Is prenatal diet associated with the composition of the vaginal microbiome?
Emma M Rosen, Chantel L Martin, Anna Maria Siega-Riz, Nancy Dole, Patricia V Basta, Myrna Serrano, Jennifer Fettweis, Michael Wu, Shan Sun, John M Thorp, Gregory Buck, Anthony A Fodor, Stephanie M Engel
Author Information
Emma M Rosen: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. ORCID
Chantel L Martin: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. ORCID
Anna Maria Siega-Riz: Departments of Nutrition and Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA. ORCID
Nancy Dole: Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Patricia V Basta: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Myrna Serrano: Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
Jennifer Fettweis: Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
Michael Wu: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Shan Sun: Department of Bioinformatics, University of North Carolina at Charlotte, Charlotte, North Carolina, USA.
John M Thorp: Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Gregory Buck: Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
Anthony A Fodor: Department of Bioinformatics, University of North Carolina at Charlotte, Charlotte, North Carolina, USA.
Stephanie M Engel: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
BACKGROUND: The vaginal microbiome has been associated with adverse pregnancy outcomes, but information on the impact of diet on microbiome composition is largely unexamined. OBJECTIVE: To estimate the association between prenatal diet and vaginal microbiota composition overall and by race. METHODS: We leveraged a racially diverse prenatal cohort of North Carolina women enrolled between 1995 and 2001 to conduct this analysis using cross-sectional data. Women completed food frequency questionnaires about diet in the previous 3 months and foods were categorised into subgroups: fruits, vegetables, nuts/seeds, whole grains, low-fat dairy, sweetened beverages and red meat. We additionally assessed dietary vitamin D, fibre and yogurt consumption. Stored vaginal swabs collected in mid-pregnancy were sequenced using 16S taxonomic profiling. Women were categorised into three groups based on predominance of species: Lactobacillus iners, Lactobacillus miscellaneous and Bacterial Vaginosis (BV)-associated bacteria. Adjusted Poisson models with robust variance estimators were run to assess the risk of being in a specific vagitype compared to the referent. Race-stratified models (Black/White) were also run. RESULTS: In this study of 634 women, higher consumption of dairy was associated with increased likelihood of membership in the L. crispatus group compared to the L. iners group in a dose-dependent manner (risk ratio quartile 4 vs. 1: 2.01, 95% confidence interval 1.36, 2.95). Increased intake of fruit, vitamin D, fibre and yogurt was also associated with increased likelihood of membership in L. crispatus compared to L. iners, but only among black women. Statistical heterogeneity was only detected for fibre intake. There were no detected associations between any other food groups or risk of membership in the BV group. CONCLUSIONS: Higher consumption of low-fat dairy was associated with increased likelihood of membership in a beneficial vagitype, potentially driven by probiotics.
