title: The protective effect of farm milk consumption on childhood asthma and atopy: the GABRIELA study.
abstract: BACKGROUND
  Farm milk consumption has been identified as an exposure that might contribute to the protective effect of farm life on childhood asthma and allergies. The mechanism of action and the role of particular constituents of farm milk, however, are not yet clear.
  
  
  OBJECTIVE
  We sought to investigate the farm milk effect and determine responsible milk constituents.
  
  
  METHODS
  In rural regions of Germany, Austria, and Switzerland, a comprehensive questionnaire about farm milk consumption and other farm-related exposures was completed by parents of 8334 school-aged children, and 7606 of them provided serum samples to assess specific IgE levels. In 800 cow's milk samples collected at the participants' homes, viable bacterial counts, whey protein levels, and total fat content were analyzed. Asthma, atopy, and hay fever were associated to reported milk consumption and for the first time to objectively measured milk constituents by using multiple regression analyses.
  
  
  RESULTS
  Reported raw milk consumption was inversely associated to asthma (adjusted odds ratio [aOR], 0.59; 95% CI, 0.46-0.74), atopy (aOR, 0.74; 95% CI, 0.61-0.90), and hay fever (aOR, 0.51; 95% CI, 0.37-0.69) independent of other farm exposures. Boiled farm milk did not show a protective effect. Total viable bacterial counts and total fat content of milk were not significantly related to asthma or atopy. Increased levels of the whey proteins BSA (aOR for highest vs lowest levels and asthma, 0.53; 95% CI, 0.30-0.97), α-lactalbumin (aOR for interquartile range and asthma, 0.71; 95% CI, 0.52-0.97), and β-lactoglobulin (aOR for interquartile range and asthma, 0.62; 95% CI, 0.39-0.97), however, were inversely associated with asthma but not with atopy.
  
  
  CONCLUSIONS
  The findings suggest that the protective effect of raw milk consumption on asthma might be associated with the whey protein fraction of milk.
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland. georg.loss@unibas.ch
authors.forename: Georg
authors.initials: G
authors.lastname: Loss
authors.forename: Silvia
authors.initials: S
authors.lastname: Apprich
authors.forename: Marco
authors.initials: M
authors.lastname: Waser
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kneifel
authors.forename: Jon
authors.initials: J
authors.lastname: Genuneit
authors.forename: Gisela
authors.initials: G
authors.lastname: Büchele
authors.forename: Juliane
authors.initials: J
authors.lastname: Weber
authors.forename: Barbara
authors.initials: B
authors.lastname: Sozanska
authors.forename: Hanna
authors.initials: H
authors.lastname: Danielewicz
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Horak
authors.forename: R J Joost
authors.initials: RJ
authors.lastname: van Neerven
authors.forename: Dick
authors.initials: D
authors.lastname: Heederik
authors.forename: Peter C
authors.initials: PC
authors.lastname: Lorenzen
authors.forename: Erika
authors.initials: E
authors.lastname: von Mutius
authors.forename: Charlotte
authors.initials: C
authors.lastname: Braun-Fahrländer
mesh_terms: D000818:Animals; D001249:Asthma / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control*; D002417:Cattle; D002648:Child; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008892:Milk; D008894:Milk Proteins / Q000008:administration & dosage; D012424:Rural Population; D011795:Surveys and Questionnaires; D000067816:Whey Proteins
chemical_list: D008894:Milk Proteins; D000067816:Whey Proteins; D007073:Immunoglobulin E