Diet and food allergy development during infancy: birth cohort study findings using prospective food diary data.

BACKGROUND After an era of only considering the allergenic properties of the infant diet and allergy outcomes, emerging data suggest that the overall composition of the infant diet might be a more important factor in the development of allergic disease. OBJECTIVE We sought to assess the relationship between infant dietary patterns in the first year of life and development of food allergy by age 2 years. METHODS We performed a nested, case-control, within-cohort study. Mothers kept prospective food diaries for the first year of life, with resultant diet data coded in a unique manner to produce new variables, which were then analyzed by using principal component analysis to identify infant feeding patterns within the study subjects. RESULTS Principal component analysis of diet diary data from 41 infants given a diagnosis of food allergy based on results of double-blind, placebo-controlled food challenges in the first 2 years of life and their 82 age-matched control subjects provided an early infant diet pattern and an ongoing diet pattern. There was no difference between the study groups for the early infant diet pattern, but for the ongoing diet pattern, there was a significant difference between the groups (P = .001). This ongoing dietary pattern was characterized by higher intake of fruits, vegetables, and home-prepared foods, with control infants having a significantly higher healthy infant diet dietary pattern score than children who had a food allergy. CONCLUSIONS An infant diet consisting of high levels of fruits, vegetables, and home-prepared foods is associated with less food allergy by the age of 2 years.