Consumption of differently processed milk products and the risk of asthma in children

Katariina Koivusaari, Essi Syrjälä, Sari Niinistö, Suvi Ahonen, Mari Åkerlund, Tuuli E. Korhonen, Jorma Toppari, Jorma Ilonen, Minna Kaila, Mikael Knip, Tapani Alatossava, Riitta Veijola, Suvi M. Virtanen

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Background: Consumption of unprocessed cow's milk has been associated with a lower risk of childhood asthma and/or atopy. Not much is known about differently processed milk products. We aimed to study the association between the consumption of differently processed milk products and asthma risk in a Finnish birth cohort. Methods: We included 3053 children from the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Nutrition Study. Asthma and its subtypes were assessed at the age of 5 years, and food consumption by food records, at the age of 3 and 6 months and 1, 2, 3, 4, and 5 years. We used conventional and processing (heat treatment and homogenization)-based classifications for milk products. The data were analyzed using a joint model for longitudinal and time-to-event data. Results: At the age of 5 years, 184 (6.0%) children had asthma, of whom 101 (54.9%) were atopic, 75 (40.8%) were nonatopic, and eight (4.3%) could not be categorized. Consumption of infant formulas [adjusted hazard ratio (95% confidence intervals) 1.15 (1.07, 1.23), p <.001] and strongly heat-treated milk products [1.06 (1.01, 1.10), p =.01] was associated with the risk of all asthma. Consumption of all cow's milk products [1.09 (1.03, 1.15), p =.003], nonfermented milk products [1.08 (1.02, 1.14), p =.008], infant formulas [1.23 (1.13, 1.34), p <.001], and strongly heat-treated milk products [1.08 (1.02, 1.15), p =.006] was associated with nonatopic asthma risk. All these associations remained statistically significant after multiple testing correction. Conclusions: High consumption of infant formula and other strongly heat-treated milk products may be associated with the development of asthma.

Original languageEnglish
Issue number1
Early online dateSept 2021
Publication statusPublished - 2022
Publication typeA1 Journal article-refereed


  • childhood chronic asthma
  • infant formula
  • joint models for longitudinal and time-to-event data
  • milk products
  • processing of milk

Publication forum classification

  • Publication forum level 2

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy
  • Immunology


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