孕期吃花生或可降低兒童過敏風險

Pregnant women who eat More peanuts and tree nuts during pregnancy might be less likely to bear nut-allergic children, a new study suggests.

一項新的研究發現，孕期女性如果多食用花生和樹堅果，可能會降低孩子堅果過敏的機率。

The research, published Monday in the journal JAMA Pediatrics, supports the current consensus among medical professionals that delaying the introduction of nuts, milk, fish, shellfish, eggs and other highly allergenic foods in young children doesn't prevent the development of food allergies, said Michael C. Young, associate clinical professor of pediatrics at Harvard Medical School, and a senior author of the study.

上述研究成果週一發表在《美國醫學會小兒科期刊》(JAMA Pediatrics)上。醫學專家目前的普遍共識是，推遲孩子食用堅果、牛奶、魚、貝類、雞蛋和其他高致敏性食品的時間，不會防止食物過敏的發生，哈佛醫學院(Harvard Medical School)小兒科臨牀副教授兼文章的高級作者Michael C. Young表示，該研究結果支持了上述觀點。

The findings inversely link a pregnant mother's consumption of peanuts or tree nuts with the onset of nut allergies in her child. The more nuts the mother ate while pregnant, or within a year before or after pregnancy, the lower the risk that the child would go on to develop nut allergies, Dr. Young said. The study doesn't demonstrate a causal relationship between a pregnant mother's diet and the onset of nut allergies in her offspring, he said.

研究結果表明，母親孕期的花生或樹堅果的食用量與兒童堅果過敏機率成反比。Young表示，母親懷孕期間或者孕期前後一年內食用的堅果越多，孩子堅果過敏的風險越低。研究並未說明孕期母親的飲食與兒童堅果過敏之間的因果關係。

The researchers stopped short of advising pregnant women to eat more nuts. Further, interventional studies -- in which researchers would separate participating pregnant women into groups and prescribe their diets, rather than simply track their consumption -- are required before they can make such a recommendation.

研究人員並未建議孕期女性多食用堅果，如果他們要這樣建議，首先要進行干預性研究：研究人員將參與研究的孕期女性進行分組並規定她們的飲食，而不只是跟蹤她們的食量。

Researchers led by A. Lindsay Frazier of the Dana-Farber/Boston Children's Cancer and Blood Disorders Center in Boston, analyzed data from 8,205 children born between Jan. 1, 1990 and Dec. 31, 1994 to mothers who had reported their diets at or around the time of pregnancy. Of the children they tracked, 140 had developed a peanut or tree nut allergy by 2009. All self-reported cases of physician-diagnosed nut allergies were reviewed independently by two pediatricians, according to the study.

Dana-Farber/波士頓兒童癌症與血液疾病中心(Dana-Farber/Boston Children's Cancer and Blood Disorders Center)的弗雷澤(A. Lindsay Frazier)領導的研究人員分析了1990年1月1日至1994年12月31日期間出生的8,205名兒童的數據，這些孩子的母親向研究人員彙報了她們在懷孕期間或者懷孕前後的飲食情況。研究發現，他們跟蹤的這些兒童中，到2009年有140人對花生或堅果過敏。所有自行報告被醫生診斷爲堅果過敏的兒童都經過了兩位兒科醫生的獨立檢查。

The prevalence of childhood peanut allergy in the U.S. has become an 'epidemic' in recent years, Dr. Young said. The rate of 1.4% in 2010 is more than triple the rate of 0.4% in 1997, according to the study. Peanut and tree nut allergies tend to overlap, and such allergies typically become evident with a child's first known exposure to peanuts or tree nuts, the study said. It defines tree nuts as walnuts, almonds, pistachios, cashews, pecans, hazelnuts, macadamias and Brazil nuts.

Young表示，近年來美國童兒堅果過敏情況呈擴大趨勢。研究發現，2010年兒童堅果過敏比例爲1.4%，較1997年的0.4%高出兩倍多。花生和樹堅果過敏往往同時出現，當兒童首次接觸花生或堅果時，是否對這類食物過敏就已經真相大白了。研究所稱的樹堅果指的是：核桃、杏仁、開心果、腰果、山胡桃、榛子、夏威夷果和巴西堅果。

Until recently, the American Academy of Pediatrics had recommended that young children avoid eating peanuts and tree nuts until at least age 3 and cautioned pregnant or nursing women against eating peanuts. In 2008, AAP did away with those guidelines after further studies showed little support for them. The new data support the AAP's move to rescind the recommendation, Dr. Young said. The research 'supports the hypothesis that early allergen exposure increases the likelihood of tolerance and thereby lowers the risk of childhood food allergy,' the study said.

直到近年，美國兒科學會(American Academy of Pediatrics, 簡稱AAP)還在建議兒童3歲前不要食用花生和樹堅果，並告誡懷孕或哺乳期的媽媽也不要食用花生。鑑於進一步的研究基本上不支持這些觀點，AAP於2008年廢除了這些建議。Young表示，新的數據支持了AAP的做法。該研究支持瞭如下假設：早期接觸過敏原可以增加對過敏原的耐受性，從而降低兒童食物過敏的風險。

Limitations of the study include that the dietary questionnaires weren't specific to the dates of the mothers' pregnancies. Only 45% of the questionnaires were completed during pregnancy, and 76% within one year.

該研究的侷限包括，飲食調查問卷不是專門針對懷孕期間的女性。只有45%的問卷是在懷孕期間完成的，有76%是在孕期前後一年內完成的。

In an editorial also published Monday in JAMA Pediatrics, Ruchi Gupta, associate professor of pediatrics at the Northwestern University Feinberg School of Medicine, counseled pregnant mothers against avoiding nuts for fear of causing their children to develop nut allergies. 'Certainly, women who are allergic to nuts should continue avoiding nuts,' she added.

週一發表在《美國醫學會小兒科期刊》上的一篇評論文章中，西北大學芬格堡醫學院(Northwestern University Feinberg School) 兒科副教授古普塔(Ruchi Gupta)告誡孕期媽媽，不要因爲擔心孩子會染上堅果過敏症而避免食用堅果。她還表示，當然，那些對堅果過敏的懷孕女性應該繼續避免接觸到這類食物。

'Mothers-to-be should feel free to curb their cravings with a dollop of peanut butter!' Dr. Gupta wrote.

古普塔寫道，是否需要食用花生醬，應該由準媽媽們自行決定。