4.7 Article

Vitamin A and D intake in pregnancy, infant supplementation, and asthma development: the Norwegian Mother and Child Cohort

Journal

AMERICAN JOURNAL OF CLINICAL NUTRITION
Volume 107, Issue 5, Pages 789-798

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1093/ajcn/nqy016

Keywords

food-frequency questionnaire; dietary supplements; pregnant women; infants; vitamin A; vitamin D; pediatric asthma; prescriptions; Norwegian Prescription Database; Norwegian Mother and Child Cohort

Funding

  1. Norwegian Ministry of Health and Care Services
  2. Ministry of Education and Research
  3. NIH/National Institute of Environmental Health Sciences [N01-ES-75558]
  4. NIH/National Institute of Neurological Disorders and Stroke [1 UO1 NS 047537-01, 2 UO1 NS 047537-06A1]
  5. Norwegian Research Council [221097]
  6. NIH, National Institute of Environmental Health Sciences [ZO1 ES49019]

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Background: Western diets may provide excess vitamin A, which is potentially toxic and could adversely affect respiratory health and counteract benefits from vitamin D. Objective: The aim of this study was to examine child asthma at age 7 y in relation to maternal intake of vitamins A and D during pregnancy, infant supplementation with these vitamins, and their potential interaction. Design: We studied 61,676 school-age children (born during 2002-2007) from the Norwegian Mother and Child Cohort with data on maternal total (food and supplement) nutrient intake in pregnancy (food-frequency questionnaire validated against biomarkers) and infant supplement use at age 6 mo (n = 54,142 children). Linkage with the Norwegian Prescription Database enabled near-complete follow-up (end of second quarter in 2015) for dispensed medications to classify asthma. We used log-binomial regression to calculate adjusted RRs (aRRs) for asthma with 95% CIs. Results: Asthma increased according to maternal intake of total vitamin A [retinol activity equivalents (RAEs)] in the highest (>= 2031 RAEs/d) compared with the lowest (<= 779 RAEs/d) quintile (aRR: 1.21; 95% CI: 1.05, 1.40) and decreased for total vitamin Din the highest (>= 13.6 mu g/d) compared with the lowest (<= 3.5 kg/d) quintile (aRR: 0.81; 95% CI: 0.67, 0.97) during pregnancy. No association was observed for maternal intake in the highest quintiles of both nutrients (aRR: 0.99; 95% CI: 0.83, 1.18) and infant supplementation with vitamin D or cod liver oil. Conclusions: Excess vitamin A (>= 2.5 times the recommended intake) during pregnancy was associated with increased risk, whereas vitamin D intake close to recommendations was associated with a reduced risk of asthma in school-age children. No association for high intakes of both nutrients suggests antagonistic effects of vitamins A and D.

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