8/29/03 Association of milk fat consumption with reduced asthma in pre-school childrenSummaryThere has been great interest in the role of diet in young children in the risk for developing childhood asthma. Wijga et al of the National Institute of Public Health in Bilthoven, Netherlands analyzed dietary patterns in 2,978 children participating in a prospective birth cohort study. They found that the prevalence of diagnosed asthma at age 3 years was lower in children who consumed whole milk at age 2 years than in children who did not (3.4% vs 5.1%). The incidence of asthma at age 3 years was particularly low in children who consumed butter daily (1.5%). The prevalence of recent wheezing was also lower in children who consumed dairy products daily than in those who did not (13.7 vs 18.4%). Consumption of brown bread was also associated with lower rates of asthma and wheezing but no associations were seen between asthma/wheezing and the consumption of fruits, vegetables, margarine or fish. The authors concluded that frequent consumption of products containing dairy fat is associated with a reduced risk of asthma symptoms. Reference Thorax 2003;58:567-72 Editor’s Comments The results described above come from one of the increasingly popular large epidemiologic projects that are puzzling to me. It is unclear whether there is truly a cause and effect relationship between ingestion of dairy fat and protection from asthma. The authors claimed that possible confounding variables were accounted for in a logistic regression analysis. However, I would be more convinced by a controlled prospective study of the effects of dairy fat were assessed in childhood populations matched carefully for all other environmental factors (dietary and otherwise). Others who have reviewed these situations have generally agreed that exclusive breast feeding for the first 3-6 months of life reduces the risk for subsequent childhood asthma. However, opinions about other dietary pattern/asthma relationships vary quite a bit. Some concluded that diets in early childhood high in the 3-omega fatty acids found in fish are associated with reduced asthma risk. (Med J Australia 2002;177 Suppl:S78-80). Others have concluded that the risk of respiratory allergies may be postponed but not eliminated by dietary approaches in infancy. (Pediatrics 2003;111:1662-71). Obviously, further investigation is warranted.
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