Buscar en
Allergologia et Immunopathologia
Toda la web
Inicio Allergologia et Immunopathologia Diet for the prevention of asthma and allergies in early childhood: Much ado abo...
Journal Information
Vol. 40. Issue 4.
Pages 244-252 (July - August 2012)
Download PDF
More article options
Vol. 40. Issue 4.
Pages 244-252 (July - August 2012)
Full text access
Diet for the prevention of asthma and allergies in early childhood: Much ado about something?
Javier Torres-Borrego��
Corresponding author
, Gloria Moreno-Solís, Ana Belén Molina-Terán
Pediatric Allergy and Pneumology Unit, Pediatrics Clinical Management Unit, Reina Sofía Children's University Hospital, Avda. Menéndez Pidal s/n, 14004, Córdoba, Spain
Article information
Full Text
Download PDF
Tables (2)
Table 1. Possible defects, biases and methodological differences of the epidemiological studies.
Table 2. Dietetic hypotheses.
Show moreShow less

In the last decades there has been an increase in allergic disease throughout the world, particularly in children. Attempts have been made to identify the causes of this “allergy epidemic” in environmental changes and changes in population hygiene, lifestyle, socioeconomic level, and eating habits that would exert epigenetic effects.

Dietetic hypotheses have been mainly focussed in long-chain polyunsaturated fatty acids, vitamin D, antioxidants, Mediterranean diet, and fruits, vegetables and fish consumption. Although the data suggest a certain association between diet and the development of asthma/allergy, there is no evidence that diet has an impact upon the prevalence of such diseases after early infancy. If indeed there is such an impact, it is likely to be confined to the prenatal period and the first months of life – when it is still possible to modulate the development of the respiratory, digestive and immune systems. Thus, once the most appropriate preventive measures have been defined, these should be implemented during pregnancy and lactation.

The existing scientific evidence is unable to recommend any primary preventive measure in the general population or in different population subgroups. Special or restrictive diets in pregnant or nursing women are not indicated. Exclusive breastfeeding for six months is questioned, since solid foods should begin to be introduced at around four months of age. Once the atopic process has started, no nutritional strategies have been found to be effective as secondary or tertiary preventive measures. Longitudinal studies in cohorts of pregnant women or newborn infants could help clarify these issues.

Vitamin D
Full Text

The aetiology of asthma and atopic diseases is multifactorial, with complex interactions between genetic and environmental factors that give rise to the resulting phenotypical manifestation of the disease. In the last 50 years there has been an increase in allergic disease throughout the world, with an estimated prevalence of 40% in children,1 giving rise to what has been referred to as an “allergy epidemic”. Since it is not possible for relevant changes in the genetic profile of the population to have developed in such a short period of time, attempts have been made to identify the causes of this increase in environmental changes (infections, pollution, climate, pneumoallergen and food allergen exposure, etc.) and changes in population hygiene and eating habits, socioeconomic level and lifestyle, amongst other factors with epigenetic effects.2,3 Amongst these factors, special mention must be made of the dietetic changes associated with the transition from a traditional to a modern diet,4 in which foods are processed to allow for longer preservation, and salt, refined sugar and saturated fat consumption has increased. Besides, the modern western lifestyle is associated with sedentarism, obesity, fast food restaurants, and a decrease in the consumption of fruit and vegetables, milk (which moreover is consumed in ultra-pasteurised form), dietary fibre and foods rich in vitamins and antioxidants.5 The “dietetic hypothesis” has two major paradigms in the beneficial effects found amongst children who follow traditional eating habits, such as those living on farms6 or in families with an anthroposophic lifestyle.7

Attempts to apply the concept of asthma as a nosologic unit or entity have failed, because there are different disease phenotypes with different denominations. In preschool children it is particularly difficult to distinguish between an incipient allergic phenotype and wheezing due to some other cause; as a result, a European panel of pediatricians8 has recently recommended avoiding the diagnosis of asthma in this age group, since there is no evidence that its physiopathology is similar to that of asthma found in older children and in adults. In this context, the term “recurrent wheezing” is preferred.

Since it is presently not possible to modify the genetic factors, the development of a rational primary asthma and allergy prevention strategy must include identification of and action upon environmental factors – amongst which nutritional factors stand out. The prenatal period and the early stages of extrauterine life are crucial for establishing preventive strategies, since it is in this period of time when maturation of the immune system and of other body systems is completed. In this sense, different stimuli (nutrition, smoking, infections) can mark the newborn infant for life with an adequate Th1/Th2 cell balance, or with a predominance of Th2 activity characteristic of atopic individuals, which will favour the appearance of allergy. There is evidence in the newborn infant of a T-cell response to environmental antigens before any direct exposure to such antigens has occurred,9,10 starting from week 22 of gestation.11

Prevention and treatment of asthma and allergy through dietetic interventions

In general, the body of evidence drawn from observational studies seeking associations between diet and asthma/allergy is small due to the limitations of these studies (Table 1). The ideal situation would be to have randomised, double-blind, placebo-controlled prospective studies, taking into account confounding factors associated with asthma/allergy, such as an increased socioeconomic level, which can be associated to more healthy habits and increased collaboration in studies. It must also be mentioned that the different dietetic hypotheses (Table 2) would not be valid for all population subgroups. It is in the early stages of life (pre- and postnatal) when intervention opportunities arise, due to the immaturity of the respiratory, digestive and immune systems, and it is here when the study of the relationship between diet and asthma is most interesting, since it is still possible in this critical period to modulate the growth and development of the mentioned body systems – with repercussions for the entire subsequent lifetime of the individual.

Table 1.

Possible defects, biases and methodological differences of the epidemiological studies.

• Limited sample size. 
• Cross-sectional design: does not reflect causal relationship. 
• Differences in the variable diet: questionnaire-based consumption frequency versus serum quantifications. 
• Differences in the variable result: wheezing, asthma, other allergic disorders, sensitisation. 
• Differences in the timing of exposure and measurement of the result: prenatal, postnatal, infancy, adult, established asthma. 
• Biases: participation, memory, reverse causality, confounding factors, auto-diagnostic factors, etc. 
Table 2.

Dietetic hypotheses.

• Interventions during pregnancy and lactation 
• Breastfeeding 
• Introduction of complementary foods 
• Long-chain polyunsaturated fatty acids (LC-PUFA) 
• Vitamin D 
• Antioxidants: vitamins A, C and E, selenium, zinc 
• Folic acid 
• Mediterranean diet 
• Consumption of fruits and vegetables 
• Fish consumption 
• Milk consumption 
Interventions during pregnancy

Physiologically, pregnancy is characterised by Th2 cell polarisation or predominance that counters the Th1 responses that prove toxic for the placenta,12 thereby avoiding miscarriages as a result of immune rejection. After delivery, however, a shift towards Th1 responses is observed as a consequence of successive microbial stimuli that afford protection against germs, with a lessening of the Th2 reactivity responsible for allergic processes. A number of publications13–15 have related complications during gestation and delivery to a lesser risk of rhinitis and asthma. The situation could be the opposite, however, i.e., allergic women may have fewer gestational complications, fewer miscarriages and a larger number of pregnancies16,17 – atopy being more frequent in infants born to term or post-term than in premature infants.18

Different preventive interventions have been proposed to reduce the impact of asthma/allergy in infancy, such as maternal dietetic restriction during pregnancy and lactation, the encouragement of natural breastfeeding, the use of hypoallergenic formulas in children that cannot be breastfed, and a delay in the introduction of some foods.19–21 Double-blind, placebo-controlled studies have shown that the avoidance of food allergens during pregnancy does not lessen the risk of allergy22; in this sense, there is no evidence for recommending exclusion diets in pregnant women, as they are not seen to be effective and may pose a nutritional risk for the mother and foetus.23

Supplementing pregnant women with vitamins E24,25 and D,26,27 zinc,24 selenium and iron,28 fish29,30 and apples31 have been suggested as protective factors against the development of asthma or allergy in the offspring. On the other hand, a longitudinal study found no association between the consumption of vegetables, fish, eggs or dairy products in pregnant women and parameters of asthma in the offspring between 1 and 8 years of age.31

Gestational age and birth weight

A cross-sectional study with ISAAC methodology conducted in 1138 German schoolchildren between 5 and 7 years of age recorded a directly proportional relationship between atopic sensitisation and gestational age, with similar findings between the IgE levels and body weight at birth.32 Obesity, with an important genetic burden, has been related to asthma, although it is not clear whether obesity is a mere triggering factor, a risk factor, a consequence, or whether it develops parallel to asthma.33

Immaturity increases the theoretical risk of allergic diseases in premature subjects, which paradoxically have a lesser incidence of allergic disorders.34 This tolerance could be explained by a combination between high concentrations of antigen on one hand and digestive and immune immaturity on the other.35 In contrast, prematurity increased risk of non-allergic pulmonary disease as a consequence of lung and immune immaturity – with great importance on the part of infections and exposure to tobacco smoke.


A meta-analysis of prospective studies suggests that exclusive breastfeeding for at least four months is associated with a lesser rate of asthma in infancy, with a greater impact in children presenting antecedents of atopy.36 However, these data could simply reflect a protective effect of breastfeeding against respiratory infections, which are the main triggering causes of wheezing in preschool children. It has also been suggested that breastfeeding prevents allergic processes only in children without antecedents of allergy, but not in those with familial atopy.37 This could be explained through reverse causality: these would be children with mothers who are more aware of the protective effects of breastfeeding, and who thus prolong breastfeeding as far as possible. The use of partially hydrolysed infant formulas has only shown usefulness in preventing the development of allergies in children at high risk (those with at least one allergic first-degree relative) – the number needed to treat in order to prevent a case of cow's milk protein allergy being 25, and such benefit moreover does not increase with extensive hydrolysates or soya formulas.38

Introduction of solid foods

The ingestion of high amount of food allergen during the first year of life can promote tolerance, whilst small and intermittent doses can induce sensitisation. This questions the appropriateness of recommending exclusive breastfeeding up to six months of age39 and the late introduction of solid foods.34 Indeed, such measures may even prove harmful.40,41 In a systematic review,21 Tarini et al. found that delays in introducing foods other than breast milk or formulas could exert a beneficial effect upon atopic dermatitis, but not on the rest of allergic disorders or upon sensitisation to both pneumoallergens and trophoallergens, which could develop via the topical route through eczematous lesions.42,43

Intestinal flora. Use of probiotics and prebiotics

Until recently, interventions designed to prevent asthma and allergy concentrated on reducing exposure to the allergen during pregnancy and lactation. Other measures, such as the use of probiotics and prebiotics, aimed to develop tolerance mechanisms through modification of the immune response of the foetus or nursing infant, whose intestine is sterile at the time of birth. Establishment of the intestinal microflora is crucial for modulating immune system maturation in the newborn infant44 – different studies have shown qualitative and quantitative differences depending on the type of delivery involved or the presence or absence of breastfeeding.45–47 The intestinal microbiota of allergic children is characterised by a predominance of Clostridium difficile,48 coliform strains and Staphylococcus aureus,49 whilst a greater presence of Lactobacillus is found in non-allergic49 and in anthroposophic infants.50 Different studies have reported different results regarding the effects of probiotics provided in the last weeks of pregnancy and in the first few months of life, as a protective measure against allergic processes, particularly atopic dermatitis.51–54 On the other hand, the provision of prebiotics during the first six months of life has been shown to afford protection against allergic symptoms and infections up to two years of age.55 However, a recent positioning document of the Nutrition Committee of the ESPGHAN does not support routine supplementing with prebiotics and probiotics in infant formulas, and underscores that the safety and efficacy data of one product are not extrapolatable to other products.56

Long-chain polyunsaturated fatty acids (LC-PUFA)

Since LC-PUFAs cannot be synthesised by the body, they must be obtained from the diet. These fatty acids are incorporated to the cell membrane phospholipids, where they exert a number of functions, including modulation of the immune and inflammatory responses. There are two major groups of LC-PUFAs: omega-3, derived from α-linolenic acid (found in plants, soya oil and fish), and which act as the precursors of docosanoids (eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids); and omega-6, derived from linoleic acid (found in corn, soya and sunflower oils and their margarines – the consumption of which has increased in the last few decades), which act as the precursors of eicosanoids (arachidonic acid and its derivatives, i.e., prostaglandins, thromboxanes and leukotrienes).

Some clinical studies have reported beneficial effects with fish oil supplementing in patients with asthma,57–59 whilst others have observed no such effects.60–62 In this context, a meta-analysis concluded that there is little evidence supporting supplementing or increasing the intake of omega-3 in the diet63 as a treatment for already-established asthma in children and adults. Since atopy is programmed in the first months of life, intervention with omega-3 once the allergic process has already become established may be too late to secure benefits. Early exposure to omega-3 may modify the Th1/Th2 profile – higher concentrations of docosanoids and IgA being observed in the milk of nursing women who received omega-3 supplements during pregnancy,64 together with higher serum levels of interferon-gamma (IFN-γ)65 in their offspring. In the CAMP study, fish oil or placebo supplementing was carried out in children at risk of developing asthma from six months of age. A resulting decrease was observed in the prevalence of wheezing, nocturnal cough or the use of bronchodilators at 18 months,66 with no influence upon sensitisation to foods or atopic dermatitis. This protective effect in turn disappeared over follow-up after three and five years.67

In an excellent review, Sala-Vila et al.68 detected numerous inconsistencies in the studies evaluating atopy risk in relation to the LC-PUFA in nursing infants’ serum samples and composition of breast milk from atopic mothers, concluding that it is not possible to establish a clear idea of the role and composition of LC-PUFAs in asthma and allergy based on the existing information. These discrepancies were influenced by the designs of the studies included in the meta-analysis. Overall, the data do not support the pre-existing idea that consumption and high levels of omega-6 and low levels of omega-3 are associated with atopy. On the other hand, emphasis is placed on the importance of the balance between both types of fatty acid, since despite individually some arachidonic acid derivatives may have inflammatory effects, their global action is of an anti-inflammatory nature.68

Vitamin D

It has been suggested that the increase in the prevalence of asthma in the western world is a consequence of vitamin D deficiency69 due to lesser exposure to sunlight. The immune modulating action of vitamin D is known,70 and the immune cells have activating receptors and enzymes for this vitamin.71 A series of cohorts involving newborn infants have reported an association between vitamin D deficiency before birth and in the first months of life and an increased risk of recurrent wheezing, asthma and allergic rhinitis26,27,72 in infancy. This could be attributed to an alteration in the response to viral infections73 – vitamin D having been shown to induce antimicrobial peptides, including cathelicidin, in vitro.74,75 In addition, there is a lesser incidence of influenza in schoolchildren who receive supplements of vitamin D376 – this effect being greater amongst asthmatics. Likewise, a protective association has been described between maternal vitamin D consumption during pregnancy and a lesser risk of developing wheezing in the first years of life,27 as well as asthma and allergic sensitisations in the future.26 Furthermore, in asthmatics, the provision of vitamin D could reduce the number and severity of the exacerbations,77–79 with suggested positive effects upon the corticosteroid action routes.80 Thus, vitamin D would exert primary preventive effects (avoiding the development of wheezing-asthma), secondary preventive effects (reducing disease severity in asthmatics), and also tertiary preventive effects (improving the response to corticosteroid treatment).

In contrast, other authors suggest that an excessive provision of Vitamin D could induce an exaggerated Th2 response, thereby favouring allergic sensitisations.81,82 In one study, vitamin D supplementing during the first year of life was associated to an increased risk of atopy, rhinitis and asthma at 31 years of age,83 although this study did not control for maternal vitamin D levels, possible confounding factors, or memory bias.


An association has been suggested between asthma and a diet poor in exogenous antioxidants84,85 such as vitamins A, C and E, and oligoelements such as zinc and selenium – which favour the production of IFN-γ and can attenuate the respiratory epithelial damage caused by free radicals. In 2010, a meta-analysis reported the intake of vitamins A, C and E to be significantly lower in patients with asthma, particularly amongst those with more serious disease.86 Previously, another meta-analysis failed to obtain evidence that antioxidant intake influences the risk of asthma.87 The existing evidence on the beneficial effects of antioxidants, vegetables and the Mediterranean diet is weak, but suggests protection against wheezing and asthma, particularly when applied to pregnant women,88 thanks to the optimisation of lung development89 and the palliation of oxidative damage in this critical period. The biological mechanisms by which these elements may influence childhood asthma could be independent of antioxidant activity, since they are not observed with all of the mentioned elements, and are also recorded with substances lacking antioxidant effects.4

Vitamin A

Vitamin A (retinol) exerts dual antioxidant action and protective anti-infection effects upon the respiratory tract.90 Children with high serum carotene levels have been found to be less likely to develop asthma91,92 – significant differences being observed in the concentrations of vitamin A between asthmatics and healthy controls.93 In addition, the consumption of vitamins A and C at levels below the recommended daily amounts is associated with a significantly higher prevalence of wheezing in the first years of life and asthma,86 and it has even been reported that the severity of asthma is inversely correlated to the blood levels of vitamin A.91 In contrast, it has not been possible to show that maternal supplementing with beta-carotenes is associated to a lesser risk of wheezing in the first years of life.31

Vitamin E

Vitamin E (α-tocopherol) is a first-order antioxidant in that it prevents the oxidation of LC-PUFAs and proteins. Moreover, it exerts immune actions by promoting Th1 responses and inhibiting Th2 differentiation.94,95 Maternal levels of vitamin E are a determinant factor for foetal growth, and for lung development and maturation.96 In this sense, there is a significant correlation between prenatal vitamin E intake and a reduction of wheezing in the first two years of life.25,97 Nutritional studies suggest a relationship between oxidative stress and bronchial inflammation; as a result, supplements of vitamin E in asthmatics could help lessen the symptoms98 and improve lung function.99,100

Vitamin C

Vitamin C (ascorbic acid) is a water-soluble antioxidant found in the airway epithelia and alveoli which is able to attenuate the oxidative damage caused by inhalatory agents, infections or cellular inflammation. In the context of the NHANES III study,92 measurements were made of the serum concentrations of vitamins in children between 6–17 years old. The bivariate analysis showed the diagnosis of asthma to be associated to lower levels of vitamin C, alpha- and beta-carotene, and beta-cryptoxanthin. However, after adjusting the results for possible confounding factors, only vitamin C and alpha-carotene continued to show statistical significance in the resulting logistic regression analysis. It has not been possible to show that an extra intake of vitamin C in pregnant women is able to reduce the risk of posterior wheezing in their offspring,25,97 although an inverse proportional relationship has been described between vitamin C intake and the risk of wheezing,101 bronchial hyperresponsiveness102,103 and FEV1 values.104,105 Despite these findings, two Cochrane reviews concluded that no generalised positive effect can be established, and that there is not enough evidence to support vitamin C supplementing in the treatment of established bronchial asthma.106,107

Folic acid

Folic acid participates in nucleotide synthesis, cell division and differentiation, and in DNA methylation, and as such is a key element in foetal development. Some authors108 have described an inverse proportional relationship between folic acid concentrations and the presence of wheezing, atopy and IgE levels in 8083 subjects over two years of age. In contrast, other investigators have related folic acid to negative effects, with the observation of an increased frequency of respiratory and allergic disease in the offspring of women who received folate supplements during pregnancy109,110 – this possibly being linked to an increased risk of respiratory infections during the first months of life.


The role of selenium, acting as coenzyme of glutathione peroxidase, is subject to controversy, for although elevated selenium levels during pregnancy and in umbilical cord blood are associated to a decreased risk of early wheezing in the first two years of life,111 no such effects are seen at five years of age.112 Other studies in turn have reported an association between selenium levels and a decrease in the prevalence of asthma,113 fewer respiratory symptoms,114 and improved lung function.100


Zinc intervenes in the metabolism of superoxide dismutase (SOD) and vitamin E. Zinc levels in the hair of wheezing children have been found to be significantly lower than in the controls.115 Although there have been reports of its beneficial effects when supplied during pregnancy25 and in the first years of life,116 the evidence supporting such a recommendation is still weak.


A number of studies have described that a frequent consumption of dairy products amongst pre-school children results in a lesser risk of asthma symptoms in these children.117,118 It is debatable whether this effect is linked to the LC-PUFA contents of milk, in which case it would only be valid for whole and scantly processed milk119 and butter,120 but not for skimmed milk products.

Despite the widespread belief that milk and its products increase airway mucus production; there is no convincing explanation for such an effect. In 2005, a review121 concluded that those individuals with this prior conviction reported perceived changes in mucus production after consuming milk, in contrast to those who did not share this belief. In a double-blind study, the “believers” detected the same increase in secretions both after consuming milk and after consuming a soya beverage with the same organoleptic properties – a situation that could be explained in terms of greater saliva production and thickening.122 It can be concluded that this belief has no scientific basis, and that there is no evidence in support of restricting or avoiding dairy products in asthmatic individuals.

Mediterranean diet. Fruit, vegetables, fish, and olive oil

The Mediterranean diet and frequent fruit consumption in children and pregnant women is associated with a lesser risk of wheezing, asthma and allergy.123–127 Willers et al.31 recorded beneficial effects of apple consumption (but not with total fruit intake) during pregnancy in relation to wheezing and asthma at five years of age. Specific studies addressing concrete foods therefore would be advisable (different fruit species belong to different botanical families with different biological properties). It has been suggested that the consumption of potentially allergenic foods during pregnancy increases the transplacental or transamniotic transmission risk of sensitisation128,129 to trophoallergens and pneumoallergens.130 In adults, the consumption of whole grain bread has been shown to exert a protective effect against asthma,131 although it cannot be ruled out that such consumption, in the same way as with fruit, might be a confounding factor associated to other healthy lifestyle factors.

The evidence on the effect of fish consumption during pregnancy in relation to allergy/asthma is inconclusive – some studies reporting a favourable effect,29,30,130 whilst others report no effect,31 or protective action against atopic dermatitis but not against the rest of allergic disorders.132 On the other hand, from week 30 of pregnancy, a Danish study comparing olive oil versus fish oil capsule supplementing found the offspring of the women in the latter group to have a lesser risk of asthma – although this same effect was observed in a third non-intervened control group.133


Following this review of the relationship between diet and asthma-atopy in the first years of life, we can conclude that the nutritional factors responsible for the increase in these diseases are not clear. The discrepancies observed by the different studies are largely attributable to methodological differences (Table 1).

Although the dietetic hypotheses are promising, and there are partial findings associating diet to the development of asthma or allergy, there is no evidence that any food or type of diet has an impact upon the prevalence of asthma after early infancy. If indeed there is such an impact, it is likely to be confined to the window of opportunity during the prenatal stage and the first months of life – a critical period when it is still possible to modulate the growth and development of the respiratory, digestive and immune systems, with repercussions for the rest of life. Thus, once the most appropriate preventive measures have been defined, these should be implemented early, during pregnancy and lactation. A possible explanation for the discrepancy between the hypothetical protective effect of certain substances and the absence of effect found in some studies involving supplements of these nutrients may be that such effects are only obtained in situations of deficiency.

Although the data suggest a certain association between diet and the development of asthma, the existing scientific evidence is unable to recommend any primary preventive measure in the general population or in specific population subgroups. Special or restrictive diets in pregnant or nursing women are not indicated. Exclusive breastfeeding for six months is questioned, since solid foods should begin to be introduced at around four months of age. Once the atopic process has started, no nutritional strategies have been found to be effective as secondary or tertiary preventive measures. Longitudinal studies involving dietetic interventions in cohorts of pregnant women or newborn infants could help clarify these issues.

Conflict of interest

The authors have no conflict of interest to declare.

R. Gupta, A. Sheikh, D.P. Strachan, H.R. Anderson.
Burden of allergic disease in the UK: secondary analyses of national databases.
Clin Exp Allergy, 34 (2004), pp. 520-526
J. Torres-Borrego, A.B. Molina-Teran, C. Montes-Mendoza.
Prevalence and associated factors of allergic rhinitis and atopic dermatitis in children.
Allergol Immunopathol (Madr), 36 (2008), pp. 90-100
J. Batlles-Garrido, J. Torres-Borrego, T. Rubí-Ruiz, A. Bonillo-Perales, Y. Gonzalez-Jiménez, J. Momblán De Cabo, et al.
Prevalence and factors linked to atopy in 10-and 11-year-old children in Almeria. Spain.
Allergol Immunopathol (Madr), 38 (2010), pp. 13-19
K. Allan, G. Devereux.
Diet and asthma: nutrition implications from prevention to treatment.
J Am Diet Assoc, 111 (2011), pp. 258-268
L.S. Greene.
Asthma, oxidant stress, and diet.
Nutrition, 15 (1999), pp. 899-907
J. Riedler, C. Braun-Fahrlander, W. Eder, M. Schreuer, M. Waser, S. Maisch, et al.
Exposure to farming in early life and development of asthma and allergy: a cross-sectional survey.
Lancet, 358 (2001), pp. 1129-1133
J.S. Alm, J. Swartz, G. Lilja, A. Scheynius, G. Pershagen.
Atopy in children of families with an anthroposophic lifestyle.
Lancet, 353 (1999), pp. 1485-1488
P.L. Brand, E. Baraldi, H. Bisgaard, A.L. Boner, J.A. Castro-Rodriguez, A. Custovic, et al.
Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach.
Eur Respir J, 32 (2008), pp. 1096-1110
M.P. Piccinni, F. Mecacci, S. Sampognaro, R. Manetti, P. Parronchi, E. Maggi, et al.
Aeroallergen sensitization can occur during fetal life.
Int Arch Allergy Immunol, 102 (1993), pp. 301-303
Z. Szepfalusi, I. Nentwich, M. Gerstmayr, E. Jost, L. Todoran, R. Gratzl, et al.
Prenatal allergen contact with milk proteins.
Clin Exp Allergy, 27 (1997), pp. 28-35
A.C. Jones, E.A. Miles, J.O. Warner, B.M. Colwell, T.N. Bryant, J.A. Warner.
Fetal peripheral blood mononuclear cell proliferative responses to mitogenic and allergenic stimuli during gestation.
Pediatr Allergy Immunol, 7 (1996), pp. 109-116
P.G. Holt, C. Macaubas, P.D. Sly.
Strategic targets for primary prevention of allergic disease in childhood.
Allergy, 53 (1998), pp. 72-76
I. Annesi-Maesano, D. Moreau, D. Strachan.
In utero and perinatal complications preceding asthma.
Allergy, 56 (2001), pp. 491-497
P. Nafstad, P. Magnus, J.J. Jaakkola.
Risk of childhood asthma and allergic rhinitis in relation to pregnancy complications.
J Allergy Clin Immunol, 106 (2000), pp. 867-873
P. Nafstad, S.O. Samuelsen, L.M. Irgens, T. Bjerkedal.
Pregnancy complications and the risk of asthma among Norwegians born between 1967 and 1993.
Eur J Epidemiol, 18 (2003), pp. 755-761
L. Braback, A. Hedberg.
Perinatal risk factors for atopic disease in conscripts.
Clin Exp Allergy, 28 (1998), pp. 936-942
L. Nilsson, N.I. Kjellman, O. Lofman, B. Bjorksten.
Parity among atopic and non-atopic mothers.
Pediatr Allergy Immunol, 8 (1997), pp. 134-136
M. Siltanen, M. Kajosaari, M. Pohjavuori, E. Savilahti.
Prematurity at birth reduces the long-term risk of atopy.
J Allergy Clin Immunol, 107 (2001), pp. 229-234
S.H. Arshad.
Primary prevention of asthma and allergy.
J Allergy Clin Immunol, 116 (2005), pp. 3-14
S.H. Arshad.
Allergen avoidance and prevention of atopy.
Curr Opin Allergy Clin Immunol, 4 (2004), pp. 119-123
B.A. Tarini, A.E. Carroll, C.M. Sox, D.A. Christakis.
Systematic review of the relationship between early introduction of solid foods to infants and the development of allergic disease.
Arch Pediatr Adolesc Med, 160 (2006), pp. 502-507
M.S. Kramer.
Maternal antigen avoidance during pregnancy for preventing atopic disease in infants of women at high risk.
Cochrane Database Syst Rev, (2000), pp. CD000133
S. Salvatore, K. Keymolen, B. Hauser, Y. Vandenplas.
Intervention during pregnancy and allergic disease in the offspring.
Pediatr Allergy Immunol, 16 (2005), pp. 558-566
G. Devereux, S.W. Turner, L.C. Craig, G. McNeill, S. Martindale, P.J. Harbour, et al.
Low maternal vitamin E intake during pregnancy is associated with asthma in 5-year-old children.
Am J Respir Crit Care Med, 174 (2006), pp. 499-507
A.A. Litonjua, S.L. Rifas-Shiman, N.P. Ly, K.G. Tantisira, J.W. Rich-Edwards, C.A. Camargo Jr., et al.
Maternal antioxidant intake in pregnancy and wheezing illnesses in children at 2 y of age.
Am J Clin Nutr, 84 (2006), pp. 903-911
G. Devereux, A.A. Litonjua, S.W. Turner, L.C. Craig, G. McNeill, S. Martindale, et al.
Maternal vitamin D intake during pregnancy and early childhood wheezing.
Am J Clin Nutr, 85 (2007), pp. 853-859
C.A. Camargo Jr., S.L. Rifas-Shiman, A.A. Litonjua, J.W. Rich-Edwards, S.T. Weiss, D.R. Gold, et al.
Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age.
Am J Clin Nutr, 85 (2007), pp. 788-795
S.O. Shaheen, R.B. Newson, A.J. Henderson, P.M. Emmett, A. Sherriff, M. Cooke.
Umbilical cord trace elements and minerals and risk of early childhood wheezing and eczema.
Eur Respir J, 24 (2004), pp. 292-297
M.T. Salam, Y.F. Li, B. Langholz, F.D. Gilliland.
Maternal fish consumption during pregnancy and risk of early childhood asthma.
J Asthma, 42 (2005), pp. 513-518
I. Romieu, M. Torrent, R. Garcia-Esteban, C. Ferrer, N. Ribas-Fito, J.M. Anto, et al.
Maternal fish intake during pregnancy and atopy and asthma in infancy.
Clin Exp Allergy, 37 (2007), pp. 518-525
S.M. Willers, A.H. Wijga, B. Brunekreef, M. Kerkhof, J. Gerritsen, M.O. Hoekstra, et al.
Maternal food consumption during pregnancy and the longitudinal development of childhood asthma.
Am J Respir Crit Care Med, 178 (2008), pp. 124-131
G. Bolte, M. Schmidt, W. Maziak, U. Keil, P. Nasca, E. von Mutius, et al.
The relation of markers of fetal growth with asthma, allergies and serum immunoglobulin E levels in children at age 5–7 years.
Clin Exp Allergy, 34 (2004), pp. 381-388
S.A. Shore.
Obesity and asthma: possible mechanisms.
J Allergy Clin Immunol, 121 (2008), pp. 1087-1093
J.J. Liem, A.L. Kozyrskyj, S.I. Huq, A.B. Becker.
The risk of developing food allergy in premature or low-birth-weight children.
J Allergy Clin Immunol, 119 (2007), pp. 1203-1209
J. Strid, M. Thomson, J. Hourihane, I. Kimber, S. Strobel.
A novel model of sensitization and oral tolerance to peanut protein.
Immunology, 113 (2004), pp. 293-303
M. Gdalevich, D. Mimouni, M. Mimouni.
Breast-feeding and the risk of bronchial asthma in childhood: a systematic review with meta-analysis of prospective studies.
J Pediatr, 139 (2001), pp. 261-266
A.L. Wright, C.J. Holberg, L.M. Taussig, F.D. Martinez.
Factors influencing the relation of infant feeding to asthma and recurrent wheeze in childhood.
Thorax, 56 (2001), pp. 192-197
D.A. Osborn, J.K. Sinn.
The Cochrane Library and dietary prevention of allergic disease and food hypersensitivity in children: an umbrella review.
Evid Based Child Health, 2 (2007), pp. 541-552
R.S. Zeiger.
Food allergen avoidance in the prevention of food allergy in infants and children.
Pediatrics, 111 (2003), pp. 1662-1671
A.W. Burks.
Early peanut consumption: postpone or promote?.
J Allergy Clin Immunol, 123 (2009), pp. 424-425
B. Tarini.
Delayed introduction of solids does not decrease the incidence of asthma or allergic rhinitis.
G. Lack.
Epidemiologic risks for food allergy.
J Allergy Clin Immunol, 121 (2008), pp. 1331-1336
A.T. Fox, P. Sasieni, G. du Toit, H. Syed, G. Lack.
Household peanut consumption as a risk factor for the development of peanut allergy.
J Allergy Clin Immunol, 123 (2009), pp. 417-423
B. Bjorksten.
The intrauterine and postnatal enviroments.
J Allergy Clin Immunology, 104 (1999), pp. 1119-1127
J. Penders, C. Thijs, C. Vink, F.F. Stelma, B. Snijders, I. Kummeling, et al.
Factors influencing the composition of the intestinal microbiota in early infancy.
Pediatrics, 118 (2006), pp. 511-521
K. Negele, J. Heinrich, M. Borte, A. von Berg, B. Schaaf, I. Lehmann, et al.
Mode of delivery and development of atopic disease during the first 2 years of life.
Pediatr Allergy Immunol, 15 (2004), pp. 48-54
B. Laubereau, B. Filipiak-Pittroff, A. von Berg, A. Grubl, D. Reinhardt, H.E. Wichmann, et al.
Caesarean section and gastrointestinal symptoms, atopic dermatitis, and sensitisation during the first year of life.
Arch Dis Child, 89 (2004), pp. 993-997
A. Woodcock, M. Moradi, F.I. Smillie, C.S. Murray, J.P. Burnie, A. Custovic.
Clostridium difficile, atopy and wheeze during the first year of life.
Pediatr Allergy Immunol, 13 (2002), pp. 357-360
B. Bjorksten, P. Naaber, E. Sepp, M. Mikelsaar.
The intestinal microflora in allergic Estonian and Swedish 2-year-old children.
Clin Exp Allergy, 29 (1999), pp. 342-346
J.S. Alm, J. Swartz, B. Björkstén, L. Engstrand, J. Engström, I. Kühn, et al.
An antroposophic lifestyle and intestinal microflora in infancy.
Pediatr Allergy Immunol, 13 (2002), pp. 402-411
E. Isolauri.
Dietary modification of atopic disease: use of probiotics in the prevention of atopic dermatitis.
Curr Allergy Asthma Rep, 4 (2004), pp. 270-275
M. Kalliomaki, S. Salminen, H. Arvilommi, P. Kero, P. Koskinen, E. Isolauri.
Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial.
Lancet, 357 (2001), pp. 1076-1079
M.A. Kalliomaki, E. Isolauri.
Probiotics and down-regulation of the allergic response.
Immunol Allergy Clin North Am, 24 (2004), pp. 739-752
S. Weston, A.R. Halbert, P. Richmond, S.L. Prescott.
Effects of probiotics on atopic dermatitis: a randomised controlled trial.
Arch Dis Child, 90 (2005), pp. 892-897
S. Arslanoglu, G.E. Moro, J. Schmitt, L. Tandoi, S. Rizzardi, G. Boehm.
Early dietary intervention with a mixture of prebiotic oligosaccharides reduces the incidence of allergic manifestations and infections during the first two years of life.
J Nutr, 138 (2008), pp. 1091-1095
C. Braegger, A. Chmielewska, T. Decsi, S. Kolacek, W. Mihatsch, L. Moreno, et al.
Supplementation of infant formula with probiotics and/or prebiotics: a systematic review and comment by the ESPGHAN committee on nutrition.
J Pediatr Gastroenterol Nutr, 52 (2011), pp. 238-250
J.P. Arm, C.E. Horton, B.W. Spur, J.M. Mencia-Huerta, T.H. Lee.
The effects of dietary supplementation with fish oil lipids on the airways response to inhaled allergen in bronchial asthma.
Am Rev Respir Dis, 139 (1989), pp. 1395-1400
M. Okamoto, F. Mitsunobu, K. Ashida, T. Mifune, Y. Hosaki, H. Tsugeno, et al.
Effects of dietary supplementation with n-3 fatty acids compared with n-6 fatty acids on bronchial asthma.
Intern Med, 39 (2000), pp. 107-111
T. Nagakura, S. Matsuda, K. Shichijyo, H. Sugimoto, K. Hata.
Dietary supplementation with fish oil rich in omega-3 polyunsaturated fatty acids in children with bronchial asthma.
Eur Respir J, 16 (2000), pp. 861-865
B. Stenius-Aarniala, A. Aro, A. Hakulinen, I. Ahola, E. Seppala, H. Vapaatalo.
Evening primose oil and fish oil are ineffective as supplementary treatment of bronchial asthma.
Ann Allergy, 62 (1989), pp. 534-537
L. Hodge, C.M. Salome, J.M. Hughes, D. Liu-Brennan, J. Rimmer, M. Allman, et al.
Effect of dietary intake of omega-3 and omega-6 fatty acids on severity of asthma in children.
Eur Respir J, 11 (1998), pp. 361-365
F.C. Thien, J.M. Mencia-Huerta, T.H. Lee.
Dietary fish oil effects on seasonal hay fever and asthma in pollen-sensitive subjects.
Am Rev Respir Dis, 147 (1993), pp. 1138-1143
F.C.K. Thien, S. De Luca, R.K. Woods, M.J. Abramson.
Dietary marine fatty acids (fish oil) for asthma in adults and children.
Cochrane Database Syst Rev, (2002),
J.A. Dunstan, J. Roper, L. Mitoulas, P.E. Hartmann, K. Simmer, S.L. Prescott.
The effect of supplementation with fish oil during pregnancy on breast milk immunoglobulin A, soluble CD14, cytokine levels and fatty acid composition.
Clin Exp Allergy, 34 (2004), pp. 1237-1242
L. Lauritzen, T.M. Kjaer, M.B. Fruekilde, K.F. Michaelsen, H. Frokiaer.
Fish oil supplementation of lactating mothers affects cytokine production in 2 1/2-year-old children.
Lipids, 40 (2005), pp. 669-676
S. Mihrshahi, J.K. Peat, K. Webb, W. Oddy, G.B. Marks, C.M. Mellis.
Effect of omega-3 fatty acid concentrations in plasma on symptoms of asthma at 18 months of age.
Pediatr Allergy Immunol, 15 (2004), pp. 517-522
J.K. Peat, S. Mihrshahi, A.S. Kemp, G.B. Marks, E.R. Tovey, K. Webb, et al.
Three-year outcomes of dietary fatty acid modification and house dust mite reduction in the childhood asthma prevention study.
J Allergy Clin Immunol, 114 (2004), pp. 807-813
A. Sala-Vila, E.A. Miles, P.C. Calder.
Fatty acid composition abnormalities in atopic disease: evidence explored and role in the disease process examined.
Clin Exp Allergy, 38 (2008), pp. 1432-1450
A.A. Litonjua.
Childhood asthma may be a consequence of vitamin D deficiency.
Curr Opin Allergy Clin Immunol, 9 (2009), pp. 202-207
N. Binkley, R. Ramamurthy, D. Krueger.
Low vitamin D status: definition, prevalence, consequences, and correction.
Endocrinol Metab Clin North Am, 39 (2010), pp. 287-301
F. Baeke, H. Korf, L. Overbergh, E. van Etten, A. Verstuyf, C. Gysemans, et al.
Human T lymphocytes are direct targets of 1,25-dihydroxyvitamin D3 in the immune system.
J Steroid Biochem Mol Biol, 121 (2010), pp. 221-227
M. Erkkola, M. Kaila, B.I. Nwaru, C. Kronberg-Kippila, S. Ahonen, J. Nevalainen, et al.
Maternal vitamin D intake during pregnancy is inversely associated with asthma and allergic rhinitis in 5-year-old children.
Clin Exp Allergy, 39 (2009), pp. 875-882
V.P. Walker, R.L. Modlin.
The vitamin D connection to pediatric infections and immune function.
Pediatr Res, 65 (2009), pp. 106R-113R
P.T. Liu, S. Stenger, H. Li, L. Wenzel, B.H. Tan, S.R. Krutzik, et al.
Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response.
Science, 311 (2006), pp. 1770-1773
T.R. Hata, P. Kotol, M. Jackson, M. Nguyen, A. Paik, D. Udall, et al.
Administration of oral vitamin D induces cathelicidin production in atopic individuals.
J Allergy Clin Immunol, 122 (2008), pp. 829-831
M. Urashima, T. Segawa, M. Okazaki, M. Kurihara, Y. Wada, H. Ida.
Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren.
Am J Clin Nutr, 91 (2010), pp. 1255-1260
J.M. Brehm, J.C. Celedon, M.E. Soto-Quiros, L. Avila, G.M. Hunninghake, E. Forno, et al.
Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica.
Am J Respir Crit Care Med, 179 (2009), pp. 765-771
J.H. White.
Vitamin D signaling, infectious diseases, and regulation of innate immunity.
Infect Immun, 76 (2008), pp. 3837-3843
J.D. McNally, K. Leis, L.A. Matheson, C. Karuananyake, K. Sankaran, A.M. Rosenberg.
Vitamin D deficiency in young children with severe acute lower respiratory infection.
Pediatr Pulmonol, 44 (2009), pp. 981-988
D.A. Searing, Y. Zhang, J.R. Murphy, P.J. Hauk, E. Goleva, D.Y. Leung.
Decreased serum vitamin D levels in children with asthma are associated with increased corticosteroid use.
J Allergy Clin Immunol, 125 (2010), pp. 995-1000
V. Matheu, O. Back, E. Mondoc, S. Issazadeh-Navikas.
Dual effects of vitamin D-induced alteration of TH1/TH2 cytokine expression: enhancing IgE production and decreasing airway eosinophilia in murine allergic airway disease.
J Allergy Clin Immunol, 112 (2003), pp. 585-592
O. Jirapongsananuruk, I. Melamed, D.Y. Leung.
Additive immunosuppressive effects of 1,25-dihydroxyvitamin D3 and corticosteroids on TH1, but not TH2, responses.
J Allergy Clin Immunol, 106 (2000), pp. 981-985
E. Hypponen, U. Sovio, M. Wjst, S. Patel, J. Pekkanen, A.L. Hartikainen, et al.
Infant vitamin D supplementation and allergic conditions in adulthood: northern Finland birth cohort 1966.
Ann N Y Acad Sci, 1037 (2004), pp. 84-95
C.A.S.A. Monteleone.
Nutrition and asthma.
Arch Intern Med, 157 (1997), pp. 23-34
G. Riccioni, T. Bucciarelli, B. Mancini, C. Di Ilio, R. Della Vecchia, N. D’Orazio.
Plasma lycopene and antioxidant vitamins in asthma: the PLAVA study.
J Asthma, 44 (2007), pp. 429-432
S. Allen, J.R. Britton, J.A. Leonardi-Bee.
Association between antioxidant vitamins and asthma outcome measures: systematic review and meta-analysis.
Thorax, 64 (2009), pp. 610-619
J. Gao, X. Gao, W. Li, Y. Zhu, P.J. Thompson.
Observational studies on the effect of dietary antioxidants on asthma: a meta-analysis.
Respirology, 13 (2008), pp. 528-536
U. Nurmatov, G. Devereux, A. Sheikh.
Nutrients and foods for the primary prevention of asthma and allergy: systematic review and meta-analysis.
J Allergy Clin Immunol, 127 (2011), pp. 724-733
G. Devereux, A. Seaton.
Diet as a risk factor for atopy and asthma.
J Allergy Clin Immunol, 115 (2005), pp. 1109-1117
Y. Mizuno, T. Furusho, A. Yoshida, H. Nakamura, T. Matsuura, Y. Eto.
Serum vitamin A concentrations in asthmatic children in Japan.
Pediatr Int, 48 (2006), pp. 261-264
P. Arora, V. Kumar, S. Batra.
Vitamin A status in children with asthma.
Pediatr Allergy Immunol, 13 (2002), pp. 223-226
R.I. Harik-Khan, D.C. Muller, R.A. Wise.
Serum vitamin levels and the risk of asthma in children.
Am J Epidemiol, 159 (2004), pp. 351-357
A.M. Al Senaidy.
Serum vitamin A and beta-carotene levels in children with asthma.
J Asthma, 46 (2009), pp. 699-702
E. Reiter, Q. Jiang, S. Christen.
Anti-inflammatory properties of alpha- and gamma-tocopherol.
Mol Aspects Med, 28 (2007), pp. 668-691
M. Li-Weber, M. Giaisi, M.K. Treiber, P.H. Krammer.
Vitamin E inhibits IL-4 gene expression in peripheral blood T cells.
S.W. Turner, D. Campbell, N. Smith, L.C. Craig, G. McNeill, S.H. Forbes, et al.
Associations between fetal size, maternal {alpha}-tocopherol and childhood asthma.
Thorax, 65 (2010), pp. 391-397
S. Martindale, G. McNeill, G. Devereux, D. Campbell, G. Russell, A. Seaton.
Antioxidant intake in pregnancy in relation to wheeze and eczema in the first two years of life.
Am J Respir Crit Care Med, 171 (2005), pp. 121-128
G. Riccioni, M. Barbara, T. Bucciarelli, C. di Ilio, N. D’Orazio.
Antioxidant vitamin supplementation in asthma.
Ann Clin Lab Sci, 37 (2007), pp. 96-101
H.J. Schunemann, B.J. Grant, J.L. Freudenheim, P. Muti, R.W. Browne, J.A. Drake, et al.
The relation of serum levels of antioxidant vitamins C and E, retinol and carotenoids with pulmonary function in the general population.
Am J Respir Crit Care Med, 163 (2001), pp. 1246-1255
G. Hu, P.A. Cassano.
Antioxidant nutrients and pulmonary function: the Third National Health and Nutrition Examination Survey (NHANES III).
Am J Epidemiol, 151 (2000), pp. 975-981
G.G.D. Bodner, K. Brown, J. Little, S. Ross, A. Seaton.
Antioxidant intake and adult-onset wheeze: a case-control study.
Eur Respir J Abnorm Child Psychol, 13 (1999), pp. 22-30
A. Seaton, G. Devereux.
Diet, infection and wheezy illness: lessons from adults.
Pediatr Allergy Immunol, 11 (2000), pp. 37-40
A.S.A. Soutar, K. Brown.
Bronchial reactivity and dietary antioxidants.
Thorax, 52 (1997), pp. 166-170
J.R.P.I. Britton, H.A. Richards, A.J. Knox, A.F. Wisniewshi, S.A. Lewis.
Dietary antioxidant vitamin intake and lung function in the general population.
Am J Respir Crit Care Med, 151 (1995), pp. 1383-1387
F.D. Gilliland, K.T. Berhane, Y.F. Li, W.J. Gauderman, R. McConnell, J. Peters.
Children's lung function and antioxidant vitamin, fruit, juice, and vegetable intake.
Am J Epidemiol, 158 (2003), pp. 576-584
B. Kaur, B.H. Rowe, E. Arnold.
Vitamin C supplementation for asthma.
Cochrane Database Syst Rev, (2009), pp. CD000993
B.R.B. Kaur, F.S. Ram.
Vitamin C supplementation for asthma.
Cochrane Database Syst Rev, 4 (2001), pp. CD000993
E.C. Matsui, W. Matsui.
Higher serum folate levels are associated with a lower risk of atopy and wheeze.
J Allergy Clin Immunol, 123 (2009), pp. 1253-1259
S.E. Haberg, S.J. London, H. Stigum, P. Nafstad, W. Nystad.
Folic acid supplements in pregnancy and early childhood respiratory health.
Arch Dis Child, 94 (2009), pp. 180-184
M.J. Whitrow, V.M. Moore, A.R. Rumbold, M.J. Davies.
Effect of supplemental folic acid in pregnancy on childhood asthma: a prospective birth cohort study.
Am J Epidemiol, 170 (2009), pp. 1486-1493
P.R. Hoffmann.
Selenium and asthma: a complex relationship.
G. Devereux, G. McNeill, G. Newman, S. Turner, L. Craig, S. Martindale, et al.
Early childhood wheezing symptoms in relation to plasma selenium in pregnant mothers and neonates.
Clin Exp Allergy, 37 (2007), pp. 1000-1008
R.N. Rubin, L. Navon, P.A. Cassano.
Relationship of serum antioxidants to asthma prevalence in youth.
Am J Respir Crit Care Med, 169 (2004), pp. 393-398
S.O. Shaheen, J.A. Sterne, R.L. Thompson, C.E. Songhurst, B.M. Margetts, P.G. Burney.
Dietary antioxidants and asthma in adults: population-based case-control study.
Am J Respir Crit Care Med, 164 (2001), pp. 1823-1828
F. Tahan, C. Karakukcu.
Zinc status in infantile wheezing.
Pediatr Pulmonol, 41 (2006), pp. 630-634
G. De Luca, F. Olivieri, G. Melotti, G. Aiello, L. Lubrano, A.L. Boner.
Fetal and early postnatal life roots of asthma.
J Matern Fetal Neonatal Med, 23 (2010), pp. 80-83
A.H. Wijga, H.A. Smit, M. Kerkhof, J.C. de Jongste, J. Gerritsen, H.J. Neijens, et al.
Association of consumption of products containing milk fat with reduced asthma risk in pre-school children: the PIAMA birth cohort study.
Thorax, 58 (2003), pp. 567-572
W. Karmaus, C. Fussman.
Consumption of milk fat and reduced asthma risk in pre-school children.
Thorax, 59 (2004), pp. 725
O.S. Von Ehrenstein, E. Von Mutius, S. Illi, L. Baumann, O. Bohm, R. von Kries.
Reduced risk of hay fever and asthma among children of farmers.
Clin Exp Allergy, 30 (2000), pp. 187-193
E. von Mutius, S.K. Weiland, C. Fritzsch, H. Duhme, U. Keil.
Increasing prevalence of hay fever and atopy among children in Leipzig, East Germany.
B. Wuthrich, A. Schmid, B. Walther, R. Sieber.
Milk consumption does not lead to mucus production or occurrence of asthma.
J Am Coll Nutr, 24 (2005), pp. 547S-555S
C.B. Pinnock, W.K. Arney.
The milk-mucus belief: sensory analysis comparing cow's milk and a soy placebo.
Appetite, 20 (1993), pp. 61-70
B.J. Okoko, P.G. Burney, R.B. Newson, J.F. Potts, S.O. Shaheen.
Childhood asthma and fruit consumption.
Eur Respir J, 29 (2007), pp. 1161-1168
J. de Batlle, J. Garcia-Aymerich, A. Barraza-Villarreal, J.M. Anto, I. Romieu.
Mediterranean diet is associated with reduced asthma and rhinitis in Mexican children.
L. Chatzi, M. Torrent, I. Romieu, R. Garcia-Esteban, C. Ferrer, J. Vioque, et al.
Mediterranean diet in pregnancy is protective for wheeze and atopy in childhood.
Thorax, 63 (2008), pp. 507-513
L. Chatzi, M. Torrent, I. Romieu, R. Garcia-Esteban, C. Ferrer, J. Vioque, et al.
Diet, wheeze, and atopy in school children in Menorca, Spain.
Pediatr Allergy Immunol, 18 (2007), pp. 480-485
L. Chatzi, G. Apostolaki, I. Bibakis, I. Skypala, V. Bibaki-Liakou, N. Tzanakis, et al.
Protective effect of fruits, vegetables and the Mediterranean diet on asthma and allergies among children in Crete.
Thorax, 62 (2007), pp. 677-683
Z. Szepfalusi, C. Loibichler, J. Pichler, K. Reisenberger, C. Ebner, R. Urbanek.
Direct evidence for transplacental allergen transfer.
Pediatr Res, 48 (2000), pp. 404-407
J.A. Holloway, J.O. Warner, G.H. Vance, N.D. Diaper, J.A. Warner, C.A. Jones.
Detection of house-dust-mite allergen in amniotic fluid and umbilical-cord blood.
Lancet, 356 (2000), pp. 1900-1902
S. Sausenthaler, S. Koletzko, B. Schaaf, I. Lehmann, M. Borte, O. Herbarth, et al.
Maternal diet during pregnancy in relation to eczema and allergic sensitization in the offspring at 2 y of age.
Am J Clin Nutr, 85 (2007), pp. 530-537
L.U. Thompson.
Antioxidants and hormone-mediated health benefits of whole grains.
Crit Rev Food Sci Nutr, 34 (1994), pp. 473-497
S.M. Willers, G. Devereux, L.C. Craig, G. McNeill, A.H. Wijga, W. Abou El-Magd, et al.
Maternal food consumption during pregnancy and asthma, respiratory and atopic symptoms in 5-year-old children.
Thorax, 62 (2007), pp. 773-779
S.F. Olsen, M.L. Osterdal, J.D. Salvig, L.M. Mortensen, D. Rytter, N.J. Secher, et al.
Fish oil intake compared with olive oil intake in late pregnancy and asthma in the offspring: 16 y of registry-based follow-up from a randomized controlled trial.
Am J Clin Nutr, 88 (2008), pp. 167-175
Copyright © 2011. SEICAP
Article options
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos