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9. Stressful life events in childhood and allergic sensitization

Author

Herberth, G., primary, Röder, S., additional, Bockelbrink, A., additional, Schäfer, T., additional, Borte, M., additional, Herbarth, O., additional, Krämer, U., additional, Behrendt, H., additional, Sausenthaler, S., additional, Heinrich, J., additional, and Lehmann, I., additional

Published
2018
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10. Regional and socio-economic differences in food, nutrient and supplement intake in school-age children in Germany: results from the GINIplus and the LISAplus studies

Author

Sausenthaler, S., Standl, M., Buyken, A., Rzehak, P., Koletzko, S., Bauer, C.P., Schaaf, B., von Berg, A., Berdel, D., Borte, M., Herbarth, O., Lehmann, I., Krämer, U., Wichmann, H.-E., Heinrich, J., GINIplus Study Group (Heinrich, J., Schoetzau, A., Poescu, M., Mosetter, M., Schindler, J., Franke, K., Laubereau, B., Thaqi, A., Zirngibl, A., Zutavern, A.), LISAplus Study Group (Heinrich, J., Bolte, G., Belcredi, P., Jacob, B., and Höhnke, A.

Subjects
Male, Parents, Cross-sectional study, Medicine (miscellaneous), Child Nutritional Physiological Phenomena, Logistic regression, Interviews as Topic, Food Preferences, Nutrient, Germany, Surveys and Questionnaires, Environmental health, Vegetables, Humans, Prospective Studies, Child, Prospective cohort study, Nutrition and Dietetics, Confounding, Public Health, Environmental and Occupational Health, Diet, Children, Regional differences, Socio-economic determinants, Feeding Behavior, Cross-Sectional Studies, Logistic Models, Geography, Socioeconomic Factors, Fruit, Dietary Supplements, Population study, Female, Energy Intake, Follow-Up Studies
Abstract

ObjectiveTo describe regional differences between eastern and western Germany with regard to food, nutrient and supplement intake in 9–12-year-old children, and analyse its association with parental education and equivalent income.DesignData were obtained from the 10-year follow-up of the two prospective birth cohort studies – GINIplus and LISAplus. Data on food consumption and supplement intake were collected using an FFQ, which had been designed for the specific study population. Information on parental educational level and equivalent income was derived from questionnaires. Logistic regression modelling was used to analyse the effect of parental education, equivalent income and region on food intake, after adjusting for potential confounders.SettingGermany.SubjectsA total of 3435 children aged 9–12 years.ResultsSubstantial regional differences in food intake were observed between eastern and western Germany. Intakes of bread, butter, eggs, pasta, vegetables/salad and fruit showed a significant direct relationship with the level of parental education after adjusting for potential confounders, whereas intakes of margarine, meat products, pizza, desserts and soft drinks were inversely associated with parental education. Equivalent income had a weaker influence on the child's food intake.ConclusionsNutritional education programmes for school-age children should therefore account for regional differences and parental education.

Published
2011

12. Associations between ambient air pollution and bone turnover markers in 10-year old children: Results from the GINIplus and LISAplus studies

Author

Liu, C., Fuertes, E., Flexeder, C., Hofbauer, L.C., Berdel, D., Hoffmann, B.H., Kratzsch, J.K., von Berg, A., Heinrich, J., GINIplus Study Group (Chen, C.M., Filipiak, B., Franke, K., Gehring, U., Laubereau, B., Popescu, M., Sausenthaler, S., Schoetzau, A., Wichmann, H.-E., Zutavern, A.), and LISAplus Study Group (Schnappinger, M.)

Subjects
Total physical activity, Male, medicine.medical_specialty, Epidemiology, Ambient Air Pollution, Bone Health, Bone Turnover Markers, Children, Osteocalcin, complex mixtures, Collagen Type I, Bone remodeling, Bone health, Cohort Studies, N-terminal telopeptide, Bone Density, Internal medicine, Air Pollution, Germany, medicine, Humans, Child, Bone mineral, Bone Development, Ambient air pollution, biology, Chemistry, Public Health, Environmental and Occupational Health, Environmental Exposure, Endocrinology, biology.protein, Female, Particulate Matter, Bone turnover markers, Peptides, Major road, Type I collagen, Biomarkers
Abstract

Negative associations between bone turnover markers and bone mineral density have been reported. In order to study the association between ambient air pollution and bone turnover markers, as indicators of bone loss, we investigated associations between land-use regression modeled air pollution (NO2, PM2.5 mass, PM2.5 – 10 [coarse particles], PM10 mass and PM2.5 absorbance) and bone turnover markers in 2264 children aged 10 years. Serum osteocalcin and C-terminal telopeptide of type I collagen (CTx), measured by Modular-System (Roche), were the two bone turnover markers considered in this analysis. In total population, NO2, PM2.5 – 10 and PM10 mass exposure were positively and significantly associated with both osteocalcin and CTx. A 2.5 (95% CI: 0.6, 4.4) ng/ml increase in osteocalcin and a 24.0 (95% CI: 6.7, 41.3) ng/L increase in CTx were observed per IQR (6.7μg/m3) increase in NO2, independent of socioeconomic status, sex, age, pubertal status, fasting status and total physical activity. The estimated coefficients were 3.0 (95% CI: 0.1, 5.8) for osteocalcin and 32.3 (95% CI: 6.1, 58.5) for CTx with PM2.5 – 10; 3.2 (95% CI: 0.0, 6.4) for osteocalcin and 30.7 (95% CI: 1.7, 59.7) for CTx with PM10. Children living close to a major road (≤ 350m) had higher levels of both osteocalcin (1.4 [−1.2, 4.0] ng/ml) and CTx (16.2 [−7.4, 39.8] ng/L). The adverse impact of ambient air pollution on bone turnover rates observed in one of the study areas showed stimulation of more such studies.

Published
2015

13. Longitudinal and cross sectional assessment of allergic diseases and social influences differ: Results from GINIplus and LISAplus

Author

Klümper, C., Krämer, U., Röder, S., Lehman, I., Bauer, C.P., Berdel, D., von Berg, A., Borte, M., Filipiak-Pittrofff, B., Heinrich, J., Herbarth, O., Hoffmann, U., Koletzko, S., Link, E., Schaaf, B., Hoffmann, B., GINIplus Study Group (Wichmann, H.-E., Schoetzau, A., Popescu, M., Franke, K., Laubereau, B., Sausenthaler, S., Zutavern, A., Filipiak, B., Gehring, U., Chen, C.M.), and LISAplus Study Group (Schnappinger, M.)

Published
2014

14. Mother's body mass index and food intake in school-aged children: Results of the GINIplus and the LISAplus studies

Author

Pei, Z., Flexeder, C., Fuertes, E., Standl, M., Berdel, D., von Berg, A., Koletzko, S., Schaaf, B., Heinrich, J., GINIplus Study Group (Chen, C.-M., Filipiak, B., Franke, K., Gehring, U., Laubereau, B., Popescu, M., Sausenthaler, S., Schoetzau, A., Wichmann, H.-E., Zutavern, A.), and LISAplus Study Group ()

Subjects
nutritional and metabolic diseases
Abstract

Background/Objectives:Mother's body mass index (BMI) is a strong predictor of child BMI. Whether mother's BMI correlates with child's food intake is unclear. We investigated associations between mother's BMI/overweight and child's food intake using data from two German birth cohorts.Subjects/Methods:Food intakes from 3230 participants were derived from parent-completed food frequency questionnaires. Intakes of 11food groups were categorized into three levels using group- and sex-specific tertile cutoffs. Mother's BMI and overweight were calculated on the basis ofquestionnaire data. Multinomial regression models assessed associations between a child's food intake and mother's BMI/overweight. Linear regression models assessed associations between a child's total energy intake and mother's BMI. Models were adjusted for study region, maternal education, child's age, sex,pubertal status andenergy intake and the BMIs of the child and father.Results:Mothers'BMI was associated with high meat intake in children (adjusted relative risk ratio (RRR (95% confidence interval))=1.06 (1.03; 1.09)). Mothers'overweight was associated with themeat intake (medium versus low RRR=1.30 (1.07; 1.59); high versus low RRR=1.50 (1.19; 1.89)) and egg intake (medium versus low RRR=1.24 (1.02; 1.50); high versus low RRR=1.30 (1.07; 1.60)) of children. There were no consistent associations for rest of the food groups. For every one-unit increase in mothers'BMI, the total energy intake in children increased by 9.2 kcal (3.7; 14.7). However, this effect was not significant after adjusting for children's BMI.Conclusions:Our results suggest that mother's BMI and mother's overweight are important correlates of a child's intake of energy, meat and eggs.

Published
2014

15. FADS1 FADS2 gene cluster, PUFA intake and blood lipids in children

Author

Standl, M., Lattka, E., Stach, B., Koletzko, S., Bauer, C.P., von Berg, A., Berdel, D., Krämer, U., Schaaf, B., Roder, S., Herbarth, O., Buyken, A., Drogies, T., Thiery, J., Koletzko, B., Heinrich, J., GINIplus Study Group (Heinrich, J., Wichmann, H.-E., Popescu, M., Schoetzau, A., Franke, K., Mosetter, M., Sausenthaler, S., Schindler, J., Zirngibl, A., Thaqi, A., Zutavern, A., Laubereau, B.), LISAplus Study Group (Wichmann, H.-E., Bolte, G., Belcredi, P., Jacob, B., Höhnke, A., Laubereau, B., and Zutavern, A.)

Subjects
Fatty Acid Desaturases, Male, Epidemiology, lcsh:Medicine, Blood lipids, Cardiovascular, Biochemistry, Pediatrics, Cohort Studies, chemistry.chemical_compound, High-density lipoprotein, Delta-5 Fatty Acid Desaturase, 0302 clinical medicine, Germany, Surveys and Questionnaires, Pediatric Cardiology, Prospective Studies, lcsh:Science, Pediatric Epidemiology, Child, Genetics, chemistry.chemical_classification, 2. Zero hunger, 0303 health sciences, Multidisciplinary, Fatty Acids, Lipids, 3. Good health, Genetic Epidemiology, Multigene Family, 030220 oncology & carcinogenesis, Fatty Acids, Unsaturated, Medicine, Female, lipids (amino acids, peptides, and proteins), Polyunsaturated fatty acid, Research Article, medicine.medical_specialty, Genotype, FADS1, FADS2, 030209 endocrinology & metabolism, Biology, Polymorphism, Single Nucleotide, Environmental Epidemiology, 03 medical and health sciences, Internal medicine, medicine, Humans, Alleles, Genetic Association Studies, Triglycerides, 030304 developmental biology, Evolutionary Biology, Triglyceride, Population Biology, Cholesterol, lcsh:R, Cholesterol, HDL, Computational Biology, Cholesterol, LDL, Diet, Minor allele frequency, Endocrinology, chemistry, Genetic Polymorphism, lcsh:Q, Population Genetics, 030217 neurology & neurosurgery
Abstract

BACKGROUND: Elevated cholesterol levels in children can be a risk factor for cardiovascular diseases in later life. In adults, it has been shown that blood lipid levels are strongly influenced by polymorphisms in the fatty acid desaturase (FADS) gene cluster in addition to nutritional and other exogenous and endogenous determinants. Our aim was to investigate whether lipid levels are determined by the FADS genotype already in children and whether this association interacts with dietary intake of n-3 fatty acids. METHODS: The analysis was based on data of 2006 children from two German prospective birth cohort studies. Total cholesterol, HDL, LDL and triglycerides were measured at 10 years of age. Six single nucleotide polymorphisms (SNPs) of the FADS gene cluster were genotyped. Dietary n-3 fatty acid intake was assessed by food frequency questionnaire. Linear regression modeling was used to assess the association between lipid levels, n-3 fatty acid intake and FADS genotype. RESULTS: Individuals carrying the homozygous minor allele had lower levels of total cholesterol [means ratio (MR) ranging from 0.96 (p = 0.0093) to 0.98 (p = 0.2949), depending on SNPs] and LDL [MR between 0.94 (p = 0.0179) and 0.97 (p = 0.2963)] compared to homozygous major allele carriers. Carriers of the heterozygous allele showed lower HDL levels [β between -0.04 (p = 0.0074) to -0.01 (p = 0.3318)] and higher triglyceride levels [MR ranging from 1.06 (p = 0.0065) to 1.07 (p = 0.0028)] compared to homozygous major allele carriers. A higher n-3 PUFA intake was associated with higher concentrations of total cholesterol, LDL, HDL and lower triglyceride levels, but these associations did not interact with the FADS1 FADS2 genotype. CONCLUSION: Total cholesterol, HDL, LDL and triglyceride concentrations may be influenced by the FADS1 FADS2 genotype already in 10 year old children. Genetically determined blood lipid levels during childhood might differentially predispose individuals to the development of cardiovascular diseases later in life.

Published
2012
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16. Predictive value of food sensitization and filaggrin mutations in children with eczema

Author

Filipiak-Pittroff, B., Schnopp, C., Berdel, D., Naumann, A., Sedlmeier, S., Onken, A., Rodriguez, E., Fölster-Holst, R., Baurecht, H., Ollert, M., Ring, J., Cramer, C., von Berg, A., Bauer, C.P., Herbarth, O., Lehmann, I., Schaaf, B., Koletzko, S., Wichmann, H.-E., Heinrich, J., Weidinger, S., GINIplus Study Group (Schoetzau, A., Mosetter, M., Gehring, U., Thaqi, A., Sausenthaler, S., Popescu, M., Schindler, J., Franke, K., Laubereau, B., Zirngibl, A., Zutavern, A.), LISAplus Study Group (Schindler, J., Höhnke, A., Bolte, G., Belcredi, P., Jacob, B., and Schoetzau, A.

Subjects
Male, Pediatrics, medicine.medical_specialty, Allergy, Immunology, Eczema, Filaggrin Proteins, Cohort Studies, Intermediate Filament Proteins, Food allergy, Predictive Value of Tests, Risk Factors, atopic dermatitis, asthma, food sensitization, food allergy, filaggrin, prediction, medicine, Immunology and Allergy, Humans, Genetic Predisposition to Disease, Asthma, Randomized Controlled Trials as Topic, business.industry, Infant, Newborn, Infant, Atopic dermatitis, medicine.disease, Relative risk, Predictive value of tests, Child, Preschool, Cohort, Mutation, Female, business, Food Hypersensitivity, Cohort study
Abstract

Background It was reported that in infants with eczema and food sensitization, the presence of a filaggrin (FLG) null mutation predicts future asthma with a specificity and positive predictive value of 100%. Objectives We sought to evaluate the predictive value of food sensitization and food allergy, FLG haploinsufficiency, and their combination in infants with early-onset eczema for persistent eczema and childhood asthma. Methods The German Infant Nutritional Intervention (GINI) and Influence of Lifestyle-related Factors on the Immune System and the Development of Allergies in Childhood (LISA) birth cohorts, as well as a collection of 65 cases of early-onset eczema with and without food allergy were investigated. Results The risk for asthma was significantly increased by food sensitization (positive diagnostic likelihood ratios [PLRs] of 1.9 [95% CI, 1.1-3.4] in the GINI cohort and 5.5 [95% CI, 2.8-10.8] in the LISA cohort) and the presence of an FLG mutation (PLRs of 2.9 [95% CI, 1.2-6.6] in the GINI cohort and 2.8 [95% CI, 1.0-7.9] in the LISA cohort) with a rather high specificity (79.1% and 92.9% in the GINI cohort and 89.0% and 91.7% in the LISA cohort, respectively) but low sensitivity (40.0% and 39.3% in the GINI cohort and 31.6% and 23.5% in the LISA cohort, respectively). Likewise, the risk for persistent eczema was increased. In the clinical cases neither food allergy nor FLG mutations had a significant effect. The combination of both parameters did not improve prediction and reached positive predictive values of 52.3% (GINI cohort), 66.9% (LISA cohort), and 30.6% (clinical cases), assuming an asthma prevalence in children with early eczema of 30%. Conclusion Early food sensitization and the presence of an FLG mutation in infants with early eczema increase the risk for later asthma, but the combination of the 2 factors does not represent a clinically useful approach to reliably identify children at risk.

Published
2011

17. Early diet and the risk of allergy: what can we learn from the prospective birth cohort studies GINIplus and LISAplus?

Author

Sausenthaler, S., Heinrich, J., Koletzko, S., GINIplus Study Group (Wichmann, H.-E., Popescu, M., Mosetter, M., Schoetzau, A., Schindler, J., Franke, K., Laubereau, B., Thaqi, A., Zirngibl, A., Zutavern, A.), LISAplus Study Group (Wichmann, H.-E., Bolte, G., Belcredi, P., Jacob, B., and Höhnke, A.

Subjects
Pediatrics, medicine.medical_specialty, Allergy, Solid food introduction, Infant nutritional intervention, Sensitization, Eczema, Age, Prevention, Formulas, Medicine (miscellaneous), Weaning, Risk Assessment, law.invention, Atopy, Randomized controlled trial, law, Pregnancy, Risk Factors, Internal medicine, Surveys and Questionnaires, Vegetables, medicine, Hypersensitivity, Humans, Plant Oils, Infant Nutritional Physiological Phenomena, Pediatric gastroenterology, Randomized Controlled Trials as Topic, Nutrition and Dietetics, business.industry, Infant, Feeding Behavior, Maternal Nutritional Physiological Phenomena, Hepatology, medicine.disease, Margarine, Diet, Solid food, Fruit, Female, Birth cohort, business
Abstract

Recently, the American Academy of Pediatrics and the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition published new guidelines on early nutrition and allergy prevention in infants and children. This article reviews epidemiologic evidence from 2 prospective German birth cohort studies, the GINIplus and the LISAplus, regarding maternal diet during pregnancy and feeding patterns in early life and the risk of allergy in light of the new recommendations. The 2 cohorts include a total of 9088 infants who were recruited within different regions of Germany between 1995 and 1999. A subgroup of 2252 infants with a hereditary risk of atopy was enrolled in a double-blind, randomized trial to investigate the effect of feeding regimen in infancy on the development of allergy with the strict recommendation that allergenic solid food be introduced late in the study. The results of the GINIplus and LISAplus studies mainly support the new finding regarding allergy prevention that a delayed introduction of solid foods or the avoidance of highly allergenic foods during the first year does not seem to be beneficial for allergy prevention. A very early introduction of solid foods and a high diversity before week 17 of age may increase the risk of later allergy. We showed that a high intake of margarine, vegetable oils, and some allergenic fruit and vegetables during pregnancy was associated with an increased risk of allergies, especially eczema. Because maternal diet during pregnancy is not reflected in the current recommendations, it should be the focus of future studies.

Published
2011

18. Effect of fatty acid status in cord blood serum on children's behavioral difficulties at 10 y of age: Results from the LISAplus Study

Author

Kohlböck, G., Glaser, C., Tiesler, C.M., Demmelmair, H., Standl, M., Romanos, M., Koletzko, B., Lehmann, I., Heinrich, J., LISAplus Study Group (Wichmann, H.-E., Bolte, G., Belcredi, P., Jacob, B., Schoetzau, A., Mosetter, M., Schindler, J., Höhnke, A., Franke, K., Laubereau, B., Sausenthaler, S., Thaqi, A., Zirngibl, A., and Zutavern, A.)

Subjects
no keywords
Abstract

BACKGROUND: Little is known about the effect of fatty acid (FA) concentrations in cord blood on long-term behavioral outcomes. OBJECTIVE: We assessed the effect of FAs in cord blood serum on children's behavioral difficulties at the age of 10 y. DESIGN: A longitudinal study of 416 children from the population-based Influences of Lifestyle-Related Factors on the Immune System and the Development of Allergies in Childhood (LISAplus) birth cohort from Munich was conducted. Individual glycerophospholipid FAs in blood were analyzed in venous cord blood. Data on children's behavior were collected with a parent-reported Strength and Difficulties Questionnaire at 10 y of age. Zero-inflated Poisson regression models were applied and adjusted for sex, parental income, smoking during pregnancy, and dietary intake of arachidonic acid (AA) and DHA at 10 y. RESULTS: A 1% increase in DHA in cord blood serum was found to decrease total difficulties by (exp)β(5)(adj) = 0.93 (SE = 0.02, P < 0.0001) and hyperactivity or inattention by (exp)β(adj) = 0.94 (SE = 0.03, P < 0.04). Higher long-chain (LC) PUFA concentrations in cord blood serum were associated with fewer emotional symptoms [(exp)β(adj) = 0.95, SE = 0.03, P = 0.01], and similarly higher AA concentrations were associated with fewer emotional symptoms [(exp)β(adj) = 0.94, SE = 0.03, P = 0.03]. CONCLUSION: Increased concentrations of DHA, LC-PUFAs, and AA in cord blood serum were associated with lower scores on a parent-completed behavioral screen. An appropriate FA supply to the developing fetus may be essential for optimal long-term behavioral outcomes in children.

Published
2011

19. Infant eczema, infant sleeping problems, and mental health at 10 years of age: The prospective birth cohort study LISAplus

Author

Schmitt, J., Chen, C.-M., Apfelbacher, C., Romanos, M., Lehmann, I., Herbarth, O., Schaaf, B., Kraemer, U., von Berg, A., Wichmann, H.-E., Heinrich, J., LISAplus Study Group (Wichmann, H.-E., Bolte, G., Belcredi, P., Jacob, B., Schoetzau, A., Mosetter, M., Schindler, J., Höhnke, A., Franke, K., Laubereau, B., Sausenthaler, S., Thaqi, A., Zirngibl, A., and Zutavern, A.)

Subjects
Male, Sleep Wake Disorders, Mental Disorders, cohort study, eczema, emotional problems, hyperactivity, Strengths and Difficulties Questionnaire, Infant, Newborn, Infant, Dermatitis, Atopic, Cohort Studies, Risk Factors, Child, Preschool, Germany, Surveys and Questionnaires, Humans, Female, Prospective Studies, Child
Abstract

Cross-sectional studies suggest an association between eczema and mental health problems, possibly modified by sleeping problems, but prospective evidence is missing. We aimed to prospectively investigate the relationship between infant eczema (within first 2 years of age), infant sleeping problems (within first 2 years of age), and the risk of mental health problems at 10 years of age. Between 1997 and 1999, a population-based birth cohort was recruited in Munich, Leipzig, Wesel, and Bad Honnef, Germany, and followed until 10 years of age. Physician-diagnosed eczema, parent-reported sleeping problems, and known environmental risk factors for atopy were regularly assessed until 10 years of age. Mental health was measured using the Strengths and Difficulties Questionnaire (parent version) at 10 years of age. We applied logistic regression modeling adjusting for environmental and lifestyle factors, allergic comorbidity, and family history of eczema.From the original cohort of 3097 neonates, 1658 (54%) were followed until age 10, while 1578 (51%) were eligible for analysis. In the fully adjusted model, children with infant eczema were at increased risk of hyperactivity/inattention at 10 years of age [odds ratio (OR) 1.78; 95% confidence interval (95% CI) 1.02-3.09]. Infant eczema with concurrent sleeping problems predicted emotional problems [OR 2.63; 95% confidence interval (95% CI) 1.20-5.76] and conduct problems (OR 3.03; 95% CI 1.01-9.12) at 10 years of age. Infant eczema with concurrent sleeping problems appears to be a risk factor for the development of mental health problems

Published
2011

20. Association between attendance of day care centres and increased prevalence of eczema in the German birth cohort study LISAplus

Author

Cramer, C., Link, E., Bauer, C.P., Hoffmann, U., von Berg, A., Lehmann, I., Herbarth, O., Borte, M., Schaaf, B., Sausenthaler, S., Wichmann, H.-E., Heinrich, J., Krämer, U., LISAplus Study Group (Wichmann, H.-E., Bolte, G., Belcredi, P., Jacob, B., Schoetzau, A., Mosetter, M., Schindler, J., Höhnke, A., Franke, K., Laubereau, B., Thaqi, A., Zirngibl, A., Zutavern, A.), and Malden, USA

Subjects
Male, Incidence, Eczema, Germany, West, Infant, children, day care attendance, East, West comparison, eczema, regional patterns, Child Day Care Centers, Social Environment, Cohort Studies, Risk Factors, Child, Preschool, Health Care Surveys, Surveys and Questionnaires, Absenteeism, Prevalence, Humans, Female, Germany, East, Child, Life Style
Abstract

Day care centre attendance is much more common in East than in West Germany. Although there is evidence that early day care might be protective against atopic diseases, several studies have shown a higher prevalence of childhood eczema in East Germany compared to West Germany. To compare prevalence and cumulative incidence of eczema in a birth cohort study in East and West Germany and to identify risk factors that are associated with eczema, which might explain regional differences. We used data from the ongoing population-based birth cohort study Influence of Life-style factors on the development of the Immune System and Allergies in East and West Germany Plus the influence of traffic emissions and genetics. In 1997, 3097 children from study areas in East and West Germany were recruited. Cumulative incidence and 1-year prevalences of eczema up to the age of 6 years were determined from yearly questionnaires. Cox regression and generalized estimating equations/logistic regression were used to quantify regional differences and to identify risk factors that might explain them. Prevalence and incidence of eczema were higher in children living in East Germany than those living in West Germany. We identified 11 risk factors that showed significant regional differences. From these factors, only 'day care attendance during the first 2 years of life' was significantly associated with eczema (odds ratio 1.56, 95% confidence interval CI 1.31-1.86). The regional differences in eczema could be explained by differences in early day care utilization. Day care centre attendance is associated with an increased prevalence and incidence of eczema. Regional differences in eczema prevalence could be explained by regional differences in utilization of early day care.

Published
2010

21. Timing of solid food introduction in relation to eczema, asthma, allergic rhinitis, and food and inhalant sensitization at the age of 6 years: results from the prospective birth cohort study LISA

Author

Zutavern, A., Brockow, I., Schaaf, B., von Berg, A., Diez, U., Borte, M., Kraemer, U., Herbarth, O., Behrendt, H., Wichmann, H.-E., Heinrich, J., LISAplus Study Group (Wichmann, H.-E., Bolte, G., Belcredi, P., Jacob, B., Schoetzau, A., Mosetter, M., Schindler, J., Höhnke, A., Franke, K., Laubereau, B., Sausenthaler, S., Thaqi, A., Zirngibl, A., and Zutavern, A.)

Subjects
Male, Pediatrics, medicine.medical_specialty, Multivariate analysis, Rhinitis, Allergic, Perennial, Time Factors, Eczema, eczema, asthma, hay fever, sensitization, allergy, cohort, reverse causality, solid food, Logistic regression, Cohort Studies, Age Distribution, Risk Factors, Surveys and Questionnaires, Confidence Intervals, Odds Ratio, Medicine, Humans, Prospective Studies, Registries, Sex Distribution, Prospective cohort study, Child, Sensitization, Asthma, business.industry, Incidence (epidemiology), Incidence, Infant, Odds ratio, medicine.disease, medicine.anatomical_structure, Child, Preschool, Pediatrics, Perinatology and Child Health, Multivariate Analysis, Regression Analysis, Female, Infant Food, business, Food Hypersensitivity, Cohort study, Follow-Up Studies
Abstract

OBJECTIVE. Current prophylactic feeding guidelines recommend a delayed introduction of solids for the prevention of atopic diseases. This study investigates whether a delayed introduction of solids (past 4 or 6 months) is protective against the development of eczema, asthma, allergic rhinitis, and food or inhalant sensitization at the age of 6 years.METHODS. Data from 2073 children in the ongoing LISA birth cohort study were analyzed at 6 years of age. Multivariate logistic regression analyses were performed for all children and for children without skin or allergic symptoms within the first 6 months of life to take into account reverse causality.RESULTS. A delayed introduction of solids (past 4 or 6 months) was not associated with decreased odds for asthma, allergic rhinitis, or sensitization against food or inhalant allergens at 6 years of age. On the contrary, food sensitization was more frequent in children who were introduced to solids later. The relationship between the timing of solid food introduction and eczema was not clear. There was no protective effect of a late introduction of solids or a less diverse diet within the first 4 months of life. However, in children without early skin or allergic symptoms were considered, eczema was significantly more frequent in children who received a more diverse diet within the first 4 months.CONCLUSIONS. This study found no evidence supporting a delayed introduction of solids beyond 4 or 6 months for the prevention of asthma, allergic rhinitis, and food or inhalant sensitization at the age of 6 years. For eczema, the results were conflicting, and a protective effect of a delayed introduction of solids cannot be excluded. Positive associations between late introduction of solids and food sensitization have to be interpreted with caution. A true protective effect of a delayed introduction of solids on food sensitization seems unlikely.

Published
2008

23. Maternal diet during pregnancy in relation to eczema and allergic sensitization in the offspring at 2 y of age1,2,3

Author

Sausenthaler, S., Koletzko, S., Schaaf, B., Lehmann, I., Borte, B., Herbarth, O., von Berg, A., Wichmann, H.-E., and Heinrich, J.

Subjects
Maternal diet, pregnancy, allergic diseases, children
Abstract

Maternal diet during pregnancy might be one of the factors that influences fetal immune responses associated with childhood allergy.We analyzed the association between maternal diet during the last 4 wk of pregnancy and allergic sensitization and eczema in the offspring at 2 y of age.Design:Data from 2641 children at 2 y of age were analyzed within a German prospective birth cohort study (LISA). Maternal diet during the last 4 wk of pregnancy was assessed with a semiquantitative food-frequency questionnaire, which was administered shortly after childbirth.Results:High maternal intake of margarine [adjusted odds ratio (aOR): 1. 49; 95% CI: 1.08, 2.04] and vegetable oils (aOR: 1.48; 95% CI: 1.14, 1.91) during the last 4 wk of pregnancy was positively associated and high maternal fish intake (aOR: 0.75; 95% CI: 0.57, 0.98) was inversely associated with eczema during the first 2 y in the offspring. High celery (aOR: 1.85; 95% CI: 1.18, 2.89) and citrus fruit (aOR: 1.73; 95% CI: 1.18, 2.53) intakes increased the risk of sensitization against food allergens. In turn, sensitization against inhalant allergens was positively related to a high maternal intake of deep-frying vegetable fat (aOR: 1.61; 95% CI: 1.02, 2.54), raw sweet pepper (aOR: 2.16; 95% CI: 1.20, 3.90), and citrus fruit (aOR: 1.72; 95% CI: 1.02, 2.92).We suggest that the intake of allergenic foods and foods rich in n–6 polyunsaturated fatty acids during pregnancy may increase and foods rich in n–3 polyunsaturated fatty acids may decrease the risk of allergic diseases in the offspring.

Published
2007

24. Impact of parental education and income inequality on children's food intake

Author

Sausenthaler, S., Kompauer, I., Mielck, A., Borte, M., Herbarth, O., Schaaf, B., von Berg, A., Heinrich, J., LISAplus Study Group (Wichmann, H.-E., Bolte, G., Belcredi, P., Jacob, B., Schoetzau, A., Mosetter, M., Schindler, J., and Höhnke, A.)

Subjects
Socio-economic status, parental education, equivalent income, diet, children
Abstract

OBJECTIVE: To analyse the association between socio-economic indicators and diet among 2-year-old children, by assessing the independent contribution of parental education and equivalent income to food intake. DESIGN: The analysis was based on data from a prospective birth cohort study. Information on diet was obtained using a semi-quantitative food-frequency questionnaire. Low and high intake of food was defined according to the lowest and the highest quintile of food consumption frequency, respectively. SETTING: Four German cities (Munich, Leipzig, Wesel, Bad Honnef), 1999-2001.Subjects Subjects were 2637 children at the age of 2 years, whose parents completed questionnaires gathering information on lifestyle factors, including parental socio-economic status, household consumption frequencies and children's diet. RESULTS: Both low parental education and low equivalent income were associated with a low intake of fresh fruit, cooked vegetables and olive oil, and a high intake of canned vegetables or fruit, margarine, mayonnaise and processed salad dressing in children. Children with a low intake of milk and cream, and a high intake of hardened vegetable fat, more likely had parents with lower education. Low butter intake was associated with low equivalent income only. CONCLUSIONS: These findings may be helpful for future intervention programmes with more targeted policies aiming at an improvement of children's diets.

Published
2007

26. Cent Eur J Public Health: Vitamin E intake in relation to allergic sensitization and IgE serum concentration

Author

Sausenthaler, S., Loebel, T., and Linseisen, J.

Subjects
Vitamin E -- Health aspects, Dietary supplements -- Health aspects, Public health -- Analysis, Immunoglobulin E -- Surveys -- Health aspects, Health, Analysis, Health aspects
Abstract

BACKGROUND: A protective role of dietary vitamin E intake on disorders related to the immune system, such as allergic diseases, has been suggested. However, results from epidemiological studies are conflicting. [...]

Published
2009

27. Respiratory health in children, and indoor exposure to (1,3)- -D-glucan, EPS mould components and endotoxin

Author

Tischer, C., primary, Gehring, U., additional, Chen, C.-M., additional, Kerkhof, M., additional, Koppelman, G., additional, Sausenthaler, S., additional, Herbarth, O., additional, Schaaf, B., additional, Lehmann, I., additional, Kramer, U., additional, Berdel, D., additional, von Berg, A., additional, Bauer, C. P., additional, Koletzko, S., additional, Wichmann, H.-E., additional, Brunekreef, B., additional, and Heinrich, J., additional

Published
2010
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28. Assoziationen zwischen BMI-Entwicklung und FTO-Gen sind altersabhängig. Ergebnisse der GINI und LISA Geburtskohortenstudien bis zum Alter von 6 Jahren

Author

Rzehak, P, primary, Scherag, A, additional, Grallert, H, additional, Sausenthaler, S, additional, Koletzko, S, additional, Bauer, C, additional, Schaaf, B, additional, Berg, A von, additional, Berdel, D, additional, Borte, M, additional, Herbarth, O, additional, Krämer, U, additional, Illig, T, additional, Wichmann, H, additional, and Hebebrand, J, additional

Published
2010
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29. Regional and socioeconomic differences in food, nutrient and supplement intake in school-age children in Germany. Results from the GINIplus and the LISAplus Study

Author

Standl, M, primary, Sausenthaler, S, additional, Buyken, A, additional, Rzehak, P, additional, Koletzko, S, additional, Bauer, C, additional, Schaaf, B, additional, Berg, A von, additional, Berdel, D, additional, Borte, M, additional, Herbarth, O, additional, Lehmann, I, additional, Krämer, U, additional, Wichmann, H, additional, and Heinrich, J, additional

Published
2010
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32. Vitamin E intake in relation to allergic sensitization and IgE serum concentration.

Author

Sausenthaler S, Loebel T, Linseisen J, Nagel G, Magnussen H, Heinrich J, Sausenthaler, Stefanie, Loebel, Tobias, Linseisen, Jakob, Nagel, Gabriele, Magnussen, Helgo, and Heinrich, Joachim

Abstract

Background: A protective role of dietary vitamin E intake on disorders related to the immune system, such as allergic diseases, has been suggested. However, results from epidemiological studies are conflicting.Objectives: The aim of present study was to analyze whether dietary vitamin E intake is related to the prevalence of allergic sensitization and total serum IgE concentrations in adult subjects.Methods: The present study population consisted of 366 adults aged 29 to 54 years participating in the German centers of the European Community Respiratory Health Survey (ECRHS) II, Erfurt and Hamburg. A validated food frequency questionnaire was used to gather information on dietary vitamin E intake. Total serum IgE concentrations and specific IgE to common allergens were analyzed by using the Pharmacia CAP System. Allergic sensitization was defined as specific serum IgE concentration > or = 0.35 kU/l.Results: The risk for allergic sensitization was substantially decreased in the middle quartiles (aOR: 0.42; 95% CI: 0.22-0.81) and the highest quartile (aOR: 0.22; 95% CI: 0.08-0.60) of total dietary vitamin E intake, after adjustment for potential confounders. Total serum IgE concentration was not statistically significantly associated with dietary vitamin E intake.Conclusions: The findings of this study suggest that dietary vitamin E intake might play a protective role in the development of allergic sensitization. [ABSTRACT FROM AUTHOR]

Published
2009
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33. Short- and long-term effects of feeding hydrolyzed protein infant formulas on growth at <LT> or = 6 y of age: results from the German Infant Nutritional Intervention Study.

Author

Rzehak P, Sausenthaler S, Koletzko S, Reinhardt D, von Berg A, Krämer U, Berdel D, Bollrath C, Grübl A, Bauer CP, Wichmann HE, Heinrich J, and German Infant Nutritional Intervention Study Group

Abstract

BACKGROUND: The short- and long-term effects of feeding with hydrolyzed formulas on growth are uncertain. OBJECTIVE: Our aim was to investigate the potential differences in body mass index (BMI) over the first 6 y of life between infants fed with partially hydrolyzed whey (pHF-W), extensively hydrolyzed whey (eHF-W), extensively hydrolyzed casein (eHF-C), or cow-milk formula (CMF) and infants exclusively breastfed for the first 16 wk of life. DESIGN: We established a prospective, randomized, double-blind trial of full-term neonates with atopic heredity in the German birth cohort followed by the German Infant Nutritional Intervention Study through the first 6 y of life. Intention-to-treat and per-protocol analyses of absolute and World Health Organization-standardized BMI trajectories for 1840 infants (pHF-W: n = 253; eHF-W: n = 265; eHF-C: n = 250, CMF: n = 276; breastfed: n = 796) were performed. RESULTS: No significant differences in absolute or World Health Organization-standardized BMI trajectories were found among the pHF-W, eHF-W, CMF, and breastfed groups during the 6-y follow-up. However, in the eHF-C group, both intention-to-treat and per-protocol analyses showed a significantly slower sex-adjusted BMI gain through the 8th to 48th week of life (-0.1 to -0.2 lower BMI z score) but not beyond. Analyses of weight and length revealed that this difference is due to a slightly diminished weight gain in the first year of life because growth in length did not differ among study groups for the entire follow-up. CONCLUSIONS: To our knowledge, this is the first randomized trial investigating both short- and long-term effects of partially and extensively hydrolyzed formula (pHF-W, eHF-W, eHF-C), CMF, and breastfeeding on growth in one trial. Feeding with eHF-C led to a transient lower weight gain in the first year of life. No long-term consequences of different formulas on BMI were observed. (c) 2009 by the American Society for Nutrition [ABSTRACT FROM AUTHOR]

Published
2009
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35. Maternal diet during pregnancy in relation to eczema and allergic sensitization in the offspring at 2 y of age.

Author

Sausenthaler S, Koletzko S, Schaaf B, Lehmann I, Borte M, Herbarth O, von Berg A, Wichmann H, Heinrich J, and LISA Study Group

Abstract

BACKGROUND: Maternal diet during pregnancy might be one of the factors that influences fetal immune responses associated with childhood allergy. OBJECTIVE: We analyzed the association between maternal diet during the last 4 wk of pregnancy and allergic sensitization and eczema in the offspring at 2 y of age. DESIGN: Data from 2641 children at 2 y of age were analyzed within a German prospective birth cohort study (LISA). Maternal diet during the last 4 wk of pregnancy was assessed with a semiquantitative food-frequency questionnaire, which was administered shortly after childbirth. RESULTS: High maternal intake of margarine [adjusted odds ratio (aOR): 1. 49; 95% CI: 1.08, 2.04] and vegetable oils (aOR: 1.48; 95% CI: 1.14, 1.91) during the last 4 wk of pregnancy was positively associated and high maternal fish intake (aOR: 0.75; 95% CI: 0.57, 0.98) was inversely associated with eczema during the first 2 y in the offspring. High celery (aOR: 1.85; 95% CI: 1.18, 2.89) and citrus fruit (aOR: 1.73; 95% CI: 1.18, 2.53) intakes increased the risk of sensitization against food allergens. In turn, sensitization against inhalant allergens was positively related to a high maternal intake of deep-frying vegetable fat (aOR: 1.61; 95% CI: 1.02, 2.54), raw sweet pepper (aOR: 2.16; 95% CI: 1.20, 3.90), and citrus fruit (aOR: 1.72; 95% CI: 1.02, 2.92). CONCLUSIONS: We suggest that the intake of allergenic foods and foods rich in n-6 polyunsaturated fatty acids during pregnancy may increase and foods rich in n-3 polyunsaturated fatty acids may decrease the risk of allergic diseases in the offspring. Copyright © 2007 American Society for Nutrition [ABSTRACT FROM AUTHOR]

Published
2007

36. Impact of parental education and income inequality on children's food intake.

Author

Sausenthaler S, Kompauer I, Mielck A, Borte M, Herbarth O, Schaaf B, von Berg A, Heinrich J, Sausenthaler, Stefanie, Kompauer, Iris, Mielck, Andreas, Borte, Michael, Herbarth, Olf, Schaaf, Beate, von Berg, Andrea, and Heinrich, Joachim

Abstract

Objective: To analyse the association between socio-economic indicators and diet among 2-year-old children, by assessing the independent contribution of parental education and equivalent income to food intake.Design: The analysis was based on data from a prospective birth cohort study. Information on diet was obtained using a semi-quantitative food-frequency questionnaire. Low and high intake of food was defined according to the lowest and the highest quintile of food consumption frequency, respectively.Setting: Four German cities (Munich, Leipzig, Wesel, Bad Honnef), 1999-2001. Subjects Subjects were 2637 children at the age of 2 years, whose parents completed questionnaires gathering information on lifestyle factors, including parental socio-economic status, household consumption frequencies and children's diet.Results: Both low parental education and low equivalent income were associated with a low intake of fresh fruit, cooked vegetables and olive oil, and a high intake of canned vegetables or fruit, margarine, mayonnaise and processed salad dressing in children. Children with a low intake of milk and cream, and a high intake of hardened vegetable fat, more likely had parents with lower education. Low butter intake was associated with low equivalent income only.Conclusions: These findings may be helpful for future intervention programmes with more targeted policies aiming at an improvement of children's diets. [ABSTRACT FROM AUTHOR]

Published
2007
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37. Sodium intake and bronchial hyperresponsiveness in adults

Author

Sausenthaler, S., Kompauer, I., Brasche, S., Linseisen, J., and Heinrich, J.

Abstract

Background: Several investigations suggested a relationship between sodium intake and asthma and bronchial hyperresponsiveness (BHR), respectively. However, clinical and epidemiological studies did not show consistent finding. Objective: We analysed the association between dietary sodium intake and BHR to methacholine among 613 adults aged 20-65 years as one of the two German centres of the European Community Respiratory Health Survey (ECRHS). Methods: Dietary sodium intake was estimated from a 3-day weighed record of food intake. We applied multiple logistic regression models contrasting the three higher quartiles of sodium intake versus the lowest to assess the risk of BHR and mild BHR estimated by PD"2"0 and PD"1"0, respectively, controlling for potential confounders and stratified for sex. In addition, we analysed PD"2"0 (dose of methacholine causing a fall of 20% in forced expiratory volume in 1s) as continuous variable expressed as transformed dose-response slope (tDRS) in the linear model. Results: Women were as expected more likely to be bronchial hyperresponsive (PD"2"0: 26.1%; PD"1"0: 52.2%) than men (PD"2"0:15.8%; PD"1"0: 34.8%) and had a lower mean daily sodium intake (2.36g) compared with men (3.15g). Logistic regression did not show any significant relationship between sodium intake and BHR in terms of PD"2"0 after adjustment for age group, education, smoking status, body mass index and height in men or women. However, mild BHR assessed as PD"1"0 was statistically significant positively related to the third (OR: 2.35; CI: 1.11-5.00) and highest quartile of sodium intake (OR: 2.28; CI: 1.06-4.88) in women, but not in men for third quartile (OR: 1.29; CI: 0.68-2.44) and for fourth quartile (OR: 1.07; CI: 0.56-2.07), respectively. Conclusion: Sodium intake by several food items does not alter BHR assessed as PD"2"0 to methacholine but may increase mild BHR assessed as PD"1"0. We conclude that, in addition, PD"1"0 has to be considered when the effect of sodium intake on BHR is studied.

Published
2005
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38. Stress-related maternal factors during pregnancy in relation to childhood eczema: results from the LISA Study

Author

Sausenthaler S, Rzehak P, Cm, Chen, Petra Clara Arck, Bockelbrink A, Schäfer T, Schaaf B, Borte M, Herbarth O, Krämer U, von Berg A, He, Wichmann, Heinrich J, and Lisa, Study Group

Subjects
Adult, Male, Eczema, Infant, Newborn, Infant, Cohort Studies, Immunomodulation, Pregnancy Complications, Pregnancy, Risk Factors, Stress, Physiological, Child, Preschool, Germany, Prevalence, Humans, Female, Child, Maternal-Fetal Exchange, Stress, Psychological, Follow-Up Studies
Abstract

Stress has been suggested to impact the onset and exacerbation of eczema and other atopic disorders. Whether early exposure to stress-related factors might exert long-term effects remains to be clarified.The objective of this study was to investigate whether stress-related maternal factors during pregnancy are associated with childhood eczema during the first 6 years of life.Data from 3004 children from a prospective German birth cohort study (LISA) were analyzed. Information from maternity certificates and questionnaire information on unwanted pregnancy were used to evaluate stress-related maternal factors during pregnancy. Prevalence data for physician-diagnosed eczema were available up to the age of 6 years.Maternal factors during pregnancy were positively associated with childhood eczema in terms of cumulative prevalence up to the age of 2 years (adjusted odds ratio, 1.48; 95% confidence interval, 0.95-2.30) after adjusting for potential confounders. Beyond the second year no increased risk was observed.The results of this study suggest that stress-related maternal factors during pregnancy are associated with an increased risk of childhood eczema during the first 2 years of life. The impact of postnatal stress such as parental divorce or separation on this association could not be clarified. Future studies should therefore further elucidate how prenatal and postnatal stress interact and whether prenatal stress might have a programming effect. If future studies confirm the findings of this study, reducing maternal stress during pregnancy might be a possible target in the primary prevention of eczema during childhood.

41. Food intake, diet quality and behavioral problems in children: results from the GINI-plus/LISA-plus studies.

Author

Kohlboeck G, Sausenthaler S, Standl M, Koletzko S, Bauer CP, von Berg A, Berdel D, Krämer U, Schaaf B, Lehmann I, Herbarth O, and Heinrich J

Subjects
Body Mass Index, Child, Choice Behavior, Cross-Sectional Studies, Dietary Sucrose adverse effects, Exercise, Female, Follow-Up Studies, Food Preferences, Germany, Humans, Life Style, Male, Odds Ratio, Surveys and Questionnaires, Affective Symptoms, Child Nutritional Physiological Phenomena, Diet, Energy Intake, Feeding Behavior
Abstract

Background/aims: To assess the association between food intake and diet quality and behavioral problems at the 10-year follow-up of the two population-based birth cohorts of the studies German Infant Nutritional Intervention and 'Influences of lifestyle-related factors on the immune system and the development of allergies in childhood'., Methods: Cross-sectional data on food intake over the past year were collected by a parent-reported food frequency questionnaire. Diet quality was based on reference values of food amounts of the optimized mixed diet. Behavioral problems were assessed by a parent-reported Strengths and Difficulties Questionnaire. Relationships between food category intake, diet quality and behavior problems were examined using multivariable regression modeling adjusted for gender, sociodemographic characteristics, body mass index, physical exercise, television viewing/PC use and total energy intake. A total of 3,361 children with complete data were analyzed., Results: Children with increased intake of confectionery had increased odds of having emotional symptoms [adjusted odds ratio (OR(adj)) 1.19, 95% confidence interval (CI) 1.08-1.32] compared to children with low intake. A higher diet quality score was associated with lower likelihood of emotional symptoms (OR(adj) 0.89, 95% CI 0.80-0.98). The unadjusted significant relationship between diet quality and hyperactivity/inattention was attenuated by adjusting for several confounders to an OR(adj) of 0.92 (95% CI 0.82-1.03)., Conclusions: Increased consumption of high-sugar products and lower diet quality are associated with a higher likelihood of emotional symptoms in children., (Copyright © 2012 S. Karger AG, Basel.)

Published
2012
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42. Long-term effects of hydrolyzed protein infant formulas on growth--extended follow-up to 10 y of age: results from the German Infant Nutritional Intervention (GINI) study.

Author

Rzehak P, Sausenthaler S, Koletzko S, Reinhardt D, von Berg A, Krämer U, Berdel D, Bollrath C, Grübl A, Bauer CP, Wichmann HE, and Heinrich J

Subjects
Child, Child, Preschool, Double-Blind Method, Female, Follow-Up Studies, Germany, Humans, Hydrolysis, Infant, Male, Prospective Studies, Time, Body Mass Index, Breast Feeding, Fetal Development drug effects, Infant Formula chemistry, Milk Proteins administration & dosage
Abstract

Background: Previous analysis in a prospective, population-based cohort reported reduced weight gain in children fed extensively hydrolyzed casein (eHF-C) formula during the first year of life but showed no effect on growth between 1 and 6 y of life. No studies have been conducted in children up to the age of 10 y., Objective: The objective was to investigate potential differences in body mass index (BMI) over the first 10 y of life between infants fed within the intervention period of the first 16 wk of life with partially hydrolyzed whey (pHF-W), extensively hydrolyzed whey (eHF-W), eHF-C, or cow-milk formula (CMF) and infants exclusively breastfed (BF) within the intervention period., Design: This was a prospective, randomized, double-blind trial in full-term neonates with atopic heredity in the German birth cohort German Infant Nutritional Intervention (GINI) followed through the first 10 y of life. Analyses of absolute and World Health Organization (WHO)-standardized BMI trajectories for 1840 infants [pHF-W (n = 253), eHF-W (n = 265), eHF-C (n = 250), CMF (n = 276), and BF (n = 796)] were conducted according to intention-to-treat principles., Results: Except for the previously reported slower BMI gain in infants fed with eHF-C formula within the first year of life, no significant differences in absolute or WHO-standardized BMI trajectories were shown between the pHF-W, eHF-W, eHF-C, CMF, and BF groups thereafter up to the age of 10 y., Conclusions: Extension of the follow-up period from 6 to 10 y for this randomized controlled trial showed no long-term consequences on BMI for the 4 infant formulas considered. These data need to be confirmed in future studies.

Published
2011
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43. Passive smoking and behavioural problems in children: results from the LISAplus prospective birth cohort study.

Author

Tiesler CM, Chen CM, Sausenthaler S, Herbarth O, Lehmann I, Schaaf B, Krämer U, von Berg A, von Kries R, Wichmann HE, and Heinrich J

Subjects
Child, Female, Humans, Male, Prospective Studies, Surveys and Questionnaires, Child Behavior Disorders etiology, Tobacco Smoke Pollution adverse effects
Abstract

Objective: To analyse the association between pre- and postnatal exposure to tobacco smoke and child behavioural problems and to further investigate the influence of trimester-specific exposure to maternal smoking and the impact of paternal smoking at home on the same outcome., Methods: Data of 3097 German children recruited at birth for a population-based, prospective study were used. Detailed information on children's tobacco smoke exposure was collected by self-administered questionnaires at each follow-up. Behavioural outcomes were measured by the Strengths and Difficulties Questionnaire applied at 10-year follow-up., Results: Children exposed to environmental tobacco smoke at home showed increased risks of hyperactivity/inattention problems. Only smoking during the entire pregnancy increased the risk for conduct and hyperactivity/inattention problems (proportional odds ratio (pOR)=1.58, 95% confidence interval (CI)=1.06-2.37 and pOR=1.67, CI=1.03-2.72). Pre- and postnatal exposure to paternal smoking was associated with hyperactivity/inattention problems in children of non-smoking mothers (pOR=1.97, CI=1.06-3.65). Effect estimates were adjusted for study centre, sex, parental educational level, mother's age at birth, having a single parent and time spent in front of a screen., Conclusions: Not only maternal smoking during pregnancy but also paternal smoking at home should be considered as a risk for hyperactivity/inattention problems in children., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Published
2011
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44. Growth of infants fed formula rich in canola oil (low erucic acid rapeseed oil).

Author

Rzehak P, Koletzko S, Koletzko B, Sausenthaler S, Reinhardt D, Grübl A, Bauer CP, Krämer U, Bollrath C, von Berg A, Berdel D, Wichmann HE, and Heinrich J

Subjects
Body Height, Body Weight, Cohort Studies, Double-Blind Method, Erucic Acids adverse effects, Female, Germany, Humans, Infant, Infant Formula standards, Infant, Newborn, Male, Rapeseed Oil, Retrospective Studies, Statistics as Topic, Weight Gain, Brassica rapa chemistry, Child Development, Fatty Acids, Monounsaturated adverse effects, Infant Formula chemistry, Plant Oils adverse effects, Seeds chemistry
Abstract

Background & Aims: Canola oil is a variety of rapeseed oil low in erucic acid (<2%). For many years, canola oil has been widely used as an ingredient in infant formula in Europe, but not in North America due to safety concerns. A number of studies have used variable canola content of infant formulas to investigate the effects of linoleic acid: α-linolenic acid ratio on visual function of infants. However, little published data is available to compare the safety of canola versus non-canola containing infant formula. The aim of this study is to investigate whether infant formulas containing canola oil support normal growth in infants as assessed by weight and length gain., Methods: Re-analyses of data on infant weight and length gain from a prospective randomized double-blind trial in full-term infants in the German Infant Nutritional Intervention study (GINI). This analysis compared growth in infants receiving infant formulas with or without canola oil from week 4 to month 7. Absolute weight and length, weight and length gain in gram or cm per day and standardized weight and length measurements were analyzed by analyses of variance and a longitudinal random effects model. Standardization was conducted according to the new WHO 2006 age- and sex-specific child growth standards., Results: Absolute and standardized weight and length measures did not differ between the formula groups with or without canola oil. This was true for both, analyses within each of the three anthropometric measurement periods (4-6 weeks, 3-4 months, 6-7 months) and for the longitudinal analyses over the whole period from 4 weeks to 7 months of life. Power analyses confirmed that sample size was sufficient to detect a difference of 3 g per day between 14 and 120 days between the two formula groups., Conclusions: Infant formula containing canola oil supports normal infant growth as assessed by weight and length gain., (Copyright © 2010 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Published
2011
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45. Respiratory health in children, and indoor exposure to (1,3)-β-D-glucan, EPS mould components and endotoxin.

Author

Tischer C, Gehring U, Chen CM, Kerkhof M, Koppelman G, Sausenthaler S, Herbarth O, Schaaf B, Lehmann I, Krämer U, Berdel D, von Berg A, Bauer CP, Koletzko S, Wichmann HE, Brunekreef B, and Heinrich J

Subjects
Asthma microbiology, Asthma prevention & control, Beds microbiology, Case-Control Studies, Child, Child, Preschool, Cohort Studies, Dust immunology, Female, Floors and Floorcoverings, Germany, Humans, Male, Netherlands epidemiology, Proteoglycans, Rhinitis, Allergic, Perennial microbiology, Rhinitis, Allergic, Perennial prevention & control, Asthma epidemiology, Fungi immunology, Rhinitis, Allergic, Perennial epidemiology, Toxins, Biological immunology, beta-Glucans immunology
Abstract

For a long time, exposure to mould and dampness-derived microbial components was considered a risk factor for the development of respiratory diseases and symptoms. Some recent studies suggested that early childhood exposure to mould components, such as (1,3)-β-D-glucan and extracellular polysaccharides (EPSs), may protect children from developing allergy. We investigated the association of exposure to (1,3)-β-D-glucan, EPS and endotoxin with asthma and allergies in 6-yr-old children. This investigation was the follow-up to a nested case-control study among three European birth cohorts. Children from two ongoing birth cohort studies performed in Germany (n = 358) and one in the Netherlands (n = 338) were selected. Levels of (1,3)-β-D-glucan, EPS and endotoxin were measured in settled house dust sampled from children's mattresses and living-room floors when the children were, on average, 5 yrs of age. At the age of 6 yrs, health outcome information was available for 678 children. In the two German subsets, domestic EPS and endotoxin exposure from children's mattresses were significantly negatively associated with physician-diagnosed asthma (OR per interquartile range increase 0.60 (95% CI 0.39-0.92) and 0.55 (95% CI 0.31-0.97), respectively). In addition, EPS exposure was inversely related to physician-diagnosed allergic rhinitis (OR 0.50, 95% CI 0.31-0.81). For the Dutch population, no associations were observed between exposure to microbial agents and respiratory health outcomes. We found inverse associations between domestic exposure to EPS and endotoxin from children's mattresses, and doctor-diagnosed asthma and rhinitis in German, but not in Dutch, school children. The reasons for the differences between countries are not clear.

Published
2011
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46. Maternal fine particulate matter exposure, polymorphism in xenobiotic-metabolizing genes and offspring birth weight.

Author

Slama R, Gräbsch C, Lepeule J, Siroux V, Cyrys J, Sausenthaler S, Herbarth O, Bauer M, Borte M, Wichmann HE, and Heinrich J

Subjects
Adult, Child, Cohort Studies, Cytochrome P-450 CYP2D6 genetics, Female, Genetic Association Studies, Germany, Glutathione S-Transferase pi genetics, Glutathione Transferase genetics, Humans, Mutation, Smoking adverse effects, Vehicle Emissions, Young Adult, Birth Weight genetics, Fetal Growth Retardation genetics, Inactivation, Metabolic genetics, Maternal Exposure adverse effects, Particulate Matter toxicity, Polymorphism, Genetic
Abstract

We aimed to describe if polymorphisms in xenobiotics-metabolizing genes modify the effect of maternal exposure to fine particulate matter (PM(2.5)) on offspring birth weight. Among newborns from LISA cohort, we tested if polymorphisms of GSTT1, GSTP1, GSTM1, and CYP2D6 genes modified the effect measure of PM(2.5) on term birth weight. Subsequently, we tested if polymorphisms modified the effect of other exposure factors with possibly similar pathways of action (active or passive smoking). PM (2.5) exposure above the median value (reference, below) was associated with birth weight changes by 76 g in the homozygous wild type genotype (n=161), -90 g in the heterozygous genotype (n=154) and -168 g in children with GSTP1 *1B/*1B mutant genotype (n=39, interaction test, p=0.05). No effect measure modification with PM(2.5) was detected for GSTT1, GSTM1 or CYP2D6 polymorphisms (p≥ 0.12). No effect measure modification with GSTP1 polymorphism was detected for active (p=0.71) nor for passive smoking effects on birth weight (p=0.13)., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Published
2010
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47. Fatty acid composition of serum glycerophospholipids in children.

Author

Glaser C, Demmelmair H, Sausenthaler S, Herbarth O, Heinrich J, and Koletzko B

Subjects
Age Factors, Child, Child, Preschool, Female, Humans, Male, Reference Values, Sex Factors, Fatty Acids analysis, Glycerophospholipids blood, Glycerophospholipids chemistry
Abstract

Objective: To determine reference values for fatty acid (FA) composition of serum glycerophospholipids (GPs) in children with a new high-throughput method., Study Design: The GP FA composition of 1326 serum samples obtained from a cohort of 951 children at 2 and 6 years, participating in the German Influences of Lifestyle Related Factors on the Immune System and the Development of Allergies in Childhood (LISA) study, was analyzed with a new high-throughput method. Only 2 simple preparation steps were necessary to obtain fatty acid methyl esters selectively from serum GPs. The FA status was determined by separating and quantifying the fatty acid methyl esters with high-resolution capillary gas chromatography., Results: FA values in serum GPs were in very good agreement with other published values in serum or plasma phospholipids for most of the analyzed FAs. No major age and sex differences in GP FA composition were observed., Conclusion: The serum GP FA values obtained from children aged 2 and 6 years may serve as reference values in clinical practice (eg, for monitoring and improving therapeutic interventions). Furthermore, they can serve as a reference point for interpreting FA values in clinical and epidemiological studies., (Copyright © 2010 Mosby, Inc. All rights reserved.)

Published
2010
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48. Variants of the FADS1 FADS2 gene cluster, blood levels of polyunsaturated fatty acids and eczema in children within the first 2 years of life.

Author

Rzehak P, Thijs C, Standl M, Mommers M, Glaser C, Jansen E, Klopp N, Koppelman GH, Singmann P, Postma DS, Sausenthaler S, Dagnelie PC, van den Brandt PA, Koletzko B, and Heinrich J

Subjects
Cohort Studies, Delta-5 Fatty Acid Desaturase, Eczema blood, Female, Humans, Infant, Infant, Newborn, Male, Polymorphism, Single Nucleotide, Eczema genetics, Fatty Acid Desaturases genetics, Fatty Acids, Unsaturated blood, Multigene Family
Abstract

Background: Association of genetic-variants in the FADS1-FADS2-gene-cluster with fatty-acid-composition in blood of adult-populations is well established. We analyze this genetic-association in two children-cohort-studies. In addition, the association between variants in the FADS-gene-cluster and blood-fatty-acid-composition with eczema was studied., Methods and Principal Findings: Data of two population-based-birth-cohorts in The Netherlands and Germany (KOALA, LISA) were pooled (n = 879) and analyzed by (logistic) regression regarding the mutual influence of single-nucleotide-polymorphisms (SNPs) in the FADS-gene-cluster (rs174545, rs174546, rs174556, rs174561, rs3834458), on polyunsaturated fatty acids (PUFA) in blood and parent-reported eczema until the age of 2 years. All SNPs were highly significantly associated with all PUFAs except for alpha-linolenic-acid and eicosapentaenoic-acid, also after correction for multiple-testing. All tested SNPs showed associations with eczema in the LISA-study, but not in the KOALA-study. None of the PUFAs was significantly associated with eczema neither in the pooled nor in the analyses stratified by study-cohort., Conclusions and Significance: PUFA-composition in young children's blood is under strong control of the FADS-gene-cluster. Inconsistent results were found for a link between these genetic-variants with eczema. PUFA in blood was not associated with eczema. Thus the hypothesis of an inflammatory-link between PUFA and eczema by the metabolic-pathway of LC-PUFAs as precursors for inflammatory prostaglandins and leukotrienes could not be confirmed by these data.

Published
2010
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49. Effect of hydrolysed formula feeding on taste preferences at 10 years. Data from the German Infant Nutritional Intervention Program Plus Study.

Author

Sausenthaler S, Koletzko S, Koletzko B, Reinhardt D, Krämer U, von Berg A, Berdel D, Bauer CP, Grübl A, Wichmann HE, and Heinrich J

Subjects
Caseins administration & dosage, Caseins metabolism, Child, Double-Blind Method, Female, Follow-Up Studies, Germany, Humans, Infant, Newborn, Male, Food Preferences, Infant Formula administration & dosage, Protein Hydrolysates administration & dosage, Taste Perception
Abstract

Background & Aims: There is some evidence that the type of infant formula received in early infancy has an influence on later food preferences. How long potential effects of taste programming persist is however not clear. Therefore, the aim of present study was to investigate whether feeding with different kinds of infant formula is associated with the acceptance of infant formula at 10 years of age., Methods: Preference testing was conducted in 833 10-year old children being part of the interventional subgroup of the German Infant Nutritional Intervention Program Plus Study (GINIplus). If they were not exclusively breastfed, these children have been fed with either one of three hydrolysed formulas or a cow's milk formula during the first four months of life., Results: Feeding with any kind of hydrolysed formula in infancy was positively associated with a higher acceptance of extensively hydrolysed casein formula (aOR: 1.88; 95% CI 1.08, 3.29) after adjusting for sex and study centre., Conclusions: Although this study did not show consistent associations and thus leaves some questions unanswered, it might stimulate further research on the potential programming effect of early infant feeding., (Copyright 2010 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Published
2010
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50. Elder siblings enhance the effect of filaggrin mutations on childhood eczema: results from the 2 birth cohort studies LISAplus and GINIplus.

Author

Cramer C, Link E, Horster M, Koletzko S, Bauer CP, Berdel D, von Berg A, Lehmann I, Herbarth O, Borte M, Schaaf B, Behrendt H, Chen CM, Sausenthaler S, Illig T, Wichmann HE, Heinrich J, and Krämer U

Subjects
Adult, Child, DNA Mutational Analysis, Dermatitis, Atopic epidemiology, Dermatitis, Atopic immunology, Double-Blind Method, Female, Filaggrin Proteins, Follow-Up Studies, Genotype, Germany, Humans, Male, Mutation genetics, Parity, Pregnancy, Prevalence, Risk Factors, Dermatitis, Atopic genetics, Intermediate Filament Proteins genetics, Siblings
Abstract

Background: Several studies showed a protective effect of elder siblings on eczema development, which is in line with the hygiene hypothesis. However, findings are not consistent, and there might exist different causal pathways for the development of eczema. Especially barrier disturbances as found in children with mutations in the filaggrin gene (FLG) seem to play an important role., Objectives: To investigate the interaction between FLG mutations and the presence of elder siblings on the development of eczema in 2 independent birth cohorts., Methods: We used data from 2 German birth cohorts (LISAplus, GINIplus) up to the age of 6 years. Genotyping for FLG mutations (R501X, 2282del4) was performed in 1039 (LISAplus) and 1828 (GINIplus) children. Data on eczema (diagnosis and symptoms) and elder siblings were obtained by parental questionnaires. The association among eczema, FLG mutations, and elder siblings was analyzed longitudinally by using generalized estimating equations., Results: We found no protective effect of elder siblings on eczema development. On the contrary, children with FLG mutations had a significantly higher risk for eczema if they had elder siblings. Attending day care centers lessened this effect. After excluding 303 children who attended early day care, the odds ratio for interaction between FLG mutations and elder siblings was 3.27 (95% CI, 1.14-9.36) in LISAplus and 2.41 (95% CI, 1.06-5.48) in GINIplus., Conclusion: Our findings did not confirm a protective sibling effect. The prevalence of eczema in children with filaggrin deficiency was higher if elder siblings were present. Our results give evidence for complex skin-driven pathogenic mechanisms that might be different depending on children's genetic backgrounds., (Copyright (c) 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.)

Published
2010
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