Respiratory effects of acute milk consumption among asthmatic and non-asthmatic children: a randomized controlled study
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RESEARCH ARTICLE
Open Access
Respiratory effects of acute milk consumption among asthmatic and nonasthmatic children: a randomized controlled study Yael Koren1†, Keren Armoni Domany2,3†, Guy Gut4, Amir Hadanny5, Shira Benor1, Oren Tavor1 and Yakov Sivan3,6*
Abstract Background: A commonly held public belief is that cow’s milk products increase mucus production and respiratory symptoms. Dietary milk elimination is often attempted despite lack of evidence. Our objective was to investigate whether a single exposure to cow’s milk is associated with respiratory symptoms and changes in pulmonary functions in asthmatic and non-asthmatic children. Methods: We conducted a prospective double blind, placebo-controlled trial on non-asthmatic and asthmatic children aged 6–18 years evaluated at a pediatric pulmonology unit. The children were randomly challenged with cow’s milk or soy milk substitute. Symptoms, spirometry, fractionalexhaled nitric-oxide (FeNO), and pulse oximetry findings were obtained at baseline and at 30, 60, 90, and 120 min following challenge. A two-way ANCOVA (with repeated measures when required) was used to compare the performances of all groups and subgroups over time. The outcome measures of each participant were compared to his/her own variables over time and in relation to his/her baseline values. In case of missing data points, missingness analysis was performed using Little’s missing completely at random (MCAR) test. Results: Fifty non-asthmatic children (26 assigned to the cow’s milk group and 24 to the soy substitute group), and 46 asthmatic children (22 in the cow’s milk group and 24 in the soy substitute group) were enrolled. Age, gender, and body mass index Z-score were comparable between the two groups. No changes in symptoms, spirometry, FeNO, or oxygen saturation measurements were observed following challenge in any of the participants in both groups, at any time point compared to baseline. (Continued on next page)
* Correspondence: [email protected] † Yael Koren and Keren Armoni Domany are first authors contributed equally to this work. 3 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 6 Department of Pediatric Pulmonology, Safra Children Hospital, Sheba Medical Center, Tel Hashomer, Israel Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use
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