Peat JK, Mihrshahi S, Kemp AS, et al. J Allergy Clin Immunol. 2004;114:807–813
Purpose of the Study.
To measure the effects of dietary supplementation with ω-3 fatty acids and house d-e (HDM) allergen avoidance in children with a family history of asthma.
Children at high risk for asthma, defined by having at least 1 parent or sibling with current asthma or frequent wheeze.
A total of 616 children at high risk for asthma were enrolled antenatally, and 526 children remained in the trial when they were 3 years old. HDM allergen avoidance involved the use of both physical and chemical methods for the reduction of allergen concentrations. Dietary intervention included supplementation of the infant’s/child’s diet with tuna fish oil and use by the family of canola-based oils and spreads. Participants were randomized to 1 of the 4 study groups: placebo diet and active HDM controls, active diet supplements and active HDM controls, placebo diet and no HDM controls, and active diet supplements and no HDM controls. The outcomes were symptoms of allergic disease and HDM allergen sensitization at 3 years.
There was a significant 10.0% (95% confidence interval [CI]: 3.7, 16.4) reduction in the prevalence of cough in atopic children in the active-diet group (P = .003; number needed to treat: 10) but a negligible 1.1% (95% CI: −7.1, 9.5) reduction in cough among nonatopic children. There was a 7.2% (95% CI: 10.11, 14.3) reduction in sensitization to HDM in the active allergen-avoidance group (P = .05; number needed to treat: 14). No significant differences in wheeze were found with either intervention.
These results suggest that HDM allergen avoidance and dietary supplementation with foods rich in ω-3 fatty acids may have a role in preventing the development of allergic sensitization and airways disease in early childhood, which offers the prospect of reducing allergic disease in later life.
Although the reported risk reduction in the active-intervention groups was modest, this study suggests that a relatively simple intervention may be used in public health to modulate the development of allergic sensitization and airways disease at an early age. Hopefully, a follow-up study will determine the long-term effect of combined dietary ω-3 fatty acid supplementation and environmental HDM allergen avoidance.