Association of breast milk fatty acids with allergic disease outcomes—A systematic review

N. T. Waidyatillake, S. C. Dharmage, K. J. Allen, C. J. Lodge, J. A. Simpson, G. Bowatte, M. J. Abramson, A. J. Lowe

Research output: Contribution to journalReview ArticleResearchpeer-review

Abstract

Introduction: Dietary polyunsaturated fatty acids (PUFAs) have immunoregulatory properties. Breast milk is rich in PUFA, and it has been hypothesized that these PUFAs may be important in the aetiology of allergic diseases. Despite a growing body of evidence, the associations between breast milk PUFA and allergic disease have not previously been systematically reviewed. Methods: The search was performed in PubMed and EMBASE databases using breastfeeding, fatty acid and allergic disease terms. Two authors were involved in selecting papers for review according to the inclusion criteria and extracting information on study characteristics and measures of association. Only studies that reported numeric associations between concentration of breast milk fatty acids and allergic disease outcomes were included. Results: A total of 18 papers met the inclusion criteria, reporting results from 15 study populations. The majority were cohort studies (n=11), with data from only two case-control and two cross-sectional studies. Sample size varied between 30 and 352 participants, and follow-up time of the cohorts varied between 3 months and 14 years. Nine studies reported on eczema, seven reported on sensitization, and only five reported on asthma/wheeze. There was heterogeneity among studies in terms of presenting the association between PUFA and allergy; therefore, estimates could not be pooled. Only a few studies observed associations between n-3 and n-6 PUFAs and allergic disease, and the magnitude of this effect varied greatly. Conclusions: There is insufficient evidence to suggest that colostrum or breast milk polyunsaturated fatty acids influence the risk of childhood allergic diseases.

Original languageEnglish
Pages (from-to)295-312
Number of pages18
JournalAllergy: European Journal of Allergy and Clinical Immunology
Volume73
Issue number2
DOIs
Publication statusPublished - 1 Feb 2018

Keywords

  • allergic disease
  • breast milk
  • colostrum
  • polyunsaturated fatty acids

Cite this

Waidyatillake, N. T., Dharmage, S. C., Allen, K. J., Lodge, C. J., Simpson, J. A., Bowatte, G., ... Lowe, A. J. (2018). Association of breast milk fatty acids with allergic disease outcomes—A systematic review. Allergy: European Journal of Allergy and Clinical Immunology, 73(2), 295-312. https://doi.org/10.1111/all.13300
Waidyatillake, N. T. ; Dharmage, S. C. ; Allen, K. J. ; Lodge, C. J. ; Simpson, J. A. ; Bowatte, G. ; Abramson, M. J. ; Lowe, A. J. / Association of breast milk fatty acids with allergic disease outcomes—A systematic review. In: Allergy: European Journal of Allergy and Clinical Immunology. 2018 ; Vol. 73, No. 2. pp. 295-312.
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Association of breast milk fatty acids with allergic disease outcomes—A systematic review. / Waidyatillake, N. T.; Dharmage, S. C.; Allen, K. J.; Lodge, C. J.; Simpson, J. A.; Bowatte, G.; Abramson, M. J.; Lowe, A. J.

In: Allergy: European Journal of Allergy and Clinical Immunology, Vol. 73, No. 2, 01.02.2018, p. 295-312.

Research output: Contribution to journalReview ArticleResearchpeer-review

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AU - Waidyatillake, N. T.

AU - Dharmage, S. C.

AU - Allen, K. J.

AU - Lodge, C. J.

AU - Simpson, J. A.

AU - Bowatte, G.

AU - Abramson, M. J.

AU - Lowe, A. J.

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AB - Introduction: Dietary polyunsaturated fatty acids (PUFAs) have immunoregulatory properties. Breast milk is rich in PUFA, and it has been hypothesized that these PUFAs may be important in the aetiology of allergic diseases. Despite a growing body of evidence, the associations between breast milk PUFA and allergic disease have not previously been systematically reviewed. Methods: The search was performed in PubMed and EMBASE databases using breastfeeding, fatty acid and allergic disease terms. Two authors were involved in selecting papers for review according to the inclusion criteria and extracting information on study characteristics and measures of association. Only studies that reported numeric associations between concentration of breast milk fatty acids and allergic disease outcomes were included. Results: A total of 18 papers met the inclusion criteria, reporting results from 15 study populations. The majority were cohort studies (n=11), with data from only two case-control and two cross-sectional studies. Sample size varied between 30 and 352 participants, and follow-up time of the cohorts varied between 3 months and 14 years. Nine studies reported on eczema, seven reported on sensitization, and only five reported on asthma/wheeze. There was heterogeneity among studies in terms of presenting the association between PUFA and allergy; therefore, estimates could not be pooled. Only a few studies observed associations between n-3 and n-6 PUFAs and allergic disease, and the magnitude of this effect varied greatly. Conclusions: There is insufficient evidence to suggest that colostrum or breast milk polyunsaturated fatty acids influence the risk of childhood allergic diseases.

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