Eighteen-month outcomes of house dust mite avoidance and dietary fatty acid modification in the childhood asthma prevention study (CAPS)

Mihrshahi, Seema; Peat, Jennifer K.; Marks, Guy B.; Mellis, Craig; Tovey, Euan R.; Webb, Karen; Britton, Warwick J.; Leeder, Stephen

doi:10.1067/mai.2003.36

Cited by 173 publications

(137 citation statements)

References 16 publications

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“…It is discussed whether an intervention at an earlier age, before allergic immune responses are established, might provide clearer health benefits (Calder, 2003). With respect to asthma, intervention studies with n-3 PUFA seem to support a protective effect of n-3 PUFA on the onset of allergic diseases (asthma) in childhood (Nagakura et al, 2000;Mihrshahi et al, 2003). In a Norwegian study, early introduction of fish in the diet was inversely associated with the risk of allergic rhinitis (Nafstad et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Allergic sensitisation and allergic rhinitis are associated with n-3 polyunsaturated fatty acids in the diet and in red blood cell membranes

et al. 2005

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Objective: Due to inconsistent results based on dietary intake data, unsaturated fatty acids in red blood cell (RBC) membranes and diet were used to investigate their association with allergic sensitisation and allergic rhinitis. Design: Cross-sectional, population-based study. Setting: Bavarian Nutrition Survey II (2002-03), Germany. Subjects: A total of 568 adult participants, 325 women and 243 men. Methods: By means of logistic regression models, the relation of fatty acids to (i) allergic sensitisation as defined by means of specific serum immunoglobulin E analysis (CAPSX1 class Z2), and (ii) self-reported allergic rhinitis was examined. Results: A high cell membrane level of eicosapentaenoic acid (EPA, 20:5 n-3) was inversely associated with allergic sensitisation, the adjusted odds ratio (OR) and 95% confidence interval (95% CI) were 0.52 (0.30-0.90) for the highest (vs lowest) quartile. A similar effect was observed for allergic rhinitis with an OR (95% CI) of 0.50 (0.24-1.03; P ¼ 0.027 for trend). A higher dietary intake of alpha-linolenic acid (ALA, 18:3 n-3) was associated with a decreased risk of allergic sensitisation and allergic rhinitis with ORs (95% CIs) of 0.51 (0.28-0.93) and 0.43 (0.20-0.93), respectively, in the highest quartiles. No other dietary or cell membrane unsaturated fatty acid was significantly associated with the outcome variables, nor was the n-6/n-3 ratio. The strongest effects were observed among subjects under the age of 40 y. Conclusions: In this cross-sectional study among adults, a high content of n-3 fatty acids in RBC membranes (EPA) or in the diet (ALA) is associated with a decreased risk of allergic sensitisation and allergic rhinitis. Sponsorship: The study was supported by funds of the Kurt-Eberhard-Bode-Stiftung and the Bavarian Ministry of Environment, Health and Consumer Protection.

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Section: Discussionmentioning

confidence: 99%

Allergic sensitisation and allergic rhinitis are associated with n-3 polyunsaturated fatty acids in the diet and in red blood cell membranes

et al. 2005

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“…In addition, the Canadian study [40], the PIAMA [18], the CAPS study [41] and the Study of Prevention of Allergy in Children in Europe (SPACE) [35] all found no effect of the intervention on mite sensitisation at age 2 yrs, while the nac MAAS study reported that the stringent mite avoidance regime was associated with an increased risk [36]. One explanation for this might be that the intervention was started too late, as sensitisation might already have occurred in utero [42,43].…”

Section: Discussionmentioning

confidence: 99%

“…The Childhood Asthma Prevention (CAPS) study [41] focused on mite allergen avoidance and/or supplementation with omega-3 fatty acids. The mite intervention was associated with lower use of oral steroids but not with wheeze, serum IgE, atopy or doctor-diagnosed asthma.…”

Section: Discussionmentioning

confidence: 99%

The PREVASC study: the clinical effect of a multifaceted educational intervention to prevent childhood asthma

Schönberger

Dompeling²,

Knottnerus³

et al. 2005

Eur Respir J

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As asthma is the most common chronic disease in childhood, much attention is directed towards primary prevention. Here, the clinical effectiveness of a multifaceted educational prevention was studied.A total of 476 high-risk children were recruited during the prenatal period by general practitioners and randomised to either: 1) a control group, receiving usual care; or 2) an intervention group in which families received instruction from nurses on how to reduce exposure of newborns to mite, pet and food allergens, and passive smoking.A total of 443 infants were followed-up for 2 yrs. At 2 yrs of age, the intervention group (n5222) had less asthma-like symptoms, including wheezing, shortness of breath and night-time cough, than the control group (n5221). No significant differences in total and specific immunoglobulin E were found between the groups. During the first 2 yrs of life, the incidence of asthma-like symptoms was similar in both groups; however, subanalysis revealed a significant reduction in the female, but not in the male, intervention group.In conclusion, the intervention used in this study was not effective in reducing asthma-like symptoms in high-risk children during the first 2 yrs of life, although it was modestly effective at 2 yrs. Follow-up is necessary to confirm whether the intervention can actually prevent the development of asthma.

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“…The first examined the role of postnatal fish oil supplementation (500 mg DHA-rich fish oil/d from weaning or from 6 months of age) in Australian children (n 616) at high risk of allergic disease (affected parents or siblings) (Mihrshahi et al 2003). The only clinical follow-up data currently available are at 18 months, where fish oil supplementation was associated with a 9·8 % absolute reduction (P ¼ 0·02) in the prevalence of any wheeze and a 7·8 % absolute reduction (P ¼ 0·04) in prevalence of wheeze of more than 1 week.…”

Section: Modulating Immune and Inflammatory Activity With Dietary N-3mentioning

confidence: 99%

The impact of long-chainn-3 polyunsaturated fatty acids on human health

et al. 2005

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A considerable literature has been published on the health benefits of fish, oil-rich fish and fish oils and their constituent long-chain (LC)n-3 PUFA. Evidence from epidemiological studies highlights the cardioprotective attributes of diets rich in fish, especially oil-rich fish. Data from intervention trials are consistent in suggesting that LCn-3 PUFA lower the risk of CVD, probably by the multiple mechanisms of lowering serum triacylglycerols, improving the LDL:HDL ratio, anti-arrhythmic effects on heart muscle, improved plaque stability, anti-thrombotic effects and reduced endothelial activation. Research indicates LCn-3 PUFA provision has an impact during development, and there is preliminary evidence that docosahexaenoic acid supplementation during pregnancy could optimise brain and retina development in the infant. LCn-3 PUFA are also postulated to ameliorate behavioural and mental health disturbances such as depression, schizophrenia, dementia and attention deficit hyperactivity disorder. However, despite some positive evidence in each of these areas, use of LCn-3 PUFA in these conditions remains at the experimental stage. In the case of immune function, there is little doubt that LCn-3 PUFA have a positive effect. Although intervention trials in rheumatoid arthritis show strong evidence of benefit, evidence for efficacy in other inflammatory conditions, including Crohn's disease, ulcerative colitis, psoriasis, lupus, multiple sclerosis, cystic fibrosis and asthma, is inconsistent or inadequate. More promising evidence in some conditions may come from studies which attempt to modify the fetal environment using LCn-3 PUFA supplementation during pregnancy.

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Eighteen-month outcomes of house dust mite avoidance and dietary fatty acid modification in the childhood asthma prevention study (CAPS)

Cited by 173 publications

References 16 publications

Allergic sensitisation and allergic rhinitis are associated with n-3 polyunsaturated fatty acids in the diet and in red blood cell membranes

Allergic sensitisation and allergic rhinitis are associated with n-3 polyunsaturated fatty acids in the diet and in red blood cell membranes

The PREVASC study: the clinical effect of a multifaceted educational intervention to prevent childhood asthma

The impact of long-chainn-3 polyunsaturated fatty acids on human health

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