The protective effect of farm milk consumption on childhood asthma and atopy: the GABRIELA study

Georg Loss; Silvia Apprich; Marco Waser; Wolfgang Kneifel; Jon Genuneit; Gisela Büchele; Juliane Weber; Barbara Sozanska; Hanna Danielewicz; Elisabeth Horak; R J Joost van Neerven; Dick Heederik; Peter C Lorenzen; Erika von Mutius; Charlotte Braun-Fahrländer; GABRIELA Study Group; Inge Wouters

doi:10.1016/j.jaci.2011.07.048

The protective effect of farm milk consumption on childhood asthma and atopy: the GABRIELA study

Georg Loss, Silvia Apprich, Marco Waser, Wolfgang Kneifel, Jon Genuneit, Gisela Büchele, Juliane Weber, Barbara Sozanska, Hanna Danielewicz, Elisabeth Horak, R J Joost van Neerven, Dick Heederik, Peter C Lorenzen, Erika von Mutius, Charlotte Braun-Fahrländer, GABRIELA Study Group, Inge Wouters

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Farm milk consumption has been identified as an exposure that might contribute to the protective effect of farm life on childhood asthma and allergies. The mechanism of action and the role of particular constituents of farm milk, however, are not yet clear.

OBJECTIVE: We sought to investigate the farm milk effect and determine responsible milk constituents.

METHODS: In rural regions of Germany, Austria, and Switzerland, a comprehensive questionnaire about farm milk consumption and other farm-related exposures was completed by parents of 8334 school-aged children, and 7606 of them provided serum samples to assess specific IgE levels. In 800 cow's milk samples collected at the participants' homes, viable bacterial counts, whey protein levels, and total fat content were analyzed. Asthma, atopy, and hay fever were associated to reported milk consumption and for the first time to objectively measured milk constituents by using multiple regression analyses.

RESULTS: Reported raw milk consumption was inversely associated to asthma (adjusted odds ratio [aOR], 0.59; 95% CI, 0.46-0.74), atopy (aOR, 0.74; 95% CI, 0.61-0.90), and hay fever (aOR, 0.51; 95% CI, 0.37-0.69) independent of other farm exposures. Boiled farm milk did not show a protective effect. Total viable bacterial counts and total fat content of milk were not significantly related to asthma or atopy. Increased levels of the whey proteins BSA (aOR for highest vs lowest levels and asthma, 0.53; 95% CI, 0.30-0.97), α-lactalbumin (aOR for interquartile range and asthma, 0.71; 95% CI, 0.52-0.97), and β-lactoglobulin (aOR for interquartile range and asthma, 0.62; 95% CI, 0.39-0.97), however, were inversely associated with asthma but not with atopy.

CONCLUSIONS: The findings suggest that the protective effect of raw milk consumption on asthma might be associated with the whey protein fraction of milk.

Original language	English
Pages (from-to)	766-773.e4
Number of pages	12
Journal	Journal of Allergy and Clinical Immunology
Volume	128
Issue number	4
DOIs	https://doi.org/10.1016/j.jaci.2011.07.048
Publication status	Published - Oct 2011

Keywords

Allergic diseases
asthma
atopy
children
farming
hay fever
microorganism
farm milk
risk
whey protein

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Loss, G., Apprich, S., Waser, M., Kneifel, W., Genuneit, J., Büchele, G., Weber, J., Sozanska, B., Danielewicz, H., Horak, E., van Neerven, R. J. J., Heederik, D., Lorenzen, P. C., von Mutius, E., Braun-Fahrländer, C., GABRIELA Study Group, & Wouters, I. (2011). The protective effect of farm milk consumption on childhood asthma and atopy: the GABRIELA study. Journal of Allergy and Clinical Immunology, 128(4), 766-773.e4. https://doi.org/10.1016/j.jaci.2011.07.048

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title = "The protective effect of farm milk consumption on childhood asthma and atopy: the GABRIELA study",

abstract = "BACKGROUND: Farm milk consumption has been identified as an exposure that might contribute to the protective effect of farm life on childhood asthma and allergies. The mechanism of action and the role of particular constituents of farm milk, however, are not yet clear.OBJECTIVE: We sought to investigate the farm milk effect and determine responsible milk constituents.METHODS: In rural regions of Germany, Austria, and Switzerland, a comprehensive questionnaire about farm milk consumption and other farm-related exposures was completed by parents of 8334 school-aged children, and 7606 of them provided serum samples to assess specific IgE levels. In 800 cow's milk samples collected at the participants' homes, viable bacterial counts, whey protein levels, and total fat content were analyzed. Asthma, atopy, and hay fever were associated to reported milk consumption and for the first time to objectively measured milk constituents by using multiple regression analyses.RESULTS: Reported raw milk consumption was inversely associated to asthma (adjusted odds ratio [aOR], 0.59; 95% CI, 0.46-0.74), atopy (aOR, 0.74; 95% CI, 0.61-0.90), and hay fever (aOR, 0.51; 95% CI, 0.37-0.69) independent of other farm exposures. Boiled farm milk did not show a protective effect. Total viable bacterial counts and total fat content of milk were not significantly related to asthma or atopy. Increased levels of the whey proteins BSA (aOR for highest vs lowest levels and asthma, 0.53; 95% CI, 0.30-0.97), α-lactalbumin (aOR for interquartile range and asthma, 0.71; 95% CI, 0.52-0.97), and β-lactoglobulin (aOR for interquartile range and asthma, 0.62; 95% CI, 0.39-0.97), however, were inversely associated with asthma but not with atopy.CONCLUSIONS: The findings suggest that the protective effect of raw milk consumption on asthma might be associated with the whey protein fraction of milk.",

keywords = "Allergic diseases, asthma, atopy, children, farming, hay fever, microorganism, farm milk, risk, whey protein",

author = "Georg Loss and Silvia Apprich and Marco Waser and Wolfgang Kneifel and Jon Genuneit and Gisela B{\"u}chele and Juliane Weber and Barbara Sozanska and Hanna Danielewicz and Elisabeth Horak and {van Neerven}, {R J Joost} and Dick Heederik and Lorenzen, {Peter C} and {von Mutius}, Erika and Charlotte Braun-Fahrl{\"a}nder and {GABRIELA Study Group} and Inge Wouters",

year = "2011",

month = oct,

doi = "10.1016/j.jaci.2011.07.048",

language = "English",

volume = "128",

pages = "766--773.e4",

journal = "Journal of Allergy and Clinical Immunology",

issn = "0091-6749",

publisher = "Mosby Inc.",

number = "4",

}

Loss, G, Apprich, S, Waser, M, Kneifel, W, Genuneit, J, Büchele, G, Weber, J, Sozanska, B, Danielewicz, H, Horak, E, van Neerven, RJJ, Heederik, D, Lorenzen, PC, von Mutius, E, Braun-Fahrländer, C, GABRIELA Study Group & Wouters, I 2011, 'The protective effect of farm milk consumption on childhood asthma and atopy: the GABRIELA study', Journal of Allergy and Clinical Immunology, vol. 128, no. 4, pp. 766-773.e4. https://doi.org/10.1016/j.jaci.2011.07.048

TY - JOUR

T1 - The protective effect of farm milk consumption on childhood asthma and atopy

T2 - the GABRIELA study

AU - Loss, Georg

AU - Apprich, Silvia

AU - Waser, Marco

AU - Kneifel, Wolfgang

AU - Genuneit, Jon

AU - Büchele, Gisela

AU - Weber, Juliane

AU - Sozanska, Barbara

AU - Danielewicz, Hanna

AU - Horak, Elisabeth

AU - van Neerven, R J Joost

AU - Heederik, Dick

AU - Lorenzen, Peter C

AU - von Mutius, Erika

AU - Braun-Fahrländer, Charlotte

AU - GABRIELA Study Group

AU - Wouters, Inge

PY - 2011/10

Y1 - 2011/10

N2 - BACKGROUND: Farm milk consumption has been identified as an exposure that might contribute to the protective effect of farm life on childhood asthma and allergies. The mechanism of action and the role of particular constituents of farm milk, however, are not yet clear.OBJECTIVE: We sought to investigate the farm milk effect and determine responsible milk constituents.METHODS: In rural regions of Germany, Austria, and Switzerland, a comprehensive questionnaire about farm milk consumption and other farm-related exposures was completed by parents of 8334 school-aged children, and 7606 of them provided serum samples to assess specific IgE levels. In 800 cow's milk samples collected at the participants' homes, viable bacterial counts, whey protein levels, and total fat content were analyzed. Asthma, atopy, and hay fever were associated to reported milk consumption and for the first time to objectively measured milk constituents by using multiple regression analyses.RESULTS: Reported raw milk consumption was inversely associated to asthma (adjusted odds ratio [aOR], 0.59; 95% CI, 0.46-0.74), atopy (aOR, 0.74; 95% CI, 0.61-0.90), and hay fever (aOR, 0.51; 95% CI, 0.37-0.69) independent of other farm exposures. Boiled farm milk did not show a protective effect. Total viable bacterial counts and total fat content of milk were not significantly related to asthma or atopy. Increased levels of the whey proteins BSA (aOR for highest vs lowest levels and asthma, 0.53; 95% CI, 0.30-0.97), α-lactalbumin (aOR for interquartile range and asthma, 0.71; 95% CI, 0.52-0.97), and β-lactoglobulin (aOR for interquartile range and asthma, 0.62; 95% CI, 0.39-0.97), however, were inversely associated with asthma but not with atopy.CONCLUSIONS: The findings suggest that the protective effect of raw milk consumption on asthma might be associated with the whey protein fraction of milk.

AB - BACKGROUND: Farm milk consumption has been identified as an exposure that might contribute to the protective effect of farm life on childhood asthma and allergies. The mechanism of action and the role of particular constituents of farm milk, however, are not yet clear.OBJECTIVE: We sought to investigate the farm milk effect and determine responsible milk constituents.METHODS: In rural regions of Germany, Austria, and Switzerland, a comprehensive questionnaire about farm milk consumption and other farm-related exposures was completed by parents of 8334 school-aged children, and 7606 of them provided serum samples to assess specific IgE levels. In 800 cow's milk samples collected at the participants' homes, viable bacterial counts, whey protein levels, and total fat content were analyzed. Asthma, atopy, and hay fever were associated to reported milk consumption and for the first time to objectively measured milk constituents by using multiple regression analyses.RESULTS: Reported raw milk consumption was inversely associated to asthma (adjusted odds ratio [aOR], 0.59; 95% CI, 0.46-0.74), atopy (aOR, 0.74; 95% CI, 0.61-0.90), and hay fever (aOR, 0.51; 95% CI, 0.37-0.69) independent of other farm exposures. Boiled farm milk did not show a protective effect. Total viable bacterial counts and total fat content of milk were not significantly related to asthma or atopy. Increased levels of the whey proteins BSA (aOR for highest vs lowest levels and asthma, 0.53; 95% CI, 0.30-0.97), α-lactalbumin (aOR for interquartile range and asthma, 0.71; 95% CI, 0.52-0.97), and β-lactoglobulin (aOR for interquartile range and asthma, 0.62; 95% CI, 0.39-0.97), however, were inversely associated with asthma but not with atopy.CONCLUSIONS: The findings suggest that the protective effect of raw milk consumption on asthma might be associated with the whey protein fraction of milk.

KW - Allergic diseases

KW - asthma

KW - atopy

KW - children

KW - farming

KW - hay fever

KW - microorganism

KW - farm milk

KW - risk

KW - whey protein

U2 - 10.1016/j.jaci.2011.07.048

DO - 10.1016/j.jaci.2011.07.048

M3 - Article

C2 - 21875744

SN - 0091-6749

VL - 128

SP - 766-773.e4

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

IS - 4

ER -

The protective effect of farm milk consumption on childhood asthma and atopy: the GABRIELA study

Abstract

Keywords

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