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Objectives: We investigated associations of breastfeeding (BF) durations and patterns and of timing of other dietary introductions with prevalence of asthma, wheeze, hay fever, rhinitis, pneumonia, and eczema among preschool children.Methods: During April 2011-April 2012, we conducted a cross-sectional study in 72 kindergartens from five districts of Shanghai, China and obtained 13,335 questionnaires of children 4–6-years-old. We used multiple logistic regression models to evaluate the target associations.Results: Compared to children who were never BF, children who were exclusively breastfed 3–6 months had the lowest risk of asthma (adjusted odds ratio and 95% confidence interval: 0.81, 0.72–0.91) and wheeze (0.93, 0.87–0.99); and exclusive BF >6 months was significantly associated with a reduced risk of hay fever (0.93, 0.89–0.97), rhinitis (0.97, 0.94–0.99), pneumonia (0.97, 0.94–0.99), and eczema (0.96, 0.93–0.99). No significant associations were found between time when fruits or vegetables were introduced and the studied diseases. Associations were independent of the child's sex and parent's ownership of the current residence. Longer duration BF was only significantly protective when there was no family history of atopy.Conclusions: This study suggests that heredity, but not sex and socioeconomic status, may negatively impact the effect of BF on childhood airway and allergic diseases. Our findings support China's national recommendation that mothers provide exclusive BF for the first four months, and continue partial BF for more than 6 months. [ABSTRACT FROM AUTHOR]

The prevalence of asthma and allergic diseases has increased rapidly in urban China since 2000. There has been limited study of associations between home environmental and lifestyle factors with asthma and symptoms of allergic disease in China. In a cross-sectional analysis of 2214 children in Beijing, we applied a two-step hybrid Least Absolute Shrinkage and Selection Operator (LASSO) algorithm to identify environmental and lifestyle-related factors associated with asthma, rhinitis and wheeze from a wide range of candidates. We used group LASSO to select variables, using cross-validation as the criterion. Effect estimates were then calculated using adaptive LASSO. Model performance was assessed using Area Under the Curve (AUC) values. We found a number of environmental and lifestyle-related factors significantly associated with asthma, rhinitis or wheeze, which changed the probability of asthma, rhinitis or wheeze from −5.76% (95%CI: −7.74%, −3.79%) to 27.4% (95%CI: 16.6%, 38.3%). The three factors associated with the largest change in probability of asthma were short birth length, carpeted floor and paternal allergy; for rhinitis they were maternal smoking during pregnancy, paternal allergy and living close to industrial area; and for wheeze they were carpeted floor, short birth length and maternal allergy. Other home environmental risk factors identified were living close to a highway, industrial area or river, sharing bedroom, cooking with gas, furry pets, cockroaches, incense, printer/photocopier, TV, damp, and window condensation in winter. Lifestyle-related risk factors were child caretakers other than parents, and age<3 for the day-care. Other risk factors included use of antibiotics, and mother's occupation. Major protective factors for wheeze were living in a rural/suburban region, air conditioner use, and mother's occupation in healthcare. Our findings suggest that changes in lifestyle and indoor environments associated with the urbanization and industrialization of China are associated with asthma, rhinitis, and wheeze in children. Image 1 • We investigated home environmental and lifestyle factors associated with children's allergy. • We used a global variable procedure (LASSO) to select potential influencing factors. • We assessed associated factors in common for asthma, wheeze and rhinitis. • We calculated the probability change due to each risk factor. • Our model has sufficient statistic power and strong predicting performance. [ABSTRACT FROM AUTHOR]