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Cow's milk exposure and asthma in a newborn cohort: repeated ascertainment indicates reverse causation

Cow's milk exposure and asthma in a newborn cohort: repeated ascertainment indicates reverse causation
Cow's milk exposure and asthma in a newborn cohort: repeated ascertainment indicates reverse causation
The effect of cow's milk consumption on childhood asthma has been debated for several years. This study attempts to provide further insight into this association through the use of a longitudinal study design. Newborns from parents with atopic history were recruited from Germany, Austria, and England (n = 696). For five repeated ascertainments, information was collected on cow's milk exposure, incidence of doctor-diagnosed asthma, and confounders. Generalized estimation equations, incorporating different models (concurrent, delayed, combined, and reverse causation), were used to determine this association. No association between cow's milk consumption and childhood asthma was found for the concurrent effects model (OR = 0.81, 95% confidence interval [CI]: 0.55, 1.20). In the delayed effects model, the direction of the association varied with time of follow-up. Thus, we stratified by period, which resulted in a significant protective delayed effect at 36 months (OR = 0.18, 95% CI = 0.06, 0.49). However, reverse causation negated this finding since the presence of asthma in prior months led to a reduction in further exposure to cow's milk (OR = 0.40, 95% CI = 0.16, 0.99). Hence, cow's milk consumption does not protect against childhood asthma. The apparent protection of cow's milk against asthma may result from parents of asthmatic children avoiding cow's milk, rather than actual prophylaxis.
asthma, cow's milk, children, reverse causation, epidemiology
0277-0903
99-105
Fussman, Chris
82b445cf-6328-4a5c-bc1e-11919c819cdb
Todem, David
f808c9b2-209a-4cea-809f-b9e3b94551c6
Forster, Johannes
b0a29055-a587-430c-b2eb-a33e3697ba47
Arshad, Hassan
c3f407a3-0954-4315-b28e-ba34e666a523
Urbanek, Radvan
b839c6d1-bb7d-4e82-805a-8e1e45e747a3
Karmaus, Wilfried
281d0e53-6b5d-4d38-9732-3981b07cd853
Fussman, Chris
82b445cf-6328-4a5c-bc1e-11919c819cdb
Todem, David
f808c9b2-209a-4cea-809f-b9e3b94551c6
Forster, Johannes
b0a29055-a587-430c-b2eb-a33e3697ba47
Arshad, Hassan
c3f407a3-0954-4315-b28e-ba34e666a523
Urbanek, Radvan
b839c6d1-bb7d-4e82-805a-8e1e45e747a3
Karmaus, Wilfried
281d0e53-6b5d-4d38-9732-3981b07cd853

Fussman, Chris, Todem, David, Forster, Johannes, Arshad, Hassan, Urbanek, Radvan and Karmaus, Wilfried (2007) Cow's milk exposure and asthma in a newborn cohort: repeated ascertainment indicates reverse causation. Journal of Asthma, 44 (2), 99-105. (doi:10.1080/02770900601180669).

Record type: Article

Abstract

The effect of cow's milk consumption on childhood asthma has been debated for several years. This study attempts to provide further insight into this association through the use of a longitudinal study design. Newborns from parents with atopic history were recruited from Germany, Austria, and England (n = 696). For five repeated ascertainments, information was collected on cow's milk exposure, incidence of doctor-diagnosed asthma, and confounders. Generalized estimation equations, incorporating different models (concurrent, delayed, combined, and reverse causation), were used to determine this association. No association between cow's milk consumption and childhood asthma was found for the concurrent effects model (OR = 0.81, 95% confidence interval [CI]: 0.55, 1.20). In the delayed effects model, the direction of the association varied with time of follow-up. Thus, we stratified by period, which resulted in a significant protective delayed effect at 36 months (OR = 0.18, 95% CI = 0.06, 0.49). However, reverse causation negated this finding since the presence of asthma in prior months led to a reduction in further exposure to cow's milk (OR = 0.40, 95% CI = 0.16, 0.99). Hence, cow's milk consumption does not protect against childhood asthma. The apparent protection of cow's milk against asthma may result from parents of asthmatic children avoiding cow's milk, rather than actual prophylaxis.

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More information

Published date: March 2007
Keywords: asthma, cow's milk, children, reverse causation, epidemiology

Identifiers

Local EPrints ID: 59301
URI: http://eprints.soton.ac.uk/id/eprint/59301
ISSN: 0277-0903
PURE UUID: 5115cf4b-d469-474a-9af4-58341dc99f02

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Date deposited: 07 Apr 2009
Last modified: 15 Mar 2024 11:15

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Contributors

Author: Chris Fussman
Author: David Todem
Author: Johannes Forster
Author: Hassan Arshad
Author: Radvan Urbanek
Author: Wilfried Karmaus

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