Fish consumption during infancy may reduce risk of preschool wheeze

Goskor E. Acta Paediatr. 2011;100:1561-2227.

A high fish intake during infancy has been reported to reduce the risk of recurrent wheeze in preschool children, according to results of a Swedish study published recently.

However, the study results indicate that children face a higher risk if they were treated with broad-spectrum antibiotics during their first week.

In the study published in Acta Paediatrica, data were obtained of 4,171 families in western Sweden, in which 50% of the birth cohort was randomly selected. Families answered questionnaires when their child reached aged 6 months, 12 months and again at 4.5 years of age, at which time 20% reported at least one episode of wheezing; whereas 5.5% had recurrent wheeze (at least three episodes of wheezing) in the previous year. Among children with recurrent wheezing episodes, 75% reported treatment with asthma medications and 55% reported doctor-diagnosed asthma.

The wheezing demographic was also arranged into two groups: those who only developed episodic viral wheeze during colds, and those who experienced multiple trigger wheeze, in which children reacted to a number of factors, including exercise, allergens and tobacco smoke.

Researchers found that two main factors affected the prevalence of preschool wheezing symptoms in the population: fish intake before 9 months of age, broad-spectrum antibiotics during the first week of life and the use of paracetamol during pregnancy. Consumption of fish was found to significantly reduce the risk of experiencing preschool wheeze, corroborating earlier reports that fish intake influences the development of allergic disease by acting on inflammatory and immunological pathways.

However, the use of broad-spectrum antibiotics during the first week of the child’s life resulted in an elevated risk of preschool wheeze. Researchers controlled for parental asthma separately in the multivariate analysis and found the effect of neonatal antibiotics to be independently significant.

“The impact of neonatal antibiotics, ie, broad-spectrum antibiotics during the first week of life, could be seen more clearly in children with more frequent wheeze, with 3.6% having received neonatal antibiotics in the ‘no wheeze’ group, 6.5% in the ‘1-2 episodes of wheeze’ group and 10.7% in the ‘>3 episodes of wheeze’ group,” the researchers wrote.

Although there was some indication of a combined effect between neonatal antibiotics and early fish consumption — the risk of preschool wheeze in children exposed to antibiotics was reduced in early fish users compared with late fish users — the interaction did not reach significance in the study group.

Disclosure: The study was supported by the Sahlgrenska Academy at the University of Gothenburg, the Research Foundation of the Swedish Asthma and Allergy Association, the Swedish Foundation for Health Care Sciences and Allergy Research and the Health & Medical Care Committee of the Regional Executive Board, Västra Götaland Region.

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