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Maternal vitamin D intake from foods during pregnancy may be negatively associated with risk of asthma and AR in childhood.

MATER IALS AND METHODScourse of diarrh ea. Maln utrition has been report ed to increase the absorption of potentially harmful antigens (2) and to impai r imm une responses (3). A poor nutrition al state may thu s increase the risk of protracted diarrh ea as well as enhance susceptibility to other infectio ns and to gastroi ntestinal allergy. The nutritio nal state of even well-no urished infants deteriorat es rapidly during diarrhea, either because of loss of appetite, deliberate withholding of oral feeds, or partial malabsorption caused by viral invasio n ofenterocytes (4).Rapid reintrodu ction of oral feedings after rehydration has been advocated to coun terac t the pote nti al hazards related to fasting during diarrhea (5). We have previously shown that rapid refeeding results in earlier cessatio n of diarrhea in well-nourished children; also, cow milk produ cts are tolerated (6). A furt her shortening of diarrhea resulted from administratio n of hu man Lactobacillus stra in (Lactobacillus GG, Gefilac, Valio Finni sh Co-operative Dairies' Associatio n, Helsinki, Finland ) together with the rapid refeeding schedule (7). The mechanisms behind such a favorable outc ome remain poorly understood. Th e effect of nutritional therapy may be immunologically med iated and may prove important in eradicating enteric infections in the imm unocompromised host.The objective of the present study was to evaluate the effect of L actobacillus GG on the intestinal immune response triggered by rotavirus infection in well-nourished children. For th is pu rpose, we used the ELISPOT assay, which measures ISC and sASC amo ng circulating lymphocytes. T hese cells are arrested du ring their maturation cycle in peripheral blood, giving indirect evidence of gut local im m une respo nse (8-10).Patients. Forty-four well-no urished children (33.4% female), between 7 and 37 mo of age, were enro lled in the present study. Th ey were admitted for acute gastroen teritis of less than 7 d du ration at the Departm ent of Pediatrics, Ta mpere U niversity Hospital, during a rotavirus epidemic .Informed consent was obtaine d from the patients' pare nts, and the protocol was approved by the hospital's Committee on Ethical Practice.Ma nagement and samples. U pon ad mission, the children were weighed and clinically examin ed. The severity of dehydration (%) was estimated. Th e children were treated according to sta ndard practice: oral rehyd ration was accom plished in 6 h with a , solution containing Na" 60 mmo l/ L and glucose 144 mm ol/L (Osmosal Novum, Leiras, Turku , Finland) given at twice the estimated fluid loss with a minimum of 30 mL/kg body weight. Th e patients were weighed daily. Th e attending nurs es followed the quality (characterized as watery, loose, or solid) and number of stools and vomitus. The du ration of diarrh ea was counted 14 1

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Both prenatal and post-natal exposure to antibiotics was associated with an increased risk of asthma. The potential role of adverse effects of antibiotics on the gut microbiota and the development of asthma should be further explored.

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The aim of the study was to assess whether perinatal factors are associated with the risk of asthma in childhood in a register-based, nested case-control study in Finland. All children born between January 1, 1996, and April 30, 2004, who were entitled to a special reimbursement for antiasthmatic drugs (i.e., had diagnosed asthma by 2006 and had purchased inhaled corticosteroids or montelukast at least once), were identified (n = 21,038). For each case, one matched control child was selected. The associations between perinatal factors, derived from the Finnish Medical Birth Register, and the risk of asthma were analyzed by conditional logistic regression. In the final multivariate model, maternal asthma, young age, smoking, previous miscarriages, and a high number of previous deliveries, as well as cesarean section, low gestational age, and low ponderal index, were associated with an increased risk of asthma in children diagnosed before the age of 3 years. Among children diagnosed at the age of 3 years or later, maternal asthma, low gestational age, and low ponderal index were associated with an increased risk, and a high number of previous deliveries was associated with a decreased risk of asthma. In conclusion, perinatal factors play a role in the development of asthma in childhood, but the etiology may differ in early and late-onset asthma.

OBJECTIVE: The goal was to examine the relationship between age at the introduction of solid foods during the first year of life and allergic sensitization in 5-year-old children. METHODS: We analyzed data from the Finnish Type 1 Diabetes Prediction and Prevention nutrition study, a prospective, birth cohort study. We studied 994 children with HLA-conferred susceptibility to type 1 diabetes mellitus for whom information on breastfeeding, age at the introduction of solid foods, and allergen-specific immunoglobulin E levels at 5 years was available. The association between age at the introduction of solid foods and allergic sensitization was analyzed by using logistic regression. RESULTS: The median duration of exclusive breastfeeding was 1.8 months (range: 0–10 months). After adjustment for potential confounders, late introduction of potatoes (>4 months), oats (>5 months), rye (>7 months), wheat (>6 months), meat (>5.5 months), fish (>8.2 months), and eggs (>10.5 months) was significantly directly associated with sensitization to food allergens. Late introduction of potatoes, rye, meat, and fish was significantly associated with sensitization to any inhalant allergen. In models that included all solid foods that were significantly related to the end points, eggs, oats, and wheat remained the most important foods related to sensitization to food allergens, whereas potatoes and fish were the most important foods associated with inhalant allergic sensitization. We found no evidence of reverse causality, taking into account parental allergic rhinitis and asthma. CONCLUSION: Late introduction of solid foods was associated with increased risk of allergic sensitization to food and inhalant allergens.