PRIMARY SHORT-TERM AND LONG-TERM PREVENTI ON OF FIRST MANIFESTATIONS OF ALLERGIC DISEASE WITH DIETARY INTERVENTION - A METAANALYSIS WITH A MODERATELY HYDROLYZED INFANT FORMULA

The incidence of atopic symptoms is steadily increasing in modern, ind ustrialized areas worldwide. As much as 30% of the pediatric populatio n is reported to be affected by allergy symptoms, at least temporarily . Therefore, efforts at prevention at the early ages are of paramount importance. As preventive studies are difficult to conduct and all of them suffer from some weaknesses, it is meaningful, than, to evaluate findings of multiple studies which examine the outcome of dietary prev ention measures of atopy during infancy with a similar concept. A meta -analysis was undertaken with the aim of combining the results of 15 c ontrolled prospective trials which measure the effect of exclusive fee ding of a moderately hydrolysed whey formula (pHF), (Nestle H.A.-formu la), on the development of atopic symptoms between 4-6 and 60 months o f age in children on high risk for allergy. Odds ratio with 95% confid ence intervals and statistical methods of meta-analysis (Mantel-Haensz el and Bayesian approach at specific time intervals are reported. The result of this meta-analysis with H.A.-formula indicates at 4-6 months that the proportion of infants developing atopic symptoms during the intervention period when fed on H.A.-formula is only about one-fourth of the proportion to those fed with the standard cow milk formula (OR = 0.25; CT: 0.18 - 0.36). For the 12 months data, the proportion with H.A.-formula is about one-third of the proportion in the cow milk form ula group (OR = 0.2; CT: 0.19 - 0.44), The odds ratios between 12 and 60 months of age still showed a significant influence of the H.A.-form ula. No significant difference was found when the H.A.-group was compa red with the breastfed infants, Breastfeeding or exclusive feeding of a moderately hydrolysed H.A.-formula (pHF) for at least 4-6 months in infants at high risk for the development of allergic disease, decrease s significantly the incidence of early atopic manifestations until 60 months of age and, therefore, can be recommended as a appropriate and in addition cost-efficient early preventive measure in at risk infants .