95 per 10 nmol/L increase).97 One study

found maternal fatty acid intake selleckchem Oligomycin A during the third trimester was associated with asthma outcome at 5 years (eg, higher α-linoleic acid and palmitic acid intake associated with ∼40% reduced risk).98 Other studies found no association between maternal dietary antioxidants99 or folate100 and vitamin A101 supplementation and childhood asthma outcomes. Exposure to milk during infancy In addition to the previously described complex interventions where milk exposure was modified, a number of studies were identified where only milk was the exposure of interest and there was evidence that early milk exposure was related to altered asthma risk. Breast milk: One systematic review with meta-analysis, two cohort studies and one intervention study were identified. Meta-analysis of 31 studies found any breast feeding reduced risk for wheeze (OR 0.92) but increased risk for asthma (OR 1.10).102 Never breast feeding was associated with increased wheeze by 4 years (OR 1.4)103 and exclusive breast feeding was associated with reduced asthma risk at 5 (OR 0.9)104 but not at 6 years of age. The intervention study found that prolonged breast feeding (up to the age of 12 months) was associated with reduced

asthma at 4 but not at 6 years of age.105 Maternal margarine intake (but not fatty acid or fish intake) while breast feeding was associated with increased risk for asthma at 5 years (HR 2.0).98 Cow’s milk formula: One systematic review, two intervention studies and one observational study

were identified. A systematic review of 10 trials concluded that hydrolysed cow’s milk formula, but not soya-based milk, reduced risk of wheezing in infancy (RR 0.4) compared with standard cow’s milk formula.106 Modification of cow’s milk formula either by a non-hydrolysing fermentation process or supplementation with fatty acids (arachidonic acid or docosahexaenoic acid) was associated with reduced risk for wheeze by 2 (13% vs 35%)107 and 3 years of age (OR 0.3)108 compared with standard cow’s milk formula. An observational study found no evidence for hydrolysed feed for the first 6 months reducing asthma risk at 3 years.109 Dietary Drug_discovery exposures during infancy There were two systematic reviews, two clinical trials and five observational studies identified; there were some associations between exposure to some dietary components and altered risk reported. Four observational studies related first dietary exposures to asthma outcomes, and one found evidence for early introduction of cereals by 6 months, and egg by 11 months was associated with 30–40% reduced risk for asthma at 5 years,110 and a second study found a direct relationship between age at introduction of oats and risk for asthma at 5 years (OR 0.4 for earliest vs latest age at introduction).111 Two other studies found no association between early or delayed introduction of any solids and asthma risk at 5112 and 6 years.