PARSIFAL

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PARSIFAL (Prevention of Allergy—Risk Factors for Sensitization Related to Farming and Anthroposophic Lifestyle) was a 2006 multicenter study, conducted in five European countries, comparing the incidence of atopic disease in children attending with that in children attending other schools. The main objectives of the PARSIFAL study were 1) to investigate whether the previously observed reduced prevalences of atopic disease in children attending Waldorf schools could be confirmed in a large population of children from 5 European countries and 2) to explore commonly found factors in families with anthroposophic lifestyles which might explain the lower prevalence of such diseases in these children.
Specific lifestyle factors studied in the families included: restrictive use of antibiotics, limited vaccinations, and a diet containing live lactobacilli, which may affect the intestinal microflora. "Anthroposophical doctors restrict the use of antibiotics, antipyretics, and vaccinations. Most children are vaccinated only against tetanus and polio, and most vaccinations are given later than recommended by the Swedish health authorities. As a result, in Sweden, measles occurs primarily in anthroposophic families. They also consume mostly local foods produced according to biodynamic principles. Vegetables preserved by spontaneous fermentation are a common dietary element, even for small children."
The study was carried out on the response to questionnaires for 6,630 children (4,606 Steiner school children and 2,024 reference children) and blood samples for 28% of all included children. Allergen-specific IgE antibody levels were measured against a mixture of common inhalant and food allergens. Antibiotics and antipyretics were used less often in the Steiner school children, whereas a diet mainly based on biodynamic food was found almost exclusively in the Steiner school children group. MMR vaccination was about three times less common than in the reference group, and the prevalence of measles infection was three times greater than in the reference group. In addition to the findings of the earlier Lancet paper,<ref name=Lancet/> the PARSIFAL study reported lower incidence of rhinoconjunctivitis (a combination of rhinitis and conjunctivitis) and atopic sensitization. Focusing on doctor-diagnosed disease, the use of antibiotics during the first year of life was associated with increased risks of rhinoconjunctivitis, asthma and atopic eczema. Early use of antipyretics was related to an increased risk of asthma and atopic eczema. Children having received MMR vaccination showed an increased risk of rhinoconjunctivitis, whereas measles infection was associated with a lower risk of eczema related to IgE antibodies.
The authors concluded that "certain features of the anthroposophic lifestyle, such as restrictive use of antibiotics and antipyretics, are associated with a reduced risk of allergic disease in children."<ref name=JACI/>

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