1ONLINE SUPPLEMENT

2
3Peanut, milk, and wheat intake during pregnancy is associated with reduced allergy and
4asthma in children
5
6Supinda Bunyavanich, MD, MPH, Sheryl L. Rifas-Shiman, MPH, Thomas A. Platts-Mills, MD,
7Lisa Workman, Joanne E. Sordillo, ScD, Carlos A. Camargo, Jr., MD, Dr.PH, Matthew W.
8Gillman, MD, SM, Diane R. Gold, MD, MPH, Augusto A. Litonjua, MD, MPH

9Supplemental Methods
10
11Maternal dietary assessment during pregnancy
12Maternal dietary assessments at the first and second trimester visits were based on a validated
13166-item semi-quantitative food frequency questionnaire (FFQ) modified for pregnancy,1 and
14have been previously described.2-4 At the first study visit (10 weeks gestation), diet since the
15womans last menstrual period was assessed using the FFQ (first trimester FFQ). At the second
16study visit (26-28 weeks gestation), dietary intake over the previous 3 months was assessed
17using the FFQ (second semester FFQ). A third trimester FFQ was not administered because (1)
18most organs have formed by the third trimester, and this study of general health sought to
19assess exposures earlier in organogenesis; and (2) we were cognizant of the additional burden
20on the participating women, as each FFQ takes at least 1 hour to complete. The total servings
21per day of each major food allergen (peanut, milk, wheat, egg, soy) were calculated by summing
22the servings per day of the foods on the FFQ containing these respective food allergens. For
23example, peanut allergen intake was the sum of servings per day of peanut (1-oz. per serving)
24and peanut butter (1 tablespoon per serving). We derived z scores for the servings per day of
25each major food allergen that were standardized to a mean of 0 and standard deviation of 1. We
26chose to use z-scores to (1) allow readers to more easily compare results across different food
27allergens, which had varying distributions for servings/day, and (2) to aid with interpretation of
28food allergens with mean servings/day < 1.
29
30Childhood outcomes
31Questions for asthma, allergic rhinitis and atopic dermatitis were from the International Study of
32Asthma and Childhood.5 Current asthma was defined as positive if a mother reported at the mid33childhood visit that her child had ever doctor-diagnosed asthma plus either use of asthma
34medication or wheezing in the past 12 months. Current allergic rhinitis was defined as positive if
35a mother reported that her child had a runny nose or sneezing apart from colds in the past 12

36months. Current atopic dermatitis was defined as positive if a mother reported at the mid37childhood visit that her child had ever doctor-diagnosed eczema plus an itchy rash in the folds of
38the elbows, behind the knees, in front of the ankles, under the buttocks, or around the neck,
39ears, or eyes in the past 12 months that did not go completely away for at least 6 months. Ever
40asthma, ever allergic rhinitis, and ever atopic dermatitis were defined as positive if a mother
41reported a doctors diagnosis of each respective condition in the child in any questionnaire since
42birth. Maternal and paternal asthma, allergic rhinitis, and atopic dermatitis were each considered
43positive if a mother reported at week 10 of gestation that she or the childs biological father had
44a history of the respective condition. Maternal asthma and allergy (henceforth maternal atopy)
45was considered positive if maternal asthma, allergic rhinitis, or atopic dermatitis was positive;
46the analogous was used to define paternal atopy. Parental atopy was considered positive if
47maternal or paternal atopy was positive.
48
49Of the 1277 children who presented for an in-person interview at mid-childhood, 702 (55.0%)
50agreed to have blood drawn and 616 (87.7% of those with blood samples) children had
51sufficient sample to measure allergen specific IgE (spIgE) levels by Phadia ImmunoCAP.
52Sensitization to a food allergen was considered positive if the respective allergen spIgE level
53was 0.35 kU/L. Prescription of an epinephrine auto-injector was assessed with the question,
54Has a health care professional, such as a doctor, physician assistant or nurse practitioner, ever
55prescribed an EpiPen for your child? A child was considered to have food allergy to peanut,
56milk, wheat, egg, and/or soy if (s)he had a spIgE level 0.35 kU/L to the particular food and
57EpiPen prescribed. We chose this definition for several reasons. Oral food challenges are not
58practical for large general birth cohort studies. However, it is recognized that sensitization alone
59overestimates clinical food allergy.6, 7 Prescription of epinephrine, however, supports that a
60trained healthcare provider evaluated the subject and was sufficiently concerned about true
61allergy. EpiPen prescription has been used as a proxy for childhood food allergy in prior
62studies.8 Epinephrine is actually underprescribed among those with convincing symptoms of

63IgE-mediated food allergy,9 and it is more likely to be prescribed in those with severe food
64allergy compared to those with mild symptoms. For these reasons, a definition for food allergy
65requiring both objective food allergen sensitization and EpiPen prescription should balance the
66overestimation based on sensitization alone and serve to capture food allergy. We additionally
67assessed peanut allergy specifically given rising prevalence of peanut allergy at the inception of
68this cohort study10; a child was considered to have had a peanut allergic reaction if his/her
69mother answered yes to, Has your child ever had an allergic reaction to peanuts, and yes to at
70least one of the following categories of allergic reaction symptoms with peanut ingestion: Skin
71related (e.g. hives, swelling), Respiratory (e.g., shortness of breath, wheezing, cough),
72Cardiovascular (e.g. low blood pressure, dizziness or fainting, Gastrointestinal (e.g. vomiting,
73diarrhea), or Anaphylaxis (severe, multi-system allergic reaction). Assessment of food allergy
74based on report of convincing IgE-mediated reaction symptoms such those covered by our
75questions has been shown to be effective, with only a 7% false positive rate.9 Due to the broad
76general health scope of this cohort and the need to prioritize questionnaire content, questions
77targeting reaction symptoms to other foods were not asked.

78Supplemental Results
79
80Associations between maternal intake of food allergens during the first and second trimesters of
81pregnancy and current allergy and asthma outcomes at mid-childhood, stratified by parental
82atopy
83
84The models stratified by parental atopy (Tables E5 and E6) were limited in power, with 95%CIs
85of wide span. In general, the results of the stratified analyses were consistent with the
86unstratified analyses. The stratified model for the association between maternal intake of food
87allergens during the first trimester and current allergy and asthma outcomes at mid-childhood
88(Table E5) showed reduced odds of wheat sensitization with first trimester wheat intake among
89those with atopic parents, as well as reduced odds of atopic dermatitis with first trimester milk
90intake among those with atopic parents. Interestingly, the odds of allergic rhinitis were reduced
91with milk consumption among those without atopic parents. Similar to the unstratified results,
92the stratified results for maternal intake of food allergens during the second trimester and
93current allergy and asthma in mid-childhood (Table E6) were less remarkable overall. Similar to
94the stratified results for the first trimester, there were reduced odds of wheat sensitization with
95second trimester wheat intake among those with atopic parents.

96

Table E1: Summary statistics for maternal intake of food allergens during the first
and second trimesters (N=1277)
Maternal intake
Food allergen

Mean (SD)

Median

Range

servings/day

z-score

servings/day

z-score

servings/day

z-score

Peanut

0.34 (0.44)

0.00 (1.00)

0.14

-0.44

0.00 - 4.00

-0.75 - 8.24

Milk

1.16 (1.04)

0.00 (1.00)

0.86

-0.29

0.00 - 6.50

-1.12 - 5.14

Wheat

2.65 (1.48)

0.00 (1.00)

2.29

-0.24

0.00 - 9.86

-1.78 - 4.86

Egg

0.32 (0.30)

0.00 (1.00)

0.21

-0.37

0.00 - 2.07

-1.07 - 5.85

Soy

0.08 (0.27)

0.00 (1.00)

0.00

-0.30

0.00 - 3.50

-0.30 12.61

Peanut

0.36 (0.43)

0.00 (1.00)

0.21

-0.36

0.00 - 2.93

-0.85 - 5.98

Milk

1.50 (1.82)

0.00 (1.00)

0.86

-0.35

0.00 - 8.07

-0.82 - 3.62

Wheat

2.69 (1.44)

0.00 (1.00)

2.37

-0.23

0.07 - 12.43

-1.82 - 6.75

Egg

0.33 (0.30)

0.00 (1.00)

0.43

0.33

0.00 - 2.07

Soy

0.08 (0.28)

0.00 (1.00)

0.00

-0.30

0.00 - 3.00

-1.13 - 5.88
-0.30 10.33

First trimester

Second trimester

97Numbers for each food allergen reflect the sum of foods on the FFQ that contained the respective food
98allergen.

Table E2: Correlation between first and second trimester maternal intake of
food allergens
Pearson
Correlation
Coefficient
0.46

<0.0001

Milk

0.38

<0.0001

Wheat

0.52

<0.0001

Egg

0.50

<0.0001

Soy

0.61

<0.0001

Food allergen
Peanut

P value

Bunyavanich et al., p.e7

99Table E3: Unadjusted and adjusted associations between maternal intake of food allergens during the first trimester of pregnancy
100and current allergy and asthma outcomes at mid-childhood
101
Intakea

Food Allergyb
N=616
Model 1d
OR
(95% CI)

Model 2e
OR
(95% CI)

Food Sensitizationc
N=616
Unadjusted
OR
(95%CI)

Model 1 d
OR
(95%CI)

Model 2e
OR
(95% CI)

Asthma
N=1277
Unadjusted
OR
(95%CI)

Model 1 d
OR
(95% CI)

Allergic rhinitis
N=1277
Model 2e
OR
(95% CI)

Unadjusted
OR
(95% CI)

Model 1 d
OR
(95% CI)

Model 2e
OR
(95% CI)

Atopic dermatitis
N=1277
Unadjusted
OR
(95% CI)

Model 1 d
OR
(95% CI)

Model 2e
OR
(95% CI)

1st
Trimester

Unadjusted
OR
(95%CI)

Peanut

0.54
0.53
0.58
0.88
0.84
0.87
0.98
1.01
1.08
0.98
0.96
0.99
0.78
0.80
0.87
(0.31, 0.94) (0.30, 0.94) (0.33, 1.02) (0.67, 1.15) (0.62, 1.13) (0.64, 1.18) (0.84, 1.16) (0.86, 1.19) (0.91, 1.28) (0.86, 1.11) (0.84, 1.11) (0.86, 1.14) (0.55, 1.10) (0.57, 1.14) (0.62, 1.23)

Milk

0.86
0.90
1.12
0.98
0.98
1.06
0.81
0.83
0.89
0.85
0.85
0.88
0.80
0.85
0.95
(0.48, 1.54) (0.50, 1.62) (0.61, 2.07) (0.78, 1.23) (0.77, 1.25) (0.82, 1.36) (0.68, 0.97) (0.69, 0.99) (0.74, 1.07) (0.74, 0.97) (0.74, 0.97) (0.76, 1.02) (0.61, 1.05) (0.65, 1.12) (0.72, 1.26)

Wheat

1.25
1.26
1.41
0.70
0.72
(0.77, 2.04) (0.75, 2.12) (0.85, 2.33) (0.51, 0.96) (0.52, 1.01)

Egg

0.75
0.76
0.64
1.20
1.29
1.25
0.99
0.95
0.89
1.04
1.01
0.96
0.99
0.97
0.88
(0.29, 1.97) (0.28, 2.08) (0.22, 1.83) (0.89, 1.63) (0.94, 1.78) (0.90, 1.73) (0.84, 1.16) (0.80, 1.13) (0.74, 1.06) (0.92, 1.19) (0.88, 1.16) (0.84, 1.11) (0.77, 1.28) (0.74, 1.27) (0.66, 1.17)

Soy

0.68
0.61
0.64
0.48
0.40
0.46
0.95
0.97
0.93
1.01
1.02
0.99
0.98
1.00
0.94
(0.20, 2.25) (0.16, 2.31) (0.18, 2.35) (0.15, 1.56) (0.11, 1.50) (0.13, 1.64) (0.80, 1.13) (0.82, 1.16) (0.77, 1.12) (0.89, 1.16) (0.89, 1.17) (0.86, 1.14) (0.76, 1.26) (0.78, 1.28) (0.71, 1.23)

0.78
0.97
1.00
1.08
0.88
0.91
0.95
0.90
0.91
1.01
(0.56, 1.09) (0.83, 1.14) (0.85, 1.18) (0.92, 1.27) (0.77, 1.01) (0.79, 1.04) (0.82, 1.09) (0.69, 1.17) (0.69, 1.20) (0.78, 1.32)

102
103aUnit for maternal intake was z-score of servings/day of foods containing the food allergen.
104bFood allergy defined as sensitization to the respective food AND EpiPen prescribed, except for peanut allergy, which was more specifically defined by convincing
105symptoms of a peanut allergic reaction (history of peanut allergy AND a cutaneous, respiratory, cardiovascular, gastrointestinal and/or anaphylactic symptom following
106peanut ingestion)
107cFood sensitization defined as spIgE 0.35 kU/L to the respective food
108dModel 1 adjusted for child age, sex, breastfeeding history, parental atopy, and maternal education.
109eModel 2 adjusted for child age, sex, breastfeeding history, parental atopy, maternal education, and childs race/ethnicity. Of note, childs race/ethnicity was highly
110collinear with maternal education. Although results for Model 2 are shown, please note that models containing collinear variables often yield inaccurate estimates.

Bunyavanich et al., p.e8

111Table E4: Unadjusted and adjusted associations between maternal intake of food allergens during the second trimester of
112pregnancy and current allergy and asthma outcomes at mid-childhood.
113
114
Intakea

Food Allergyb
N=616
Model 1d
OR
(95% CI)

Model 2e
OR
(95% CI)

Food Sensitizationc
N=616
Unadjusted
OR
(95%CI)

Model 1 d
OR
(95%CI)

Model 2e
OR
(95% CI)

Asthma
N=1277
Unadjusted
OR
(95%CI)

Model 1 d
OR
(95% CI)

Allergic rhinitis
N=1277
Model 2e
OR
(95% CI)

Unadjusted
OR
(95% CI)

Model 1 d
OR
(95% CI)

Model 2e
OR
(95% CI)

Atopic dermatitis
N=1277
Unadjusted
OR
(95% CI)

Model 1 d
OR
(95% CI)

Model 2e
OR
(95% CI)

2nd
Trimester

Unadjusted
OR
(95%CI)

Peanut

0.87
0.88
0.91
0.91
0.97
0.96
0.92
0.90
0.80
0.80
0.98
0.96
1.04
0.94
(0.61, 1.25) (0.61, 1.27) (0.68, 1.40) (0.69, 1.19) (0.68, 1.21) (0.72, 1.29) (0.82, 1.15) (0.80, 1.15) (0.87, 1.24) (0.80, 1.06) (0.78, 1.05) (0.81, 1.10) (0.58, 1.11) (0.57, 1.11)

Milk

1.41
1.47
1.60
1.21
1.17
1.21
1.03
1.00
1.03
1.04
1.03
1.05
0.92
0.93
0.97
(0.89, 2.22) (0.91, 2.37) (0.95, 2.70) (0.97, 1.50) (0.93, 1.47) (0.96, 1.52) (0.87, 1.21) (0.84, 1.19) (0.86, 1.22) (0.91, 1.18) (0.90, 1.18) (0.92, 1.21) (0.70, 1.21) (0.71, 1.22) (0.73, 1.29)

Wheat

1.07
1.07
1.21
0.73
0.75
0.79
0.96
0.92
1.02
0.90
0.91
0.97
0.68
0.64
0.74
(0.65, 1.77) (0.62, 1.85) (0.68, 2.16) (0.55, 0.99) (0.55, 1.03) (0.57, 1.09) (0.81, 1.15) (0.76, 1.10) (0.84, 1.23) (0.79, 1.03) (0.79, 1.06) (0.84, 1.12) (0.50, 0.93) (0.46, 0.90) (0.53, 1.03)

Egg

0.77
0.77
0.69
0.69
1.06
0.99
1.12
1.06
1.00
1.14
1.07
1.03
1.18
1.16
1.05
(0.30, 2.03) (0.28, 2.15) (0.25, 1.92) (0.25, 1.92) (0.75, 1.49) (0.69, 1.41) (0.95, 1.31) (0.89, 1.27) (0.83, 1.21) (1.00, 1.30) (0.93, 1.23) (0.89, 1.19) (0.93, 1.49) (0.91, 1.50) (0.79, 1.38)

Soy

1.21
1.18
1.19
1.03
1.02
1.05
1.00
1.02
0.98
0.96
0.98
0.95
0.63
0.60
0.56
(0.97, 1.51) (0.95, 1.48) (0.93, 1.53) (0.82, 1.31) (0.81, 1.30) (0.82, 1.34) (0.85, 1.17) (0.86, 1.20) (0.83, 1.15) (0.84, 1.11) (0.85, 1.13) (0.82, 1.09) (0.33, 1.18) (0.32, 1.15) (0.29, 1.09)

0.89
(0.64, 1.23)

115
116aUnit for maternal intake was z-score of servings/day of foods containing the food allergen.
117bFood allergy defined as sensitization to the respective food AND EpiPen prescribed, except for peanut allergy, which was more specifically defined by convincing
118symptoms of a peanut allergic reaction (history of peanut allergy AND a cutaneous, respiratory, cardiovascular, gastrointestinal and/or anaphylactic symptom following
119peanut ingestion)
120cFood sensitization defined as spIgE 0.35 kU/L to the respective food
121dAdjusted for child age, sex, breastfeeding history, parental atopy, and maternal education.
122eAdjusted for child age, sex, breastfeeding history, parental atopy, maternal education, and childs race/ethnicity. Of note, childs race/ethnicity was highly collinear with
123maternal education. Although results for Model 2 are shown, please note that models containing collinear variables often yield inaccurate estimates.

Bunyavanich et al., p.e9

124Table E5: Associations between maternal intake of food allergens during the first trimester of pregnancy and current allergy and
125asthma outcomes at mid-childhood, stratified by parental atopy d
126
Intakea
1st
Trimester

Food Allergyb
N=616

Food Sensitizationc
N=616

Asthma
N=1277

Allergic rhinitis
N=1277

Atopic dermatitis
N=1277

Parental Atopy

Parental Atopy

Parental Atopy

Parental Atopy

Parental Atopy

No (n=252)

Yes (n=360)

No (n=252)

Yes (n=360)

No (n=516)

Yes (n=755)

No (n=516)

Yes (n=755)

No (n=516)

Yes (n=755)

Peanut

0.29
(0.07, 1.09)

0.65
(0.36, 1.18)

0.59
(0.31, 1.11)

0.95
(0.69, 1.30)

1.15
(0.85, 1.56)

0.96
(0.78, 1.17)

1.03
(0.78, 1.35)

0.94
(0.80, 1.11)

0.91
(0.53, 1.57)

0.76
(0.49, 1.19)

Milk

0.19
(0.02, 2.13)

1.21
(0.63, 2.29)

0.77
(0.48, 1.24)

1.06
(0.80, 1.41)

0.78
(0.55, 1.09)

0.84
(0.68, 1.03)

0.76
(0.59, 0.99)

0.88
(0.75, 1.04)

1.35
(0.89, 2.05)

0.65
(0.44, 0.96)

Wheat

1.69
(0.75, 3.85)

0.97
(0.48, 1.99)

0.78
(0.44, 1.37)

0.64
(0.41, 0.98)

1.01
(0.76, 1.34)

0.98
(0.80, 1.20)

0.93
(0.73, 1.17)

0.89
(0.75, 1.06)

1.04
(0.67, 1.61)

0.85
(0.60, 1.21)

Egg

0.59
(0.09, 3.79)

0.74
(0.22, 2.52)

1.61
(0.90, 2.87)

1.12
(0.75, 1.68)

0.97
(0.71, 1.31)

0.95
(0.77, 1.17)

1.03
(0.82, 1.29)

0.99
(0.83, 1.17)

0.80
(0.47, 1.34)

1.06
(0.77, 1.46)

Soy

0.54
(0.03, 9.02)

0.63
(0.13, 3.12)

0.63
(0.13, 3.01)

0.15
(0.01, 2.51)

0.54
(0.22, 1.37)

1.02
(0.86, 1.22)

0.97
(0.71, 1.34)

1.03
(0.88, 1.20)

1.37
(1.01, 1.86)

0.55
(0.23, 1.36)

127
128aUnit for maternal intake was z-score of servings/day of foods containing the food allergen.
129bFood allergy defined as sensitization to the respective food AND EpiPen prescribed, except for peanut allergy, which was more specifically defined by convincing
130symptoms of a peanut allergic reaction (history of peanut allergy AND a cutaneous, respiratory, cardiovascular, gastrointestinal and/or anaphylactic symptom following
131peanut ingestion)
132cFood sensitization defined as spIgE 0.35 kU/L to the respective food
133dModels adjusted for child age, sex, breastfeeding history, and maternal education.

Bunyavanich et al., p.e10

134Table E6: Associations between maternal intake of food allergens during the second trimester of pregnancy and current allergy
135and asthma outcomes at mid-childhood, stratified by parental atopy d
136
Intakea
2nd
Trimester

Food Allergyb
N=616

Food Sensitizationc
N=616

Asthma
N=1277

Allergic rhinitis
N=1277

Atopic dermatitis
N=1277

Parental Atopy

Parental Atopy

Parental Atopy

Parental Atopy

Parental Atopy

No (n=252)

Yes (n=360)

No (n=252)

Yes (n=360)

No (n=516)

Yes (n=755)

No (n=516)

Yes (n=755)

No (n=516)

Yes (n=755)

Peanut

0.99
(0.55, 1.78)

0.83
(0.51, 1.33)

0.94
(0.61, 1.44)

0.87
(0.59, 1.29)

1.21
(0.91, 1.62)

0.84
(0.66, 1.06)

0.96
(0.74, 1.25)

0.88
(0.74, 1.06)

0.95
(0.52, 1.76)

0.75
(0.50, 1.13)

Milk

1.24
(0.47, 3.27)

1.62
(0.91, 2.87)

1.04
(0.67, 1.61)

1.23
(0.94, 1.60)

1.24
(0.92, 1.67)

0.92
(0.74, 1.13)

1.09
(0.86, 1.37)

1.00
(0.85, 1.19)

1.03
(0.66, 1.63)

0.87
(0.62, 1.23)

Wheat

1.33
(0.54, 3.27)

0.88
(0.42, 1.83)

1.06
(0.62, 1.80)

0.59
(0.39, 0.89)

1.14
(0.82, 1.57)

0.82
(0.66, 1.03)

0.99
(0.77, 1.28)

0.87
(0.73, 1.04)

0.99
(0.58, 1.72)

0.51
(0.33, 0.80)

Egg

0.39
(0.04, 3.92)

0.86
(0.25, 2.91)

0.88
(0.46, 1.69)

1.04
(0.69, 1.57)

1.20
(0.85, 1.70)

1.03
(0.83, 1.27)

1.19
(0.92, 1.55)

1.02
(0.86, 1.21)

1.21
(0.75, 1.94)

1.12
(0.83, 1.52)

Soy

1.35
(1.02, 1.79)

0.88
(0.41, 1.89)

1.21
(0.94, 1.56)

0.52
(0.17, 1.60)

0.86
(0.54, 1.38)

1.07
(0.88, 1.30)

0.95
(0.73, 1.23)

1.01
(0.84, 1.20)

0.94
(0.54, 1.64)

0.33
(0.09, 1.19)

137
138aUnit for maternal intake was z-score of servings/day of foods containing the food allergen.
139bFood allergy defined as sensitization to the respective food AND EpiPen prescribed, except for peanut allergy, which was more specifically defined by convincing
140symptoms of a peanut allergic reaction (history of peanut allergy AND a cutaneous, respiratory, cardiovascular, gastrointestinal and/or anaphylactic symptom following
141peanut ingestion)
142cFood sensitization defined as spIgE 0.35 kU/L to the respective food
143dModels adjusted for child age, sex, breastfeeding history, and maternal education

Bunyavanich et al., p.e11

144

Table E7: Maternal dietary intake during the first and second trimesters
stratified by parental atopy

Maternal intake

First trimester
Peanut
Milk
Wheat
Egg
Soy
Second trimester
Peanut
Milk
Wheat
Egg
Soy

Participants with midchildhood data

(N = 1277)

Participants with midchildhood data AND

spIgE levels measured
(N = 616)

Parental Atopy

Parental Atopy

No
(n = 516)

Yes
(n=755)

No
(n=252)

Yes
(n=360

0.31 (0.39)
1.17 (1.01)
2.60 (1.51)
0.31 (0.32)
0.07 (0.24)

0.35 (0.48)
1.16 (1.06)
2.68 (1.47)
0.33 (0.29)
0.09 (0.29)

0.26 (0.39)
1.15 (1.02)
2.54 (1.39)
0.31 (0.30)
0.06 (0.22)

0.32 (0.51)
1.18 (1.12)
2.72 (1.47)
0.33 (0.26)
0.09 (0.33)

0.34 (0.40)
1.52 (1.79)
2.58 (1.37)
0.31 (0.27)
0.08 (0.30)

0.38 (0.45)
1.48 (1.84)
2.77 (1.49)
0.34 (0.31)
0.09 (0.27)

0.27 (0.38)
1.51 (1.77)
2.52 (1.28)
0.31 (0.28)
0.08 (0.36)

0.32 (0.41)
1.52 (1.90)
2.76 (1.49)
0.35 (0.30)
0.10 (0.32)

145Numbers are mean (SD) total servings per day of each major food allergen, which were calculated by summing the
146servings per day of the foods on the FFQ that contained these respective food allergen

Bunyavanich et al., p.e12

147Table E8: Unadjusted and adjusted cross-sectional associations between specific food allergies (peanut, milk,
148wheat, egg and soy) and current asthma, current allergic rhinitis and current atopic dermatitis at mid-childhood
149(N=616)
150
151
Food Allergy

Asthma

Allergic rhinitis

Atopic dermatitis

Unadjusted Model 1a
Model 2b
Unadjusted Model 1
Model 2
OR (95%CI) OR (95%CI) OR (95%CI) OR (95%CI) OR (95%CI) OR (95%CI)

Unadjusted Model 1
OR (95%CI) OR (95%CI)

Model 2
OR (95%CI)

Peanut

4.27
6.92
5.50
3.37
(1.83,10.00) (2.74,17.45) (2.13,14.25) (1.56, 7.29)

4.39
(1.95, 9.87)

4.01
(1.77, 9.10)

5.72
7.39
(1.65,19.88) (2.00,27.33)

6.21
(1.62,23.85)

Milk

5.48
5.44
3.55
1.68
(1.44,20.79) (1.29,23.06) (0.82,15.44) (0.56, 5.08)

1.61
(0.51, 5.07)

1.43
(0.45, 4.57)

1.79
1.65
(0.21,15.22) (0.18,14.85)

1.23
(0.13,11.54)

Wheat

5.25
7.04
6.19
3.37
(1.72,15.99) (2.12,23.35) (1.81,21.14) (1.21, 9.42)

3.63
3.56
7.34
8.13
(1.25,10.57) (1.22,10.39) (1.68,31.99) (1.73,38.25)

7.96
(1.61,39.31)

Egg

4.33
4.97
3.69
1.48
(0.86,21.80) (0.92,26.82) (0.65,20.85) (0.33, 6.66)

1.56
(0.34, 7.21)

Soy

3.92
6.36
5.71
3.19
(1.39,11.08) (2.07,19.56) (1.82,17.92) (1.21, 8.36)

4.09
4.03
4.76
5.79
(1.49,11.19) (1.47,11.09) (0.89,25.38) (1.03,32.65)

1.44
(0.31, 6.76)

NAc

NAc

NAc
5.79
(0.98,34.32)

152
153aAdjusted for child age, sex, breastfeeding history, parental atopy, and maternal education
154bAdjusted for child age, sex, breastfeeding history, parental atopy, maternal education, and childs race/ethnicity. Of note, childs race/ethnicity was
155highly collinear with maternal education. Although results for Model 2 are shown, please note that models containing collinear variables often yield
156inaccurate estimates.
157c0 patients with egg allergy and current atopic dermatitis at mid-childhood.
158

Bunyavanich et al., p.e13

159Supplemental References:
1601.

Fawzi WW, Rifas-Shiman SL, Rich-Edwards JW, Willett WC, Gillman MW. Calibration of

161

a semi-quantitative food frequency questionnaire in early pregnancy. Ann Epidemiol

162

2004; 14:754-62.

1632.

Camargo CA, Jr., Rifas-Shiman SL, Litonjua AA, Rich-Edwards JW, Weiss ST, Gold DR,

164

et al. Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in

165

children at 3 y of age. Am J Clin Nutr 2007; 85:788-95.

1663.

Litonjua AA, Rifas-Shiman SL, Ly NP, Tantisira KG, Rich-Edwards JW, Camargo CA, Jr.,

167

et al. Maternal antioxidant intake in pregnancy and wheezing illnesses in children at 2 y

168

of age. Am J Clin Nutr 2006; 84:903-11.

1694.

Oken E, Kleinman KP, Berland WE, Simon SR, Rich-Edwards JW, Gillman MW. Decline

170

in fish consumption among pregnant women after a national mercury advisory. Obstet

171

Gynecol 2003; 102:346-51.

1725.

Asher MI, Keil U, Anderson HR, Beasley R, Crane J, Martinez F, et al. International

173

Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir

174

J 1995; 8:483-91.

1756.

Liu AH, Jaramillo R, Sicherer SH, Wood RA, Bock SA, Burks AW, et al. National

176

prevalence and risk factors for food allergy and relationship to asthma: results from the

177

National Health and Nutrition Examination Survey 2005-2006. J Allergy Clin Immunol

178

2010; 126:798-806 e13.

1797.

Branum AM, Lukacs SL. Food allergy among children in the United States. Pediatrics

180

2009; 124:1549-55.

1818.

Mullins RJ, Clark S, Camargo CA, Jr. Socio-economic status, geographic remoteness

182

and childhood food allergy and anaphylaxis in Australia. Clin Exp Allergy 2010; 40:1523-

183

32.

Bunyavanich et al., p.e14

1849.

Sicherer SH, Munoz-Furlong A, Burks AW, Sampson HA. Prevalence of peanut and tree

185

nut allergy in the US determined by a random digit dial telephone survey. J Allergy Clin

186

Immunol 1999; 103:559-62.

18710.

Warner JO. Peanut allergy: a major public health issue. Pediatr Allergy Immunol 1999;

188

10:14-20.

189
190