Blandine de Lauzon-Guillain’s research while affiliated with Université Paris Cité and other places

The antioxidant capacity and the inflammatory potential of diet during pregnancy may represent a prevention opportunity for allergic and respiratory diseases. We aimed to investigate the associations between the antioxidant and inflammatory potential of maternal diet in the last three months of pregnancy with allergic and respiratory diseases in children. Analyses were performed on 9679 mother-child pairs from the ELFE birth cohort. The dietary total antioxidant capacity (DTAC), without coffee, was estimated with the Trolox equivalent antioxidant capacity (TEAC), the total radical trapping antioxidant parameter (TRAP), and the ferric reducing-antioxidant power (FRAP). The inflammatory potential of the maternal diet was assessed by the energy-adjusted Dietary Inflammatory Index (E-DII). Allergic and respiratory diseases in children up to 5.5 years were considered jointly through five allergic and respiratory multimorbidity clusters (“asymptomatic” - reference, “early wheeze without asthma”, “asthma only”, “allergies without asthma”, “multi-allergic”). Multinomial logistic regressions were performed and adjusted for main confounders. A diet with a higher antioxidant potential was associated with a lower risk of belonging to the “early wheeze without asthma” cluster (aOR(95%CI) = 0.95 (0.90;0.99) per standard deviation (SD) of TEAC score). A higher E-DII was associated with a higher risk of belonging to the “asthma only” cluster (aOR(95% CI)= 1.09 (1.00;1.19) per SD). No association was found with the “allergies without asthma” or “multi-allergic” clusters. An antioxidant-rich diet during pregnancy was associated with better respiratory health while a pro-inflammatory diet was associated with poorer respiratory health in children up to 5.5 years, though the associations were weak.

Background While complementary feeding can be challenging, little emphasis has been placed on the introduction to food texture/pieces, especially in terms of neurodevelopmental outcomes. This study aims to determine the association between the timing of introduction to food pieces during infancy and neurodevelopment in early childhood. We hypothesized that late introduction to food texture/pieces relates to unfavorable neurodevelopmental outcomes. Methods Families (n = 18329) were recruited from the general population during the nationwide ELFE (Étude Longitudinale Française depuis l’Enfance) birth cohort in France, and 8511 were selected for a complete case analysis. Age at introduction to food pieces was determined based on repeated assessments during the first year. A range of neurodevelopmental outcomes among children were assessed using validated instruments, i.e. composite scores at 1 and 3.5 years, and a score for language acquisition at 2 years. Risk for developmental delay at 3.5 years was defined based on a developmental quotient (DQ) below 90 according to the child’s chronological age and the respective composite score at this age. We used linear regression modelling to evaluate associations between age at introduction to food pieces and the standardised neurodevelopmental scores, while logistic regression models were used in the analyses according to the risk for developmental delay. Results Our findings highlight consistent associations between late introduction to food pieces (i.e., after 10 months, compared to early (before 8 months)) and lower estimates of standardised neurodevelopmental scores at ages 1, 2 and 3.5 years (-0.35 [-0.40; -0.30], -0.15 [-0.20; -0.10] and − 0.18 [-0.23; -0.13], respectively). Infants introduced to pieces late were also more likely to be at risk for developmental delay according to DQ < 90 (OR [95%CI] = 1.62 [1.36; 1.94]). Conclusions This study shows that late introduction to food pieces (> 10 months) is related to lower neurodevelopmental scores. Given the challenges that complementary feeding may pose, concerted efforts are required to enhance our understanding of the sensory aspects of early diets and to ultimately provide guidance.

Evidence linking maternal diet during pregnancy to allergic or respiratory diseases in children remains sparse, and outcomes were mainly studied separately. We aim to investigate these associations by considering clusters of allergic and respiratory multimorbidity among 9679 mother–child pairs from the Elfe birth cohort. Maternal diet quality was evaluated using a food-based score (Diet Quality score), a nutrient-based score (PANDiet score) and food group intakes. Adjusted multinomial logistic regressions on allergic and respiratory multimorbidity clusters up to 5.5 years were performed. Child allergic and respiratory diseases were described through five clusters: “asymptomatic” (43%, reference), “early wheeze without asthma” (34%), “asthma only” (7%), “allergies without asthma” (7%), “multi-allergic” (9%). A higher PANDiet score and an increased legume consumption were associated with a reduced risk of belonging to the “early wheeze without asthma” cluster. A U-shaped relationship was observed between maternal fish consumption and the “allergies without asthma” cluster. To conclude, adequate nutrient intake during pregnancy was weakly associated with a lower risk of “early wheeze without asthma” in children. No association was found with food groups, considered jointly or separately, except for legumes and fish, suggesting that maternal adherence to nutritional guidelines might be beneficial for allergic and respiratory diseases prevention.

The evidence regarding the association between infant formula (IF) composition and the prevention of allergy and respiratory diseases remains sparse and inconclusive. This study aimed to evaluate whether some IF characteristics were associated with the risk of allergy or respiratory diseases in childhood. Among 1243 formula‐fed children from the EDEN mother–child cohort, IF characteristics concerning long‐chain polyunsaturated fatty acids (LCPUFAs) enrichment, prebiotic/probiotic enrichment, and hydrolysis of proteins were identified from the ingredients list. Eczema, wheezing, food allergy, asthma, and allergic rhinitis up to age 8 years were prospectively collected and summarized into four allergic and respiratory multimorbidity clusters. Associations between 4‐month IF characteristics and risk of allergy or respiratory diseases were tested using logistic regressions adjusted on main confounders. The consumption of LCPUFA‐enriched formula was not linked to allergic and respiratory multimorbidity clusters, but to a lower risk of any allergy, eczema, and wheezing. Probiotic‐enriched formula consumption was associated with a lower risk of belonging to the ‘Allergy without asthma’ cluster (odds ratio [OR] [95% confidence interval, CI] = 0.63 [0.40–0.99]), and consumption of a formula enriched in Bifidobacterium lactis was associated with a lower risk of any allergy (OR [95% CI] = 0.59 [0.41–0.85]). Partially hydrolysed formula (pHF) consumption was associated with a higher risk of belonging to the ‘Allergy without asthma’ cluster (OR [95% CI] = 2.73 [1.65–4.51]). This study confirms the positive association between pHF consumption and the risk of allergy found in previous observational studies and suggests that consumption of LCPUFA‐enriched or probiotic‐enriched formula was associated with a lower risk of allergy.

Socioeconomic status (SES) influences the risk of both physical diseases, such as asthma, and neurodevelopmental conditions, including attention-deficit/hyperactivity disorder (ADHD). Using Causal Mediation Analysis on French birth-cohort data, we found a causal pathway from SES to ADHD symptoms, in part mediated by asthma. An increase in family income at age 3 by one unit resulted in lower ADHD symptoms at age 5, by −0.37 [95% CI: −0.50, −0.24] SDQ-score-points, with additional −0.04 [95% CI: −0.08, −0.01] points reduction indirectly via asthma at age 3, both with statistical significance. Importantly, family income at age 3 exerted both direct and indirect (via asthma) negative effects on later ADHD symptoms with much higher magnitudes for the direct effect. Our findings underscore the importance of apprehending ADHD symptoms in the broader context of socioeconomic disparities, along with their comorbidities with asthma, potentially influencing public health interventions and clinical practice in managing ADHD.