BACKGROUND: The protective effect of breast-feeding on the development of childhood asthma remains a matter of controversy. We conducted a systematic review of prospective studies that evaluated the association between exclusive breast-feeding during the first 3 months after birth and asthma. STUDY DESIGN: We searched the 1966-1999 MEDLINE database and reviewed reference lists of relevant articles to identify 12 prospective studies that met pre-stated inclusion criteria. Methodological aspects of the studies, duration and exclusivity of breast-feeding, and outcomes were assessed. Effect estimates were abstracted by the investigators, using a standardized approach. RESULTS: The summary odds ratio (OR) for the protective effect of breast-feeding was 0.70 (95% CI 0.60 to 0.81). The effect estimate was greater in studies of children with a family history of atopy (OR = 0.52) than in studies of a combined population (OR = 0.73). CONCLUSIONS: Exclusive breast-feeding during the first months after birth is associated with lower asthma rates during childhood. The effect, caused by immunomodulatory qualities of breast milk, avoidance of allergens, or a combination of these and other factors, strengthens the advantage of breast-feeding, especially if a family history of atopy is present.

OBJECTIVE: To discuss current evidence about the relation between prenatal and childhood Mediterranean diet, and the development of asthma and allergies in children.

DESIGN: Review of the literature.

SETTING AND RESULTS: Four recent studies conducted in Mediterranean countries (Spain, Greece) and one conducted in Mexico evaluated the association between childhood Mediterranean diet and asthma outcomes in children. All of the studies reported beneficial associations between a high level of adherence to the Mediterranean diet during childhood and symptoms of asthma or allergic rhinitis. Individual foods or food groups contributing to the protective effect of Mediterranean diet included fish, fruits, vegetables, legumes, nuts and cereals, while detrimental components included red meat, margarine and junk food intake. Two studies focused on prenatal Mediterranean diet: the first is a birth cohort in Spain that showed a protective effect of a high adherence to the Mediterranean diet during pregnancy on persistent wheeze, atopic wheeze and atopy at the age of 6.5 years; while the second is a cross-sectional study in Mexico, collecting information more than 6 years after pregnancy, that showed no associations between maternal Mediterranean diet during pregnancy and allergic symptoms in childhood except for current sneezing.

CONCLUSIONS: Findings from recent studies suggest that a high level of adherence to the Mediterranean diet early in life protects against the development of asthma and atopy in children. Further studies are needed to better understand the mechanisms of this protective effect, to evaluate the most relevant window of exposure, and to address specific components of diet in relation to disease.

BACKGROUND AND PURPOSE: Tai Chi Chuan, a traditional Chinese exercise, is thought to improve cardiopulmonary function in patients with chronic disease. This study investigated the effect of Tai Chi Chuan on the pulmonary function and daily symptoms of asthmatic children. METHODS: Thirty asthmatic children were enrolled into the study. Fifteen of the 30 children participated in a 12-week Tai Chi Chuan program and the remaining 15 constituted the control group. Prior to study participation, the pulmonary function of all enrolled children was assessed at rest, after exercise, and after exercise plus iced water. A 3-day symptoms questionnaire was also completed and a score obtained after each pulmonary function test. RESULTS: There were no significant differences between the two groups in baseline pulmonary function and severity of asthmatic symptoms before study commencement, at rest, after exercise, or after exercise plus iced water. However, after the 12-week program, children in the Tai Chi Chuan group had a significant improvement in pulmonary function compared to the control group. Although there were no significant differences in post-training symptom scores at rest and after exercise between the two groups, under the stronger challenge of exercise plus iced water, children in the Tai Chi Chuan group had milder symptoms than those in the control group. CONCLUSION: Our data show that Tai Chi Chuan can improve the pulmonary function of asthmatic children. However, long-term follow-up is required to determine the impact of Tai Chi Chuan on the severity of asthmatic symptoms.

Tai-Chi-Chuan (TCC) is an exercise of low-to-moderate intensity which is suitable for asthmatic patients. The aim of our study is to investigate improvements of the lung function, airway inflammation, and quality of life of asthmatic children after TCC. Participants included sixty-one elementary school students and they were divided into asthmatic (n = 29) and nonasthmatic (n = 32) groups by the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Among them, 20 asthmatic and 18 nonasthmatic children volunteered to participate in a 60-minute TCC exercise weekly for 12 weeks. Baseline and postintervention assessments included forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEFR), fractional exhaled nitric oxide (FeNO) level, and Standardised Pediatric Asthma Quality of Life Questionnaire (PAQLQ(S)). After intervention, the level of FeNO decreased significantly; PEFR and the FEV1/FVC also improved significantly in both asthmatic group and nonasthmatic group after TCC. The asthmatic children also had improved quality of life after TCC. The results indicated that TCC could improve the pulmonary function and decrease airway inflammation in both children with mild asthma and those without asthma. It also improves quality of life in mild asthmatic children. Nevertheless, further studies are required to determine the effect of TCC on children with moderate-to-severe asthma.