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 Vitamin D deficiency and asthma are common at higher latitudes . Although vitamin D has important immunologic effects , its relation with asthma is unknown . OBJECTIVE We hypothesized that a higher maternal intake of vitamin D during pregnancy is associated with a lower risk of  recurrent wheeze in children at 3 y of age . DESIGN The participants were 1194 mother-child pairs in Project Viva-a prospect i ve prebirth cohort study in Massachusetts . We assessed the maternal intake of vitamin D during pregnancy from a vali date d food-frequency question naire . The primary outcome was recurrent wheeze , ie , a positive asthma predictive index ( > or=2 wheezing attacks among children with a personal diagnosis of eczema or a parental history of asthma ) . RESULTS The mean ( + /-SD ) total vitamin D intake during pregnancy was 548 + /- 167 IU/d . By age 3 y , 186 children ( 16 % ) had recurrent wheeze . Compared with mothers in the lowest quartile of daily intake ( median : 356 IU ) , those in the highest quartile ( 724 IU ) had a lower risk of having a child with recurrent wheeze [ odds ratio ( OR ) : 0.39 ; 95 % CI : 0.25 , 0.62 ; P for trend < 0.001 ] . A 100-IU increase in vitamin D intake was associated with lower risk ( OR : 0.81 ; 95 % CI : 0.74 , 0.89 ) , regardless of whether vitamin D was from the diet ( OR : 0.81 ; 95 % CI : 0.69 , 0.96 ) or supplements ( OR : 0.82 ; 95 % CI : 0.73 , 0.92 ) . Adjustment for 12 potential confounders , including maternal intake of other dietary factors , did not change the results . CONCLUSION In the northeastern United States , a higher maternal intake of vitamin D during pregnancy may decrease the risk of recurrent wheeze in early childhood 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 Past evidence has suggested a role of artificial sweeteners in allergic disease ; yet , the evidence has been inconsistent and unclear . Objective To examine relation of intake of artificially-sweetened beverages during pregnancy with  child asthma and allergic rhinitis  at 18 months and 7 years . Methods We analyzed data from 60,466 women enrolled during pregnancy in the prospect i ve longitudinal Danish National Birth Cohort between 1996 and 2003 . At the 25th week of gestation we administered a vali date d Food Frequency Question naire which asked in detail about intake of artificially-sweetened soft drinks . At 18 months , we evaluated child asthma using interview data . We also assessed asthma and allergic rhinitis through a question naire at age 7 and by using national registries . Current asthma was defined as self-reported asthma diagnosis and wheeze in the past 12 months . We examined the relation between intake of artificially-sweetened soft drinks and child allergic disease outcomes and present here odds ratios with 95 % CI comparing daily vs. no intake . Results At 18 months , we found that mothers who consumed more artificially-sweetened non-carbonated soft drinks were 1.23 ( 95 % CI : 1.13 , 1.33 ) times more likely to report a child asthma diagnosis compared to non-consumers . Similar results were found for child wheeze . Consumers of artificially-sweetened carbonated drinks were more likely to have a child asthma diagnosis in the patient ( 1.30 , 95 % CI : 1.01 , 1.66 ) and medication ( 1.13 , 95 % CI : 0.98 , 1.29 ) registry , as well as self-reported allergic rhinitis ( 1.31 , 95 % CI : 0.98 , 1.74 ) during the first 7 years of follow-up . We found no associations for sugar-sweetened soft drinks . Conclusion Carbonated artificially-sweetened soft drinks were associated with registry-based asthma and self-reported allergic rhinitis , while early childhood outcomes were related to non-carbonated soft drinks . These results suggest that consumption of artificially-sweetened soft drinks during pregnancy may play a role in offspring allergic disease development OBJECTIVE To determine the change in prevalence of  asthma , eczema and allergic rhinitis in Australian schoolchildren between 1993 and 2002 . DESIGN Question naire based survey , using the protocol of the International Study of Asthma and Allergy in Childhood . SETTING Metropolitan Melbourne primary schools within a 20 km radius of the GPO in 1993 and 2002 . SUBJECTS All children in school years 1 and 2 ( ages 6 and 7 ) attending a r and om sample of 84 schools in 1993 and 63 schools in 2002 . MAIN OUTCOME MEASURES Parent-reported symptoms of atopic disease ; treatment for asthma ; country of birth . RESULTS There was a 26 % reduction in the 12-month period prevalence of reported wheeze , from 27.2 % in 1993 to 20.0 % in 2002 . The magnitude of reduction was similar for boys ( 27 % ) and girls ( 25 % ) . The 12-month period prevalence of reported eczema increased from 11.1 % in 1993 to 17.2 % in 2002 , and rhinitis increased from 9.7 % to 12.7 % . There were reductions in the proportion of children attending an emergency department for asthma in the previous year ( 3.6 % to 2.3 % ) , the proportion admitted to hospital ( 1.7 % to 1.1 % ) and the proportion taking asthma medication ( 18.5 % to 13.4 % ) . Of those who reported frequent wheeze , there was an increase in the proportion taking regular inhaled steroids ( 34.5 % to 40.9 % ) . CONCLUSION There has been a significant reduction in the prevalence of reported asthma in Melbourne schoolchildren , whereas the prevalence of eczema and allergic rhinitis has continued to increase BACKGROUND Long-chain n-3 PUFAs found in oily fish may have a role in lowering the risk of allergic disease . OBJECTIVE The objective was to assess whether an increased intake of oily fish in pregnancy modifies neonatal immune responses and early markers of atopy . DESIGN Women ( n = 123 ) were r and omly assigned to continue their habitual diet , which was low in oily fish , or to consume 2 portions of salmon per week ( providing 3.45 g EPA plus DHA ) from 20 wk gestation until delivery . In umbilical cord blood sample s ( n = 101 ) , we measured n-3 fatty acids , IgE concentrations , and immunologic responses . Infants were clinical ly evaluated at age 6 mo ( n = 86 ) . RESULTS Cord blood mononuclear cell ( C BMC ) production of interleukin (IL)-2 , IL-4 , IL-5 , IL-10 , and tumor necrosis factor-α in response to phytohemagglutinin ( PHA ) and of IL-2 in response to Dermatophagoides pteronyssinus allergen 1 ( Derp1 ) was lower in the salmon group ( all P ≤ 0.03 ) . In the subgroup of C BMC s in which an allergic phenotype was confirmed in the mother or father , IL-10 production in response to Toll-like receptor 2 , 3 , and 4 agonists , ovalbumin , salmon parvalbumin , or Derp1 and prostagl and in E(2 ) production in response to lipopolysaccharide or PHA was lower in the salmon group ( all P ≤ 0.045 ) . Total IgE at birth and total IgE , incidence and severity of atopic dermatitis , and skin-prick-test positivity at 6 mo of age were not different between the 2 groups . CONCLUSION Oily fish intervention in pregnancy modifies neonatal immune responses but may not affect markers of infant atopy assessed at 6 mo of age . This trial is registered at clinical trials.gov as NCT00801502 BACKGROUND Evidence suggests that asthma is rooted in the intrauterine environment and that intake of marine n-3 polyunsaturated fatty acids ( n-3 PUFAs ) in pregnancy may have immunomodulatory effects on the child . OBJECTIVE Our aim was to examine whether increasing maternal intake of n-3 PUFAs in pregnancy may affect offspring risk of asthma . DESIGN In 1990 , a population -based sample of 533 women with normal pregnancies were r and omly assigned 2:1:1 to receive four 1-g gelatin capsules/d with fish oil providing 2.7 g n-3 PUFAs ( n = 266 ) ; four 1-g , similar-looking capsules/d with olive oil ( n = 136 ) ; or no oil capsules ( n = 131 ) . Women were recruited and r and omly assigned around gestation week 30 and asked to take capsules until delivery . Among 531 live-born children , 528 were identified in registries and 523 were still alive by August 2006 .  Diagnoses from the International Coding of Diseases version 10 were extracted from a m and atory registry that recorded diagnoses reported from hospital contacts . RESULTS During the 16 y that passed since childbirth , 19 children from the fish oil  and  olive oil groups had received an asthma-related diagnosis ; 10 had received the diagnosis allergic asthma . The hazard rate of asthma was reduced by 63 % ( 95 % CI : 8 % , 85 % ; P = 0.03 ) , whereas the hazard rate of allergic asthma was reduced by 87 % ( 95 % CI : 40 % , 97 % ; P = 0.01 ) in the fish oil compared with the olive oil group . CONCLUSION Under the assumption that intake of olive oil in the dose provided here was inert , our results support that increasing n-3 PUFAs in late pregnancy may carry an important prophylactic potential in relation to offspring asthma Thirty seven breast fed infants with eczema were studied to see whether changes in their mothers ' diets affected their skin condition .  Nineteen mothers and babies took part in a double blind crossover trial of exclusion of egg and cows ' milk , and 18 took part in open exclusion of 11 foods  followed by double blind challenge to those mothers whose infants seemed to respond . Babies were examined at the beginning and end of each dietary period , and the extent and severity of the rash were given a numerical score . The eczema improved in six infants when their mothers avoided egg and cows ' milk and worsened again when these were reintroduced . Two infants suffered gastrointestinal reactions after maternal ingestion of egg and cows ' milk , one developing colitis . Maternal dietary exclusion seems to benefit some breast fed babies with eczema 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 ecz 
    Output:
    
agent
***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 Vitamin D deficiency and asthma are common at higher latitudes . Although vitamin D has important immunologic effects , its relation with asthma is unknown . OBJECTIVE We hypothesized that a higher maternal intake of vitamin D during pregnancy is associated with a lower risk of  recurrent wheeze in children at 3 y of age . DESIGN The participants were 1194 mother-child pairs in Project Viva-a prospect i ve prebirth cohort study in Massachusetts . We assessed the maternal intake of vitamin D during pregnancy from a vali date d food-frequency question naire . The primary outcome was recurrent wheeze , ie , a positive asthma predictive index ( > or=2 wheezing attacks among children with a personal diagnosis of eczema or a parental history of asthma ) . RESULTS The mean ( + /-SD ) total vitamin D intake during pregnancy was 548 + /- 167 IU/d . By age 3 y , 186 children ( 16 % ) had recurrent wheeze . Compared with mothers in the lowest quartile of daily intake ( median : 356 IU ) , those in the highest quartile ( 724 IU ) had a lower risk of having a child with recurrent wheeze [ odds ratio ( OR ) : 0.39 ; 95 % CI : 0.25 , 0.62 ; P for trend < 0.001 ] . A 100-IU increase in vitamin D intake was associated with lower risk ( OR : 0.81 ; 95 % CI : 0.74 , 0.89 ) , regardless of whether vitamin D was from the diet ( OR : 0.81 ; 95 % CI : 0.69 , 0.96 ) or supplements ( OR : 0.82 ; 95 % CI : 0.73 , 0.92 ) . Adjustment for 12 potential confounders , including maternal intake of other dietary factors , did not change the results . CONCLUSION In the northeastern United States , a higher maternal intake of vitamin D during pregnancy may decrease the risk of recurrent wheeze in early childhood 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 Past evidence has suggested a role of artificial sweeteners in allergic disease ; yet , the evidence has been inconsistent and unclear . Objective To examine relation of intake of artificially-sweetened beverages during pregnancy with  child asthma and allergic rhinitis  at 18 months and 7 years . Methods We analyzed data from 60,466 women enrolled during pregnancy in the prospect i ve longitudinal Danish National Birth Cohort between 1996 and 2003 . At the 25th week of gestation we administered a vali date d Food Frequency Question naire which asked in detail about intake of artificially-sweetened soft drinks . At 18 months , we evaluated child asthma using interview data . We also assessed asthma and allergic rhinitis through a question naire at age 7 and by using national registries . Current asthma was defined as self-reported asthma diagnosis and wheeze in the past 12 months . We examined the relation between intake of artificially-sweetened soft drinks and child allergic disease outcomes and present here odds ratios with 95 % CI comparing daily vs. no intake . Results At 18 months , we found that mothers who consumed more artificially-sweetened non-carbonated soft drinks were 1.23 ( 95 % CI : 1.13 , 1.33 ) times more likely to report a child asthma diagnosis compared to non-consumers . Similar results were found for child wheeze . Consumers of artificially-sweetened carbonated drinks were more likely to have a child asthma diagnosis in the patient ( 1.30 , 95 % CI : 1.01 , 1.66 ) and medication ( 1.13 , 95 % CI : 0.98 , 1.29 ) registry , as well as self-reported allergic rhinitis ( 1.31 , 95 % CI : 0.98 , 1.74 ) during the first 7 years of follow-up . We found no associations for sugar-sweetened soft drinks . Conclusion Carbonated artificially-sweetened soft drinks were associated with registry-based asthma and self-reported allergic rhinitis , while early childhood outcomes were related to non-carbonated soft drinks . These results suggest that consumption of artificially-sweetened soft drinks during pregnancy may play a role in offspring allergic disease development OBJECTIVE To determine the change in prevalence of  asthma , eczema and allergic rhinitis in Australian schoolchildren between 1993 and 2002 . DESIGN Question naire based survey , using the protocol of the International Study of Asthma and Allergy in Childhood . SETTING Metropolitan Melbourne primary schools within a 20 km radius of the GPO in 1993 and 2002 . SUBJECTS All children in school years 1 and 2 ( ages 6 and 7 ) attending a r and om sample of 84 schools in 1993 and 63 schools in 2002 . MAIN OUTCOME MEASURES Parent-reported symptoms of atopic disease ; treatment for asthma ; country of birth . RESULTS There was a 26 % reduction in the 12-month period prevalence of reported wheeze , from 27.2 % in 1993 to 20.0 % in 2002 . The magnitude of reduction was similar for boys ( 27 % ) and girls ( 25 % ) . The 12-month period prevalence of reported eczema increased from 11.1 % in 1993 to 17.2 % in 2002 , and rhinitis increased from 9.7 % to 12.7 % . There were reductions in the proportion of children attending an emergency department for asthma in the previous year ( 3.6 % to 2.3 % ) , the proportion admitted to hospital ( 1.7 % to 1.1 % ) and the proportion taking asthma medication ( 18.5 % to 13.4 % ) . Of those who reported frequent wheeze , there was an increase in the proportion taking regular inhaled steroids ( 34.5 % to 40.9 % ) . CONCLUSION There has been a significant reduction in the prevalence of reported asthma in Melbourne schoolchildren , whereas the prevalence of eczema and allergic rhinitis has continued to increase BACKGROUND Long-chain n-3 PUFAs found in oily fish may have a role in lowering the risk of allergic disease . OBJECTIVE The objective was to assess whether an increased intake of oily fish in pregnancy modifies neonatal immune responses and early markers of atopy . DESIGN Women ( n = 123 ) were r and omly assigned to continue their habitual diet , which was low in oily fish , or to consume 2 portions of salmon per week ( providing 3.45 g EPA plus DHA ) from 20 wk gestation until delivery . In umbilical cord blood sample s ( n = 101 ) , we measured n-3 fatty acids , IgE concentrations , and immunologic responses . Infants were clinical ly evaluated at age 6 mo ( n = 86 ) . RESULTS Cord blood mononuclear cell ( C BMC ) production of interleukin (IL)-2 , IL-4 , IL-5 , IL-10 , and tumor necrosis factor-α in response to phytohemagglutinin ( PHA ) and of IL-2 in response to Dermatophagoides pteronyssinus allergen 1 ( Derp1 ) was lower in the salmon group ( all P ≤ 0.03 ) . In the subgroup of C BMC s in which an allergic phenotype was confirmed in the mother or father , IL-10 production in response to Toll-like receptor 2 , 3 , and 4 agonists , ovalbumin , salmon parvalbumin , or Derp1 and prostagl and in E(2 ) production in response to lipopolysaccharide or PHA was lower in the salmon group ( all P ≤ 0.045 ) . Total IgE at birth and total IgE , incidence and severity of atopic dermatitis , and skin-prick-test positivity at 6 mo of age were not different between the 2 groups . CONCLUSION Oily fish intervention in pregnancy modifies neonatal immune responses but may not affect markers of infant atopy assessed at 6 mo of age . This trial is registered at clinical trials.gov as NCT00801502 BACKGROUND Evidence suggests that asthma is rooted in the intrauterine environment and that intake of marine n-3 polyunsaturated fatty acids ( n-3 PUFAs ) in pregnancy may have immunomodulatory effects on the child . OBJECTIVE Our aim was to examine whether increasing maternal intake of n-3 PUFAs in pregnancy may affect offspring risk of asthma . DESIGN In 1990 , a population -based sample of 533 women with normal pregnancies were r and omly assigned 2:1:1 to receive four 1-g gelatin capsules/d with fish oil providing 2.7 g n-3 PUFAs ( n = 266 ) ; four 1-g , similar-looking capsules/d with olive oil ( n = 136 ) ; or no oil capsules ( n = 131 ) . Women were recruited and r and omly assigned around gestation week 30 and asked to take capsules until delivery . Among 531 live-born children , 528 were identified in registries and 523 were still alive by August 2006 .  Diagnoses from the International Coding of Diseases version 10 were extracted from a m and atory registry that recorded diagnoses reported from hospital contacts . RESULTS During the 16 y that passed since childbirth , 19 children from the fish oil  and  olive oil groups had received an asthma-related diagnosis ; 10 had received the diagnosis allergic asthma . The hazard rate of asthma was reduced by 63 % ( 95 % CI : 8 % , 85 % ; P = 0.03 ) , whereas the hazard rate of allergic asthma was reduced by 87 % ( 95 % CI : 40 % , 97 % ; P = 0.01 ) in the fish oil compared with the olive oil group . CONCLUSION Under the assumption that intake of olive oil in the dose provided here was inert , our results support that increasing n-3 PUFAs in late pregnancy may carry an important prophylactic potential in relation to offspring asthma Thirty seven breast fed infants with eczema were studied to see whether changes in their mothers ' diets affected their skin condition .  Nineteen mothers and babies took part in a double blind crossover trial of exclusion of egg and cows ' milk , and 18 took part in open exclusion of 11 foods  followed by double blind challenge to those mothers whose infants seemed to respond . Babies were examined at the beginning and end of each dietary period , and the extent and severity of the rash were given a numerical score . The eczema improved in six infants when their mothers avoided egg and cows ' milk and worsened again when these were reintroduced . Two infants suffered gastrointestinal reactions after maternal ingestion of egg and cows ' milk , one developing colitis . Maternal dietary exclusion seems to benefit some breast fed babies with eczema 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 ecz 
    Output:
    