title: Fatty acids in breast milk and development of atopic eczema and allergic sensitisation in infancy.
abstract: BACKGROUND
  One of the explanations for the increasing prevalence of atopic diseases is a relative low perinatal supply of n-3 fatty acids. However, this does not explain the protective effects of whole-fat dairy products or high levels of transfatty acids in breast milk, observed in some studies. We evaluated the role of perinatal supply of fatty acids in the early development of atopic eczema and allergic sensitisation.
  
  
  METHODS
  Fatty acids, including n-3 long-chain polyunsaturated fatty acids (LCPs) as well as ruminant fatty acids (rumenic acid, cis-9,trans-11-C18:2 conjugated linoleic acid; and vaccenic acid, trans-11-C18:1), were determined in breast milk sampled at 1 month postpartum from 310 mother-infant pairs in the KOALA Birth Cohort Study, the Netherlands. Children were followed for atopic outcomes until 2 years of age.
  
  
  RESULTS
  Higher concentrations of n-3 LCPs as well as ruminant fatty acids were associated with lower risk of (1) parent-reported eczema, (2) atopic dermatitis (UK Working Party criteria), and (3) sensitisation at age 1 year (as revealed by specific serum IgE levels to cow's milk, hen's egg and/or peanut). In multivariable logistic regression analysis, the inverse associations between ruminant fatty acid concentrations in breast milk and atopic outcomes were found to be independent from n-3 LCPs.
  
  
  CONCLUSIONS
  The results confirm a protective role of preformed n-3 LCPs in the development of atopic disease. Moreover, this is the first study in humans confirming results from animal studies of protective effects of ruminant fatty acids against the development of atopic manifestations.
authors.affiliation: Maastricht University/CAPHRI School of Public Health and Primary Care, Maastricht, the Netherlands. c.thijs@epid.unimaas.nl
authors.forename: C
authors.initials: C
authors.lastname: Thijs
authors.forename: A
authors.initials: A
authors.lastname: Müller
authors.forename: L
authors.initials: L
authors.lastname: Rist
authors.forename: I
authors.initials: I
authors.lastname: Kummeling
authors.forename: B E P
authors.initials: BE
authors.lastname: Snijders
authors.forename: M
authors.initials: M
authors.lastname: Huber
authors.forename: R
authors.initials: R
authors.lastname: van Ree
authors.forename: A P
authors.initials: AP
authors.lastname: Simões-Wüst
authors.forename: P C
authors.initials: PC
authors.lastname: Dagnelie
authors.forename: P A
authors.initials: PA
authors.lastname: van den Brandt
mesh_terms: D000328:Adult; D000818:Animals; D002417:Cattle; D002675:Child, Preschool; D015331:Cohort Studies; D003876:Dermatitis, Atopic / Q000453:epidemiology*; D005227:Fatty Acids / Q000032:analysis*; D015525:Fatty Acids, Omega-3 / Q000032:analysis; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology*; D015994:Incidence; D007223:Infant; D008892:Milk / Q000737:chemistry; D008895:Milk, Human / Q000737:chemistry*; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011795:Surveys and Questionnaires
chemical_list: D005227:Fatty Acids; D015525:Fatty Acids, Omega-3