Influencia de la dieta de la mujer lactante en el desarrollo de alergias en el niño: una revisión bibliográfica
Resumen Introducción: El aumento de enfermedades alérgicas producido en los últimos años se ha asociado a factores genéticos y ambientales, entre los que se encuentra la alimentación con leche materna, que puede prevenir la alergia o, por el contrario, sensibilizar a ciertos alérgenos, según sea la composición de la propia leche, el sistema inmune del lactante o su epigenética. El objetivo de esta revisión bibliográfica es evaluar el nivel de evidencia científica que existe actualmente sobre el impacto que tiene la dieta materna durante la lactancia en la prevención o desarrollo de enfermedades alérgicas del niño. Metodología: Se ha realizado una revisión bibliográfica consultando en las bases de datos PubMed, TripDatabase y Cochrane Library de todos los artículos escritos en inglés de los últimos 5 años revisando resúmenes y artículos completos. Discusión: Los estudios controlados aleatorizados son éticamente difíciles de realizar, por lo que la mayoría de los estudios publicados son observacionales y están sujetos a sesgos. Algunos estudios han encontrado asociaciones entre el consumo materno de grasas saturadas y leche de vaca con una menor prevalencia de enfermedades alérgicas, pero otras revisiones concluyen que no hay suficiente evidencia para afirmar el impacto de la dieta materna en las alergias. Otros factores como la exposición a alérgenos ambientales y la genética también influyen. Conclusiones: La heterogeneidad de los resultados puede ser debida a que muchos de los estudios realizados son observacionales y, por tanto, no controlan bien las variables externas influyentes. Esto podría solucionarse con la realización de más ensayos clínicos que realicen un adecuado control de todas estas variables.
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Kramer MS, Kakuma R. Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child. Cochrane Libr [Internet]. 2012;2012(9). Disponible en: https://pubmed.ncbi.nlm.nih.gov/22972039/
Metcalfe JR, Marsh JA, D’Vaz N, Geddes DT, Lai CT, Prescott SL et al. Effects of maternal dietary egg intake during early lactation on human milk ovalbumin concentration: a randomized controlled trial. Clin Exp Allergy [Internet]. 2016;46(12):1605-13. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27562481/
Taylor R, Keane D, Borrego P, Arcaro K. Effect of maternal diet on maternal milk and breastfed infant gut microbiomes: A scoping review. Nutrients [Internet]. 2023;15(6):1420. Disponible en: https://pubmed.ncbi.nlm.nih.gov/36986148/
Friedman NJ, Zeiger RS. The role of breast-feeding in the development of allergies and asthma. J Allergy Clin Immunol [Internet]. 2005;115(6):1238-48. Disponible en: https://pubmed.ncbi.nlm.nih.gov/15940141/
Sicherer SH, Burks AW. Maternal and infant diets for prevention of allergic diseases: understanding menu changes in 2008. J Allergy Clin Immunol [Internet]. 2008;122(1):29-33. Disponible en: https://pubmed.ncbi.nlm.nih.gov/18547624/
Schocker F, Jappe U. Breastfeeding: Maternally transferred allergens in breast milk: Protective or sensitizing? Mol Nutr Food Res [Internet]. 2022;66(15). Disponible en: https://pubmed.ncbi.nlm.nih.gov/35619210/
Jeurink PV, Knipping K, Wiens F, Barańska K, Stahl B, Garssen J et al. Importance of maternal diet in the training of the infant’s immune system during gestation and lactation. Crit Rev Food Sci Nutr [Internet]. 2019;59(8):1311-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29393671/
Palmer DJ, Silva DT, Prescott SL. Maternal peanut and egg consumption during breastfeeding randomized pilot trial. Pediatr Allergy Immunol [Internet]. 2022;33(9). Disponible en: https://onlinelibrary.wiley.com/doi/10.1111/pai.13845
Miliku K, Azad M. Breastfeeding and the developmental origins of asthma: Current evidence, possible mechanisms, and future research priorities. Nutrients [Internet]. 2018;10(8):995. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30061501/
Stråvik M, Barman M, Hesselmar B, Sandin A, Wold AE, Sandberg A-S. Maternal intake of cow’s milk during lactation is associated with lower prevalence of food allergy in offspring. Nutrients [Internet]. 2020;12(12):3680. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33260602/
Sozańska B, Sikorska-Szaflik H. Diet modifications in primary prevention of asthma. Where do we stand? Nutrients [Internet]. 2021;13(1):173. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33429965/
Greer FR, Sicherer SH, Burks AW, Abrams SA, Fuchs GJ III, Kim JH et al. The effects of early nutritional interventions on the development of atopic disease in infants and children: The role of maternal dietary restriction, breastfeeding, hydrolyzed formulas, and timing of introduction of allergenic complementary foods. Pediatrics [Internet]. 2019;143(4). Disponible en: https://pubmed.ncbi.nlm.nih.gov/30886111/
Wang L-C, Chiang B-L, Huang Y-M, Shen P-T, Huang H-Y, Lin B-F. Lower vitamin D levels in the breast milk is associated with atopic dermatitis in early infancy. Pediatr Allergy Immunol [Internet]. 2020;31(3):258-64. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31758588/
Tena’ain NAH, Shukri NAM. Food allergens in maternal diet during breastfeeding and outcome of elimination diet on infant allergy development: A systematic review. Inter J Health Allied SCI [Internet]. 2020;4(3):1216-28. Disponible en: https://journals.iium.edu.my/ijahs/index.php/IJAHS/article/view/481
Donovan S, Dewey K, Novotny R, Stang J, Taveras E, Kleinman R et al. Maternal diet during pregnancy and lactation and risk of child food allergies and atopic allergic diseases: A systematic review. U.S. Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Nutrition Evidence Systematic Review; 2020;46(12):1605-13. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK578647/https://pubmed.ncbi.nlm.nih.gov/35289989/
Demers-Mathieu V, Lavangnananda S. Restricting cow’s milk in the maternal diet reduces the titers of β-lactoglobulin-specific IgG antibodies in human milk. Breastfeed Med [Internet]. 2022;17(6):501-5. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35325546/
Landau T, Vakulenko-Lagun B, Brandwein M. The protective effect of moderate maternal peanut consumption on peanut sensitization and allergy. Ann Allergy Asthma Immunol [Internet]. 2023;131(2):231-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/37098405/
Nagakura K-I, Sato S, Shinahara W, Kido H, Fujita H, Yanai T et al. Effect of maternal egg intake during the early neonatal period and risk of infant egg allergy at 12 months among breastfeeding mothers: A randomized clinical trial. JAMA Netw Open [Internet]. 2023;6(7). Disponible en: https://pubmed.ncbi.nlm.nih.gov/37428506/
Devonshire AL, Robison RG. Prevention of food allergy. Allergy Asthma Proc [Internet]. 2019;40(6):450-2. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31690392/
Abrams EM, Shaker MS, Chan ES, Brough HA, Greenhawt M. Prevention of food allergy in infancy: the role of maternal interventions and exposures during pregnancy and lactation. Lancet Child Adolesc Health [Internet]. 2023;7(5):358-66. Disponible en: https://pubmed.ncbi.nlm.nih.gov/36871575/
Calatayud Sáez F, Calatayud Moscoso del Prado B, Luque Navas M, Calatayud Moscoso del Prado A, Gallego Fernández-Pacheco JG, Rivas Ruiz F. Effects of the affinity to the Mediterranean diet pattern together with breastfeeding on the incidence of childhood asthma and other inflammatory and recurrent diseases. Allergol Immunopathol (Madr) [Internet]. 2021;49(6):48-55. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34761656/
Metcalfe JR, Marsh JA, D’Vaz N, Geddes DT, Lai CT, Prescott SL et al. Effects of maternal dietary egg intake during early lactation on human milk ovalbumin concentration: a randomized controlled trial. Clin Exp Allergy [Internet]. 2016;46(12):1605-13. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27562481/
Taylor R, Keane D, Borrego P, Arcaro K. Effect of maternal diet on maternal milk and breastfed infant gut microbiomes: A scoping review. Nutrients [Internet]. 2023;15(6):1420. Disponible en: https://pubmed.ncbi.nlm.nih.gov/36986148/
Friedman NJ, Zeiger RS. The role of breast-feeding in the development of allergies and asthma. J Allergy Clin Immunol [Internet]. 2005;115(6):1238-48. Disponible en: https://pubmed.ncbi.nlm.nih.gov/15940141/
Sicherer SH, Burks AW. Maternal and infant diets for prevention of allergic diseases: understanding menu changes in 2008. J Allergy Clin Immunol [Internet]. 2008;122(1):29-33. Disponible en: https://pubmed.ncbi.nlm.nih.gov/18547624/
Schocker F, Jappe U. Breastfeeding: Maternally transferred allergens in breast milk: Protective or sensitizing? Mol Nutr Food Res [Internet]. 2022;66(15). Disponible en: https://pubmed.ncbi.nlm.nih.gov/35619210/
Jeurink PV, Knipping K, Wiens F, Barańska K, Stahl B, Garssen J et al. Importance of maternal diet in the training of the infant’s immune system during gestation and lactation. Crit Rev Food Sci Nutr [Internet]. 2019;59(8):1311-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29393671/
Palmer DJ, Silva DT, Prescott SL. Maternal peanut and egg consumption during breastfeeding randomized pilot trial. Pediatr Allergy Immunol [Internet]. 2022;33(9). Disponible en: https://onlinelibrary.wiley.com/doi/10.1111/pai.13845
Miliku K, Azad M. Breastfeeding and the developmental origins of asthma: Current evidence, possible mechanisms, and future research priorities. Nutrients [Internet]. 2018;10(8):995. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30061501/
Stråvik M, Barman M, Hesselmar B, Sandin A, Wold AE, Sandberg A-S. Maternal intake of cow’s milk during lactation is associated with lower prevalence of food allergy in offspring. Nutrients [Internet]. 2020;12(12):3680. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33260602/
Sozańska B, Sikorska-Szaflik H. Diet modifications in primary prevention of asthma. Where do we stand? Nutrients [Internet]. 2021;13(1):173. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33429965/
Greer FR, Sicherer SH, Burks AW, Abrams SA, Fuchs GJ III, Kim JH et al. The effects of early nutritional interventions on the development of atopic disease in infants and children: The role of maternal dietary restriction, breastfeeding, hydrolyzed formulas, and timing of introduction of allergenic complementary foods. Pediatrics [Internet]. 2019;143(4). Disponible en: https://pubmed.ncbi.nlm.nih.gov/30886111/
Wang L-C, Chiang B-L, Huang Y-M, Shen P-T, Huang H-Y, Lin B-F. Lower vitamin D levels in the breast milk is associated with atopic dermatitis in early infancy. Pediatr Allergy Immunol [Internet]. 2020;31(3):258-64. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31758588/
Tena’ain NAH, Shukri NAM. Food allergens in maternal diet during breastfeeding and outcome of elimination diet on infant allergy development: A systematic review. Inter J Health Allied SCI [Internet]. 2020;4(3):1216-28. Disponible en: https://journals.iium.edu.my/ijahs/index.php/IJAHS/article/view/481
Donovan S, Dewey K, Novotny R, Stang J, Taveras E, Kleinman R et al. Maternal diet during pregnancy and lactation and risk of child food allergies and atopic allergic diseases: A systematic review. U.S. Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Nutrition Evidence Systematic Review; 2020;46(12):1605-13. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK578647/https://pubmed.ncbi.nlm.nih.gov/35289989/
Demers-Mathieu V, Lavangnananda S. Restricting cow’s milk in the maternal diet reduces the titers of β-lactoglobulin-specific IgG antibodies in human milk. Breastfeed Med [Internet]. 2022;17(6):501-5. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35325546/
Landau T, Vakulenko-Lagun B, Brandwein M. The protective effect of moderate maternal peanut consumption on peanut sensitization and allergy. Ann Allergy Asthma Immunol [Internet]. 2023;131(2):231-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/37098405/
Nagakura K-I, Sato S, Shinahara W, Kido H, Fujita H, Yanai T et al. Effect of maternal egg intake during the early neonatal period and risk of infant egg allergy at 12 months among breastfeeding mothers: A randomized clinical trial. JAMA Netw Open [Internet]. 2023;6(7). Disponible en: https://pubmed.ncbi.nlm.nih.gov/37428506/
Devonshire AL, Robison RG. Prevention of food allergy. Allergy Asthma Proc [Internet]. 2019;40(6):450-2. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31690392/
Abrams EM, Shaker MS, Chan ES, Brough HA, Greenhawt M. Prevention of food allergy in infancy: the role of maternal interventions and exposures during pregnancy and lactation. Lancet Child Adolesc Health [Internet]. 2023;7(5):358-66. Disponible en: https://pubmed.ncbi.nlm.nih.gov/36871575/
Calatayud Sáez F, Calatayud Moscoso del Prado B, Luque Navas M, Calatayud Moscoso del Prado A, Gallego Fernández-Pacheco JG, Rivas Ruiz F. Effects of the affinity to the Mediterranean diet pattern together with breastfeeding on the incidence of childhood asthma and other inflammatory and recurrent diseases. Allergol Immunopathol (Madr) [Internet]. 2021;49(6):48-55. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34761656/
Borrego Mateos, R., & Sanz Durán, L. (2024). Influencia de la dieta de la mujer lactante en el desarrollo de alergias en el niño: una revisión bibliográfica. Revista De Lactancia Materna, 2, e31825. https://doi.org/10.14201/rlm.31825
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