title: Cow's milk-based beverage consumption in 1- to 4-year-olds and allergic manifestations: an RCT.
abstract: BACKGROUND
  Nutrients such as docosahexaenoic acid (DHA), prebiotics and β-glucan have been associated with reduced incidence of respiratory illnesses and allergic manifestations (AM). Our objective was to assess if consumption of a cow's milk-based beverage with these and other nutrients supports respiratory, gastrointestinal, and skin health in otherwise well-nourished, healthy children.
  
  
  METHODS
  In this double-blind, randomized, controlled trial, healthy children (1-4 years of age) from two daycare centers in Brazil were fed three servings/day of a cow's milk-based beverage (CMBB; n = 125) containing DHA, the prebiotics polydextrose (PDX) and galactooligosaccharides (GOS), β-glucan, and other key nutrients, or a control cow's milk-based beverage (control; n = 131) for up to 28 weeks. Occurrence of respiratory infections, diarrheal disease and AM was assessed by study pediatricians and the number of episodes were analyzed with the Cochran-Mantel-Haenszel test and the Andersen-Gill model.
  
  
  RESULTS
  The CMBB group had fewer episodes of AM, which included allergic rhinitis or conjunctivitis, wheezing, allergic cough, eczema and urticaria, compared to the control group (p = 0.021). The hazard ratio for increased number of episodes of AM was lower in the CMBB group compared to control (HR, 0.64; 95 % CI 0.47-0.89; p = 0.007). There was no difference in the incidence of respiratory infections and diarrheal disease between groups.
  
  
  CONCLUSIONS
  A cow's milk-based beverage containing DHA, PDX/GOS, and yeast β-glucan, and supplemented with micronutrients, including zinc, vitamin A and iron, when consumed 3 times/day for 28 weeks by healthy 1- to 4-year-old children was associated with fewer episodes of allergic manifestations in the skin and the respiratory tract.
  
  
  BACKGROUND
  registration number: NCT01431469.
authors.affiliation: Federal University of Bahia, Salvador, Bahia, Brazil. pontes77@hotmail.com.
authors.forename: M V
authors.initials: MV
authors.lastname: Pontes
authors.affiliation: Federal University of Bahia, Salvador, Bahia, Brazil. ribeirot21@gmail.com.
authors.forename: T C M
authors.initials: TC
authors.lastname: Ribeiro
authors.affiliation: Federal University of Bahia, Salvador, Bahia, Brazil. hugocrj@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Ribeiro
authors.affiliation: Federal University of Bahia, Salvador, Bahia, Brazil. mattosangela@gmail.com.
authors.forename: A P
authors.initials: AP
authors.lastname: de Mattos
authors.affiliation: Federal University of Bahia, Salvador, Bahia, Brazil. indhiralmeida@gmail.com.
authors.forename: I R
authors.initials: IR
authors.lastname: Almeida
authors.affiliation: Federal University of Bahia, Salvador, Bahia, Brazil. vivianmascarenhas@gmail.com.
authors.forename: V M
authors.initials: VM
authors.lastname: Leal
authors.affiliation: Federal University of Bahia, Salvador, Bahia, Brazil. gabinutty@yahoo.com.br.
authors.forename: G N
authors.initials: GN
authors.lastname: Cabral
authors.affiliation: Mead Johnson Pediatric Nutrition Institute, Evansville, IN, USA. Suzanne.Stolz@mjn.com.
authors.forename: S
authors.initials: S
authors.lastname: Stolz
authors.affiliation: Mead Johnson Pediatric Nutrition Institute, Evansville, IN, USA. Weihong.Zhuang@mjn.com.
authors.forename: W
authors.initials: W
authors.lastname: Zhuang
authors.affiliation: Mead Johnson Pediatric Nutrition Institute, Evansville, IN, USA. deolindascalabrin@gmail.com.
authors.forename: D M F
authors.initials: DM
authors.lastname: Scalabrin
mesh_terms: D000818:Animals; D001628:Beverages; D015415:Biomarkers / Q000097:blood; D001938:Brazil; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology*; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000008:administration & dosage / Q000032:analysis; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology*; D015994:Incidence; D007223:Infant; D016753:Interleukin-10 / Q000097:blood; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage; D008892:Milk; D056692:Prebiotics / Q000008:administration & dosage; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D012959:Socioeconomic Factors; D053773:Transforming Growth Factor beta1 / Q000097:blood; D016896:Treatment Outcome; D014312:Trisaccharides / Q000008:administration & dosage / Q000032:analysis; D047071:beta-Glucans / Q000008:administration & dosage / Q000032:analysis
chemical_list: D015415:Biomarkers; D018977:Micronutrients; D056692:Prebiotics; D053773:Transforming Growth Factor beta1; D014312:Trisaccharides; D047071:beta-Glucans; D016753:Interleukin-10; D004281:Docosahexaenoic Acids; C072242:4'-galactooligosaccharide