title: Increased food diversity in the first year of life is inversely associated with allergic diseases.
abstract: BACKGROUND
  The role of dietary factors in the development of allergies is a topic of debate, especially the potential associations between infant feeding practices and allergic diseases. Previously, we reported that increased food diversity introduced during the first year of life reduced the risk of atopic dermatitis.
  
  
  OBJECTIVE
  In this study we investigated the association between the introduction of food during the first year of life and the development of asthma, allergic rhinitis, food allergy, or atopic sensitization, taking precautions to address reverse causality. We further analyzed the association between food diversity and gene expression of T-cell markers and of Cε germline transcript, reflecting antibody isotype switching to IgE, measured at 6 years of age.
  
  
  METHODS
  Eight hundred fifty-six children who participated in a birth cohort study, Protection Against Allergy Study in Rural Environments/EFRAIM, were included. Feeding practices were reported by parents in monthly diaries during the first year of life. Data on environmental factors and allergic diseases were collected from questionnaires administered from birth up to 6 years of age.
  
  
  RESULTS
  An increased diversity of complementary food introduced in the first year of life was inversely associated with asthma with a dose-response effect (adjusted odds ratio with each additional food item introduced, 0.74 [95% CI, 0.61-0.89]). A similar effect was observed for food allergy and food sensitization. Furthermore, increased food diversity was significantly associated with an increased expression of forkhead box protein 3 and a decreased expression of Cε germline transcript.
  
  
  CONCLUSIONS
  An increased diversity of food within the first year of life might have a protective effect on asthma, food allergy, and food sensitization and is associated with increased expression of a marker for regulatory T cells.
authors: University of Zurich, Children's Hospital, and Christine Kühne-Center for Allergy Research and Education, Zurich, Switzerland. Electronic address: Caroline.Roduit@kispi.uzh.ch.
authors: Caroline
authors: C
authors: Roduit
authors: Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich and Christine Kühne-Center for Allergy Research and Education, Zurich, Switzerland.
authors: Remo
authors: R
authors: Frei
authors: Dr von Hauner Children's Hospital, Ludwig-Maximilians-Universität, Munich, Germany.
authors: Martin
authors: M
authors: Depner
authors: Dr von Hauner Children's Hospital, Ludwig-Maximilians-Universität, Munich, Germany.
authors: Bianca
authors: B
authors: Schaub
authors: Swiss Tropical and Public Health Institute and the University of Basel, Basel, Switzerland.
authors: Georg
authors: G
authors: Loss
authors: Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
authors: Jon
authors: J
authors: Genuneit
authors: Institute for Laboratory Medicine, Pathobiochemistry and Molecular Diagnostics, Philipps University of Marburg, Marburg, Germany.
authors: Petra
authors: P
authors: Pfefferle
authors: Department of Environment Health, National Institute for Health and Welfare, Kuopio, Finland.
authors: Anne
authors: A
authors: Hyvärinen
authors: Department of Environment Health, National Institute for Health and Welfare, Kuopio, Finland.
authors: Anne M
authors: AM
authors: Karvonen
authors: Children's Hospital Schwarzach, Schwarzach, Austria.
authors: Josef
authors: J
authors: Riedler
authors: Department of Respiratory Disease, UMR/CNRS 6249 Chrono-environment, University Hospital of Besançon, Besançon, France.
authors: Jean-Charles
authors: JC
authors: Dalphin
authors: Department of Environment Health, National Institute for Health and Welfare, Kuopio, Finland.
authors: Juha
authors: J
authors: Pekkanen
authors: Dr von Hauner Children's Hospital, Ludwig-Maximilians-Universität, Munich, Germany.
authors: Erika
authors: E
authors: von Mutius
authors: Swiss Tropical and Public Health Institute and the University of Basel, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors: Charlotte
authors: C
authors: Braun-Fahrländer
authors: Children's Hospital of Eastern Switzerland St Gallen and the Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.
authors: Roger
authors: R
authors: Lauener
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005060:Europe / Q000453:epidemiology; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000209:etiology*; D017578:Immunoglobulin Class Switching; D007073:Immunoglobulin E / Q000276:immunology; D007223:Infant; D007225:Infant Food; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D007073:Immunoglobulin E
keywords: Asthma; children; food allergy and sensitization; food diversity