Reversing or aborting the increase in allergic and other immune-related non-communicable diseases (NCDs) in the western world, first observed for allergic rhinitis from the 1890ies ¹ , requires primary prevention strategies, probably on a general population level. The diseases are likely to be related to changes in lifestyle, environment or both ² , including reduced microbial diversity, increased use of xenobiotics in industrial and consumer products, exposure to tobacco or nicotinic products and variations in diets and nutritional elements. While some primary allergy preventive strategies may be effective in high risk children ³ , the relevance for preventive strategies on a population level is unclear ⁴ . This article is protected by copyright. All rights reserved.