Reassuring dietary advice for pregnant women

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Allergic reactions to peanuts or tree nuts such as walnuts or almonds (P/TN) can be life-threatening, and are a significant concern to parents of allergic children. Such children require careful monitoring in their early years to ensure they do not consume even traces of these allergens.

1317092_74386703Allergic reactions to peanuts or tree nuts such as walnuts or almonds (P/TN) can be life-threatening, and are a significant concern to parents of allergic children. Such children require careful monitoring in their early years to ensure they do not consume even traces of these allergens.

Understandably, pregnant women want to know if it is safe for them to consume P/TN during pregnancy will it increase the likelihood that their offspring will be allergic to these items? And until recently, the response from experts has been conflicting, with some saying such consumption is safe, while others warn against it. Added to these concerns is the fact that the prevalence of peanut allergies in American children has risen sharply in the last decade.

Pregnant women can rest easy because recent data suggests that, not only is P/TN consumption safe during pregnancy, it may also help protect against these allergies. Dr. A. Lindsay Graham from Harvard Medical School and the Dana Farber Cancer Center and colleagues followed approximately 11,000 girls and boys who were between 10 and 14 years old in 2004. They were all children of mothers enrolled in the Nurses Health Study II, whose diets had been recorded. In 2009, the mothers indicated whether or not their children had food allergies, and if so the respective allergens were noted. The researchers also contacted the physicians of allergic children for confirmation.

After excluding children whose mothers didn t return questionnaires, or those for whom only non-P/TN allergies were confirmed, the researchers had a final group of about 8200 children, of whom 140 had P/TN allergies. Dr. Graham and colleagues then evaluated the association between the mothers consumption of peanuts or tree nuts during and before pregnancy, with the occurrence of P/TN allergies in their children.

The findings were strong: there was a significant inverse relationship between a woman s consumption of peanuts or tree nuts during pregnancy, and the chance that her child would develop an allergy to those items. Stated another way, the more P/TN a woman ate, the less likely it was that her child would have an allergy to those foods. This was true only for women who did not themselves have such allergies.

In an accompanying editorial, Dr. Ruchi Gupta from Northwestern University commented [G]uidelines stand: Pregnant women should not eliminate nuts from their diet as peanuts are a good source of protein and also provide folic acid, which could potentially prevent both neural tube defects and nut sensitization.

ACSH s Dr. Ruth Kava added So the take home message from this study is that, for women who are not allergic to peanuts, it s OK to indulge in that peanut butter and pickle sandwich without worrying about increasing the risk of their babies developing a peanut allergy.