal egg ingestion was associated with breastmilk ovalbumin concentration. Specifically, for each additional egg ingested per week, there was an average 25% increase in ovalbumin concentration (95% CI: 5-48%, P = 0.01). Breastmilk ovalbumin concentrations were significantly higher in the 'high-egg' group (> 4 eggs per week) compared with the 'egg-free' group (P = 0.04). However, one-third of women had no breastmilk ovalbumin detected. No detectable associations were found between mammary epithelium permeability and breastmilk ovalbumin concentrations. Infant plasma egg-specific IgG4 levels were also positively associated with maternal egg ingestion, with an average 22% (95% CI: 3-45%) increase in infant egg-specific IgG4 levels per additional egg consumed per week (P = 0.02).
Conclusions and clinical relevance
Increased maternal egg ingestion is associated with increased breastmilk ovalbumin, and markers of immune tolerance in infants. These results highlight the potential for maternal diet to benefit infant oral tolerance development during lactation.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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