Three-year outcomes of dietary fatty acid modification and house dust mite reduction in the Childhood Asthma Prevention Study.
BACKGROUND
Two factors thought to influence the risk of asthma are the promoting effect of sensitization to house dust mites and the preventive effect of increased omega-3 fatty acids. Although house dust mite allergen avoidance has been used as a preventive strategy in several trials, the effect of omega-3 fatty acid supplementation in the primary prevention of asthma and allergic disease is not known.


OBJECTIVE
To measure the effects of dietary supplementation with omega-3 fatty acids and house dust mite allergen avoidance in children with a family history of asthma.


METHODS
A total of 616 children at high risk of asthma were enrolled antenatally in a randomized controlled trial, and 526 children remained in the trial at age 3 years. The outcomes were symptoms of allergic disease and allergen sensitization.


RESULTS
There was a significant 10.0% (95% CI, 3.7-16.4) reduction in the prevalence of cough in atopic children in the active diet group ( P=.003; number needed to treat, 10) but a negligible 1.1% (95% CI, -7.1 to 9.5) reduction cough among nonatopic children. There was a 7.2% (95% CI, 10.11-14.3) reduction in sensitization to house dust mite in the active allergen avoidance group ( P=.05; number needed to treat, 14). No significant differences in wheeze were found with either intervention.


CONCLUSIONS
These results suggest that our interventions, designed to be used in simple public health campaigns, may have a role in preventing the development of allergic sensitization and airways disease in early childhood. This offers the prospect of reducing allergic disease in later life.
Discipline of Paediatrics and Child Health, Children's Hospital at Westmead Clinical School, University of Sydney, Australia.
Jennifer K
JK
Peat
Seema
S
Mihrshahi
Andrew S
AS
Kemp
Guy B
GB
Marks
Euan R
ER
Tovey
Karen
K
Webb
Craig M
CM
Mellis
Stephen R
SR
Leeder
D000328:Adult; D016902:Air Pollution, Indoor / Q000517:prevention & control*; D000485:Allergens / Q000276:immunology*; D001249:Asthma / Q000178:diet therapy / Q000517:prevention & control*; D001512:Bedding and Linens; D002675:Child, Preschool; D015331:Cohort Studies; D004041:Dietary Fats / Q000627:therapeutic use; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D039981:Pyroglyphidae / Q000276:immunology*; D016896:Treatment Outcome
D000485:Allergens; D004041:Dietary Fats; D015525:Fatty Acids, Omega-3