High Sugar Intake During Pregnancy May Increase Pediatric Asthma Risk

Children whose mothers had a higher intake of sugar sweetened beverages and total fructose had a 19% greater chance of developing asthma in mid-childhood.

Consuming high amounts of sugary beverages in utero and during early childhood may increase asthma, according to new research.

Study co-author Sheryl Rifas-Shiman, MPH, told MD Magazine that previous studies have linked intake of sugary beverages with obesity, and obesity with asthma. However, this study found that sugary beverages and high fructose may influence the risk of asthma independent of obesity.

“These findings suggest there are additional mechanisms by which sugary beverages and fructose influence asthma risk beyond their effects on obesity,” Rifas-Shiman said.

There have been very few studies of longitudinal associations between early life exposure to fructose and asthma risk. However, the Avon Longitudinal Study of Parents and Children (ALSPAC), a birth-cohort study that charted the health of 14,500 families in Bristol, UK, found that independent of sugar intake in early childhood, maternal intake of free sugar during pregnancy was associated with an increased risk of allergic diseases and asthma by the ages of 7 to 9 years.

Between 1999 and 2002, a total of 1068 mother-child pairs were recruited during early pregnancy from 8 obstetrics offices in Massachusetts. Researchers performed in-person study visits at the end of the first and second trimesters of pregnancy and with mothers and children during the first few days after delivery.

Additional in-person visits with mothers and children were conducted in early childhood (median age 3.3 years) and mid-childhood (median age 7.7 years).

Mean (SD) maternal age at enrollment was 32.5 years and pregnancy BMI was 24.6; 10% smoked during pregnancy, 71% were college educated, and 62% had household incomes greater than $70,000. Of the children, 51 percent were female and 32% were non-white.

Data on consumption of beverages during pregnancy was collected though semi-quantitative food frequency questionnaires (FFQ), modified for use in pregnancy. The children’s beverage consumption data was evaluated using a child FFQ for early-childhood and mid-childhood. For both, sugar-sweetened beverages were defined as regular soda and fruit drinks.

Children whose mothers had a higher intake of sugar sweetened beverages (OR 1.70; 95% CI; 1.08, 2.67) and total fructose (OR 1.58; 95% CI; 0.98, 2.53) had a 19% greater chance of developing asthma in mid-childhood. Children in early childhood with a higher fructose intake (OR 1.79; 95% CI; 1.07-2.97) also had a greater chance of developing asthma in mid-childhood.

Higher sugar sweetened beverage intake also correlated with younger maternal age, higher pre-pregnancy BMI, and lower education and income.

“We don’t know the exact pathways by which sugary beverages and fructose lead to asthma, but we believe, at least in part, they act by increasing inflammation which may influence a child’s lung development,” Rifas-Shiman said. “An important next step is to further evaluate potential mechanisms, including further assessment of the effects of fructose and fructose metabolites on airway inflammation or hyper-activity that may be independent of obesity.”

Rifas-Shiman added that while their observational study has not proven a cause-and-effect relationship, avoiding high consumption of sugary beverages during pregnancy and early childhood could be one of several ways to reduce the risk of childhood asthma.

“Women should drink water or milk as preferred beverages, while pregnant and the same applies to kids,” Rifas-Shiman said.

The study, "Prenatal and Early-life Fructose, Fructose-containing Beverages, and Mid-Childhood Asthma," was published online in the Annals of the American Thoracic Society.

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