(PTFS06-01-25) Associations Between Infant Dietary Patterns and Childhood Food Allergy Outcomes: A Prospective Observational Study

Objectives: Early life diet may have lasting impacts on food allergy development by affecting immune priming by the gut microbiome. This study investigates associations between early complementary feeding patterns, microbial succession, and food allergy outcomes.

Methods: Longitudinal stool samples have been collected from three independent cohorts in Durham, NC USA (n = 71), Boston, Massachusetts USA (n = 194), and northern provinces of the Netherlands (n = 146) at at least three time points between 2 to 24 months of age. Bacterial 16S rRNA sequencing and DNA metabarcoding of food were performed to assess gut microbiome composition and dietary patterns, respectively. Principal component analysis (PCA) was used to analyze compositional data, and generalized linear models (GLM) were employed to explore associations between dietary patterns, microbial taxa, and food allergy outcomes.

Results: The study population consisted of 50% male and 50% female infants. PCA of dietary metabarcoding data revealed distinct dietary patterns across cohorts (PERMANOVA, p < 0.001), with clear separation driven by taxa such as Rosaceae (apples, berries), Musa spp. (banana), and Fabaceae (legumes). Dietary diversity, measured as the number of unique plant species detected (plant metabarcoding richness, pMR), varied significantly between cohorts (Welch’s ANOVA, p < 0.001), with higher diversity observed in the Netherlands cohort (Games-Howell Test, p < 0.01). Notably, in the Boston cohort, we found that infants with a higher pMR were enriched for taxa negatively associated with food allergy development (GLM, p < 0.05). Similarly, infants with lower pMR were enriched for taxa positively associated with food allergy development (GLM, p < 0.05).

Conclusions: Higher dietary diversity, as reflected by pMR, is associated with increased abundance of anti-allergenic microbial taxa and decreased abundance of pro-allergenic taxa, suggesting a protective role against food allergy development.

Funding Sources: Gerber Foundation