Low salivary cortisol levels in infants of families with an anthroposophic lifestyle☆
Introduction
The prevalence of IgE-associated allergic diseases has increased markedly during the past decades, especially in children, although recent reports indicate that the occurrence in some regions has stabilised (Asher et al., 2006). Several factors, including an anthroposophic lifestyle, have been associated with protection against development of allergic diseases (Alm et al., 1999, Strachan, 2000, Garn and Renz, 2007). The protective effect of an anthroposophic lifestyle during early childhood has been attributed to factors like an organic diet including fermentation by live lactobacilli, home deliveries and restrictive use of antibiotics, antipyretics and vaccinations (Alm et al., 1999, Alfven et al., 2006, Floistrup et al., 2006, Dicksved et al., 2007). However, an anthroposophic lifestyle also implies specific environmental conditions for the infant aimed at reducing negative stress (Glöcker and Goebel, 2007). A relationship between psychosocial factors like exposure to environmental stressors and the development of atopic disorders in children has been indicated (Chida et al., 2008). Further, parental stress has been associated to later development of asthmatic and allergic diseases in children (Milam et al., 2008, Cookson et al., 2009) and alterations in cortisol levels have been shown in children predisposed to disease (Ball et al., 2006). One possible pathway could be a “stress-modified” hypothalamus-pituitary-adrenal (HPA)-axis (Knackstedt et al., 2005).
Cortisol is the main end product of the HPA-axis activity and has a central role for several organ systems (Sapolsky et al., 2000). There is a close relationship between variations in serum/plasma concentration of free cortisol and saliva cortisol (Kirschbaum and Hellhammer, 1994). Saliva sampling has been applied in a large number of studies on the impact of environmental influences during infancy on behaviour and cognition, which support previous findings from animal studies (Lupien et al., 2009). To our knowledge no study has been published on cortisol levels in infants who grow up in an environment characterised by intentional stress regulation, such as in the anthroposophic society. The low risk of allergy among children with an anthroposophic lifestyle adds to the importance of such a study. Thus, the aim of our study was to investigate if infants in families with an anthroposophic lifestyle have different levels of salivary cortisol than other children.
Section snippets
Methods
This study is based on ALADDIN (Assessment of Lifestyle and Allergic Disease During INfancy), a prospective birth cohort study which started in 2004 and focuses on the impact of lifestyle during pregnancy and early childhood on the development of allergic disease. A total of 330 families were enrolled between September 2004 and November 2007. Families were recruited at anthroposophic health care centres in Järna (n = 120) and Stockholm (n = 69) and from conventional health care centres in Järna (n =
Results
Of 330 families recruited 4 were excluded due to preterm delivery and 2 due to miscarriage. Nineteen families decided not to continue in the study: 6 due to stressful situations/complications during delivery, 4 due to diseases of the child, 3 due to moving, 1 because of disease of the mother during pregnancy, and 5 for unknown reasons.
At the age of 6 months of the infants 305 families remained in the study and of these 210 (53 anthroposophic, 82 partly anthroposophic and 75 non-anthroposophic)
Discussion
In this study of salivary cortisol of 6-month olds and their parents, levels on all sampling occasions were lower in infants growing up in anthroposophic families than in families with more conventional lifestyle. Infants with the most anthroposophic lifestyle had the lowest levels of cortisol, those with the non-anthroposophic lifestyle the highest and the “partly anthroposophic group” levels in between, suggesting a “dose–response” relationship. Parental cortisol levels did not differ between
Conflicts of interest statements
We declare that we have no conflict of interests in connection with this paper.
Role of funding source
None.
Acknowledgments
The authors would like to acknowledge the families participating in ALADDIN for their trust and contribution to this study and the “ALADDIN-group” for their involvement in this work. We would like to thank Margareta Eriksson and Bartolome de la Torre. This work was supported by grants from the Swedish Research Council for Working Life and Social Research, The Stockholm County Council, The “Mjölkdroppen” Society, The Cancer- and Allergy Fund, The Centre for Allergy Research Karolinska
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