Introduction Early infant diet might influence the risk of subsequent allergic disease.
Methods The Merthyr Allergy Prevention Study (MAPS) was a randomised controlled trial in infants at high risk of allergic disease. The trial determined whether a cow’s milk exclusion diet for the first 4 months of life decreased the risk of allergic disease including asthma compared with a normal diet. A soya milk preparation was offered to those in the intervention group. A standardised questionnaire for allergic disease was completed at ages 1, 7, 15 and 23 years, with clinical assessment at 1, 7 and 23 years. The effect of the intervention on the risk of atopy, asthma and wheeze at age 23 years was determined.
Findings 487 subjects entered the study; at age 23 years 299 completed the questionnaire, of which 119 attended clinical assessment. Subjects randomised to the intervention group had a significantly increased risk of atopy (adjusted OR 2.97, 95% CI 1.30 to 6.80; p=0.01) and asthma (OR 2.07, 95%CI 1.09 to 3.91; p=0.03) at age 23 years, but not wheeze (OR 1.43, 95%CI 0.87 to 2.37; p=0.16). Earlier exposure to cow’s milk was associated with a decreased risk of wheeze and asthma at age 23 years, while earlier exposure to soya milk was associated with an increased risk of atopy and asthma.
Interpretation In infants at high risk of allergic disease, either cow’s milk exclusion or early soya milk introduction for the first 4 months of life increases the risk of atopy, wheeze and asthma in adulthood.
- paediatric asthma
Data availability statement
Data are available upon reasonable request.
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Contributors SH conceived the study, recruited the subjects at age 23 years, analysed the findings and wrote the paper; KJ conceived the study and wrote the paper; FD conceived the study, analysed the findings and wrote the paper; IJD analysed the findings and wrote the paper.
Funding Welsh Office of Research and Development (now Health and Social Research Wales) WORD ReF05/1/186. The MAPS study received funding from the Welsh Scheme for the Development of Health and SocialCare Research and Wyeth Laboratories. The 23 year year follow upfollow-up was funded by the Welsh Office of Research and Development (subsequently Health and Social Care Research Wales). None of the funders had any role in any of study design; the collection, analysis, and interpretation of data; the writing of the report; and the decision to submit the paper for publication. The corresponding author (ID) confirms that he had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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