human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND OBJECTIVE : Relative deficiency of dietary omega 3 polyunsaturated fatty acids ( n-3 PUFA ) has been implicated in the rising allergy prevalence in Westernized countries . Fish oil supplementation may provide an intervention strategy for primary allergy prevention . The objective of this study was to assess the effect of fish oil n-3 PUFA supplementation from birth to 6 months of age on infant allergic disease . METHODS : In a double-blind r and omized controlled trial , 420 infants at high atopic risk received a daily supplement of fish oil containing 280 mg docosahexaenoic acid and 110 mg eicosapentaenoic acid or a control ( olive oil ) , from birth to age 6 months . PUFA levels were measured in 6-month-old infants ’ erythrocytes and plasma and their mothers ’ breast milk . Eczema , food allergy , asthma and sensitization were assessed in 323 infants for whom clinical follow-up was completed at 12 months of age . RESULTS : At 6 months of age , infant docosahexaenoic acid and eicosapentaenoic acid levels were significantly higher ( both P < .05 ) and erythrocyte arachidonic acid levels were lower ( P = .003 ) in the fish oil group . Although n-3 PUFA levels at 6 months were associated with lower risk of eczema ( P = .033 ) and recurrent wheeze ( P = .027 ) , the association with eczema was not significant after multiple comparisons and there was no effect of the intervention per se on the primary study outcomes . Specifically , between-group comparisons revealed no differences in the occurrence of allergic outcomes including sensitization , eczema , asthma , or food allergy . CONCLUSIONS : Postnatal fish oil supplementation improved infant n-3 status but did not prevent childhood allergic disease Background Observational studies suggest high prenatal vitamin D intake may be associated with reduced childhood wheezing .  We examined the effect of prenatal vitamin D on childhood wheezing  in an interventional study . Methods We r and omised 180 pregnant women at 27 weeks gestation to either  no vitamin D , 800 IU ergocalciferol daily until delivery or single oral bolus of 200,000 IU cholecalciferol  , in an ethnically stratified , r and omised controlled trial . Supplementation improved but did not optimise vitamin D status . Research ers blind to allocation assessed offspring at 3 years . Primary outcome was any history of wheeze assessed by vali date d question naire . Secondary outcomes included atopy , respiratory infection , impulse oscillometry and exhaled nitric oxide . Primary analyses used logistic and linear regression . Results We evaluated 158 of 180 ( 88 % ) offspring at age 3 years for the primary outcome . Atopy was assessed by skin test for 95 children ( 53 % ) , serum IgE for 86 ( 48 % ) , exhaled nitric oxide for 62 ( 34 % ) and impulse oscillometry of acceptable quality for 51 ( 28 % ) . We found no difference between supplemented and control groups in risk of wheeze  [ no vitamin D : 14/50 ( 28 % ) ; any vitamin D : 26/108 ( 24 % ) ( risk ratio 0.86 ; 95 % confidence interval 0.49 , 1.50 ; P = 0.69 ) ] . There was no significant difference in atopy , eczema risk , lung function or exhaled nitric oxide between supplemented groups and controls . Conclusion Prenatal vitamin D supplementation in late pregnancy that had a modest effect on cord blood vitamin D level , was not associated with decreased wheezing in offspring at age three years . Trial Registration Controlled-Trials.com IS RCT BACKGROUND Some breastfed infants with atopic eczema benefit from elimination of cow milk , egg , or other antigens from their mother 's diet . Maternal dietary antigens are also known to cross the placenta . OBJECTIVES To assess the effects of prescribing an antigen avoidance diet during pregnancy or lactation , or both , on maternal and infant nutrition and on the prevention or treatment of atopic disease in the child . SEARCH METHODS We search ed the Cochrane Pregnancy and Childbirth Group 's Trials Register ( 6 July 2012 ) . SELECTION CRITERIA All r and omized or quasi-r and omized comparisons of maternal dietary antigen avoidance prescribed to pregnant or lactating women . We excluded trials of multimodal interventions that included manipulation of the infant 's diet other than breast milk or of non-dietary aspects of the infant 's environment . DATA COLLECTION AND ANALYSIS We extracted data from published reports , supplemented by additional information received from the trialists we contacted . MAIN RESULTS The evidence from five trials , involving 952 participants , does not suggest a protective effect of maternal dietary antigen avoidance during pregnancy on the incidence of atopic eczema during the first 18 months of life . Data on allergic rhinitis or conjunctivitis , or both , and urticaria are limited to a single trial each and are insufficient to draw meaningful inferences . Longer-term atopic outcomes have not been reported . The restricted diet during pregnancy was associated with a slightly but statistically significantly lower mean gestational weight gain , a non-significantly higher risk of preterm birth , and a non-significant reduction in mean birthweight . The evidence from two trials , involving 523 participants , did not observe a significant protective effect of maternal antigen avoidance during lactation on the incidence of atopic eczema during the first 18 months or on positive skin-prick tests to cow milk , egg , or peanut antigen at one , two , or seven years . One crossover trial involving 17 lactating mothers of infants with established atopic eczema found that maternal dietary antigen avoidance was associated with a non-significant reduction in eczema severity . AUTHORS ' CONCLUSIONS Prescription of an antigen avoidance diet to a high-risk woman during pregnancy is unlikely to reduce substantially her child 's risk of atopic diseases , and such a diet may adversely affect maternal or fetal nutrition , or both . Prescription of an antigen avoidance diet to a high-risk woman during lactation may reduce her child 's risk of developing atopic eczema , but better trials are needed . Dietary antigen avoidance by lactating mothers of infants with atopic eczema may reduce the severity of the eczema , but larger trials are needed Antioxidant intakes in pregnancy may influence fetal immune programming and the risk of allergic disease . We investigated associations between maternal intakes of β-carotene , vitamin C , vitamin E , copper and zinc , and infant allergic outcomes .  Antioxidant intakes of pregnant women ( n = 420 ) assessed prospect ively by a food frequency question naire , were examined in relation to allergic outcomes at 1 year of age ( n = 300 ) . The main relationships with allergic outcomes were seen with dietary vitamin C and copper . Specifically , higher maternal dietary vitamin C intake was associated with a reduced risk of any diagnosed infant allergic disease and wheeze . After adjustment for potential confounders the relationship with wheeze remained statistically significant . There was also an inverse linear relationship between vitamin C and food allergy . Higher dietary copper intake was associated with reduced risk of eczema , wheeze and any allergic disease . The relationship with wheeze and any allergic disease remained statistically significant in multivariate analysis , and there was also an inverse linear relationship between copper and food allergy . However , these relationships were only seen for nutrients present in food . There were no relationships between β-carotene , vitamin E or zinc and any allergic outcomes . In summary , this study suggests that maternal diet of fresh foods rich in vitamin C is associated with reduced risk of infant wheeze , and that copper intake is associated with reduced risk of several allergic outcomes Objective To evaluate a multistrain , high-dose probiotic in the prevention of  eczema .  Design A r and omised , double-blind , placebo-controlled , parallel group trial . Setting s Antenatal clinics , research clinic , children at home . Patients Pregnant women and their infants . Interventions Women from 36 weeks gestation and their infants to age 6 months received daily either the probiotic ( Lactobacillus salivarius CUL61 , Lactobacillus paracasei CUL08 , Bifidobacterium animalis subspecies lactis CUL34 and Bifidobacterium bifidum CUL20 ; total of 1010 organisms/day ) or matching placebo . Main outcome measure Diagnosed eczema at age 2 years . Infants were followed up by question naire . Clinical examination and skin prick tests to common allergens were done at 6 months and 2 years . Results The cumulative frequency of diagnosed eczema at 2 years was similar in the probiotic ( 73/214 , 34.1 % ) and placebo arms ( 72/222 , 32.4 % ; OR 1.07 , 95 % CI 0.72 to 1.6 ) . Among the secondary outcomes , the cumulative frequency of skin prick sensitivity at 2 years was reduced in the probiotic ( 18/171 ; 10.5 % ) compared with the placebo arm ( 32/173 ; 18.5 % ; OR 0.52 , 95 % CI 0.28 to 0.98 ) . The statistically significant differences between the arms were mainly in sensitisation to cow 's milk and hen 's egg proteins at 6 months . Atopic eczema occurred in 9/171 ( 5.3 % ) children in the probiotic arm and 21/173 ( 12.1 % ) in the placebo arm ( OR 0.40 , 95 % CI 0.18 to 0.91 ) . Conclusions The study did not provide evidence that the probiotic either prevented eczema during the study or reduced its severity . However , the probiotic seemed to prevent atopic sensitisation to common food allergens and so reduce the incidence of atopic eczema in early childhood . Trial registration Number IS RCT N26287422 BACKGROUND The impact of breast milk feeding on susceptibility to asthma in childhood is highly controversial , due in part to failure of the majority of studies in the area to adequately account for key confounders exemplified by respiratory infection history , plus the effects of recall bias . METHODS As part of a prospect i ve cohort study on the role of respiratory infections in asthma development in high-risk children , we measured the concentration of a panel of anti-infective proteins in maternal milk sample s  and analyzed associations between these and subsequent atopy- , infection- , and asthma-related outcomes prospect ively to age 10 years . RESULTS We observed significant but transient inverse associations between the concentration of milk proteins and susceptibility to upper respiratory infections in year 1 only , and parallel but positive transient associations with early lower respiratory infections and atopy . No associations were seen with asthma-related outcomes . CONCLUSIONS Breast milk feeding may influence the expression of inflammatory symptoms associated with respiratory infections and atopy in early life , but these effects appear to be inconsistent and transient . The heterogeneous nature of breast-feeding effects suggests it may influence systemic immunoinflammatory function at several different levels BACKGROUND Extended breast-feeding is recommended for newborn children at risk of allergy-associated diseases , but the evidence of a protective effect on sensitization and these diseases remains elusive . OBJECTIVE The aim of this study was to investigate the effects of the duration of exclusive breast-feeding on the development of sensitization in preschool children . METHODS Information on breast-feeding was gathered by interviews involving 335 children aged 1 , 6 , and 12 months from the Copenhagen Prospect i ve Study on Asthma in Childhood2000 birth cohort born to mothers with a history of asthma . Skin prick test responses and specific IgE levels against 12 common inhalant and 10 food allergens were assessed longitudinally at ages ½ year , 1½ years , 4 years , and 6 years . Eczema , wheeze/asthma , and allergic rhinitis were diagnosed at the Copenhagen Prospect i ve Studies on Asthma in Childhood clinic at 7 years of age , strictly adhering to predefined algorithms . Associations between duration of exclusive breast-feeding and outcomes were analyzed by logistic regression . RESULTS We found no significant association between duration of  exclusive breast-feeding and development of sensitization in the first 6 years of life ( odds ratio [ OR ] : ½ year , 1.10 [ 95 % CI , 0.90 - 1.36 ] ; 1½ years , 1.15 [ 95 % CI , 0.97 - 1.36 ] ; 4 years , 1.08 [ 95 % CI , 0.93 - 1.25 ] ; and 6 years , 0.96 [ 95 % CI , 0.84 - 1.10 ] ) or with current eczema , wheeze/asthma , and allergic rhinitis at age 7 years ( OR , 1.07 [ 95 % CI , 0.92 - 1.24 ] ; OR , 0.97 [ 95 % CI , 0.82 - 1 
    Output:
    
agent
Based on the existing information , it is not possible to establish the role of antioxidants and vitamin D supplementation in atopic disease development .
There is no evidence of major effects of prenatal use of folic acid on asthma or allergies .
The association of some nutritional interventions with less atopic sensitization seems rather speculative even if such an effect has not been found for some other foods .
The findings indicate rather a balanced and diverse diet without restrictions than a special dietary protocol .
Farming-related exposures may protect against the development of atopic disorders in children .
Long-chain polyunsaturated fatty acids and probiotics seem to be promising c and i date s for allergy prevention .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND OBJECTIVE : Relative deficiency of dietary omega 3 polyunsaturated fatty acids ( n-3 PUFA ) has been implicated in the rising allergy prevalence in Westernized countries . Fish oil supplementation may provide an intervention strategy for primary allergy prevention . The objective of this study was to assess the effect of fish oil n-3 PUFA supplementation from birth to 6 months of age on infant allergic disease . METHODS : In a double-blind r and omized controlled trial , 420 infants at high atopic risk received a daily supplement of fish oil containing 280 mg docosahexaenoic acid and 110 mg eicosapentaenoic acid or a control ( olive oil ) , from birth to age 6 months . PUFA levels were measured in 6-month-old infants ’ erythrocytes and plasma and their mothers ’ breast milk . Eczema , food allergy , asthma and sensitization were assessed in 323 infants for whom clinical follow-up was completed at 12 months of age . RESULTS : At 6 months of age , infant docosahexaenoic acid and eicosapentaenoic acid levels were significantly higher ( both P < .05 ) and erythrocyte arachidonic acid levels were lower ( P = .003 ) in the fish oil group . Although n-3 PUFA levels at 6 months were associated with lower risk of eczema ( P = .033 ) and recurrent wheeze ( P = .027 ) , the association with eczema was not significant after multiple comparisons and there was no effect of the intervention per se on the primary study outcomes . Specifically , between-group comparisons revealed no differences in the occurrence of allergic outcomes including sensitization , eczema , asthma , or food allergy . CONCLUSIONS : Postnatal fish oil supplementation improved infant n-3 status but did not prevent childhood allergic disease Background Observational studies suggest high prenatal vitamin D intake may be associated with reduced childhood wheezing .  We examined the effect of prenatal vitamin D on childhood wheezing  in an interventional study . Methods We r and omised 180 pregnant women at 27 weeks gestation to either  no vitamin D , 800 IU ergocalciferol daily until delivery or single oral bolus of 200,000 IU cholecalciferol  , in an ethnically stratified , r and omised controlled trial . Supplementation improved but did not optimise vitamin D status . Research ers blind to allocation assessed offspring at 3 years . Primary outcome was any history of wheeze assessed by vali date d question naire . Secondary outcomes included atopy , respiratory infection , impulse oscillometry and exhaled nitric oxide . Primary analyses used logistic and linear regression . Results We evaluated 158 of 180 ( 88 % ) offspring at age 3 years for the primary outcome . Atopy was assessed by skin test for 95 children ( 53 % ) , serum IgE for 86 ( 48 % ) , exhaled nitric oxide for 62 ( 34 % ) and impulse oscillometry of acceptable quality for 51 ( 28 % ) . We found no difference between supplemented and control groups in risk of wheeze  [ no vitamin D : 14/50 ( 28 % ) ; any vitamin D : 26/108 ( 24 % ) ( risk ratio 0.86 ; 95 % confidence interval 0.49 , 1.50 ; P = 0.69 ) ] . There was no significant difference in atopy , eczema risk , lung function or exhaled nitric oxide between supplemented groups and controls . Conclusion Prenatal vitamin D supplementation in late pregnancy that had a modest effect on cord blood vitamin D level , was not associated with decreased wheezing in offspring at age three years . Trial Registration Controlled-Trials.com IS RCT BACKGROUND Some breastfed infants with atopic eczema benefit from elimination of cow milk , egg , or other antigens from their mother 's diet . Maternal dietary antigens are also known to cross the placenta . OBJECTIVES To assess the effects of prescribing an antigen avoidance diet during pregnancy or lactation , or both , on maternal and infant nutrition and on the prevention or treatment of atopic disease in the child . SEARCH METHODS We search ed the Cochrane Pregnancy and Childbirth Group 's Trials Register ( 6 July 2012 ) . SELECTION CRITERIA All r and omized or quasi-r and omized comparisons of maternal dietary antigen avoidance prescribed to pregnant or lactating women . We excluded trials of multimodal interventions that included manipulation of the infant 's diet other than breast milk or of non-dietary aspects of the infant 's environment . DATA COLLECTION AND ANALYSIS We extracted data from published reports , supplemented by additional information received from the trialists we contacted . MAIN RESULTS The evidence from five trials , involving 952 participants , does not suggest a protective effect of maternal dietary antigen avoidance during pregnancy on the incidence of atopic eczema during the first 18 months of life . Data on allergic rhinitis or conjunctivitis , or both , and urticaria are limited to a single trial each and are insufficient to draw meaningful inferences . Longer-term atopic outcomes have not been reported . The restricted diet during pregnancy was associated with a slightly but statistically significantly lower mean gestational weight gain , a non-significantly higher risk of preterm birth , and a non-significant reduction in mean birthweight . The evidence from two trials , involving 523 participants , did not observe a significant protective effect of maternal antigen avoidance during lactation on the incidence of atopic eczema during the first 18 months or on positive skin-prick tests to cow milk , egg , or peanut antigen at one , two , or seven years . One crossover trial involving 17 lactating mothers of infants with established atopic eczema found that maternal dietary antigen avoidance was associated with a non-significant reduction in eczema severity . AUTHORS ' CONCLUSIONS Prescription of an antigen avoidance diet to a high-risk woman during pregnancy is unlikely to reduce substantially her child 's risk of atopic diseases , and such a diet may adversely affect maternal or fetal nutrition , or both . Prescription of an antigen avoidance diet to a high-risk woman during lactation may reduce her child 's risk of developing atopic eczema , but better trials are needed . Dietary antigen avoidance by lactating mothers of infants with atopic eczema may reduce the severity of the eczema , but larger trials are needed Antioxidant intakes in pregnancy may influence fetal immune programming and the risk of allergic disease . We investigated associations between maternal intakes of β-carotene , vitamin C , vitamin E , copper and zinc , and infant allergic outcomes .  Antioxidant intakes of pregnant women ( n = 420 ) assessed prospect ively by a food frequency question naire , were examined in relation to allergic outcomes at 1 year of age ( n = 300 ) . The main relationships with allergic outcomes were seen with dietary vitamin C and copper . Specifically , higher maternal dietary vitamin C intake was associated with a reduced risk of any diagnosed infant allergic disease and wheeze . After adjustment for potential confounders the relationship with wheeze remained statistically significant . There was also an inverse linear relationship between vitamin C and food allergy . Higher dietary copper intake was associated with reduced risk of eczema , wheeze and any allergic disease . The relationship with wheeze and any allergic disease remained statistically significant in multivariate analysis , and there was also an inverse linear relationship between copper and food allergy . However , these relationships were only seen for nutrients present in food . There were no relationships between β-carotene , vitamin E or zinc and any allergic outcomes . In summary , this study suggests that maternal diet of fresh foods rich in vitamin C is associated with reduced risk of infant wheeze , and that copper intake is associated with reduced risk of several allergic outcomes Objective To evaluate a multistrain , high-dose probiotic in the prevention of  eczema .  Design A r and omised , double-blind , placebo-controlled , parallel group trial . Setting s Antenatal clinics , research clinic , children at home . Patients Pregnant women and their infants . Interventions Women from 36 weeks gestation and their infants to age 6 months received daily either the probiotic ( Lactobacillus salivarius CUL61 , Lactobacillus paracasei CUL08 , Bifidobacterium animalis subspecies lactis CUL34 and Bifidobacterium bifidum CUL20 ; total of 1010 organisms/day ) or matching placebo . Main outcome measure Diagnosed eczema at age 2 years . Infants were followed up by question naire . Clinical examination and skin prick tests to common allergens were done at 6 months and 2 years . Results The cumulative frequency of diagnosed eczema at 2 years was similar in the probiotic ( 73/214 , 34.1 % ) and placebo arms ( 72/222 , 32.4 % ; OR 1.07 , 95 % CI 0.72 to 1.6 ) . Among the secondary outcomes , the cumulative frequency of skin prick sensitivity at 2 years was reduced in the probiotic ( 18/171 ; 10.5 % ) compared with the placebo arm ( 32/173 ; 18.5 % ; OR 0.52 , 95 % CI 0.28 to 0.98 ) . The statistically significant differences between the arms were mainly in sensitisation to cow 's milk and hen 's egg proteins at 6 months . Atopic eczema occurred in 9/171 ( 5.3 % ) children in the probiotic arm and 21/173 ( 12.1 % ) in the placebo arm ( OR 0.40 , 95 % CI 0.18 to 0.91 ) . Conclusions The study did not provide evidence that the probiotic either prevented eczema during the study or reduced its severity . However , the probiotic seemed to prevent atopic sensitisation to common food allergens and so reduce the incidence of atopic eczema in early childhood . Trial registration Number IS RCT N26287422 BACKGROUND The impact of breast milk feeding on susceptibility to asthma in childhood is highly controversial , due in part to failure of the majority of studies in the area to adequately account for key confounders exemplified by respiratory infection history , plus the effects of recall bias . METHODS As part of a prospect i ve cohort study on the role of respiratory infections in asthma development in high-risk children , we measured the concentration of a panel of anti-infective proteins in maternal milk sample s  and analyzed associations between these and subsequent atopy- , infection- , and asthma-related outcomes prospect ively to age 10 years . RESULTS We observed significant but transient inverse associations between the concentration of milk proteins and susceptibility to upper respiratory infections in year 1 only , and parallel but positive transient associations with early lower respiratory infections and atopy . No associations were seen with asthma-related outcomes . CONCLUSIONS Breast milk feeding may influence the expression of inflammatory symptoms associated with respiratory infections and atopy in early life , but these effects appear to be inconsistent and transient . The heterogeneous nature of breast-feeding effects suggests it may influence systemic immunoinflammatory function at several different levels BACKGROUND Extended breast-feeding is recommended for newborn children at risk of allergy-associated diseases , but the evidence of a protective effect on sensitization and these diseases remains elusive . OBJECTIVE The aim of this study was to investigate the effects of the duration of exclusive breast-feeding on the development of sensitization in preschool children . METHODS Information on breast-feeding was gathered by interviews involving 335 children aged 1 , 6 , and 12 months from the Copenhagen Prospect i ve Study on Asthma in Childhood2000 birth cohort born to mothers with a history of asthma . Skin prick test responses and specific IgE levels against 12 common inhalant and 10 food allergens were assessed longitudinally at ages ½ year , 1½ years , 4 years , and 6 years . Eczema , wheeze/asthma , and allergic rhinitis were diagnosed at the Copenhagen Prospect i ve Studies on Asthma in Childhood clinic at 7 years of age , strictly adhering to predefined algorithms . Associations between duration of exclusive breast-feeding and outcomes were analyzed by logistic regression . RESULTS We found no significant association between duration of  exclusive breast-feeding and development of sensitization in the first 6 years of life ( odds ratio [ OR ] : ½ year , 1.10 [ 95 % CI , 0.90 - 1.36 ] ; 1½ years , 1.15 [ 95 % CI , 0.97 - 1.36 ] ; 4 years , 1.08 [ 95 % CI , 0.93 - 1.25 ] ; and 6 years , 0.96 [ 95 % CI , 0.84 - 1.10 ] ) or with current eczema , wheeze/asthma , and allergic rhinitis at age 7 years ( OR , 1.07 [ 95 % CI , 0.92 - 1.24 ] ; OR , 0.97 [ 95 % CI , 0.82 - 1 
    Output:
    