Abstract
Introduction Diet diversity (DD) in infancy may be protective for early
food allergy (FA) but there is limited knowledge about how DD
incorporating consumption frequency influences FA risk. Methods Three
measures of DD were investigated in 2060 infants at 6 and/or 9 months of
age within the NorthPop Birth Cohort Study; a weighted DD score based on
intake frequency, the number of introduced foods, and the number of
introduced allergenic foods. In multivariable logistic regression models
based on directed acyclic graphs, associations to parentally reported
physician diagnosed FA at 9- and 18-months age were estimated, including
sensitivity- and stratified analyses. Results High weighted DD scores
(24-31p) at 9 months of age was associated with a 61% decreased FA risk
at age 18 months [OR (95% CI) = 0.39 0.18-0.88] compared with
infants with the lowest DD scores (0-17p). The association remained
significant after exclusion of early FA cases. Having introduced 13-14
foods at age 9 months, independent of consumption frequency, was
associated to a 45% decreased FA risk [OR (95% CI) = 0.55
(0.31-0.98)] compared to having introduced 0-10 foods. When
stratifying, results remained only for children with no FA history in
the family. No association was seen between reduced FA risk and DD
measured at 6 months of age or having introduced more allergenic foods
in infancy. Conclusion A diverse diet at 9 months of age may prevent FA
at 18 months and results underscore the need for additional
investigations on the impact of consumption frequency in infancy.