Vitamin D in pregnancy and early life: the right target for prevention of allergic disease?

Abstract

Evaluation of: Weisse et al. Maternal and newborn vitamin D status and its impact on food allergy development in the German LINA cohort study. Allergy 68, 220–228 (2013).

Allergic diseases are the most common chronic disorders of childhood. The alarming trend is that these diseases are expressed early in life and are no longer outgrown in childhood. Over the last 10 years, the rates of food allergy and eczema have continued to increase dramatically in children as part of what appears to be a ‘second wave’ of the allergy epidemic. Although the risk factors for allergic disease are multifactorial, the early onset has implicated lifestyle and environmental factors as significant contributors to this escalating trend. Weisse et al. present supporting evidence for vitamin D being positively associated with children’s risk for food allergy or sensitization against food allergens during their first 2 years of life and argue against the use of vitamin D supplements to protect against allergy. Here, the authors provide a mechanistic insight into how high cord blood vitamin D levels can result in increased food allergy risk in children.

Keywords::

• allergy
• pregnancy
• supplementation
• vitamin D

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This 485 includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• • Large proportions of pregnant mothers are vitamin D deficient, leading to reduced vitamin D levels in newborn.

• • There is growing concern that increased rates of vitamin D insufficiency in pregnancy may have adverse consequences for early immune development of the fetus.

• • There is some evidence that adequate maternal vitamin D intake or status protects offspring against respiratory conditions such as wheezing, asthma and allergic rhinitis but there is less information about the relationship to other early allergic outcomes such as eczema and food allergy, the later which are increasing at an alarming rate.

• • Randomized controlled trials are urgently needed to assess the effects of vitamin D supplementation during pregnancy or early life and its effect on allergic outcomes during childhood.