What do review papers conclude about food and dietary patterns? Relationship of diet in the development of atopy in infancy Improving autism perinatal risk factors: A systematic review. Validation of the global resource of eczema trials (GREAT database) Effect of combined maternal and infant food-allergen avoidance on development of atopy in early infancy: a randomized study. Maternal smoking during pregnancy and conduct problems in high-risk youth: a developmental framework. Effects of maternal diet during late pregnancy and lactation on the development of atopic diseases in infants up to 18 months of age—in‐vivo results Maternal dietary folate, folic acid and vitamin D intakes during pregnancy and lactation and the risk of cows' milk allergy in the offspring. Impact of dietary counselling on nutrient intake during pregnancy: a prospective cohort study. Early exposure to solid foods and the development of eczema in children up to 4 years of age. The development and prediction of atopy in high-risk children: follow-up at age seven years in a prospective randomized study of combined maternal and infant food allergen avoidance. Development of atopic dermatitis according to age of onset and association with early-life exposures. Editorial: an author's checklist for measure development and validation manuscripts. Prevention of allergic disease during childhood by allergen avoidance: the Isle of Wight prevention study. The impact of cash transfers on social determinants of health and health inequalities in Sub-Saharan Africa: a systematic review protocol Lipid-Based Nutrient Supplements During Pregnancy and Lactation Did Not Affect Human Milk Oligosaccharides and Bioactive Proteins in a Randomized Trial Using systematic reviews to inform NIHR HTA trial planning and design: a retrospective cohort Preventing food allergy: protocol for a rapid systematic review Prenatal and Infancy Home Visiting by Nurses: From Randomized Trials to Community Replication Allergen exposure in infancy and the development of sensitization, wheeze, and asthma at 4 years. The effect of weight management interventions that include a diet component on weight‐related outcomes in pregnant and postpartum women: a systematic review protocol A Systematic Evaluation of the Impact of STRICTA and CONSORT Recommendations on Quality of Reporting for Acupuncture Trials Food Predictors of Plasma Carotenoids
Nutrients and other bioactive constituents of foods may interact with each other and the surrounding food matrix in complex ways . Therefore , associations between single nutrients and chronic disease may be difficult to identify and interpret , but when dietary patterns ( DPs ) are examined the combination of many food factors will be considered . An explorative literature search of published review articles was conducted to obtain a fuller underst and ing of current DPs in epidemiological research , to discuss pros and cons of DPs in nutrition research , and to identify results of studies linking DPs to chronic disease risk in adults . R and omized feeding trials providing the experimental diets to study participants have repeatedly demonstrated that diets based on current dietary recommendations are associated with important health benefits . Systematic review s of feeding trials and prospect i ve population studies of DPs and chronic disease risk reach similar conclusions regardless of the methodology used to construct DPs . However , to date only a few review articles of DP studies have followed a systematic process using independent review ers with strict inclusion , exclusion , and study quality criteria . Diets with plenty of plants foods , fish , and seafood that preferably include vegetable oils and low-fat dairy products are associated with a lower risk of most chronic diseases . In contrast , Western-type DPs with food products low in essential nutrients and high in energy , like sugar-sweetened beverages , sweets , refined cereals and solid fats ( e.g. butter ) , and high in red and processed meats , are associated with adverse health effects . An emphasis on high- quality original research , and systematic review s following a structured process to objective ly select and judge studies , is needed in order to enforce a strong future knowledge base regarding DPs and chronic disease We examined the relationship of diet to the development of atopic manifestations in a group of infants with an immediate family history of atopy , followed prospect ively from birth for up to 20 months of age . There was no relationship between the development of atopic dermatitis , rhinitis and wheeze and either 2 or 4 months exclusive breast feeding , or the introduction of cow 's milk or solids in the first 4 months of life . In addition there was no relationship between the introduction of milk , egg or wheat into the diet and the development of skin‐test positivity to these foods . In fact , five infants developed positive skin tests to the food prior to its introduction into the diet , suggesting exposure via maternal breast milk . Thus we have been unable to show a protective effect of either breast feeding or cow 's milk or solid avoidance on the development of atopic disease in infancy BACKGROUND Current underst and ing of the etiology of autism is based on the interaction of multiple genes with each other and with environmental factors , leading to a neurodevelopmental process that results in the expression of autism spectrum disorder ( ASD ) in the child . This suggests that it might be possible to strengthen resilience to environmental stressors during the perinatal period to improve outcomes and possibly prevent the development of ASD . METHODS We search ed the MEDLINE data base for multiple perinatal factors associated with the development of ASD published between January 1 , 2005 and July 1 , 2018 . The search terms used were " autism " crossed with either " perinatal , " " prenatal , " " gestational , " or " pregnancy , " and crossed again with each perinatal risk factor highlighted in this review including topics on parental health , infections , medications , and environmental stressors . We then search ed interventions that may improve neurodevelopmental outcome before and during pregnancy , including supplements , breastfeeding , and postpartum stress reduction . We identified recent or unique metanalyses and systematic review s of the identified focus and on r and omized controlled trials and summarized these using the most recent and comprehensive review s. RESULTS Folate , omega-3 , vitamin D3 , environmental toxin avoidance , correcting deficiencies , immune boosting , and prolonged breast feeding are all reported to be linked to the possible reduction of adverse pregnancy outcomes including ASD . CONCLUSIONS Studies of individual components for improving pregnancy outcomes and several uncontrolled preconception to infancy medical practice s suggest that multiple interventions might improve the outcomes of pregnancies where there is risk for developing ASD Background Eczema ( syn . Atopic Eczema or Atopic Dermatitis ) is a chronic , relapsing , itchy skin condition which probably results from a combination of genetic and environmental factors . The Global Re source of EczemA Trials ( GREAT ) is a collection of records of r and omised controlled trials ( RCTs ) for eczema treatment produced from a highly sensitive search of six reference data bases . We sought to assess the sensitivity of the GREAT data base as a tool to save future research ers repeating extensive bibliographic search es . Methods All Cochrane systematic review on treatments for eczema and five non-Cochrane systematic review s on eczema were identified as a reference set to assess the utility of the GREAT data base in identifying r and omised controlled trials ( RCTs ) . RCTs included in the systematic review s were checked for inclusion in the GREAT data base by two independent authors . A third author resolved any disagreements . Results Five Cochrane and six non-Cochrane systematic review s containing a total of 105 RCTs of eczema treatments were included . Of these , 95 fitted the inclusion criteria for the GREAT data base and 88 were published from 2000 onwards . Of the 88 eligible studies , 92 % were found in the GREAT data base . Seven trials were not included in the GREAT data base - two of these were reported within a review paper and one as an abstract with no trial results . Conclusions The sensitivity of the GREAT data base for trials from 2000 onwards was high ( 75/88 trials , 94 % ) . Sensitivity for the period prior to 2000 was less sensitive , due to differences in how the trials were identified prior to this time.‘Dual ’ filtering for new records has recently become part of the GREAT data base methodology and should further improve the sensitivity of the data base in time . The GREAT data base can be considered as a primary source for future systematic review s including r and omised controlled trials of eczema treatments , but search es should be supplemented by checking reference lists for eligible trials , search ing trial registries and contacting pharmaceutical companies for unpublished studies The effect of maternal and infant avoidance of allergenic foods on food allergy was examined in a prenatally r and omized , controlled trial of infants of atopic parents . The diet of the prophylactic-treated group ( N = 103 ) included ( 1 ) maternal avoidance of cow 's milk , egg , and peanut during the third trimester of pregnancy and lactation and ( 2 ) infant use of casein hydrolysate ( Nutramigen ) for supplementation or weaning , and avoidance of solid foods for 6 months ; cow 's milk , corn , soy , citrus , and wheat , for 12 months ; and egg , peanut , and fish , for 24 months . In the control group ( N = 185 ) , mothers had unrestricted diets , and infants followed American Academy of Pediatrics feeding guidelines . The cumulative prevalence of atopy was lower at 12 months in the prophylactic-treated ( 16.2 % ) compared to the control ( 27.1 % ) group ( p = 0.039 ) , result ing from reduced food-associated atopic dermatitis , urticaria and /or gastrointestinal disease by 12 months ( 5.1 % versus 16.4 % ; p = 0.007 ) , and any positive food skin test by 24 months ( 16.5 % versus 29.4 % ; p = 0.019 ) , caused primarily by fewer positive milk skin tests ( 1 % versus 12.4 % ; p = 0.001 ) . The prevalences of allergic rhinitis , asthma , and inhalant skin tests were unaffected . Serum IgE levels in the prophylactic-treated group were marginally lower only at 4 months . Thus , reduced exposure of infants to allergenic foods appeared to reduce food sensitization and allergy primarily during the first year of life Smoking during pregnancy is associated with adverse consequences for children . Most recently , it has been established as a risk factor for developmental psychopathology , specifically Conduct Disorder ( CD ) . Although this association has been shown to be robust , developmental pathways from exposure to CD have not been established . We examined how prenatal exposure to cigarettes interacts with child and family factors to increase risk of CD symptoms in a longitudinal study of 10-year-old urban , African-American youth ( N = 77 ) . The effects of prenatal exposure at school age were moderated by child sex . Boys whose mothers smoked during pregnancy were significantly more likely to develop CD symptoms , but exposure did not increase risk in girls . A similar trend was found during infancy : prenatal smoking was associated with low sociability/negative emotionality only for boys . The effects of smoking during pregnancy were also moderated by the quality of the early caregiving environment . Exposed boys whose mothers were unresponsive during infancy were at increased risk of CD symptoms , but exposed boys with early responsive mothers were not . Prospect i ve studies , with developmentally based measures of behavior across time , are critical for further elucidating pathways from prenatal exposure to cigarettes to the development of clinical disorder . The identification of a potentially modifiable , prenatal risk factor for early onset developmental psychopathology has important implication s for prevention One hundred and sixty‐two women with respiratory allergy to animal d and ers and /or pollens were r and omly allocated to a diet consisting of either a very low ingestion of hens ' egg and cows ' milk or a daily ingestion of one hens ' egg and about 11 of cows ' milk during the last 3 months of pregnancy .  One hundred and sixty‐three infants were followed prospect ively up to 18 months of age when the cumulated incidence of atopic disease in each child was evaluated blindly . No significant differences in the distribution of atopic disease were found among the infants in relation to the maternal diet during late pregnancy . The numbers of skin‐prick tests positive to ovalbumin , ovomucoid , β‐lactoglobulin and cows ' milk were likewise not influenced by differences in the maternal diet during late pregnancy . Genetic factors rather than maternal diet during the perinatal period probably have a greater effect on the incidence of atopic diseases during early infancy Maternal nutrient intake during pregnancy and lactation potentially influences the development of allergic diseases . Cows ' milk allergy ( CMA ) is often the first manifestation of atopic diseases , but the impact of early nutritional influences on CMA has not been explored . The associations between maternal intakes of folate , folic acid and vitamin D during pregnancy and lactation were addressed in a prospect i ve , population -based birth cohort within the Finnish Type 1 Diabetes Prediction and Prevention Study . Mothers of 4921 children during pregnancy and 2940 children during lactation provided information on maternal dietary intake during the 8th month of pregnancy and the 3rd month of lactation using a detailed , vali date d FFQ . Information on diagnosed CMA in the offspring was obtained from a medical registry as well as queried from the parents . The Finnish food composition data base was used to calculate nutrient intake . Logistic regression was applied for statistical analyses .  Folate intake and folic acid and vitamin D supplement  use were associated with an increased risk of CMA in the offspring , whereas vitamin D intake from foods during pregnancy was associated with a decreased risk of CMA . Thus , maternal nutrient intake during pregnancy and lactation may affect the development of CMA in offspring . Supplementation with folic acid may not be beneficial in terms of CMA development , especially in children of allergic mothers . The association between dietary supplement use and CMA risk can at least partly be explained by increased health-seeking behaviour among more educated mothers who also use more dietary supplements The aim of this study was to assess the impact of dietary counselling combined with the provision of food products on food and nutrient intake in pregnant women . We carried out a prospect i ve cohort study of healthy and atopic pregnant women ( n 209 ) , who were r and omized into dietary intervention and control groups . The intervention group received dietary counselling and food products to modify the fat composition of their diet to meet current recommendations . Three-day food records were collected during each trimester of pregnancy . Women in the intervention group consumed more vegetables , fruits , soft margarines and vegetable oils and less butter than those in the control group during the course of pregnancy ( P<0.05 ) . The main distinction between the groups in nutrient intake over the pregnancy was attributable to a higher energy intake ( % energy ) of PUFA by 0.5%energy ( 95 % CI 0.1 , 0.8 ) and to a lower intake of SFA by 0.8 % energy ( 95 % CI -1.4 , -0.4 ) in the intervention group . Dietary intake of vitamin E was 1.4 mg ( 95 % CI 0.6 , 2.2 ) , folate 20.9 microg ( 95 % CI 0.8 , 41.0 ) and ascorbic acid 19.8 mg ( 95 % CI 3.5 , 36.0 ) higher in the intervention group compared to the controls , while no differences in other nutrients were detected . Dietary counselling combined with the provision of food products during pregnancy is of importance in modifying food and nutrient intake , with potential health benefits Early exposure to solid foods in infancy has been associated with the development of allergic diseases . However , scientific evidence for this is conflicting . The aim of this study was to examine the association between early exposure to solid foods in the infant 's diet and the development of  eczema up to 4 years of age . We conducted an etiologic case-control study nested in the PIPO cohort ( Prospect i ve Cohort on the Influence of Perinatal Factors on the Occurrence of Asthma and Allergies ) . In this cohort data on nutrition , environmental exposures and parent-reported eczema were collected prospect ively starting from 5 months pregnancy by means of question naires administered during two home visits and semi-annual postal question naires . In addition , detailed information on the timing of introduction of solid foods at individual food item level was collected at 1 year of age . Adjusted odds ratios and 95 % confidence intervals were computed using logistic regression analysis as a measure of association between eczema and the timing of exposure to solid foods . Early introduction ( within the first 4 months ) of solid foods was inversely associated with eczema up to 4 years of age ( adj OR : 0.49 ; 95 % CI : 0.32 - 0.74 ) . Moreover , we found that early exposure to solid foods was associated with a reduced risk for eczema only among children with allergic parents ( adj OR : 0.35 ; 95 % CI : 0.20 - 0.63 ) , whereas no significant effect was found among children with non-allergic parents ( adj OR : 0.69 ; 95 % CI : 0.37 - 1.29 ) . The results of this study show that early exposure to solid foods is associated with less parent-reported eczema in children , particularly among children with allergic parents . Therefore , the current study does not support a delayed introduction of solid foods for the prevention of  eczema  in childhood BACKGROUND The natural history of allergic disease and its potential for prevention merit close examination because of the explosive worldwide increase in the prevalence and morbidity of atopic disorders . This study examines the development of atopy at age 7 years in 165 children in a high-risk cohort , previously reported from birth to age 4 years . METHODS In this prospect i ve , r and omized , controlled study of food allergen avoidance in infancy , the prophylactic-treated group consisted of infants whose mothers avoided cow 's milk , egg , and peanut during the last trimester of pregnancy and lactation and who , themselves ,  avoided cow 's milk until age 1 year ( casein hydrolysate supplementation before age 1 ) , egg until age 2 years , and peanut and fish until age 3 years . The control group consisted of maternal/infant pairs who followed st and ard feeding practice s. RESULTS Despite a significant reduction in food allergy and milk sensitization before age 2 years , none of the following differed between the groups at age 7 years : food allergy , atopic dermatitis , allergic rhinitis , asthma , any atopic disease , lung function , food or aeroallergen sensitization , serum IgE level , or presence of nasal eosinophils or nasal basophilic cells .  Children with food allergy by 4 years evidence d higher 7-year ( current ) prevalences of allergic rhinitis and asthma ( p < 0.01 ) . Atopic diseases/parameters at age 7 years were shown , by multivariate analysis ( p < 0.05 ) , to be associated with several genetic and environmental risk factors ( male gender , maternal nonwhite ethnicity and asthma , and household smoking ) , as well as predictive atopic markers during infancy ( elevated serum IgE level ; egg , cow 's milk , and peanut sensitization ; and nasal eosinophils and nasal basophilic cells ) . CONCLUSIONS These findings help to : ( 1 ) eluci date the natural history of atopic disease in high-risk children ; ( 2 ) document the progression of allergy from atopic dermatitis , food allergy , and food sensitization to respiratory allergy and aeroallergen sensitization despite food allergy prevention in infancy ; ( 3 ) identify allergy predictive markers ; and ( 4 ) exp and our appreciation of the interactions of genetic and environmental factors in the development of atopy BACKGROUND Environmental factors can affect the development of  atopic dermatitis  , and this was described to be already effective during pregnancy and in early life . An important early postnatal exposure is nutrition , although its association with allergic disease remains unclear . OBJECTIVE We sought to determine prospect ively whether early postnatal exposures , such as the introduction to complementary food in the first year of life , are associated with the development of atopic dermatitis , taking into account the reverse causality . METHODS One thous and forty-one children who participated in the Protection Against Allergy- Study in Rural Environments birth cohort study were included in the current study .  Atopic dermatitis  was defined by a doctor 's diagnosis reported by the parents of children up to 4 years of age , by question naires , and /or by positive SCORAD scores from 1 year of age and according to the age of onset within or after the first year of life . Feeding practice s were reported by parents in monthly diaries between the 3rd and 12th months of life . RESULTS The diversity of introduction of complementary food in the first year of life was associated with a reduction in the risk of having atopic dermatitis with onset after the first year of life ( adjusted odds ratio for atopic dermatitis with each additional major food item introduced , 0.76 ; 95 % CI , 0.65 - 0.88 ) . The introduction of yogurt in the first year of life also reduced the risk for atopic dermatitis ( adjusted odds ratio , 0.41 ; 95 % CI , 0.23 - 0.73 ) . CONCLUSION As early-life exposure , the introduction of yogurt and the diversity of food introduced in the first year of life might have a protective effect against atopic dermatitis A recent special issue of the Journal of Pediatric Psychology included papers focused on evidence -based assessment across several broad domains of assessment in pediatric psychology ( e.g. , adherence , pediatric pain , and quality of life ) . In one of these papers , Holmbeck et al. ( 2008 ) review ed strengths and limitations of existing measures of psychosocial adjustment and psychopathology , concluding that many measures lacked supporting psychometric data ( e.g. , basic indices of reliability and validity ) that would permit a complete evaluation of these measures . Given that measure development and validation papers are frequently published in JPP ( Brown , 2007 ) , it is important that we attend to guiding psychometric principles when developing and disseminating data on new measures to be employed with pediatric population s ( Nunnally & Bernstein , 1994 ) . Thus , the purpose of this paper is to present and describe a checklist for authors to use when su bmi tting measure development papers to JPP . This checklist is included in the Appendix and is also included at the following link on the JPP website : http://www.oxfordjournals.org/our_journals/jpepsy/for _ authors /measure%20development%20checklist.pdf Findings presented by Holmbeck et al. ( 2008 ) indicated that 34 of the 37 measures review ed met pre-established “ evidence -based assessment ” ( EBA ) criteria for “ well-established ” measures ( Cohen et al. , 2008 ) . To be considered “ well-established , ” a measure had to have been presented in at least two peer- review ed journal articles by different investigatory teams , have demonstrated adequate levels of reliability and validity , and be accompanied by supporting information ( e.g. , a measure manual ) . Although most measures that we review ed met these criteria , we also found that most of the 34 “ well-established ” measures were hampered by at least one major psychometric flaw and /or lacked important psychometric data . We concluded that a more fine-grained EBA classification system is needed . One important distinction in this literature relates to differences between empirically supported assessment and evidence -based assessment . This type of distinction was first discussed in the literature on clinical interventions ( e.g. , Spring , 2007 ) . An empirically supported intervention is one that has demonstrated efficacy in r and omized clinical trials or clinic-based effectiveness trials . An evidence -based intervention has empirical support in the manner just described , but also “ integrates research evidence , clinical expertise , and patient preferences and characteristics … empirically-supported treatments  ( ESTs )  are an important component of evidence -based practice ( EBP ) , but EBP can not be reduced to ESTs ” ( Spring , 2007 , p.611 ) . Applying these terms to the field of assessment and measure development efforts , an empirically supported assessment measure would be one that demonstrates satisfactory psychometric characteristics , broadly defined . To be evidence based , the measure should also demonstrate utility in clinical setting s , be useful in making diagnoses , be sensitive to treatment effects , and /or provide incremental validity above and beyond other similar measures . Although papers in the special issue of JPP frequently referred to “ evidence -based assessment ” ( Cohen et al. , 2009 ) , the articles included in the issue tended to evaluate the degree to which the measures were empirically-supported rather than evidence based . To be “ evidence -based , ” our review s would have needed to integrate an evaluation of clinical utility , diagnostic utility , and treatment sensitivity with the empirical psychometric data presented in each review . As noted , the published review s were more likely to focus on the latter rather than on the former . As suggested by Mash and Hunsley ( 2005 ) , detailed EBA profiles would provide a complete evaluation of evidence across each of several psychometric and clinical ly relevant dimensions , including : ( a ) internal consistency , ( b ) test – retest reliability , ( c ) the availability of normative data , ( d ) content validity , ( e ) construct validity , ( f ) convergent and discriminant validity , ( g ) criterion-related validity , ( h ) incremental validity , ( i ) clinical utility , ( j ) diagnostic utility , and ( k ) treatment sensitivity . The focus on incremental validity and clinical and diagnostic utility raises the bar from a focus on “ empirical support ” ( i.e. , where the focus would tend to be primarily on psychometric data ) to a broad focus on the “ evidence base ” for a measure . In developing the checklist that is the focus of this article , we attempted to provide a list of criteria relevant to establishing the evidence base ( and not just empirical support ) for a measure . In addition to shifting the focus from providing “ empirical support ” for a measure to providing an “ evidence base ” for our instruments , a checklist for measure development papers would permit JPP review ers to evaluate such papers in the same way that review ers of r and omized clinical trials make use of the Consoli date d St and ards of Reporting Trials ( CONSORT ) checklist and flowchart ( Altman et al. , 2001 ) . The CONSORT checklist contains reporting st and ards with respect to method ological features of and the manner in which results are reported in clinical trials . Moreover , authors are required to provide a flowchart that describes details of sample recruitment and attrition during the course of the study . Thus , a checklist for measure development papers would serve two interrelated purpose s : ( a ) it would provide guidance to authors as they embark on the measure development process and would provide a list of criteria authors can use as they develop an evidence base for their measures , and ( b ) it would begin to st and ardize the manner in which psychometric and other assessment -related data are presented in measure development papers for this journal . Before providing a more detailed overview of the checklist , it is important to note that this checklist is rather exhaustive ( see Appendix ) . As such , it represents what would “ ideally ” be expected for a measure development or validation manuscript rather than minimal criteria for such papers . No one paper can provide a complete evaluation of all important psychometric and clinical ly relevant dimensions that will establish once- and -for-all the evidence base for a measure . Instrument refinement is part of a measure development process that gradually builds an evidence base for a scale ( see Smith & McCarthy , 1995 , for suggestions on measure refinement ) . Indeed , the validation of any measure is a cumulative process that occurs across many different types of research studies and across research programs BACKGROUND Early life allergen exposure may increase the risk of childhood allergy , but the protective effect of reduction in allergen exposure remains uncertain . OBJECTIVE To evaluate the effect of reduction in food and house dust mite ( HDM ) allergen exposure in infancy in preventing asthma and allergy . METHODS Infants , at higher risk because of family predisposition , were recruited prenatally and r and omized to prophylactic ( n = 58 ) and control ( n = 62 ) groups . Prophylactic group infants were either breast-fed with mother on a low allergen diet or given an extensively hydrolyzed formula . Exposure to HDM was reduced by the use of an acaricide and mattress covers . The control group followed st and ard advice .  Development of allergic diseases and sensitization to common allergens ( atopy ) was assessed blindly at ages 1 , 2 , 4 , and 8 years in all 120 children . RESULTS Repeated measurement analysis , adjusted for all relevant confounding variables , confirmed a preventive effect on asthma : adjusted odds ratio ( OR ) , 0.24 ; 95 % CI , 0.09 - 0.66 ; P = .005 ; atopic dermatitis , OR , 0.23 ; CI , 0.08 - 0.64 ; P = .005 ; rhinitis , OR , 0.42 ; CI , 0.19 - 0.92 ; P = .03 ; and atopy , OR , 0.13 ; CI , 0.05 - 0.32 ; P < .001 . The protective effect was primarily observed in the subgroup of children with persistent disease ( symptoms at all visits ) and in those with evidence of allergic sensitization . CONCLUSION Allergic diseases can be reduced , for at least the first 8 years of life , by combined food and HDM allergen avoidance in infancy . CLINICAL IMPLICATION S Strict food and HDM allergen avoidance should be considered for prevention of allergy in high-risk infants Background There is increasing pressure to address the social determinants of health ( SDoH ) and health inequities through the implementation of culturally acceptable interventions particularly in Sub-Saharan Africa ( SSA ) where health outcomes are generally poor . Available evaluation research on cash transfers ( CTs ) suggests that the programs may influence the wider determinants of health in SSA ; yet , there has been no attempt to synthesize the evidence regarding their contribution to tackling the SDoH and health inequalities . To date , nearly all the review s on CTs ' impact on health have predominantly featured evidence from Latin America with limited transferability to the social , cultural , and political environments in SSA . Therefore , the aim of this study is to undertake a systematic review to assess the role of CTs in tackling the wider determinants of health and health inequalities in SSA . Methods / design A systematic review of published and unpublished literature on CTs ’ impact on health and health determinants covering the period 2000–2016 will be undertaken . Studies will be considered for inclusion if they present quantitative or qualitative data , including all relevant study design s. The SDoH conceptual framework will be used to guide the data extraction process . EPPI Review er software will be used for data management and analysis . Studies included in the review will be analyzed by narrative synthesis and /or meta- analysis as appropriate for the nature of the data retrieved . Discussion This review will provide empirical evidence on the impact of CTs on SDoH to inform CT policy , implementation , and research in SSA . The protocol follows the Preferred Reporting Items for Systematic Review and Meta- Analysis Protocol s ( PRISMA -P ) . Systematic review registration This protocol has been registered with the PROSPERO international prospect i ve register of systematic review s , reference CRD42015025015 Background : Human milk oligosaccharides ( HMOs ) and bioactive proteins are beneficial to infant health . Recent evidence suggests that maternal nutrition may affect the amount of HMOs and proteins in breast milk ; however , the effect of nutrient supplementation on HMOs and bioactive proteins has not yet been well studied . Objective : We aim ed to determine whether lipid-based nutrient supplements ( LNSs ) affect milk bioactive protein and HMO concentrations at 6 mo postpartum in women in rural Malawi . These are secondary outcomes of a previously published r and omized controlled trial . Methods : Women were r and omly assigned to consume either an iron and folic acid capsule ( IFA ) daily from ≤20 wk gestation until delivery , followed by placebo daily from delivery to 6 mo postpartum , or a multiple micronutrient ( MMN ) capsule or LNS daily from ≤20 wk gestation to 6 mo postpartum . Breast milk concentrations of total HMOs , sialylated HMOs , fucosylated HMOs , lactoferrin , lactalbumin , lysozymes , antitrypsin , immunoglobulin A , and osteopontin were analyzed at 6 mo postpartum ( n = 647 ) . Between-group differences in concentrations and in proportions of women classified as having low concentrations were tested . Results : HMO and bioactive protein concentrations did not differ between groups ( P > 0.10 for all comparisons ) . At 6 mo postpartum , the proportions of women with low HMOs or bioactive proteins were not different between groups except for osteopontin . A lower proportion of women in the IFA group had low osteopontin compared with the LNS group after adjusting for covariates ( OR : 0.5 ; 95 % CI : 0.3 , 0.9 ; P = 0.016 ) . Conclusion : The study findings do not support the hypothesis that supplementation with an LNS or MMN capsule during pregnancy and postpartum would increase HMO or bioactive milk proteins at 6 mo postpartum among Malawian women . This trial was registered at clinical trials.gov as NCT01239693 Background Chalmers and Glasziou ’s paper published in 2014 recommends research funding bodies should m and ate that proposals for additional primary research are built on systematic review s of existing evidence showing what is already known . Jones et al. identified 11 ( 23 % ) of 48 trials funded during 2006–8 by the National Institute for Health Research Health Technology Assessment ( NIHR HTA ) Programme did not reference a systematic review . This study did not explore the reasons for trials not referencing a systematic review or consider trials using any other evidence in the absence of a systematic review . Referencing a systematic review may not be possible in certain circumstances , for instance if the systematic review does not address the question being proposed in the trial . The current study extended Jones ’ study by exploring the reasons for why trials did not reference a systematic review and included a more recent cohort of trials funded in 2013 to determine if there were any changes in the referencing or use of systematic review s. Methods Two cohorts of NIHR HTA r and omised controlled trials were included . Cohort I included the same trials as Jones et al. ( with the exception of one trial which was discontinued ) . Cohort II included NIHR HTA trials funded in 2013 . Data extraction was undertaken independently by two review ers using full applications and trial protocol s. Descriptive statistics was used and no formal statistical analyses were conducted . Results Five ( 11 % ) trials of the 47 funded during 2006–2008 did not reference a systematic review . These 5 trials had warranted reasons for not referencing systematic review s. All trials from Cohort II referenced a systematic review . A quarter of all those trials with a preceding systematic review used a different primary outcome than those stated in the review s. Conclusions The NIHR requires that proposals for new primary research are justified by existing evidence and the findings of this study confirm the adherence to this requirement with a high rate of applications using systematic review Background The European Academy of Allergy and Clinical Immunology is developing guidelines about how to prevent and manage food allergy . As part of the guidelines development process , a systematic review is planned to examine published research about the prevention of food allergy . This systematic review is one of seven inter-linked evidence syntheses that are being undertaken in order to provide a state-of-the-art synopsis of the current evidence base in relation to epidemiology , prevention , diagnosis and clinical management , and impact on quality of life , which will be used to inform clinical recommendations . The aim of this systematic review will be to assess the effectiveness of approaches for the primary prevention of food allergy . Methods Seven bibliographic data bases will be search ed from their inception to September 30 , 2012 for systematic review s , r and omized controlled trials , quasi-r and omized controlled trials , controlled clinical trials , controlled before- and -after studies , interrupted time series and cohort studies . Cohort studies will be included due to an inability to r and omize with interventions such as breastfeeding . Studies that focused on the development of either food sensitization ( a proxy measure ) or food allergy will also be eligible for inclusion . Studies will be critically appraised using the Critical Appraisal Skills Program and Cochrane Risk of Bias tools , as appropriate . Discussion There is a lack of rigorous evidence to support recommendations about how to prevent the development of food allergy . It would appear that it is important to see the prevention of food allergy in the context of individual , family and wider factors that may influence its development . There is much left to learn about preventing food allergy , and this is a priority given the high societal and healthcare costs involved . This systematic review will help to further this learning This paper summarizes a 25-year program of research that has attempted to improve the early health and development of low-income mothers and children and their future life trajectories with prenatal and infancy home visiting by nurses .  The program has been tested in two separate large-scale r and omized controlled trials with different population s living in different context s. The program has been successful in improving parental care of the child as reflected in fewer injuries and ingestions that may be associated with child abuse and neglect ; and maternal life-course , reflected in fewer subsequent pregnancies , greater work force participation , and reduced use of public assistance and food stamps . In the first trial , the program also produced long-term effects on the number of arrests , convictions , emergent substance use , and promiscuous sexual activity of 15-year-old children whose nurse-visited mothers were low-income and unmarried when they registered in the study during pregnancy . Since 1996 , the program has been offered for public investment outside of research context s. Careful attention has been given to ensuring that the program is replicated with fidelity to the model tested in the scientifically controlled studies by working with community leaders to ensure that organization and community context s are favorable for the program ; by providing the nurses with excellent training and technical assistance and detailed visit-by-visit guidelines ; and by providing organizations with a web-based clinical information system that creates a basis for monitoring program performance and continuous quality improvement BACKGROUND The relationship between mite and pet allergen exposure in infancy and the subsequent development of sensitization and asthma is complex . OBJECTIVE We prospect ively investigated the effect of allergen exposure at 3 months of age on the development of sensitization , wheeze , and physician-diagnosed asthma in the first 4 years of life in a birth cohort of children with and without an atopic mother . METHODS Children participated in the Prevention and Incidence of Asthma and Mite Allergy study .  Allergen exposure at 3 months of age was determined from mattress dust sample s. Specific IgE to inhalant allergens was measured at 4 years of age , and information about wheeze and physician-diagnosed asthma was collected with yearly question naires . RESULTS Mite and cat allergen exposure in infancy were associated with an increased risk of specific sensitization to house dust mite and cat , respectively , at 4 years of age . There were borderline significant associations between cat allergen exposure and persistent wheeze in the total study population and between dog allergen exposure and persistent wheeze in children with a nonatopic mother . In children with an atopic mother , there was some indication of a positive association between mite allergen exposure and physician-diagnosed asthma . CONCLUSION Early house dust mite and cat allergen exposure might lead to sensitization and , in case of cat allergen exposure , to persistent wheeze . Early mite and dog allergen exposure might lead to asthma and persistent wheeze , respectively , but only in subgroups defined by maternal atopy Review question / objective What are the effects of weight management interventions that include a diet component on weight‐related outcomes in pregnant and postpartum women ? The primary objective of this systematic review is to evaluate the effectiveness of weight management interventions which include a diet component and are aim ed at limiting gestational weight gain and postpartum weight retention in women . The second objective of this systematic review is to investigate included intervention components with respect to effect on weight‐related outcomes . This may include , but is not limited to : length of intervention , use of face‐to‐face counselling , group or individual consultations , use of other interventions components including exercise , use of goals and use of support tools like food diaries , coaching , including email or text message support . Background Around half of all women of reproductive age are either overweight or obese,1,2,3 with women aged 25‐34 years having a greater risk of substantial weight gain compared with men of all ages.1,4 Excessive gestational weight gain ( GWG ) and postpartum weight retention ( PPWR ) may play a significant role in long term obesity . Having one child doubles the five‐ and 10‐year obesity incidence for women , with many women who gain excessive weight during pregnancy remaining obese permanently.5 Excessive GWG and /or PPWR can also significantly contribute to short‐ and long‐term adverse health outcomes for mother , baby and future pregnancies.6,7 Maternal obesity increases the risk of pregnancy related complications such as pre‐eclampsia , gestational diabetes mellitus , stillbirth and the rate of caesarean section.8 Childhood obesity is a further long term complication of maternal obesity for offspring , which may persist in to adulthood.9 Excess GWG is also a risk factor for PPWR both in the short and long‐term.10,11 Nehring et al. conducted a meta‐ analysis with over 65,000 women showing that , compared to women who gained weight within recommendations during pregnancy , women with GWG above Institute of Medicine weight gain recommendations , 12 retained an additional 3.1 kg and 4.7 kg after three and greater than or equal to 15 years postpartum , respectively.13 The health risk associated with PPWR is highlighted in a study of 151,025 Swedish women followed between 1992 and 2001.The study identified the risk of adverse pregnancy outcomes for those who gained three or more units of Body Mass Index ( kg/m2 ) between consecutive pregnancies ( an average of two years ) was much higher compared with women whose BMI changed from ‐1.0 and 0.9 units.14 Long‐term chronic disease risk may also be affected by PPWR as weight retention at the end of the first year post‐partum has been found to be a predictor of maternal overweight 15 years later.15With around 14‐20 % of women retaining 5 kg or more 12 months postpartum,16,5 the risk of developing conditions like diabetes , metabolic syndrome and cardiovascular disease may be increased.17 It becomes evident that interventions which aim to support attainment of healthy weight both in the antenatal and postpartum periods are key health priorities for women during this life stage . Lifestyle factors of overweight , having poor diet quality , and not undertaking enough moderate‐to‐vigorous physical activity are amongst the top five predictors of mortality in women.18 Additionally it is noted that , for many women , pregnancy and the postpartum period are associated with a reduction in physical activity.19 It is known that a combination of poor dietary choices , an increase in sedentary time and reduction in physical activity are all contributors to the development of overweight and obesity . With this in mind , current research has focused on lifestyle interventions to limit GWG and PPWR . Thangaratinam et al. review ed 44 r and omized controlled trials ( 7278 women ) where interventions including diet , physical activity or both were evaluated for their influence on maternal weight during  pregnancy.20 Results indicate that all were significantly effective in reducing GWG compared with the control group . More specifically , dietary interventions were the most effective in reducing weight gain , with a mean weight loss of ‐3.84 kg compared with ‐0.72 kg and ‐1.06 kg for physical activity and the mixed ( diet plus physical activity ) approach , respectively.20 This finding is supported by Hill and colleagues ' recent systematic review of theory based interventions to limit GWG.21 Included studies in this review reported an underpinning theory base and were classified as adopting a dietary , physical activity or mixed approach . Hill et al. concluded that studies which included a diet intervention were significantly more effective at limiting GWG.21 In 2011 Tanentsapf et al. review ed the effect of dietary interventions alone for reducing GWG in normal weight , overweight and obese pregnant women.22 This review analysed 13 r and omized controlled trials and quasi‐r and omized controlled trials with a dietary intervention to prevent excessive GWG in women . The review concluded that dietary interventions during pregnancy were effective in reducing GWG with an effect of ‐1.92 kg ( n=1434 ) compared with the control group.22 Tanentsapf et al. identified that trials differed in the conduct of the interventions with various diet and non‐diet related components utilised . Dietary approaches were highly variable with some trials focusing only on calorie restriction and others included additional target macronutrient distribution for intake . Some trials further provided feedback based on maternal weight gain guidelines .12 Interventions also varied in delivery method with a variety of modes used , including face‐to‐face , individual or group consultations and /or written correspondence . The frequency of communication , despite the type or mix , also changed from trial to trial with additional methods via telephone , posted material s , feedback or food diaries utilised . The inclusion of physical activity in addition to diet intervention was also common . Whilst the recent review by Tanentsapf et al.22 identified that dietary interventions are effective in reducing GWG , the review did not investigate the impact that different intervention components , delivery methods or dietary counselling approaches had on gestational weight management . It remains unclear as to which intervention components optimize GWG in women . The impact of lifestyle interventions has also been investigated in the postpartum period . The recent systematic review from van der Pligt et al. reported seven of 11 studies review ed were successful in limiting PPWR.23 As with studies aim ed at limiting GWG , interventions included in van der Pligt et al. 's review differed greatly in their conduct . Six of these seven studies included both dietary and physical activity components for the intervention , with the final successful study including a diet only intervention . Five of the successful studies recruited overweight or obese women only . Intervention time varied considerably in successful studies with some running for as little at ten days , and others up to six months . Bertz et al. demonstrated that their 12‐week behavior modification intervention which targeted diet alone or diet and exercise , including two individual sessions with a dietitian and physical therapist , provision of scales for weight self‐monitoring and bi‐weekly text messages was successful in achieving significant weight loss following the intervention , and sustained at one year.24 The diet intervention and the diet and exercise intervention  yielded significant weight loss compared to the control . Following 12 weeks a reduction of ‐8.3 + /‐ 4.2 kg for diet intervention and ‐6.9 + /‐ 3.0 kg for diet and exercise was observed . Additionally after one year , the diet intervention showed ‐10.2 + /‐ 5.7 kg reduction and ‐7.3 + /‐ 6.3 kg for the diet and exercise intervention (p<0.001).24 Colleran et al. also found significant weight change results by implementing a 16‐week intervention which consisted of weekly individual sessions with a dietitian regarding calorie restriction , two additional home visits regarding exercise , weekly food diary completion and email support.25 The intervention group had greater weight loss compared to the control group ( ‐5.8 kg + /‐ 3.5 kg vs ‐1.6 kg + /‐ 5.4 kg ) . It can be seen that various methods have been utilized in investigating the impact of diet and physical activity interventions on PPWR . The review by van der Pligt et al.23 highlights the impact successful lifestyle interventions can have on postpartum weight change . However , this review did not investigate the different intervention strategies utilized . It remains unclear as to the optimal setting , delivery method , diet strategy , contact frequency or intervention length to limit PPWR . Previous systematic review s for both GWG and PPWR have focused on the effectiveness of lifestyle interventions as a whole for weight management in pregnant and postpartum women.20,23 And despite Tanentsapf et al. 's focus on dietary interventions for GWG,22 much is still unknown about the effectiveness of differing diet interventions over the antenatal and postpartum period . Specifically , the impact of differing diet intervention strategies on maternal weight gain is not known . Firstly , this systematic review will focus on whether  weight management interventions which include a dietary component  are effective in pregnant and postpartum women . In addition to this , this review will investigate the different intervention strategies utilized and their effectiveness in maternal weight management . A search of systematic review protocol data bases has shown that there is no current review underway for this topic Background We investigated whether there had been an improvement in quality of reporting for r and omised controlled trials of acupuncture since the publication of the STRICTA and CONSORT statements . We conducted a before- and -after study , comparing ratings for quality of reporting following the publication of both STRICTA and CONSORT recommendations . Methodology and Principal Findings Ninety peer review ed journal articles reporting the results of acupuncture trials were selected at r and om from a wider sample frame of 266 papers . Papers published in three distinct time periods ( 1994–1995 , 1999–2000 and 2004–2005 ) were compared . Assessment criteria were developed directly from CONSORT and STRICTA checklists . Papers were independently assessed for quality of reporting by two assessors , one of whom was blind to information which could have introduced systematic bias ( e.g. date of publication ) . We detected a statistically significant increase in the reporting of CONSORT items for papers published in each time period measured . We did not , however , find a difference between the number of STRICTA items reported in journal articles published before and 3 to 4 years following the introduction of STRICTA recommendations . Conclusions and Significance The results of this study suggest that general st and ards of reporting for acupuncture trials have significantly improved since the introduction of the CONSORT statement in 1996 , but that quality in reporting details specific to acupuncture interventions has yet to change following the more recent introduction of STRICTA recommendations . Wider targeting and revision of the guidelines is recommended Empirical prediction models that weight food frequency question naire ( FFQ ) food items by their relation to nutrient biomarker concentrations may estimate nutrient exposure better than nutrient intakes derived from food composition data bases . Carotenoids may especially benefit because contributing foods vary in bioavailability and assessment validity . Our objective was to develop empirical prediction models for the major plasma carotenoids and total carotenoids and evaluate their validity compared with dietary intakes calculated from st and ard food composition tables . 4180 nonsmoking women in the Nurses ’ Health Study ( NHS ) blood subcohort with previously measured plasma carotenoids were r and omly divided into training ( n = 2787 ) and testing ( n = 1393 ) subsets . Empirical prediction models were developed in the training subset by stepwise selection from foods contributing ≥0.5 % to intake of the relevant carotenoid . Spearman correlations between predicted and measured plasma concentrations were compared to Spearman correlations between dietary intake and measured plasma concentrations for each carotenoid . Three to 12 foods were selected for the α-carotene , β-carotene , β-cryptoxanthin , lutein/zeaxanthin , lycopene , and total carotenoids prediction models . In the testing subset , Spearman correlations with measured plasma concentrations for the calculated dietary intakes and predicted plasma concentrations , respectively , were 0.31 and 0.37 for α-carotene , 0.29 and 0.31 for β-carotene , 0.36 and 0.41 for β-cryptoxanthin , 0.28 and 0.31 for lutein/zeaxanthin , 0.22 and 0.23 for lycopene , and 0.22 and 0.27 for total carotenoids . Empirical prediction models may modestly improve assessment of some carotenoids , particularly α-carotene and β-cryptoxanthin
Based on the existing information , it is not possible to establish the role of antioxidants and vitamin D supplementation in atopic disease development .
There is no evidence of major effects of prenatal use of folic acid on asthma or allergies .
The association of some nutritional interventions with less atopic sensitization seems rather speculative even if such an effect has not been found for some other foods .
The findings indicate rather a balanced and diverse diet without restrictions than a special dietary protocol .
Farming-related exposures may protect against the development of atopic disorders in children .
Long-chain polyunsaturated fatty acids and probiotics seem to be promising c and i date s for allergy prevention .
The paper refers to the recently published empirical data and systematic review s on the impact of diets , foods , nutrients and bioactive substance exposures in pregnancy and in early infancy , on the development of atopic disorders .