Diet during pregnancy and infancy and risk of allergic or autoimmune disease: A systematic review and meta-analysis

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Maternal probiotic and fish oil supplementation may reduce risk of eczema and allergic sensitisation to food, respectively."><meta name="keywords" content="pmid:29489823, PMC5830033, doi:10.1371/journal.pmed.1002507, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review, Vanessa Garcia-Larsen, Despo Ierodiakonou, Robert J Boyle, Autoimmune Diseases / epidemiology, Autoimmune Diseases / etiology*, Diet*, Female, Humans, Hypersensitivity / epidemiology, Hypersensitivity / etiology*, Infant, Infant Nutritional Physiological Phenomena*, Infant, Newborn, Maternal Nutritional Physiological Phenomena*, Pregnancy, Prenatal Exposure Delayed Effects / epidemiology, Prenatal Exposure Delayed Effects / etiology, Prenatal Exposure Delayed Effects / immunology*, Risk Factors, PubMed Abstract, NIH, NLM, NCBI, National Institutes of Health, National Center for Biotechnology Information, National Library of Medicine, MEDLINE"><meta name="robots" content="index,nofollow,noarchive"><meta property="og:title" content="Diet during pregnancy and infancy and risk of allergic or autoimmune disease: A systematic review and meta-analysis - PubMed"><meta property="og:url" content="https://pubmed.ncbi.nlm.nih.gov/29489823/"><meta property="og:description" content="Our findings support a relationship between maternal diet and risk of immune-mediated diseases in the child. 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Maternal probiotic and fish oil supplementation may reduce risk of eczema and allergic sensitisation to food, respectively."><meta name="twitter:image" content="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/pubmed-meta-image-v2.jpg">  <link rel="search" type="application/opensearchdescription+xml" href="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/opensearch.xml" title="PubMed search">  <noscript> <link rel="stylesheet" type="text/css" href="https://cdn.ncbi.nlm.nih.gov/pubmed/277eb475-38df-4990-a0ee-0080b04e86fc/core/no-script.css"> </noscript> <meta name="citation_title" content="Diet during pregnancy and infancy and risk of allergic or autoimmune disease: A systematic review and meta-analysis"> <meta name="citation_authors" content="Garcia-Larsen V;Ierodiakonou D;Jarrold K;Cunha S;Chivinge J;Robinson Z;Geoghegan N;Ruparelia A;Devani P;Trivella M;Leonardi-Bee J;Boyle RJ;"> <meta name="citation_date" content="02/28/2018"> <meta name="citation_publisher" content="PLoS Med"> <meta name="citation_journal_title" content="PLoS medicine"> <meta name="citation_pmid" content="29489823"> <meta name="citation_abstract_html_url" content="https://pubmed.ncbi.nlm.nih.gov/29489823/"> <meta name="citation_volume" content="15"> <meta name="citation_issue" content="2"> <meta name="citation_doi" content="10.1371/journal.pmed.1002507"> <meta name="citation_issn" content="1549-1676"> <link rel="canonical" href="https://pubmed.ncbi.nlm.nih.gov/29489823/" /> </head> <body > <noscript> <div class="no-script-banner" id="no-script-banner"> <div class="warning-message"> <div class="warning-message-text"> This site needs JavaScript to work properly. 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new collection</label> </li> <li> <input type="radio" id="collections-action-panel-existing" class="collections-existing" name="collections" value="existing" checked="true" data-ga-category="save_share" data-ga-action="collections" data-ga-label="collections_radio_existing"> <label for="collections-action-panel-existing">Add to an existing collection</label> </li> </ul> </div> <div class="controls-wrapper"> <div class="action-panel-control-wrap new-collections-controls"> <label for="collections-action-panel-add-to-new" class="action-panel-label required-field-asterisk"> Name your collection: </label> <input type="text" name="add-to-new-collection" id="collections-action-panel-add-to-new" class="collections-action-add-to-new" pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/" maxlength="100" data-ga-category="save_share" data-ga-action="create_collection" data-ga-label="non_favorties_collection"> <div class="collections-new-name-too-long usa-input-error-message selection-validation-message"> Name must be less than 100 characters </div> </div> <div class="action-panel-control-wrap existing-collections-controls"> <label for="collections-action-panel-add-to-existing" class="action-panel-label"> Choose a collection: </label> <select id="collections-action-panel-add-to-existing" class="action-panel-selector collections-action-add-to-existing" data-ga-category="save_share" data-ga-action="select_collection" data-ga-label="($('#collections-action-add-to-existing').val() === 'Favorites') ? 'Favorites' : 'non_favorites_collection'"> </select> <div class="collections-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your collection due to an error<br> <a href="#">Please try again</a> </div> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore data-ga-category="save_share" data-ga-action="collections" data-ga-label="add"> Add </button> <button class="action-panel-cancel" aria-label="Close 'Add to Collections' panel" ref="linksrc=close_collections_panel" aria-controls="collections-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="collections" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="bibliography-action-panel" class="bibliography-action-panel action-panel in-progress-dots-panel" aria-hidden="true" data-bibliography-open-panel-enabled="false" data-bibliography-open-panel-url-hash="#open-bibliography-panel"> <div class="inner-wrap"> <h3 class="action-panel-heading"> Add to My Bibliography </h3> <form id="bibliography-action-panel-form" class="bibliography-action-panel-form action-panel-content action-form action-panel-smaller-selectors" data-add-to-bibliography-max-amount="100" data-add-to-bibliography-batch-size="10" data-bibliography-delegates-url="/list-bibliography-delegates/" data-add-to-bibliography-url="/add-to-bibliography/" data-get-article-ids-by-search-url="/get-article-ids-by-search/" data-mybib-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/mybibliography/"> <input type="hidden" name="csrfmiddlewaretoken" value="VqRYAgLtqim4MRjUHdk8YWgStH1qlcj8MOvX63ANtKwCW2KwWKayxC47FbeMj0pY"> <div class="action-panel-control-wrap bibliographies-controls"> <div class="choice-group"> <ul class="bibliographies-action-add radio-group-items"> <li> <input name="bibliography" id="my-bibliography" class="my-bibliography" type="radio" checked/> <label for="my-bibliography">My Bibliography</label> </li> </ul> </div> </div> <div class="bibliographies-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your delegates due to an error<br> <a href="#">Please try again</a> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore> Add </button> <button class="action-panel-cancel" aria-label="Close 'Add to bibliography' panel" ref="linksrc=close_bibliography_panel" aria-controls="bibliography-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="mybib" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="saved-search-action-panel" class="saved-search-action-panel action-panel " aria-hidden="true" data-saved-search-open-panel-enabled="false" data-saved-search-open-panel-url-hash="#open-saved-search-panel"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Your saved search </h2> <form id="saved-search-action-panel-form" class="saved-search-action-panel-form action-panel-content action-form" data-create-saved-search-url="/create-saved-search/" data-try-search-terms-url="/try-search-term/" data-saved-search-root-url="https://www.ncbi.nlm.nih.gov/myncbi/searches/"> <input type="hidden" name="csrfmiddlewaretoken" value="VqRYAgLtqim4MRjUHdk8YWgStH1qlcj8MOvX63ANtKwCW2KwWKayxC47FbeMj0pY"> <div class="action-panel-control-wrap"> <label for="saved-search-name" class="action-panel-label saved-search-name-label required-field-asterisk"> Name of saved search: </label> <input maxlength="200" type="text" name="saved-search-name" id="saved-search-name" class="saved-search-name" value="" required pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/"> </div> <div class="action-panel-control-wrap"> <label for="saved-search-term" class="action-panel-label required-field-asterisk"> Search terms: </label> <textarea name="saved-search-term" id="saved-search-term" class="saved-search-term" required></textarea> </div> <div class="test-search-term-wrap"> <a href="#" class="try-search-term">Test search terms</a> </div> <div class="choice-group action-panel-extra-margin-top"> <span class="action-panel-label" id="fieldset-label"> Would you like email updates of new search results? </span> <fieldset id="saved-search-alert" aria-describedby="fieldset-label"> <legend class="usa-sr-only">Saved Search Alert Radio Buttons</legend> <ul class="radio-group-items"> <li> <input type="radio" id="saved-search-alert-yes" class="saved-search-alert-yes" name="saved-search-alert" value="yes" checked> <label for="saved-search-alert-yes" class="action-panel-label">Yes</label> </li> <li> <input aria-label="No radio input" type="radio" id="saved-search-alert-no" class="saved-search-alert-no" name="saved-search-alert" value="no"> <label for="saved-search-alert-no" class="action-panel-label">No</label> </li> </ul> </fieldset> </div> <div class="alert-schedule-wrap"> <div class="action-panel-control-wrap"> <label class="action-panel-label"> Email: </label> <span aria-label="Email address" id="saved-search-email" class="action-panel-label"><span class="action-panel-label-bold"></span> (<a class="myncbi-account-settings" href="https://www.ncbi.nlm.nih.gov/account/settings/">change</a>)</span> </div> <div class="action-panel-control-wrap action-panel-extra-margin-top"> <label for="saved-search-frequency" class="action-panel-label"> Frequency: </label> <select id="saved-search-frequency" class="no-border-panel-selector saved-search-frequency"> <option value="monthly">Monthly</option> <option value="weekly">Weekly</option> <option value="daily">Daily</option> </select> </div> <div class="action-panel-control-wrap saved-search-monthly-additional"> <label for="saved-search-monthly-on-day" class="action-panel-label"> Which day? </label> <select id="saved-search-monthly-on-day" class="no-border-panel-selector"> <option value="Sunday">The first Sunday</option> <option value="Monday">The first Monday</option> <option value="Tuesday">The first Tuesday</option> <option value="Wednesday">The first Wednesday</option> <option value="Thursday">The first Thursday</option> <option value="Friday">The first Friday</option> <option value="Saturday">The first Saturday</option> <option value="day">The first day</option> <option value="weekday">The first weekday</option> </select> </div> <div class="action-panel-control-wrap saved-search-weekly-additional"> <label for="saved-search-weekly-on-day" class="action-panel-label"> Which day? </label> <select id="saved-search-weekly-on-day" class="no-border-panel-selector saved-search-weekly-on-day"> <option value="Sunday">Sunday</option> <option value="Monday">Monday</option> <option value="Tuesday">Tuesday</option> <option value="Wednesday">Wednesday</option> <option value="Thursday">Thursday</option> <option value="Friday">Friday</option> <option value="Saturday">Saturday</option> </select> </div> <div class="action-panel-control-wrap"> <label for="saved-search-report" class="action-panel-label"> Report format: </label> <select id="saved-search-report" class="no-border-panel-selector saved-search-report"> <option value="DocSum">Summary</option> <option value="DocSumText">Summary (text)</option> <option value="Abstract">Abstract</option> <option value="AbstractText">Abstract (text)</option> <option value="MEDLINE">PubMed</option> </select> </div> <div class="action-panel-control-wrap"> <label for="saved-search-amount" class="action-panel-label"> Send at most: </label> <select id="saved-search-amount" class="no-border-panel-selector saved-search-amount"> <option value="1">1 item</option> <option value="5" selected>5 items</option> <option value="10">10 items</option> <option value="20">20 items</option> <option value="50">50 items</option> <option value="100">100 items</option> <option value="200">200 items</option> </select> </div> <div> <input type="checkbox" id="saved-search-send-if-no-result" class="saved-search-send-if-no-result" name="saved-search-send-if-no-result"> <label for="saved-search-send-if-no-result" class="action-panel-label smaller-checkbox"> Send even when there aren't any new results </label> </div> <div class="action-panel-control-wrap option-text-in-email-wrap"> <label for="saved-search-email-text" class="action-panel-label"> Optional text in email: </label> <textarea name="saved-search-email-text" id="saved-search-email-text" class="saved-search-email-text"></textarea> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Saving..." data-ga-category="save_share" data-ga-action="alert" data-ga-label="save"> Save </button> <button class="action-panel-cancel" aria-label="Close 'Your saved search' panel" ref="linksrc=close_saved_search_panel" aria-controls="saved-search-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="alert" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="citation-manager-action-panel" class="citation-manager-action-panel action-panel" aria-hidden="true"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Create a file for external citation management software </h2> <form id="citation-manager-action-panel-form" class="action-panel-content action-form" action="/results-export-ids/" data-by-search-action="/results-export-search-data/" data-by-ids-action="/results-export-ids/" method="post" data-by-search-method="post" data-by-ids-method="post"> <input type="hidden" name="csrfmiddlewaretoken" value="VqRYAgLtqim4MRjUHdk8YWgStH1qlcj8MOvX63ANtKwCW2KwWKayxC47FbeMj0pY"> <input name="results-format" type="hidden" value="pubmed"/> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Sending..." data-ga-category="save_share" data-ga-action="citation_manager" data-ga-label="save"> Create file </button> <button class="action-panel-cancel" aria-label="Close 'Send citations to citation manager' panel" ref="linksrc=close_citation_manager_panel" aria-controls="citation-manager-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="citation_manager" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="rss-action-panel" class="rss-action-panel action-panel " aria-hidden="true"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Your RSS Feed </h2> <form id="rss-action-panel-form" class="rss-action-panel-form action-panel-content action-form" data-create-rss-feed-url="/create-rss-feed-url/" data-search-form-term-value=""> <input type="hidden" name="csrfmiddlewaretoken" value="VqRYAgLtqim4MRjUHdk8YWgStH1qlcj8MOvX63ANtKwCW2KwWKayxC47FbeMj0pY"> <div class="action-panel-control-wrap"> <label for="rss-name" class="action-panel-label required-field-asterisk"> Name of RSS Feed: </label> <input maxlength="200" placeholder="Name" type="text" name="rss-name" id="rss-name" class="rss-name" value='' required pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/"> </div> <div class="rss-limit-wrap"> <div class="action-panel-control-wrap action-panel-extra-margin-top"> <label for="rss-limit" class="action-panel-label"> Number of items displayed: </label> <select id="rss-limit" class="no-border-panel-selector rss-limit"> <option value="5">5</option> <option value="10">10</option> <option value="15" selected="selected">15</option> <option value="20">20</option> <option value="50">50</option> <option value="100">100</option> </select> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Creating..." data-ga-category="save_share" data-ga-action="alert" data-ga-label="save"> Create RSS </button> <button class="action-panel-cancel" aria-label="Close 'Your RSS' panel" ref="linksrc=close_rss_panel" aria-controls="rss-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="alert" data-ga-label="cancel"> Cancel </button> </div> <div class="action-panel-control-wrap rss-link-copy-wrap"> <label for="rss-link" class="usa-sr-only">RSS Link</label> <input placeholder="Your RSS Feed Link" type="text" name="rss-link" id="rss-link" class="rss-link" title="RSS Link"> <button type="button" disabled class="rss-link-copy-button disabled" data-ga-category="save_share" data-ga-action="rss" data-ga-label="copy"> Copy </button> </div> </form> </div> </div> </div> </div> <div class="article-page" id="article-page" data-article-pmid="29489823"> <aside class="page-sidebar"> <div class="inner-wrap"> <div class="full-text-links"> <div class="full-view"> <h3 class="title"> Full text links </h3> <div class="full-text-links-list"> <a class="link-item dialog-focus" href="https://dx.plos.org/10.1371/journal.pmed.1002507" target="_blank" rel="noopener" ref="linksrc=fulltextorjournal_fulltext&is_pmc=False&PrId=4656&itool=Abstract-def&log$=linkouticon&uid=29489823&db=pubmed&nlmid=101231360" title="See full text options at Public Library of Science" data-ga-category="full_text" data-ga-action="Public Library of Science" data-ga-label="29489823" ><img src="https://cdn.ncbi.nlm.nih.gov/corehtml/query/egifs/https:--journals.plos.org-resource-img-external-pmed_120x30.png" alt="Public Library of Science full text link"><span class="text"> Public Library of Science </span></a><a class="link-item pmc " href="https://pmc.ncbi.nlm.nih.gov/articles/pmid/29489823/" target="_blank" rel="noopener" ref="linksrc=fulltextorjournal_fulltext&is_pmc=True&PrId=3494&itool=Abstract-def&log$=linkouticon&uid=29489823&db=pubmed&nlmid=101231360" title="Free full text at PubMed Central" data-ga-category="full_text" data-ga-action="PMC" data-ga-label="29489823" ><span 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data-collections-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/"><input type="hidden" name="csrfmiddlewaretoken" value="VqRYAgLtqim4MRjUHdk8YWgStH1qlcj8MOvX63ANtKwCW2KwWKayxC47FbeMj0pY"><div class="choice-group" role="radiogroup"><ul class="radio-group-items"><li><input type="radio" id="collections-action-dialog-new" class="collections-new" name="collections" value="new" data-ga-category="collections_button" data-ga-action="click" data-ga-label="collections_radio_new"><label for="collections-action-dialog-new">Create a new collection</label></li><li><input type="radio" id="collections-action-dialog-existing" class="collections-existing" name="collections" value="existing" checked="true" data-ga-category="collections_button" data-ga-action="click" data-ga-label="collections_radio_existing"><label for="collections-action-dialog-existing">Add to an existing collection</label></li></ul></div><div class="controls-wrapper"><div class="action-panel-control-wrap new-collections-controls"><label for="collections-action-dialog-add-to-new" class="action-panel-label required-field-asterisk"> Name your collection: </label><input type="text" name="add-to-new-collection" id="collections-action-dialog-add-to-new" class="collections-action-add-to-new" pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/" maxlength="100" data-ga-category="collections_button" data-ga-action="create_collection" data-ga-label="non_favorties_collection"><div class="collections-new-name-too-long usa-input-error-message selection-validation-message"> Name must be less than 100 characters </div></div><div class="action-panel-control-wrap existing-collections-controls"><label for="collections-action-dialog-add-to-existing" class="action-panel-label"> Choose a collection: </label><select id="collections-action-dialog-add-to-existing" class="action-panel-selector collections-action-add-to-existing" data-ga-category="collections_button" data-ga-action="select_collection" data-ga-label="($('.collections-action-add-to-existing').val() === 'Favorites') ? 'Favorites' : 'non_favorites_collection'"></select><div class="collections-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your collection due to an error<br><a href="#">Please try again</a></div></div></div><div class="action-panel-actions"><button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore data-ga-category="collections_button" data-ga-action="click" data-ga-label="add"> Add </button><button class="action-panel-cancel" aria-label="Close 'Add to Collections' panel" ref="linksrc=close_collections_panel" aria-controls="collections-action-panel" aria-expanded="false" data-ga-category="collections_button" data-ga-action="click" data-ga-label="cancel"> Cancel </button></div></form></div></div></div></div><button class="more-actions-button more-actions-dialog-trigger" title="Open dialog with more actions to take" ref="linksrc=more_actions_btn"></button><div class="display-options" 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data-ga-label="PLoS Med"> Search in NLM Catalog </a></li><li><a class="add-to-search-link dropdown-block-link" ref ="linksrc=add_to_search_link" role="button" data-search-term='"PLoS Med"[jour]' data-ga-category="search" data-ga-action="add_to_search" data-ga-label='"PLoS Med"[jour]' href="#"> Add to Search </a></li></ul></div></div></div><span class="period">. </span><span class="cit">2018 Feb 28;15(2):e1002507.</span> </div> <span class="citation-doi"> doi: 10.1371/journal.pmed.1002507. </span> <span class="secondary-date"> eCollection 2018 Feb. </span> </div> <h1 class="heading-title"> Diet during pregnancy and infancy and risk of allergic or autoimmune disease: A systematic review and meta-analysis </h1> <div class="inline-authors"> <div class="authors"> <div class="authors-list"> <span class="authors-list-item "><a class="full-name" href="/?term=Garcia-Larsen+V&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Vanessa Garcia-Larsen">Vanessa Garcia-Larsen</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Ierodiakonou+D&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Despo Ierodiakonou">Despo Ierodiakonou</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom." href="#full-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Jarrold+K&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Katharine Jarrold">Katharine Jarrold</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom." href="#full-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Cunha+S&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Sergio Cunha">Sergio Cunha</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Chivinge+J&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Jennifer Chivinge">Jennifer Chivinge</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom." href="#full-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Robinson+Z&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Zoe Robinson">Zoe Robinson</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom." href="#full-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Geoghegan+N&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Natalie Geoghegan">Natalie Geoghegan</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom." href="#full-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Ruparelia+A&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Alisha Ruparelia">Alisha Ruparelia</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom." href="#full-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Devani+P&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Pooja Devani">Pooja Devani</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom." href="#full-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Trivella+M&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Marialena Trivella">Marialena Trivella</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom." href="#full-view-affiliation-4" ref="linksrc=author_aff"> 4 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Leonardi-Bee+J&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Jo Leonardi-Bee">Jo Leonardi-Bee</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom." href="#full-view-affiliation-5" ref="linksrc=author_aff"> 5 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Boyle+RJ&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Robert J Boyle">Robert J Boyle</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom." href="#full-view-affiliation-3" ref="linksrc=author_aff"> 3 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, United Kingdom." href="#full-view-affiliation-6" ref="linksrc=author_aff"> 6 </a></sup></span> </div> </div> </div> <div class="short-article-details"> Affiliations <button class="more-details" id="toggle-authors" data-alt-text="Collapse" aria-controls="expanded-authors" aria-expanded="false" data-pinger-ignore data-fetch-url="/29489823/long-authors/" data-id-prefix=""> <span class="title"> Expand </span> </button> </div> <div class="extended-article-details" id="expanded-authors" aria-hidden="true"> <div class="expanded-authors" id="full-view-expanded-authors"> <div class="affiliations"> <h3 class="title"> Affiliations </h3> <ul class="item-list"> <li data-affiliation-id="full-view-affiliation-1" id="full-view-affiliation-1" ><sup class="key">1</sup> Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America.</li> <li data-affiliation-id="full-view-affiliation-2" id="full-view-affiliation-2" ><sup class="key">2</sup> Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom.</li> <li data-affiliation-id="full-view-affiliation-3" id="full-view-affiliation-3" ><sup class="key">3</sup> Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom.</li> <li data-affiliation-id="full-view-affiliation-4" id="full-view-affiliation-4" ><sup class="key">4</sup> Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom.</li> <li data-affiliation-id="full-view-affiliation-5" id="full-view-affiliation-5" ><sup class="key">5</sup> Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom.</li> <li data-affiliation-id="full-view-affiliation-6" id="full-view-affiliation-6" ><sup class="key">6</sup> Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, United Kingdom.</li> </ul> </div> </div> </div> <ul class="identifiers" id="full-view-identifiers"> <li> <span class="identifier pubmed"> <span class="id-label"> PMID: </span> <strong class="current-id" title="PubMed ID">29489823</strong> </span> </li> <li> <span class="identifier pmc"> <span class="id-label"> PMCID: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=PMC5830033&id_type=PMC" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5830033/" data-ga-category="full_text" data-ga-action="PMCID" > PMC5830033 </a> </span> </li> <li> <span class="identifier doi"> <span class="id-label"> DOI: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=10.1371/journal.pmed.1002507&id_type=DOI" href="https://doi.org/10.1371/journal.pmed.1002507" data-ga-category="full_text" data-ga-action="DOI" > 10.1371/journal.pmed.1002507 </a> </span> </li> </ul> <div class="in-clipboard-label " hidden> Item in Clipboard </div> </div> <div class="short-view" id="short-view-heading"> <div class="publication-type" >Meta-Analysis</div> <h1 class="heading-title"> Diet during pregnancy and infancy and risk of allergic or autoimmune disease: A systematic review and meta-analysis </h1> <div class="short-citation"> <span class="authors-list"> <span class="authors-list-item "><span class="full-name">Vanessa Garcia-Larsen</span><span class="citation-separator"> et al.</span></span> </span> <span class="citation-journal"> PLoS Med<span class="citation-separator">.</span> </span> <span class="date"> <time class="citation-year" datetime="2018">2018</time><span class="citation-separator">.</span> </span> </div> <div class="more-article-details-section with-display-settings"> <button 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</span> </div> <div class="expanded-authors" id="short-view-expanded-authors"> <div class="authors"> <h3 class="title"> Authors </h3> <div class="authors-list"> <span class="authors-list-item "><a class="full-name" href="/?term=Garcia-Larsen+V&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Vanessa Garcia-Larsen">Vanessa Garcia-Larsen</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Ierodiakonou+D&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Despo Ierodiakonou">Despo Ierodiakonou</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom." href="#short-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Jarrold+K&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Katharine Jarrold">Katharine Jarrold</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom." href="#short-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Cunha+S&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Sergio Cunha">Sergio Cunha</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Chivinge+J&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Jennifer Chivinge">Jennifer Chivinge</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom." href="#short-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Robinson+Z&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Zoe Robinson">Zoe Robinson</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom." href="#short-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Geoghegan+N&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Natalie Geoghegan">Natalie Geoghegan</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom." href="#short-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Ruparelia+A&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Alisha Ruparelia">Alisha Ruparelia</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom." href="#short-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Devani+P&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Pooja Devani">Pooja Devani</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom." href="#short-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Trivella+M&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Marialena Trivella">Marialena Trivella</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom." href="#short-view-affiliation-4" ref="linksrc=author_aff"> 4 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Leonardi-Bee+J&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Jo Leonardi-Bee">Jo Leonardi-Bee</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom." href="#short-view-affiliation-5" ref="linksrc=author_aff"> 5 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Boyle+RJ&cauthor_id=29489823" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Robert J Boyle">Robert J Boyle</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom." href="#short-view-affiliation-3" ref="linksrc=author_aff"> 3 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, United Kingdom." href="#short-view-affiliation-6" ref="linksrc=author_aff"> 6 </a></sup></span> </div> </div> <div class="affiliations"> <h3 class="title"> Affiliations </h3> <ul class="item-list"> <li data-affiliation-id="short-view-affiliation-1" id="short-view-affiliation-1" ><sup class="key">1</sup> Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America.</li> <li data-affiliation-id="short-view-affiliation-2" id="short-view-affiliation-2" ><sup class="key">2</sup> Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom.</li> <li data-affiliation-id="short-view-affiliation-3" id="short-view-affiliation-3" ><sup class="key">3</sup> Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom.</li> <li data-affiliation-id="short-view-affiliation-4" id="short-view-affiliation-4" ><sup class="key">4</sup> Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom.</li> <li data-affiliation-id="short-view-affiliation-5" id="short-view-affiliation-5" ><sup class="key">5</sup> Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom.</li> <li data-affiliation-id="short-view-affiliation-6" id="short-view-affiliation-6" ><sup class="key">6</sup> Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, United Kingdom.</li> </ul> </div> </div> <ul class="identifiers" id="short-view-identifiers"> <li> <span class="identifier pubmed"> <span class="id-label"> PMID: </span> <strong class="current-id" title="PubMed ID">29489823</strong> </span> </li> <li> <span class="identifier pmc"> <span class="id-label"> PMCID: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=PMC5830033&id_type=PMC" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5830033/" data-ga-category="full_text" data-ga-action="PMCID" > PMC5830033 </a> </span> </li> <li> <span class="identifier doi"> <span class="id-label"> DOI: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=10.1371/journal.pmed.1002507&id_type=DOI" href="https://doi.org/10.1371/journal.pmed.1002507" data-ga-category="full_text" data-ga-action="DOI" > 10.1371/journal.pmed.1002507 </a> </span> </li> </ul> <div class="in-clipboard-label " hidden> Item in Clipboard </div> </div> </div> </header> <div class="actions-buttons inline"><div class="inner-wrap"><button class="full-text-links-button full-text-links-dialog-trigger" title="Open dialog with full text links" ref="linksrc=full_text_links"> Full text links </button><button class="citation-button citation-dialog-trigger" aria-label="Open dialog with citation text in different styles" data-ga-category="save_share" data-ga-action="cite" data-ga-label="open" data-all-citations-url="/29489823/citations/" data-citation-style="nlm" data-pubmed-format-link="/29489823/export/"><span class="button-label">Cite</span></button><button class="more-actions-button more-actions-dialog-trigger" title="Open dialog with more actions to take" ref="linksrc=more_actions_btn"></button><div class="display-options" data-format-key="format" data-default-format-value="abstract" data-current-format-value="abstract" role="region"><button class="trigger usa-button" title="Change format" data-ga-category="display_options" data-ga-action="display_options_dialog"><span class="button-label">Display options</span></button><div class="dropdown" hidden><div class="title"> Display options </div><div class="content"><div class="format-container"><span class="option-label"> Format </span><select name="format" data-initial-value="abstract" aria-label="Display format" id="inline-actions-display-format"><option value="abstract">Abstract</option><option value="pubmed">PubMed</option><option value="pmid">PMID</option></select></div></div></div></div></div></div> <div class="abstract" id="abstract"> <h2 class="title"> Abstract </h2> <div class="abstract-content selected" id="eng-abstract"> <p> <strong class="sub-title"> Background: </strong> There is uncertainty about the influence of diet during pregnancy and infancy on a child's immune development. We assessed whether variations in maternal or infant diet can influence risk of allergic or autoimmune disease. </p> <p> <strong class="sub-title"> Methods and findings: </strong> Two authors selected studies, extracted data, and assessed risk of bias. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess certainty of findings. We searched Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica dataBASE (EMBASE), Web of Science, Central Register of Controlled Trials (CENTRAL), and Literatura Latino Americana em Ciências da Saúde (LILACS) between January 1946 and July 2013 for observational studies and until December 2017 for intervention studies that evaluated the relationship between diet during pregnancy, lactation, or the first year of life and future risk of allergic or autoimmune disease. We identified 260 original studies (964,143 participants) of milk feeding, including 1 intervention trial of breastfeeding promotion, and 173 original studies (542,672 participants) of other maternal or infant dietary exposures, including 80 trials of maternal (n = 26), infant (n = 32), or combined (n = 22) interventions. Risk of bias was high in 125 (48%) milk feeding studies and 44 (25%) studies of other dietary exposures. Evidence from 19 intervention trials suggests that oral supplementation with nonpathogenic micro-organisms (probiotics) during late pregnancy and lactation may reduce risk of eczema (Risk Ratio [RR] 0.78; 95% CI 0.68-0.90; I2 = 61%; Absolute Risk Reduction 44 cases per 1,000; 95% CI 20-64), and 6 trials suggest that fish oil supplementation during pregnancy and lactation may reduce risk of allergic sensitisation to egg (RR 0.69, 95% CI 0.53-0.90; I2 = 15%; Absolute Risk Reduction 31 cases per 1,000; 95% CI 10-47). GRADE certainty of these findings was moderate. We found weaker support for the hypotheses that breastfeeding promotion reduces risk of eczema during infancy (1 intervention trial), that longer exclusive breastfeeding is associated with reduced type 1 diabetes mellitus (28 observational studies), and that probiotics reduce risk of allergic sensitisation to cow's milk (9 intervention trials), where GRADE certainty of findings was low. We did not find that other dietary exposures-including prebiotic supplements, maternal allergenic food avoidance, and vitamin, mineral, fruit, and vegetable intake-influence risk of allergic or autoimmune disease. For many dietary exposures, data were inconclusive or inconsistent, such that we were unable to exclude the possibility of important beneficial or harmful effects. In this comprehensive systematic review, we were not able to include more recent observational studies or verify data via direct contact with authors, and we did not evaluate measures of food diversity during infancy. </p> <p> <strong class="sub-title"> Conclusions: </strong> Our findings support a relationship between maternal diet and risk of immune-mediated diseases in the child. Maternal probiotic and fish oil supplementation may reduce risk of eczema and allergic sensitisation to food, respectively. </p> </div> </div> <p class="disclaimer" id="disclaimer"> <a href="/disclaimer/" target="_blank" data-ga-category="literature_resources" data-ga-action="disclaimer_link" data-ga-label="under_abstract">PubMed Disclaimer</a> </p> <div class="conflict-of-interest" id="conflict-of-interest"> <h2 class="title"> Conflict of interest statement </h2> <div class="statement"> <p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">I have read the journal's policy and the authors of this manuscript have the following competing interests: RJB, VGL, JLB, SC, and DI received support from the UK Food Standards Agency for the submitted work. MT received a consultation fee from the UK Food Standards Agency for methodological work on this systematic review. No other support was received from any organisation for the submitted work. The authors have no financial relationships with any organisations that might have an interest in the submitted work in the previous three years. RJB was a co-investigator and author of two of the trials included in this systematic review. The authors report no other relationships or activities that could appear to have influenced the submitted work.</p> </div> </div> <div class="figures" id="figures"> <h2 class="title"> Figures </h2> <div class="figures-list" id="slides-container" itemscope itemtype="http://schema.org/ImageGallery"> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="0" data-label-slug="fig-1"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/ed8f075d6228/pmed.1002507.g001.jpg" itemprop="contentUrl" aria-describedby="figure-caption-0" role="button" data-image-width="615" data-image-height="422" data-image-alt="Fig 1" data-pmc-id="PMC5830033" data-figure-id="pmed.1002507.g001"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-0" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/af1d106e058d/pmed.1002507.g001.gif" alt="Fig 1" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="615"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="422"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> Fig 1. PRISMA flow chart. </p> </strong> <div class="figure-caption-contents"><p> CENTRAL, Central… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> Fig 1. PRISMA flow chart. </p> </strong> <div class="figure-caption-contents"><p> CENTRAL, Central Register of Controlled Trials; EMBASE, Excerpta Medica dataBASE;… </p></div> </div> <figcaption id="figure-caption-0" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> Fig 1. PRISMA flow chart. </strong> <div class="figure-caption-contents">CENTRAL, Central Register of Controlled Trials; EMBASE, Excerpta Medica dataBASE; LILACS, Literatura Latino Americana em Ciências da Saúde; MEDLINE, Medical Literature Analysis and Retrieval System Online.</div> </figcaption> </figure> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="1" data-label-slug="fig-2"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/4ac466c79770/pmed.1002507.g002.jpg" itemprop="contentUrl" aria-describedby="figure-caption-1" role="button" data-image-width="709" data-image-height="358" data-image-alt="Fig 2" data-pmc-id="PMC5830033" data-figure-id="pmed.1002507.g002"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-1" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/160446aa6d08/pmed.1002507.g002.gif" alt="Fig 2" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="709"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="358"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> Fig 2 </p> </strong> <div class="figure-caption-contents"><p> Observational study findings for a… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> Fig 2 </p> </strong> <div class="figure-caption-contents"><p> Observational study findings for a relationship between breastfeeding ever and recurrent wheeze at… </p></div> </div> <figcaption id="figure-caption-1" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> Fig 2 </strong> <div class="figure-caption-contents">Observational study findings for a relationship between breastfeeding ever and recurrent wheeze at age 5–14 years (A) and a Funnel plot for this analysis showing evidence of publication bias (B). Egger test <i>P</i> = 0.012. CI, confidence interval; OR, odds ratio; W, weight.</div> </figcaption> </figure> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="2" data-label-slug="fig-3"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/4189738e9bc6/pmed.1002507.g003.jpg" itemprop="contentUrl" aria-describedby="figure-caption-2" role="button" data-image-width="782" data-image-height="528" data-image-alt="Fig 3" data-pmc-id="PMC5830033" data-figure-id="pmed.1002507.g003"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-2" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/ecdd821110c8/pmed.1002507.g003.gif" alt="Fig 3" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="782"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="528"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> Fig 3 </p> </strong> <div class="figure-caption-contents"><p> Observational study findings for a… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> Fig 3 </p> </strong> <div class="figure-caption-contents"><p> Observational study findings for a relationship between breastfeeding ever (A) or exclusive breastfeeding… </p></div> </div> <figcaption id="figure-caption-2" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> Fig 3 </strong> <div class="figure-caption-contents">Observational study findings for a relationship between breastfeeding ever (A) or exclusive breastfeeding for ≥3–4 months (B) and type 1 diabetes mellitus. CI, confidence interval; OR, odds ratio; W, weight.</div> </figcaption> </figure> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="3" data-label-slug="fig-4"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/cbc27311f0fa/pmed.1002507.g004.jpg" itemprop="contentUrl" aria-describedby="figure-caption-3" role="button" data-image-width="733" data-image-height="237" data-image-alt="Fig 4" data-pmc-id="PMC5830033" data-figure-id="pmed.1002507.g004"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-3" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/1bcddd42bc35/pmed.1002507.g004.gif" alt="Fig 4" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="733"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="237"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> Fig 4 </p> </strong> <div class="figure-caption-contents"><p> RCT findings for probiotic supplementation… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> Fig 4 </p> </strong> <div class="figure-caption-contents"><p> RCT findings for probiotic supplementation compared with no probiotics and risk of eczema… </p></div> </div> <figcaption id="figure-caption-3" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> Fig 4 </strong> <div class="figure-caption-contents">RCT findings for probiotic supplementation compared with no probiotics and risk of eczema (A) or atopic eczema (B) at age ≤4 years. CI, confidence interval; RCT, randomised controlled trial; RR, risk ratio; W, weight.</div> </figcaption> </figure> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="4" data-label-slug="fig-5"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/299dfe057777/pmed.1002507.g005.jpg" itemprop="contentUrl" aria-describedby="figure-caption-4" role="button" data-image-width="793" data-image-height="267" data-image-alt="Fig 5" data-pmc-id="PMC5830033" data-figure-id="pmed.1002507.g005"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-4" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/9d62e440a2d1/pmed.1002507.g005.gif" alt="Fig 5" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="793"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="267"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> Fig 5 </p> </strong> <div class="figure-caption-contents"><p> RCT findings for probiotic supplementation… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> Fig 5 </p> </strong> <div class="figure-caption-contents"><p> RCT findings for probiotic supplementation compared with no probiotics and risk of allergic… </p></div> </div> <figcaption id="figure-caption-4" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> Fig 5 </strong> <div class="figure-caption-contents">RCT findings for probiotic supplementation compared with no probiotics and risk of allergic sensitisation to any allergen (A), any inhalant allergen (B), any food allergen (C), egg (D), milk (E), or peanut (F). CI, confidence interval; RCT, randomised controlled trial; RR, risk ratio; W, weight.</div> </figcaption> </figure> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="5" data-label-slug="fig-6"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/18ea0c702d01/pmed.1002507.g006.jpg" itemprop="contentUrl" aria-describedby="figure-caption-5" role="button" data-image-width="792" data-image-height="288" data-image-alt="Fig 6" data-pmc-id="PMC5830033" data-figure-id="pmed.1002507.g006"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-5" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/9593028d69bf/pmed.1002507.g006.gif" alt="Fig 6" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="792"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="288"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> Fig 6. RCT findings for prebiotic supplementation… </p> </strong> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> Fig 6. RCT findings for prebiotic supplementation compared with no prebiotics and risk of eczema… </p> </strong> </div> <figcaption id="figure-caption-5" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> Fig 6. RCT findings for prebiotic supplementation compared with no prebiotics and risk of eczema at age ≤4 years. </strong> <div class="figure-caption-contents">CI, confidence interval; RCT, randomised controlled trial; RR, risk ratio; W, weight.</div> </figcaption> </figure> <figure class="figure-item tail" itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="6" data-label-slug="fig-7"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/a695de96bb1e/pmed.1002507.g007.jpg" itemprop="contentUrl" aria-describedby="figure-caption-6" role="button" data-image-width="738" data-image-height="424" data-image-alt="Fig 7" data-pmc-id="PMC5830033" data-figure-id="pmed.1002507.g007"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-6" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/791a68a81e26/pmed.1002507.g007.gif" alt="Fig 7" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="738"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="424"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> Fig 7 </p> </strong> <div class="figure-caption-contents"><p> RCT findings for omega-3 polyunsaturated… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> Fig 7 </p> </strong> <div class="figure-caption-contents"><p> RCT findings for omega-3 polyunsaturated fatty acid supplementation compared with no polyunsaturated fatty… </p></div> </div> <figcaption id="figure-caption-6" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> Fig 7 </strong> <div class="figure-caption-contents">RCT findings for omega-3 polyunsaturated fatty acid supplementation compared with no polyunsaturated fatty acids and risk of allergic sensitisation to any allergen (A), any inhalant allergen (B), any food allergen (C), milk (D), egg (E), or peanut (F). CI, confidence interval; RCT, randomised controlled trial; RR, risk ratio; W, weight.</div> </figcaption> </figure> <figure class="figure-item tail" itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="7" data-label-slug="fig-8"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/908033dd5207/pmed.1002507.g008.jpg" itemprop="contentUrl" aria-describedby="figure-caption-7" role="button" data-image-width="740" data-image-height="326" data-image-alt="Fig 8" data-pmc-id="PMC5830033" data-figure-id="pmed.1002507.g008"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-7" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/acc706994ada/pmed.1002507.g008.gif" alt="Fig 8" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="740"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="326"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> Fig 8 </p> </strong> <div class="figure-caption-contents"><p> Randomised controlled trial findings for… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> Fig 8 </p> </strong> <div class="figure-caption-contents"><p> Randomised controlled trial findings for multifaceted dietary interventions compared with no multifaceted intervention… </p></div> </div> <figcaption id="figure-caption-7" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> Fig 8 </strong> <div class="figure-caption-contents">Randomised controlled trial findings for multifaceted dietary interventions compared with no multifaceted intervention and risk of allergic rhinitis at age ≤4 years (A) or 5–14 years (B), wheeze (C) or recurrent wheeze (D) at age 5–14 years, and wheeze (E) or recurrent wheeze (F) at age ≤4 years. CI, confidence interval; RCT, randomised controlled trial; RR, risk ratio; W, weight.</div> </figcaption> </figure> <figure class="figure-item tail" itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="8" data-label-slug="fig-9"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/c49abd85e924/pmed.1002507.g009.jpg" itemprop="contentUrl" aria-describedby="figure-caption-8" role="button" data-image-width="702" data-image-height="1298" data-image-alt="Fig 9" data-pmc-id="PMC5830033" data-figure-id="pmed.1002507.g009"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-8" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/ea95b324b0ff/pmed.1002507.g009.gif" alt="Fig 9" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="702"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="1298"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> Fig 9 </p> </strong> <div class="figure-caption-contents"><p> RCT findings for vitamin supplementation… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> Fig 9 </p> </strong> <div class="figure-caption-contents"><p> RCT findings for vitamin supplementation compared with no vitamin supplementation and risk of… </p></div> </div> <figcaption id="figure-caption-8" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> Fig 9 </strong> <div class="figure-caption-contents">RCT findings for vitamin supplementation compared with no vitamin supplementation and risk of wheeze (A), recurrent wheeze (B), or eczema (C) at age ≤4 years. CI, confidence interval; RCT, randomised controlled trial; RR, risk ratio; W, weight.</div> </figcaption> </figure> <figure class="figure-item tail" itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="9" data-label-slug="fig-10"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/c32496fe59e8/pmed.1002507.g010.jpg" itemprop="contentUrl" aria-describedby="figure-caption-9" role="button" data-image-width="771" data-image-height="1047" data-image-alt="Fig 10" data-pmc-id="PMC5830033" data-figure-id="pmed.1002507.g010"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-9" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/465155bb5e0b/pmed.1002507.g010.gif" alt="Fig 10" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="771"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="1047"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> Fig 10 </p> </strong> <div class="figure-caption-contents"><p> TSA of intervention trials evaluating… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> Fig 10 </p> </strong> <div class="figure-caption-contents"><p> TSA of intervention trials evaluating the effect of probiotics on risk of eczema… </p></div> </div> <figcaption id="figure-caption-9" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> Fig 10 </strong> <div class="figure-caption-contents">TSA of intervention trials evaluating the effect of probiotics on risk of eczema (A) and the subgroups of studies that did (B) or did not (C) supplement lactating mothers during the postnatal period. The vertical red line is the optimal information size, i.e., the cumulative sample size required to establish with 80% power and 5% 2-sided significance whether the intervention reduces risk of the outcome by ≥20%, allowing for repeatedly meta-analysing the accumulating studies. The horizontal green line is a z score of +1.96, equal to two-sided <i>P</i> = 0.05. The cumulative Z-statistic (blue line) does not reach the optimal information size in analysis of all studies (A) or maternal supplementation studies (B) but does cross the trial sequential monitoring boundary (curved red line), showing evidence for ≥20% relative risk reduction. The cumulative Z-statistic (blue line) for studies without maternal supplementation (C) crosses the futility boundary and reaches the optimal information size without crossing ±1.96, indicating evidence of futility such that further trials of this intervention are not required. Findings were similar for ≥30% relative risk reduction and for eczema associated with allergic sensitisation. No., number; TSA, trial sequential analysis.</div> </figcaption> </figure> <figure class="figure-item tail" itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="10" data-label-slug="fig-11"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/2f6614a7b633/pmed.1002507.g011.jpg" itemprop="contentUrl" aria-describedby="figure-caption-10" role="button" data-image-width="615" data-image-height="242" data-image-alt="Fig 11" data-pmc-id="PMC5830033" data-figure-id="pmed.1002507.g011"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-10" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b9/5830033/7f3bbbe5ae30/pmed.1002507.g011.gif" alt="Fig 11" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="615"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="242"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> Fig 11. TSA of intervention trials evaluating… </p> </strong> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> Fig 11. TSA of intervention trials evaluating the effect of fish oil supplementation on risk… </p> </strong> </div> <figcaption id="figure-caption-10" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> Fig 11. TSA of intervention trials evaluating the effect of fish oil supplementation on risk of allergic sensitisation to egg. </strong> <div class="figure-caption-contents">The vertical red line is the optimal information size, i.e., the cumulative sample size required to establish with 80% power and 5% 2-sided significance whether the intervention reduces risk of the outcome by ≥20%, allowing for repeatedly meta-analysing the accumulating studies. The horizontal green line is a z score of +1.96, equal to two-sided <i>P</i> = 0.05. The cumulative Z-statistic (blue line) does not reach the optimal information size and does not cross the trial sequential monitoring boundary (curved red line), indicating no clear evidence for ≥20% relative risk reduction. Findings were similar for ≥30% relative risk reduction. No., number; TSA, trial sequential analysis.</div> </figcaption> </figure> </div> <div class="see-all actions-bar"> <button class="show-more" aria-controls="slides-container" data-ga-category="figure" data-ga-action="show_all"> All figures (11) </button> </div>  <div class="pswp figures-dialog" id="figures-dialog" tabindex="-1" role="dialog" aria-hidden="true" data-image-gallery-uid="article-figures" aria-label="Figures Dialog">  <div class="pswp__bg"></div>  <div class="pswp__scroll-wrap">  <div class="pswp__container"> <div class="pswp__item"></div> <div class="pswp__item"></div> <div class="pswp__item"></div> </div>  <div class="pswp__ui pswp__ui--hidden"> <div class="pswp__top-bar">  <div class="pswp__counter"></div> <button class="pswp__button pswp__button--close" title="Close (Esc)"></button> <button class="pswp__button pswp__button--share" title="Share"></button> <button class="pswp__button pswp__button--fs" title="Toggle fullscreen"></button> <button class="pswp__button 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Early-life environmental determinants of allergic diseases and the wider pandemic of inflammatory noncommunicable diseases. J Allergy Clin Immunol. 2013; 131(1): 23–30. doi: <a href="https://doi.org/10.1016/j.jaci.2012.11.019" rel="noopener nofollow" target="_blank" title="External link: 10.1016/j.jaci.2012.11.019">10.1016/j.jaci.2012.11.019</a> - <a class="reference-link" href="https://doi.org/10.1016/j.jaci.2012.11.019" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="10.1016/j.jaci.2012.11.019" > DOI </a> - <a class="reference-link" href="/23265694/" ref="linksrc=references_link&ordinalpos=2" data-ga-category="reference" data-ga-action="23265694" > PubMed </a> </li> </ol> </li> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> Cuello-Garcia CA, Fiocchi A, Pawankar R, Yepes-Nunez JJ, Morgano GP, et al. World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Prebiotics. 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Primary prevention of food allergy. Allergy. 2014; 69(5): 590–601. doi: <a href="https://doi.org/10.1111/all.12398" rel="noopener nofollow" target="_blank" title="External link: 10.1111/all.12398">10.1111/all.12398</a> - <a class="reference-link" href="https://doi.org/10.1111/all.12398" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="10.1111/all.12398" > DOI </a> - <a class="reference-link" href="/24697491/" ref="linksrc=references_link&ordinalpos=2" data-ga-category="reference" data-ga-action="24697491" > PubMed </a> </li> </ol> </li> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> Greer FR, Sicherer SH, Burks AW, Comm N. Effects of early nutritional interventions on the development of atopic disease in infants and children: The role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics. 2008; 121(1): 183–191. doi: <a href="https://doi.org/10.1542/peds.2007-3022" rel="noopener nofollow" target="_blank" title="External link: 10.1542/peds.2007-3022">10.1542/peds.2007-3022</a> - <a class="reference-link" href="https://doi.org/10.1542/peds.2007-3022" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="10.1542/peds.2007-3022" > DOI </a> - <a class="reference-link" href="/18166574/" ref="linksrc=references_link&ordinalpos=2" data-ga-category="reference" data-ga-action="18166574" > PubMed </a> </li> </ol> </li> </ol> <div class="actions-bar"> <button class="show-all" ref="linksrc=show_all_references_link" aria-controls="top-references-list-1" data-next-page-url="/29489823/references/" data-ga-category="reference" data-ga-action="show_more" > Show all 34 references </button> </div> </div> </div> </div> <div id="publication-types" class="publication-types keywords-section"> <h2 class="title"> Publication types </h2> <ul 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