EARNEST (2006 – 2010)

Early nutrition programming-long term follow up of efficacy and safety trials and integrated epidemiological, genetic, animal, consumer and economic research

Thematic priority: Food quality and health
Area of work programme: Impact of food on health

Specific aims (HMGU-contribution to WP 1.2.3):
To test the hypotheses that infant nutrition (formulae +/- breast milk, introduction of solid food during the first 6 months of life) influences at age 10 years (1) allergies (asthma, allergic rhinitis, atopic dermatitis); (2) overweight and obesity; (3) food references/choice.

Impact of infant nutrition on allergies: Breast-feeding is considered the ideal form of nutrition for healthy infants, but its protective effect against development of allergies remains controversial. For non breast-fed infants, the choice of formula, especially for children with a family history of allergies, also remains a challenge. The GINI (German Infant Nutritional Intervention) study is a large intervention study involving 2252 newborns recruited in 1995-1998 with double-blind randomisation to 3 different hypoallergenic formulae and one conventional cow's milk based formula at birth, with markedly different taste and nitrogen contents. Participants will be 10 years of age in 2005 - 2008.

Impact of infant nutrition on later obesity: Observational data indicate long term effects of postnatal nutrition on the prevalence of later obesity, with lower rates in children previously breast-fed. This could relate to permanent physiological changes caused by some intrinsic property of human milk or to psychological factors, such as locus of control over feeding rate (baby versus parent) or taste preference. Little is known about long term effects of early chemosensory experience on ingestive behaviours in humans. Animal studies indicate that early learning of odours can have long-term influence on later food choice. Conventional cow's milk-based formulas are often described as having low levels of sweetness whereas hydrolysate formulas have, at least to adults, an extremely unpalatable, offensive taste and odor.

Study design:
Long term follow up of existing cohorts of infants randomised to hypoallergenic formulas with reference to allergies, overweight and food preferences.
Activity leader: Joachim Heinrich (HMGU, Neuherberg).

Study population:
This large birth-cohort comprises a group of exclusively breastfed infants and a group of infants fed 4 different infant formulas assigned in a double blind, randomized fashion during the first 4 months of life.

Study methods:
Outcome measures: determined in the cohort at age 10 years:

  1. Asthma prevalence and allergies:
    1. specific and total IgE as markers of allergic sensitization (RAST);
    2. atopic dermatitis by: standardized questionnaire and standardized examination, SCORAD;
    3. allergic rhinoconjunctivitis by: standardized questionnaire;
    4. asthma by standardized questionnaire and lung function test, bronchial hyperresponsiveness (cold air challenge).

  2. Overweight and Obesity:
    1. Body mass index (BMI);
    2. Body composition measured by Bioelectric impedance;
    3. Parental BMI (reported) will be recorded.

  3. Food preference / Current diet:
    1. standardized test sessions for a wide range of tastes;
    2. validated food frequency questionnaire

Study period:

10 year follow up of the GINI Study.
5 years (2005-09)

Current status:
Field work is ongoing.

Sibylle Koletzko, Berthold Koletzko (Munich), H.-Erich Wichmann (Neuherberg), Andrea von Berg, Dietrich Berdel (Wesel), Peter Bauer and Armin Grübl (Munich).

EARNEST consortium consisting of more than 20 partners (Co-ordinator: Berthold Koletzko, LMU Munich) and GINI study group.

EU-6th Framework

Helmholtz Zentrum München
Institute of Epidemiology I
Dr. Joachim Heinrich
P.O.Box 1129
D- 85758 Neuherberg
Tel. +49 (0)89-3187 4150
Fax +49 (0)89-3187 3380

Related publications:

Sausenthaler, S., Heinrich, J., Koletzko, S.; for the GINIplus and LISAplus Study Groups:
Earlydiet and the risk of allergy: what can we learn from the prospective birth cohort studies GINIplus and LISAplus?
Am J Clin Nutr 2011 Dec;94(6):2012S-2017S.

Rzehak, P., Koletzko, S., Koletzko, B., Sausenthaler, S., Reinhardt, D., Grübl, A., Bauer, C.P., Krämer, U., Bollrath, C., von Berg, A., Berdel, D., Wichmann, H.E., Heinrich, J.; GINI Study Group:
Growth of infants fed formula rich in canola oil (low erucic acid rapeseed oil).
Clin Nutr. 2011 Jun;30(3):339-45.

Sausenthaler S, Heinrich J:
Geschmacksprägung in der frühen Kindheit.
Kinderärztliche Praxis (Sonderheft Kinderernährung und gesunder Lebensstil) 2006; 32-34.

Sausenthaler S, Kohlhammer Y, Schäffer L, Heinrich J, Koletzko S, Koletzko B:
Genetically determined lower bitter-taste sensitivity in Africans?
British Journal of Nutrition 2006; 96:607-608.


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