Georg Loss1, Martin Depner2, Laurien H Ulfman3, R J Joost van Neerven4, Alexander J Hose2, Jon Genuneit5, Anne M Karvonen6, Anne Hyvärinen6, Vincent Kaulek7, Caroline Roduit8, Juliane Weber2, Roger Lauener9, Petra Ina Pfefferle10, Juha Pekkanen11, Outi Vaarala12, Jean-Charles Dalphin7, Josef Riedler13, Charlotte Braun-Fahrländer14, Erika von Mutius15, Markus J Ege15. 1. Dr von Hauner Children's Hospital, Ludwig Maximilian University, Munich, Germany; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. Electronic address: georg.loss@med.uni-muenchen.de. 2. Dr von Hauner Children's Hospital, Ludwig Maximilian University, Munich, Germany. 3. FrieslandCampina, Amersfoort, The Netherlands. 4. FrieslandCampina, Amersfoort, The Netherlands; Cell Biology and Immunology, Wageningen University, Wageningen, The Netherlands. 5. Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany. 6. Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland. 7. Department of Respiratory Disease, UMR/CNRS 6249 chrono-environment, University Hospital of Besançon, Besançon, France. 8. Children's Hospital, University of Zürich, Zürich, Switzerland; Christine Kühne Center for Allergy Research and Education, Davos, Switzerland. 9. Christine Kühne Center for Allergy Research and Education, Davos, Switzerland; Children's Hospital of Eastern Switzerland, St Gallen, Switzerland. 10. Institute for Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University of Marburg, Marburg, Germany; Member of the German Center for Lung Research, Munich, Germany. 11. Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland; Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. 12. Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland. 13. Children's Hospital, Schwarzach, Austria. 14. Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. 15. Dr von Hauner Children's Hospital, Ludwig Maximilian University, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research, Munich, Germany.
Abstract
BACKGROUND: Breast-feeding is protective against respiratory infections in early life. Given the co-evolutionary adaptations of humans and cattle, bovine milk might exert similar anti-infective effects in human infants. OBJECTIVE: To study effects of consumption of raw and processed cow's milk on common infections in infants. METHODS: The PASTURE birth cohort followed 983 infants from rural areas in Austria, Finland, France, Germany, and Switzerland, for the first year of life, covering 37,306 person-weeks. Consumption of different types of cow's milk and occurrence of rhinitis, respiratory tract infections, otitis, and fever were assessed by weekly health diaries. C-reactive protein levels were assessed using blood samples taken at 12 months. RESULTS: When contrasted with ultra-heat treated milk, raw milk consumption was inversely associated with occurrence of rhinitis (adjusted odds ratio from longitudinal models [95% CI]: 0.71 [0.54-0.94]), respiratory tract infections (0.77 [0.59-0.99]), otitis (0.14 [0.05-0.42]), and fever (0.69 [0.47-1.01]). Boiled farm milk showed similar but weaker associations. Industrially processed pasteurized milk was inversely associated with fever. Raw farm milk consumption was inversely associated with C-reactive protein levels at 12 months (geometric means ratio [95% CI]: 0.66 [0.45-0.98]). CONCLUSIONS: Early life consumption of raw cow's milk reduced the risk of manifest respiratory infections and fever by about 30%. If the health hazards of raw milk could be overcome, the public health impact of minimally processed but pathogen-free milk might be enormous, given the high prevalence of respiratory infections in the first year of life and the associated direct and indirect costs.
BACKGROUND: Breast-feeding is protective against respiratory infections in early life. Given the co-evolutionary adaptations of humans and cattle, bovine milk might exert similar anti-infective effects in humaninfants. OBJECTIVE: To study effects of consumption of raw and processed cow's milk on common infections in infants. METHODS: The PASTURE birth cohort followed 983 infants from rural areas in Austria, Finland, France, Germany, and Switzerland, for the first year of life, covering 37,306 person-weeks. Consumption of different types of cow's milk and occurrence of rhinitis, respiratory tract infections, otitis, and fever were assessed by weekly health diaries. C-reactive protein levels were assessed using blood samples taken at 12 months. RESULTS: When contrasted with ultra-heat treated milk, raw milk consumption was inversely associated with occurrence of rhinitis (adjusted odds ratio from longitudinal models [95% CI]: 0.71 [0.54-0.94]), respiratory tract infections (0.77 [0.59-0.99]), otitis (0.14 [0.05-0.42]), and fever (0.69 [0.47-1.01]). Boiled farm milk showed similar but weaker associations. Industrially processed pasteurized milk was inversely associated with fever. Raw farm milk consumption was inversely associated with C-reactive protein levels at 12 months (geometric means ratio [95% CI]: 0.66 [0.45-0.98]). CONCLUSIONS: Early life consumption of raw cow's milk reduced the risk of manifest respiratory infections and fever by about 30%. If the health hazards of raw milk could be overcome, the public health impact of minimally processed but pathogen-free milk might be enormous, given the high prevalence of respiratory infections in the first year of life and the associated direct and indirect costs.
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