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general health status
until 2 years in an unselected infant population Improves following an
allergen re-duced dietary intervention programme: THE ZUFF-STUDY Exl BM,
Deland U, Wall M, Preysch U, Secretin MC 1, M van t’Hoff, J
Mulder 2 DH Shmerling 3 (1)
Department of Nutrition, Nestlé, Vevey; (2)
University Dept. of Statistics, Nijmegen Netherlands, (3) Emerit. Children’s Hospital,
Univer.Zürich; CH Background: Atopic
diseases are increasing all over the world and early infant nutrition seems
to play a major role.
In addition, breastfed infants are still healthier
than non-breast-fed infants. Research into allergy-prevention programs is mainly done in
high-risk newborn populations. But as many infants without specific risk
for allergies will become allergic in pure figures than with an elevated
risk (11/100). Objective: Evaluation of the health
related effects of an allergen-reduced nutrition during the first 4-6
months in an unselceted infant population until 2 years of age Methods: This prospective nutritional
intervention study compares neonates in an intervention cohort (Z:breastfeeding
(BF) and/or allergen-reduced pHF-(hydrolysed) infant formula, no weaning
food; for at least 4 months; n=540) with a control cohort (FF: no
specific feeding advice; n = 556) on the basis of growth criteria (weight,
length, head circumference, BMI ) and health criteria (overall, gastroint.,
respiratory, skin). Allocation to groups was based on exclusive
breastfeeding (eBF) (Z=227, FF=162), partial-BF (Z=196; FF=311) or non-BF
(Z=43, FF=62). Important confounding & structural factors were computed
as covariates by logistic regression. Results: Growth was identical in both
groups. At 6 months, the total number of infants with health problems was
lower in Z than in FF (33 vs 49%; p < 0.0001; worst-case: OR 0.6; 95%CI
0.4-0.8), mainly due to skin problems (12 vs 28%; p < 0.0001; OR 0.3;
95%CI 0.2-0.5). Both, the pBF (34 vs 46%, OR 0.6, 95%CI 0.4-0.9) and nBF
groups in Z were at an advantage over those in FF at 6 months (28 vs 57%,
OR 0.3, 95% CI 0.1-0.7), again mainly due to the skin problems. With 3
months, the pBF and nBF in Z did not differ from the eBF (25%,26% vs 29%),
however in FF the pBF and nBF had more health problems than the eBF
(40%,39% vs 31%). At 2 years the Z cohort had still less skin problems than
the FF (7% vs 15%), the
cumulative incidence of the skin was still highly significant
(p<0.0001). Conclusions: Our data indicate that the
general health status, mainly shown at the skin, even in a normal infant
population, is enhanced by an allergen-reduced diet. A dietary regime of
this type should thus be encouraged for all non- or partially breastfed
infants regardless of any elevated allergic risk status.