101
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Barros R, Moreira A, Padrão P, Teixeira VH, Carvalho P, Delgado L, Lopes C, Severo M, Moreira P. Dietary patterns and asthma prevalence, incidence and control. Clin Exp Allergy 2016; 45:1673-80. [PMID: 25818037 DOI: 10.1111/cea.12544] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 02/05/2015] [Accepted: 03/11/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND The increased asthma prevalence in westernized societies has been suggested to be related to environment exposures and lifestyle changes, particularly diet. We aimed to explore the association between dietary patterns and asthma prevalence, incidence and control in a nationally representative population. METHODS Data from 32,644 adults, 53% female, from the 4th Portuguese National Health Survey were analysed. Prevalence of asthma was 5.3%; 'current asthma', defined by asthma symptoms within previous year, 3.5%; 'current medicated asthma' defined by use of asthma medication within previous year, 3.0%; 'current severe asthma' defined by emergency visit because of asthma within previous year, 1.4%; and 'incident asthma', 0.2%. Dietary patterns (DP) were identified by latent trait models based on dietary intake. Unconditional logistic regression models were performed to analyse association between DP and asthma. Age, gender, education, family income, proxy reporting information, smoking, body mass index and physical activity level were analysed as confounders. RESULTS Two of the five identified DP were associated with asthma: 'high fat, sugar and salt' DP (positively correlated with pastry, chocolate and sweet desserts, candies, salty snacks, chips, fruit juices, soft drinks and alcoholic beverages consumption at snacks) was associated with asthma prevalence (OR = 1.13, 95% CI = 1.03, 1.24) and current severe asthma (OR = 1.23, 95% CI = 1.03, 1.48), while 'fish, fruit and vegetables' DP (positively correlated with fish, vegetables and fruit intake at meals) was negatively associated with current (OR = 0.84, 95% CI = 0.73, 0.98), and current medicated asthma (OR = 0.84, 95% CI = 0.72, 0.98), after adjustment for confounders. CONCLUSION & CLINICAL RELEVANCE Our results suggest a protective association between 'fish, vegetables and fruit' DP and current asthma and current medicated asthma, and a detrimental association between 'high fat, sugar and salt' DP and severe asthma prevalence, further supporting the rational for diet and lifestyle intervention studies in asthma based on whole dietary patterns and physical activity.
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Affiliation(s)
- R Barros
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - A Moreira
- Laboratory of Immunology, Basic and Clinical Immunology Unit, Faculty of Medicine, University of Porto, Porto, Portugal.,Immunoallergology Department, Centro Hospitalar São João, Porto, Portugal
| | - P Padrão
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.,Epiunit - Public Health Institute, University of Porto, Porto, Portugal
| | - V H Teixeira
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.,Research Centre on Physical Activity and Health, University of Porto, Porto, Portugal
| | - P Carvalho
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - L Delgado
- Laboratory of Immunology, Basic and Clinical Immunology Unit, Faculty of Medicine, University of Porto, Porto, Portugal.,Immunoallergology Department, Centro Hospitalar São João, Porto, Portugal
| | - C Lopes
- Epiunit - Public Health Institute, University of Porto, Porto, Portugal.,Department Clinical Epidemiology, Predictive Medicine and Public Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - M Severo
- Epiunit - Public Health Institute, University of Porto, Porto, Portugal.,Department Clinical Epidemiology, Predictive Medicine and Public Health, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Medical Education and Simulation Clinical Epidemiology, Predictive Medicine and Public Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - P Moreira
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.,Research Centre on Physical Activity and Health, University of Porto, Porto, Portugal
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102
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Kantor R, Silverberg JI. Environmental risk factors and their role in the management of atopic dermatitis. Expert Rev Clin Immunol 2016; 13:15-26. [PMID: 27417220 DOI: 10.1080/1744666x.2016.1212660] [Citation(s) in RCA: 194] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors. Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD. Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.
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Affiliation(s)
- Robert Kantor
- a Department of Dermatology , Northwestern University , Chicago , IL , USA
| | - Jonathan I Silverberg
- b Departments of Dermatology, Preventive Medicine and Medical Social Sciences , Northwestern University , Chicago , IL , USA
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103
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The lipid profile in obese asthmatic children compared to non-obese asthmatic children. Allergol Immunopathol (Madr) 2016; 44:346-50. [PMID: 27112546 DOI: 10.1016/j.aller.2015.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 11/18/2015] [Accepted: 12/03/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND A relationship between asthma and obesity has been documented in children and adolescents. An alternate day calorie restriction diet has been reported to improve asthma symptoms by decreasing levels of serum cholesterol and triglycerides, reducing markers of oxidative stress and increasing levels of the antioxidant uric acid. Therefore, to investigate the lipid profile in asthmatic children may be important in asthma control treatment. MATERIALS AND METHODS One hundred and sixty newly diagnosed persistent asthmatic children were selected to participate in the study. They were divided into four groups based on their body mass index (BMI): Group I normal weight (BMI=20-24.9kg/m(2), n=30); Group II under-weight (BMI<20kg/m(2), n=30); Group III overweight (BMI=25-30kg/m(2), n=25); and Group IV obese (BMI>30kg/m(2), n=25). Fasting blood sugar, fasting insulin, and HbA1c were measured to exclude the possibility of pre-diabetes. Lipid profile measurements included total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), apo-A1, apo-B and triglycerides. RESULTS There were no significant differences in the levels of apo-A1, apo-B, triglycerides, cholesterol and LDL in all four groups. Only the level of HDL was higher in GIV>GIII>GII>GI (75.84±13.95, 68.56±15.28, 64.17±13.93, 63.17±14.34mg/dl, respectively). There were no cases of pre-diabetes in any of the four groups. CONCLUSION Hypercholesterolaemia and hypertriglyceridaemia were not found in any of the persistent asthmatic children, and thus they are not high risk factors for asthma. Similarly, there were no differences in apo-A1 and apo-B between any of the BMI groups. No differences were found in LDL levels, however HDL levels were increased in all four groups, indicating that allergic sensitisation may have occurred. Controlling body weight and restricting calorie intake may be as important as appropriate pharmacological management in controlling asthma.
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104
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Sheth A, Asher MI, Ellwood P, Ellwood E. Can geodata be used to determine the distribution of fast food outlets in relation to the prevalence and severity of asthma? A novel methodology. Allergol Immunopathol (Madr) 2016; 44:307-13. [PMID: 26589338 DOI: 10.1016/j.aller.2015.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 07/16/2015] [Indexed: 01/04/2023]
Abstract
RESEARCH QUESTION Can the distribution of fast food outlets be obtained and effectively used to identify if there is a relationship between the placement of these and the prevalence and severity of asthma, rhinoconjunctivitis and eczema (ARE) in children and adolescents? METHOD Fast food restaurant location data was obtained for seven countries. Data from the International Study of Asthma and Allergies in Childhood (ISAAC) was used from 53 centres in the same seven countries. Each ISAAC centre provided a detailed map of the study area. The location of restaurants and ISAAC centres were overlaid using the ArcMap software, and the number of restaurants within each ISAAC centre counted. Bivariate regression analysis was used to compare outlet density with ARE prevalence and severity. RESULTS The results from the analyses showed a positive (non-significant) trend on a regression plot between outlet density and ARE severity. This project has shown that it is practical to systematically obtain and map fast food outlets and compare their distribution worldwide with the prevalence and severity of diseases, in this case ARE. The devised methodology has proven to be an efficient way to obtain restaurant distribution data in a form that is manageable and suitable to compare with area based disease prevalences. This project has shown that a larger scale investigation is both feasible and warranted.
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Affiliation(s)
- A Sheth
- Department of Paediatrics: Child and Youth Health, The University of Auckland, New Zealand.
| | - M I Asher
- Department of Paediatrics: Child and Youth Health, The University of Auckland, New Zealand
| | - P Ellwood
- Department of Paediatrics: Child and Youth Health, The University of Auckland, New Zealand
| | - E Ellwood
- Department of Paediatrics: Child and Youth Health, The University of Auckland, New Zealand
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105
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Gostner JM, Becker K, Kofler H, Strasser B, Fuchs D. Tryptophan Metabolism in Allergic Disorders. Int Arch Allergy Immunol 2016; 169:203-15. [PMID: 27161289 PMCID: PMC5433561 DOI: 10.1159/000445500] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Allergic diseases such as asthma and rhinitis, as well the early phase of atopic dermatitis, are characterized by a Th2-skewed immune environment. Th2-type cytokines are upregulated in allergic inflammation, whereas there is downregulation of the Th1-type immune response and related cytokines, such as interferon-x03B3; (IFN-x03B3;). The latter is a strong inducer of indoleamine 2,3-dioxygenase-1 (IDO-1), which degrades the essential amino acid tryptophan, as part of an antiproliferative strategy of immunocompetent cells to halt the growth of infected and malignant cells, and also of T cells - an immunoregulatory intervention to avoid overactivation of the immune system. Raised serum tryptophan concentrations have been reported in patients with pollen allergy compared to healthy blood donors. Moreover, higher baseline tryptophan concentrations have been associated with a poor response to specific immunotherapy. It has been shown that the increase in tryptophan concentrations in patients with pollen allergy only exists outside the pollen season, and not during the season. Interestingly, there is only a minor alteration of the kynurenine to tryptophan ratio (Kyn/Trp, an index of tryptophan breakdown). The reason for the higher tryptophan concentrations in patients with pollen allergy outside the season remains a matter of discussion. To this regard, the specific interaction of nitric oxide (NO∙) with the tryptophan-degrading enzyme IDO-1 could be important, because an enhanced formation of NO∙ has been reported in patients with asthma and allergic rhinitis. Importantly, NO∙ suppresses the activity of the heme enzyme IDO-1, which could explain the higher tryptophan levels. Thus, inhibitors of inducible NO∙ synthase should be reconsidered as candidates for antiallergic therapy out of season that may abrogate the arrest of IDO-1 by decreasing the production of NO∙. Considering its association with the pathophysiology of atopic disease, tryptophan metabolism may play a relevant role in the pathophysiology of allergic disorders.
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Affiliation(s)
- Johanna M. Gostner
- Division of Medical Biochemistry, Biocenter, Innsbruck Medical
University, Innsbruck
| | - Katrin Becker
- Division of Biological Chemistry, Biocenter, Innsbruck Medical
University, Innsbruck
| | | | - Barbara Strasser
- Division of Medical Biochemistry, Biocenter, Innsbruck Medical
University, Innsbruck
| | - Dietmar Fuchs
- Division of Biological Chemistry, Biocenter, Innsbruck Medical
University, Innsbruck
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106
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Logan AC, Jacka FN, Craig JM, Prescott SL. The Microbiome and Mental Health: Looking Back, Moving Forward with Lessons from Allergic Diseases. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2016; 14:131-47. [PMID: 27121424 PMCID: PMC4857870 DOI: 10.9758/cpn.2016.14.2.131] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 11/05/2015] [Indexed: 02/06/2023]
Abstract
Relationships between gastrointestinal viscera and human emotions have been documented by virtually all medical traditions known to date. The focus on this relationship has waxed and waned through the centuries, with noted surges in interest driven by cultural forces. Here we explore some of this history and the emerging trends in experimental and clinical research. In particular, we pay specific attention to how the hygiene hypothesis and emerging research on traditional dietary patterns has helped re-ignite interest in the use of microbes to support mental health. At present, the application of microbes and their structural parts as a means to positively influence mental health is an area filled with promise. However, there are many limitations within this new paradigm shift in neuropsychiatry. Impediments that could block translation of encouraging experimental studies include environmental forces that work toward dysbiosis, perhaps none more important than westernized dietary patterns. On the other hand, it is likely that specific dietary choices may amplify the value of future microbial-based therapeutics. Pre-clinical and clinical research involving microbiota and allergic disorders has predated recent work in psychiatry, an early start that provides valuable lessons. The microbiome is intimately connected to diet, nutrition, and other lifestyle variables; microbial-based psychopharmacology will need to consider this contextual application, otherwise the ceiling of clinical expectations will likely need to be lowered.
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Affiliation(s)
- Alan C Logan
- International Inflammation (in-FLAME) Network, Worldwide Universities Network (WUN), Geelong, Australia.,International Society for Nutritional Psychiatry Research (ISNPR), Geelong, Australia
| | - Felice N Jacka
- International Inflammation (in-FLAME) Network, Worldwide Universities Network (WUN), Geelong, Australia.,International Society for Nutritional Psychiatry Research (ISNPR), Geelong, Australia.,The Centre for Innovation in Mental and Physical Health and Clinical Treatment, School of Medicine, Deakin University, Geelong, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Australia.,Black Dog Institute, Sydney, Australia
| | - Jeffrey M Craig
- International Inflammation (in-FLAME) Network, Worldwide Universities Network (WUN), Geelong, Australia.,Group of Early Life Epigenetics, Department of Paediatrics, Murdoch Children's Research Institute, University of Melbourne, Melbourne, Australia
| | - Susan L Prescott
- International Inflammation (in-FLAME) Network, Worldwide Universities Network (WUN), Geelong, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
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107
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The possible mechanisms of the human microbiome in allergic diseases. Eur Arch Otorhinolaryngol 2016; 274:617-626. [DOI: 10.1007/s00405-016-4058-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 04/16/2016] [Indexed: 12/17/2022]
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108
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Willemsen LEM. Dietary n-3 long chain polyunsaturated fatty acids in allergy prevention and asthma treatment. Eur J Pharmacol 2016; 785:174-186. [PMID: 27041644 DOI: 10.1016/j.ejphar.2016.03.062] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 03/23/2016] [Accepted: 03/31/2016] [Indexed: 02/01/2023]
Abstract
The rise in non-communicable diseases, such as allergies, in westernized countries links to changes in lifestyle and diet. N-3 long chain polyunsaturated fatty acids (LCPUFA) present in marine oils facilitate a favorable milieu for immune maturation and may contribute to allergy prevention. N-3 LCPUFA can suppress innate and adaptive immune activation and induce epigenetic changes. Murine studies convincingly show protective effects of fish oil, a source of n-3 LCPUFA, in food allergy and asthma models. Observational studies in human indicate that high dietary intake of n-3 LCPUFA and low intake of n-6 PUFA may protect against the development of allergic disease early in life. High n-6 PUFA intake is also associated with an increased asthma risk while n-3 LCPUFA may be protective and reduce symptoms. The quality of the marine oil used has impact on efficacy of allergy prevention and several observations link in particular n-3 LCPUFA DHA to allergy suppression. Randomized controlled trials indicate that optimal timing, duration and dosage of n-3 LC-PUFA is required to exert an allergy protective effect. Supplementation during early pregnancy and lactation has shown promising results regarding allergy prevention. However these findings should be confirmed in a larger cohort. Although clinical trials in asthma patients reveal no consistent clinical benefits of n-3 LCPUFA supplementation on lung function, it can suppress airway inflammation. Future food-pharma approaches may reveal whether adjunct therapy with dietary n-3 LCPUFA can improve allergy prevention or immunotherapy via support of allergen specific oral tolerance induction or contribute to the efficacy of drug therapy for asthma patients.
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Affiliation(s)
- Linette E M Willemsen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Universiteitsweg 99, 3584 CG Utrecht, The Netherlands.
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109
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Silveira DH, Zhang L, Prietsch SOM, Vecchi AA, Susin LRO. Association between dietary habits and asthma severity in children. Indian Pediatr 2016; 52:25-30. [PMID: 25638180 DOI: 10.1007/s13312-015-0561-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To investigate association between dietary habits and asthma severity in children. DESIGN Cross-sectional study. SETTING Two teaching hospitals in Brazil. PARTICIPANTS Cases (n=268) were children (3-12yr) with persistent asthma and age-matched controls (n=126) were those with intermittent asthma. MAIN OUTCOME MEASURES Dietary habits were determined based on food consumption in the past 12 months classified as frequent (≥3 times per week) or infrequent (never or <3 times per week).Nutritional status was classified into two categories according to WHO Child Growth Standards: obese: >2Z-score of BMI-for-age; non-obese: ≤2Z-score of BMI-for-age. RESULTS After adjusting for confounding factors, maternal smoking during pregnancy, preterm birth and obesity were significantly associated with persistent asthma, with adjusted ORs (95% CI) of 2.11 (1.08- 4.13), 2.61(1.07-6.35) and 2.89 (1.49-5.61), respectively. No significant association was observed between frequency of consumption of specific foods, food groups, or dietary pattern (pro- or contra-Mediterranean diet) and the severity of asthma. CONCLUSIONS This study did not find a significant association between dietary habits and asthma severity in children. Maternal smoking during pregnancy, preterm birth and obesity were independent factors associated with persistent asthma.
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Affiliation(s)
- Denise Halpern Silveira
- School of Nutrition, Federal University of Pelotas; *Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Rio Grande, Rio Grande; and #Faculty of Medicine, Federal University of Pelotas, Pelotas; Brazil. Correspondence to: Dr Denise Halpern Silveira, Rua Raimundo Correia, 155, 96055-700- Três Vendas, Pelotas, RS-Brazil.
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Nitin J, Palagani R, Shradha NH, Vaibhav J, Kowshik K, Manoharan R, Nelliyanil M. Prevalence, severity and risk factors of allergic disorders among people in south India. Afr Health Sci 2016; 16:201-9. [PMID: 27358633 DOI: 10.4314/ahs.v16i1.27] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Allergic disorders are not usually life-threatening conditions but they impair the person's ability to function. It thus adversely affects the psychological wellbeing and quality of life. These implications of allergic disorders can be minimized if strategies are planned for its early identification followed by appropriate interventions. OBJECTIVES To find out the prevalence and risk factors of allergic disorders. METHODS Data was collected by house to house survey among participants aged 18 years and above using a standardized allergy assessment questionnaire. RESULTS Mean age of the 400 participants was 42.8±14.7 years. Majority 105(26.2%) were in the age group 36 to 45 years. Majority were females 287(71.7%) and were house wives 217(54.2%). Majority of participants were of upper socio economic class 98(44.7%) out of 219 and majority were from urban areas 326(81.5%). The prevalence of allergy among participants was found to be 115(28.7%). Out of these 115, 37(32.2%) had possibility of allergy, 60(52.2%) had probability of allergy and the rest 18(15.6%) had very high likelihood for allergy. People residing in semi urban areas had increased risk of allergy (p=0.024) than those from urban areas. The prevalence of asthma was 30(7.5%) and skin allergy was 23(5.8%). Most common precipitating factors for allergy were dust exposure 103(25.8%) followed by seasonal changes 71(17.8%). Family history of allergy was associated with allergy among participants (p<0.001). Usage of firewood was associated with symptoms of respiratory allergy among participants (p=0.01). CONCLUSION The study revealed some important determinants of allergic disorders which have important implications to frame appropriate prevention and health educational strategies.
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Affiliation(s)
- Joseph Nitin
- Kasturba Medical College, Manipal University, Mangalore, Community Medicine
| | - Revathi Palagani
- Kasturba Medical College, Manipal University, Mangalore, Community Medicine
| | - N H Shradha
- Kasturba Medical College, Manipal University, Mangalore, Community Medicine
| | - Jain Vaibhav
- Kasturba Medical College, Manipal University, Mangalore, Community Medicine
| | - K Kowshik
- Kasturba Medical College, Manipal University, Mangalore, Community Medicine
| | - Roshan Manoharan
- Kasturba Medical College, Manipal University, Mangalore, Community Medicine
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111
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Garcia-Marcos L. Mediterranean diet as a protection against asthma: Still another brick in building a causative association. Allergol Immunopathol (Madr) 2016; 44:97-8. [PMID: 26955759 DOI: 10.1016/j.aller.2016.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 02/26/2016] [Indexed: 10/22/2022]
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112
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Cross-sectional associations of dietary habits with asthma and wheeze in childhood: confounding for avoidance behaviors. Sci Bull (Beijing) 2015. [DOI: 10.1007/s11434-015-0957-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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113
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Role of Environmental Factors in the Development of Pediatric Eosinophilic Esophagitis. Dig Dis Sci 2015; 60:3364-72. [PMID: 26062820 DOI: 10.1007/s10620-015-3740-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 05/28/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND Despite accumulating data on the pathogenesis of eosinophilic esophagitis, not much is known about risk factors for the development of the disease. The role of factors such as smoking, breastfeeding, early antibiotic exposure and other factors that have been associated with other allergic diseases has not been well studied in children with eosinophilic esophagitis. AIM To explore the role of environmental and medication exposures in the development of pediatric eosinophilic esophagitis. METHODS We conducted a cross-sectional case-control study, utilizing a parent and child questionnaire and medical chart review. Urine cotinine levels, measured by high-performance liquid chromatography, were obtained as objective evidence for smoking exposure. RESULTS One hundred and two children with eosinophilic esophagitis and 167 controls were recruited. The controls were mainly diagnosed with functional gastrointestinal disorders (33%) and gastroesophageal reflux disease (29%). Food allergy, specifically for peanuts and tree nuts, and allergy to pollen, tree, and grass were significantly higher among eosinophilic esophagitis children. Smoking exposure, both primary and secondary, was not associated with pediatric eosinophilic esophagitis when compared to controls (odds ratio 0.96, 95% confidence interval 0.58-1.59). Furthermore, early smoking exposure in the first year of life was higher among controls. Common accepted risk factors for allergy and atopy, such as breastfeeding practices, antibiotics exposure, animals' exposure, and others, were not found to be associated with eosinophilic esophagitis in our study. CONCLUSION Common risk factors in other allergic and atopic conditions were not found to be associated with eosinophilic esophagitis.
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114
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Han YY, Forno E, Brehm JM, Acosta-Pérez E, Alvarez M, Colón-Semidey A, Rivera-Soto W, Campos H, Litonjua AA, Alcorn JF, Canino G, Celedón JC. Diet, interleukin-17, and childhood asthma in Puerto Ricans. Ann Allergy Asthma Immunol 2015; 115:288-293.e1. [PMID: 26319606 PMCID: PMC4721241 DOI: 10.1016/j.anai.2015.07.020] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/03/2015] [Accepted: 07/08/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND Dietary patterns might influence the pathogenesis of asthma in Puerto Ricans, the ethnic group most affected by this disease in the United States. OBJECTIVE To examine the association among diet, T-helper cell type 17 cytokines, and asthma in Puerto Rican children. METHODS As part of a case-control study of 678 Puerto Rican children 6 to 14 years old in San Juan, participants completed a 75-item questionnaire on the child's food consumption in the prior week. Foods were aggregated into 7 groups: fruits, vegetables, grains, protein foods, dairy, fats, and sweets. Logistic regression was used to evaluate consumption frequency of each group, plasma T-helper cell type 17 cytokine levels, and asthma. Based on this analysis, a food score (range -2 [unhealthy diet: high consumption of dairy products and sweets, low consumption of vegetables and grains] to +2 [healthy diet: high consumption of grains and vegetables, low consumption of dairy and sweets]) was created to identify dietary patterns. RESULTS High consumption of grains was associated with lower odds of asthma (adjusted odds ratio [aOR] 0.52, 95% confidence interval [CI] 0.33-0.82), whereas frequent consumption of dairy products (aOR 1.93, 95% CI 1.32-2.84) or sweets (aOR 1.82, 95% CI 1.08-2.72) was associated with higher odds of asthma. A healthier diet (each 1-point increment in food score) was associated with lower levels of interleukin-17F (β = -1.48 pg/mL, 95% CI -1.78 to -1.20) and with 36% decreased odds of asthma (aOR 0.64, 95% CI 0.53-0.77). CONCLUSION A healthy diet, with frequent consumption of vegetables and grains and low consumption of dairy products and sweets, was associated with lower levels of interleulin-17F and decreased odds of childhood asthma in Puerto Ricans.
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Affiliation(s)
- Yueh-Ying Han
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA
| | - Erick Forno
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA
| | - John M. Brehm
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA
| | - Edna Acosta-Pérez
- Behavioral Sciences Research Institute and Department of Pediatrics, University of Puerto Rico, San Juan, PR
| | - María Alvarez
- Behavioral Sciences Research Institute and Department of Pediatrics, University of Puerto Rico, San Juan, PR
| | - Angel Colón-Semidey
- Behavioral Sciences Research Institute and Department of Pediatrics, University of Puerto Rico, San Juan, PR
| | | | | | - Augusto A. Litonjua
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - John F. Alcorn
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA
| | - Glorisa Canino
- Behavioral Sciences Research Institute and Department of Pediatrics, University of Puerto Rico, San Juan, PR
| | - Juan C. Celedón
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA
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von Ehrenstein OS, Aralis H, Flores MES, Ritz B. Fast food consumption in pregnancy and subsequent asthma symptoms in young children. Pediatr Allergy Immunol 2015; 26:571-7. [PMID: 26109272 DOI: 10.1111/pai.12433] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Recent cross-sectional studies suggested children's current fast food consumption to be related to frequency of asthma and allergies. Maternal prenatal diet has been suspected to contribute to children's asthma and atopic disease risks. OBJECTIVES We hypothesized that maternal fast food intake during pregnancy increases offspring's risk for asthmatic symptoms. METHODS We conducted a population-based study of 1201 mother/child pairs in Los Angeles, California. Detailed information about prenatal fast food intake and other dietary, lifestyle/environmental factors, and pregnancy was collected shortly after birth; further data were retrieved from birth certificates. Using the International Study of Asthma and Allergies in Childhood core questions, asthma and rhinitis symptoms were assessed, and doctor's diagnoses were recorded in offspring 3.5 years after birth. Poisson regression with robust error variance using a log link function was used to estimate relative risks (RRs). Models were adjusted using covariates or propensity scores. RESULTS Maternal prenatal fast food consumption related to increased relative risks of their children for severe, and current asthma symptoms (wheeze last 12 months combined with doctor's diagnosis) in a dose-dependent manner: 'once a month': RR: 0.99 (95% CI: 0.36, 2.75), 'once a week': 1.26 (0.47, 3.34); '3-4 days a week': 2.17 (0.77, 6.12); and 'every day' 4.46 (1.36 14.6) compared to 'never', adjusting for potential confounders (p for trend = 0.0025). There was also suggestion of increased risks for rhinitis symptoms. CONCLUSIONS These findings suggest that in utero exposure to frequent fast food through maternal diet may be a risk factor for asthmatic symptoms in young children.
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Affiliation(s)
- O S von Ehrenstein
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - H Aralis
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - M E S Flores
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,Department of Family and Social Medicine, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, Bronx, NY, USA
| | - B Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
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Wood LG, Lagleva M, Shah S, Berthon BS, Galbraith S, Henry R, Kepreotes H, Gibson PG. Dietary changes in migrant adolescents with increasing length of stay in Australia and associated risk of wheeze--a retrospective, cross sectional study. BMC Pediatr 2015; 15:102. [PMID: 26306546 PMCID: PMC4549889 DOI: 10.1186/s12887-015-0420-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 08/17/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Recent studies have reported that asthma prevalence increases on migration to Australia. We hypothesised that changes in dietary intake contribute to this phenomenon. The aim of this study was to assess dietary intake in relation to migration status, length of stay in Australia and the association with self-reported wheeze. METHODS Students (n = 144) in a multicultural high school in Western Sydney completed the asthma symptoms ISAAC video questionnaire (AVQ3.0), spirometry and allergy skin prick tests. A dietitian administered a'Food Frequency' and 'Food Habits' questionnaire and a dietary history interview. RESULTS Students who spoke a language other than English, consumed a traditional or mixed dietary pattern, with lower consumption of saturated fat, compared to students who spoke English only. Saturated fat intake increased and fibre intake decreased with length of time in Australia. Intake of foods high in saturated or trans fatty acids were positively associated with length of stay in Australia. No associations between nutrient intake or whole food intake and self-reported wheeze were observed. CONCLUSION As time progressed, dietary intake of immigrant children changed. While this was not associated with the development of wheeze in the students in this cohort, these changes are likely to have negative health consequences.
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Affiliation(s)
- Lisa G Wood
- Centre for Asthma and Respiratory Diseases, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia.
| | - Marivic Lagleva
- Primary Health Care Education and Research Unit, Western Clinical School and School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
| | - Smita Shah
- Primary Health Care Education and Research Unit, Western Clinical School and School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
| | - Bronwyn S Berthon
- Centre for Asthma and Respiratory Diseases, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia.
| | - Sally Galbraith
- School of Mathematics and Statistics, University of New South Wales, Sydney, New South Wales, Australia.
| | - Richard Henry
- University of New South Wales, Sydney, NSW, Australia.
| | - Helen Kepreotes
- Department of Nutrition and Dietetics, Sydney Children's Hospital Network, Randwick Campus, Sydney, New South Wales, Australia.
| | - Peter G Gibson
- Centre for Asthma and Respiratory Diseases, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia. .,Department of Respiratory and Sleep Medicine, John Hunter Hospital, Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.
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Cepeda AM, Del Giacco SR, Villalba S, Tapias E, Jaller R, Segura AM, Reyes G, Potts J, Garcia-Larsen V. A Traditional Diet Is Associated with a Reduced Risk of Eczema and Wheeze in Colombian Children. Nutrients 2015; 7:5098-110. [PMID: 26121530 PMCID: PMC4516989 DOI: 10.3390/nu7075098] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 06/04/2015] [Accepted: 06/16/2015] [Indexed: 11/20/2022] Open
Abstract
Background: Diet might influence the risk of allergic diseases. Evidence from developing countries with high prevalence of childhood asthma is scant. Methods: Information on wheeze, rhinitis, and eczema was collected from 3209 children aged 6–7 years in 2005, who were taking part in the International Study on Asthma and Allergy in Children (ISAAC) in Colombia. Intake frequency of twelve food groups was assessed. Associations between each food group and current wheeze, rhino-conjunctivitis, and eczema were investigated with multiple logistic regressions, adjusting for potential confounders. Simes’ procedure was used to test for multiple comparisons. Results: 14.9% of children reported wheeze in the last 12 months, 16% rhino-conjunctivitis, and 22% eczema. Eczema was negatively associated with consumption of fresh fruits and pulses three or more times per week (adjusted Odds ratio (aOR): 0.64; 95% Confidence Interval (CI): 0.49 to 0.83; p value = 0.004; and aOR: 0.62, 95% CI: 0.47 to 0.80; p value < 0.001, respectively). Current wheeze was negatively associated with intake of potatoes (aOR: 0.44, 95% CI: 0.31 to 0.62, p value = 0.005), whilst this outcome was positively associated with consumption of fast food (aOR: 1.76, 95% CI: 1.32 to 2.35, p value = 0.001). These associations remained statistically significant after controlling for multiple comparisons. Conclusions: A traditional diet might have a protective effect against eczema and wheeze in Colombian children, whilst intake of fast foods increases this risk.
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Affiliation(s)
- Alfonso M Cepeda
- Fundación Hospital Universitario Metropolitano de Barranquilla, Barranquilla KRA 42F No. 75B-18, Colombia.
| | | | - Sara Villalba
- Fundación Hospital Universitario Metropolitano de Barranquilla, Barranquilla KRA 42F No. 75B-18, Colombia.
| | - Elmy Tapias
- Fundación Hospital Universitario Metropolitano de Barranquilla, Barranquilla KRA 42F No. 75B-18, Colombia.
| | - Rodolfo Jaller
- Fundación Hospital Universitario Metropolitano de Barranquilla, Barranquilla KRA 42F No. 75B-18, Colombia.
| | - Ana María Segura
- Fundación Hospital Universitario Metropolitano de Barranquilla, Barranquilla KRA 42F No. 75B-18, Colombia.
| | - Gloria Reyes
- Fundación Hospital Universitario Metropolitano de Barranquilla, Barranquilla KRA 42F No. 75B-18, Colombia.
| | - James Potts
- Respiratory Epidemiology and Public Health Group, National Heart & Lung Institute, Imperial College London, London SW3 6LR, UK.
| | - Vanessa Garcia-Larsen
- Respiratory Epidemiology and Public Health Group, National Heart & Lung Institute, Imperial College London, London SW3 6LR, UK.
- Royal Brompton Hospital and Harefield NHS Foundation Trust, London SW3 6NP, UK.
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Thorburn AN, McKenzie CI, Shen S, Stanley D, Macia L, Mason LJ, Roberts LK, Wong CHY, Shim R, Robert R, Chevalier N, Tan JK, Mariño E, Moore RJ, Wong L, McConville MJ, Tull DL, Wood LG, Murphy VE, Mattes J, Gibson PG, Mackay CR. Evidence that asthma is a developmental origin disease influenced by maternal diet and bacterial metabolites. Nat Commun 2015; 6:7320. [PMID: 26102221 DOI: 10.1038/ncomms8320] [Citation(s) in RCA: 608] [Impact Index Per Article: 67.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 04/27/2015] [Indexed: 12/27/2022] Open
Abstract
Asthma is prevalent in Western countries, and recent explanations have evoked the actions of the gut microbiota. Here we show that feeding mice a high-fibre diet yields a distinctive gut microbiota, which increases the levels of the short-chain fatty acid, acetate. High-fibre or acetate-feeding led to marked suppression of allergic airways disease (AAD, a model for human asthma), by enhancing T-regulatory cell numbers and function. Acetate increases acetylation at the Foxp3 promoter, likely through HDAC9 inhibition. Epigenetic effects of fibre/acetate in adult mice led us to examine the influence of maternal intake of fibre/acetate. High-fibre/acetate feeding of pregnant mice imparts on their adult offspring an inability to develop robust AAD. High fibre/acetate suppresses expression of certain genes in the mouse fetal lung linked to both human asthma and mouse AAD. Thus, diet acting on the gut microbiota profoundly influences airway responses, and may represent an approach to prevent asthma, including during pregnancy.
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Affiliation(s)
- Alison N Thorburn
- Department of Immunology, Monash University, Clayton, Victoria 3800, Australia
| | - Craig I McKenzie
- Department of Immunology, Monash University, Clayton, Victoria 3800, Australia
| | - Sj Shen
- Department of Immunology, Monash University, Clayton, Victoria 3800, Australia
| | - Dragana Stanley
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland 4702, Australia
| | - Laurence Macia
- Department of Immunology, Monash University, Clayton, Victoria 3800, Australia
| | - Linda J Mason
- Department of Immunology, Monash University, Clayton, Victoria 3800, Australia
| | - Laura K Roberts
- Department of Immunology, Monash University, Clayton, Victoria 3800, Australia
| | - Connie H Y Wong
- Department of Immunology, Monash University, Clayton, Victoria 3800, Australia
| | - Raymond Shim
- Department of Immunology, Monash University, Clayton, Victoria 3800, Australia
| | - Remy Robert
- Department of Immunology, Monash University, Clayton, Victoria 3800, Australia
| | - Nina Chevalier
- 1] Department of Immunology, Monash University, Clayton, Victoria 3800, Australia [2] Department of Rheumatology and Clinical Immunology, University Medical Center, 79106 Freiburg, Germany
| | - Jian K Tan
- Department of Immunology, Monash University, Clayton, Victoria 3800, Australia
| | - Eliana Mariño
- Department of Immunology, Monash University, Clayton, Victoria 3800, Australia
| | - Rob J Moore
- 1] CSIRO Animal, Food, and Health Sciences, Geelong, Victoria 3220, Australia [2] Department of Microbiology, Monash University, Clayton, Victoria 3800, Australia
| | - Lee Wong
- Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria 3800, Australia
| | - Malcolm J McConville
- 1] Department of Biochemistry and Molecular Biology, Bio21 Institute of Molecular Science and Biotechnology, University of Melbourne, Melbourne, Victoria 3010, Australia [2] Metabolomics Australia, Bio21 Institute of Molecular Sciences and Biotechnology, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Dedreia L Tull
- Metabolomics Australia, Bio21 Institute of Molecular Sciences and Biotechnology, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Lisa G Wood
- Centre for Asthma and Respiratory Disease, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales 2300, Australia
| | - Vanessa E Murphy
- Centre for Asthma and Respiratory Disease, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales 2300, Australia
| | - Joerg Mattes
- Centre for Asthma and Respiratory Disease, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales 2300, Australia
| | - Peter G Gibson
- Centre for Asthma and Respiratory Disease, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales 2300, Australia
| | - Charles R Mackay
- 1] Department of Immunology, Monash University, Clayton, Victoria 3800, Australia [2] Charles Perkins Centre, Sydney University Medical School, University of Sydney, Sydney, New South Wales 2006, Australia
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119
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Asthma control in pregnancy is associated with pre-conception dietary patterns. Public Health Nutr 2015; 19:332-8. [PMID: 25908413 DOI: 10.1017/s1368980015001226] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To examine pre-conception dietary patterns in pregnant asthmatic women and to identify associations between maternal diet and asthma control during pregnancy. DESIGN Cross-sectional study. Pre-conception food frequency data were collected retrospectively. Asthma control was assessed using the Global Initiative for Asthma guidelines. Dietary patterns were derived using factor analysis. Binary logistic regression analyses were used to test the association between uncontrolled asthma and each dietary pattern (Z-score), with values presented as odds ratio and 95 % confidence interval. SETTING Antenatal clinic in a tertiary hospital, Adelaide, Australia, May 2009-July 2013. SUBJECTS One hundred and fifty-eight asthmatic pregnant women. RESULTS Three dietary patterns were identified: (i) 'high protein/fruit' (strong food group loadings for fish, meat, chicken, fruit); (ii) 'high fat/sugar/takeaway' (takeaway foods, crisps, refined grains); and (iii) 'vegetarian-type' (vegetables, fruit, soya milk, whole grains). A 1 sd increase in score on the high fat/sugar/takeaway pattern was associated with increased likelihood of uncontrolled asthma (adjusted OR=1·54; 95 % CI 1·07, 2·23; P=0·022). Women with uncontrolled asthma (n 115) had higher energy-adjusted intakes of saturated fat, monounsaturated fat, carbohydrate, sugar and fibre compared with women with controlled asthma (n 43, all P≤0·05). CONCLUSIONS Pre-pregnancy dietary patterns may influence maternal asthma control. Our work highlights the importance of achieving a healthy diet before pregnancy that is low in saturated fat, sugar and takeaway foods, and therefore higher in lean meats, poultry and fish, as well as fruits, vegetables and whole grains. A healthy dietary pattern should be encouraged in all asthmatic women who are of childbearing age, and should additionally be promoted before pregnancy and beyond.
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120
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West CE, Renz H, Jenmalm MC, Kozyrskyj AL, Allen KJ, Vuillermin P, Prescott SL. The gut microbiota and inflammatory noncommunicable diseases: associations and potentials for gut microbiota therapies. J Allergy Clin Immunol 2015; 135:3-13; quiz 14. [PMID: 25567038 DOI: 10.1016/j.jaci.2014.11.012] [Citation(s) in RCA: 172] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 11/10/2014] [Accepted: 11/10/2014] [Indexed: 02/08/2023]
Abstract
Rapid environmental transition and modern lifestyles are likely driving changes in the biodiversity of the human gut microbiota. With clear effects on physiologic, immunologic, and metabolic processes in human health, aberrations in the gut microbiome and intestinal homeostasis have the capacity for multisystem effects. Changes in microbial composition are implicated in the increasing propensity for a broad range of inflammatory diseases, such as allergic disease, asthma, inflammatory bowel disease (IBD), obesity, and associated noncommunicable diseases (NCDs). There are also suggestive implications for neurodevelopment and mental health. These diverse multisystem influences have sparked interest in strategies that might favorably modulate the gut microbiota to reduce the risk of many NCDs. For example, specific prebiotics promote favorable intestinal colonization, and their fermented products have anti-inflammatory properties. Specific probiotics also have immunomodulatory and metabolic effects. However, when evaluated in clinical trials, the effects are variable, preliminary, or limited in magnitude. Fecal microbiota transplantation is another emerging therapy that regulates inflammation in experimental models. In human subjects it has been successfully used in cases of Clostridium difficile infection and IBD, although controlled trials are lacking for IBD. Here we discuss relationships between gut colonization and inflammatory NCDs and gut microbiota modulation strategies for their treatment and prevention.
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Affiliation(s)
- Christina E West
- International Inflammation (in-FLAME) Network of the World Universities Network; Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
| | - Harald Renz
- International Inflammation (in-FLAME) Network of the World Universities Network; Department of Clinical Chemistry and Molecular Diagnostics, University of Marburg, Marburg, Germany
| | - Maria C Jenmalm
- International Inflammation (in-FLAME) Network of the World Universities Network; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Anita L Kozyrskyj
- International Inflammation (in-FLAME) Network of the World Universities Network; Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Katrina J Allen
- International Inflammation (in-FLAME) Network of the World Universities Network; Murdoch Childrens Research Institute and Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Peter Vuillermin
- International Inflammation (in-FLAME) Network of the World Universities Network; Child Health research Unit, Barwon Health, Geelong, Australia
| | - Susan L Prescott
- International Inflammation (in-FLAME) Network of the World Universities Network; School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
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Vlaski E, Lawson JA. Urban-rural differences in asthma prevalence among young adolescents: The role of behavioural and environmental factors. Allergol Immunopathol (Madr) 2015; 43:131-41. [PMID: 24485936 DOI: 10.1016/j.aller.2013.09.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 09/21/2013] [Indexed: 01/11/2023]
Abstract
BACKGROUND Asthma prevalence has been reported to be lower in rural areas compared to urban areas, although this has been inconsistent. This study aims to identify the influence of urban-rural residence on asthma prevalence in adolescents in the Republic of Macedonia and to investigate characteristics that may explain observed associations. METHODS Following International Study of Asthma and Allergies in Childhood protocol, a national sample of Macedonian urban and rural dwelling adolescents (12-16 years) was recruited in 2006. Self-completed questionnaires were used to collect data on wheeze and asthma as well as personal, environmental and dietary characteristics. Following descriptive and multiple logistic regression analyses, a mediation analysis approach was performed to help explain observed associations. RESULTS A lower prevalence of current wheeze and ever-diagnosed asthma was observed in rural compared to urban dwelling adolescents (4.9% vs. 7.2% and 1.2% vs. 1.9%, respectively). After adjustment for potential confounders, the associations, although still protective, were not statistically significant (wheeze: OR=0.74, 95%CI=0.46-1.21; asthma: OR=0.97, 95%CI=0.38-2.46). The associations between urban-rural status with current wheeze and asthma were mediated by region of the country (wheeze 9%; asthma 19%) and by diet (>5% change for both wheeze and asthma). Having a dog resulted in a strengthening of the association between urban-rural status and current wheeze by 11.9%. CONCLUSIONS The prevalence of asthma and wheeze was lower in rural dwelling Macedonian adolescents and the association was mediated by the region of the country with diet likely to be part of the reason for this mediating effect.
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Affiliation(s)
- E Vlaski
- Department of Pulmonology and Allergology, University Children's Clinic, Skopje, Republic of Macedonia.
| | - J A Lawson
- Department of Medicine, Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
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Rodriguez A, Vaca MG, Chico ME, Rodrigues LC, Barreto ML, Cooper PJ. Lifestyle domains as determinants of wheeze prevalence in urban and rural schoolchildren in Ecuador: cross sectional analysis. Environ Health 2015; 14:15. [PMID: 25649682 PMCID: PMC4417196 DOI: 10.1186/1476-069x-14-15] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 01/26/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND The acquisition of a modern lifestyle may explain variations in asthma prevalence between urban and rural areas in developing countries. However, the effects of lifestyle on asthma have been investigated as individual factors with little consideration given to the effects of lifestyle as a set of attributes. The aim of the present study was to identify modern lifestyle domains and assess how these domains might explain wheeze prevalence in urban and rural areas. METHODS We analysed data from cross-sectional studies of urban and rural schoolchildren in Esmeraldas Province, Ecuador. Variables were grouped as indicators of socioeconomic factors, sedentarism, agricultural activities and household characteristics to represent the main lifestyle features of the study population. We used multiple correspondence analyses to identify common lifestyle domains and cluster analysis to allocate children to each domain. We evaluated associations between domains and recent wheeze by logistic regression. RESULTS We identified 2-3 lifestyle domains for each variable group. Although wheeze prevalence was similar in urban (9.4%) and rural (10.3%) schoolchildren, lifestyle domains presented clear associations with wheeze prevalence. Domains relating to home infrastructure (termed transitional, rudimentary, and basic urban) had the strongest overall effect on wheeze prevalence in both urban (rudimentary vs. basic urban, OR = 2.38, 95% CI 1.12-5.05, p = 0.024) and rural areas (transitional vs. basic urban, OR = 2.02, 95% CI 1.1-3.73, p = 0.024; rudimentary vs. basic urban, OR = 1.88, 95% CI 1.02-3.47, p = 0.043). A high level of sedentarism was associated with wheeze in the rural areas only (OR = 1.64, 95% CI 1.23-2.18, p = 0.001). CONCLUSIONS We identified lifestyle domains associated with wheeze prevalence, particularly living in substandard housing and a high level of sedentarism. Such factors could be modified through programmes of improved housing and education. The use of lifestyle domains provides an alternative methodology for the evaluation of variations in wheeze prevalence in populations with different levels of development.
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Affiliation(s)
- Alejandro Rodriguez
- />Laboratorio de Investigación FEPIS, Quinindé, Esmeraldas Province Ecuador
- />Centro de Investigación en Enfermedades Infecciosas y Crónicas, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- />Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Maritza G Vaca
- />Laboratorio de Investigación FEPIS, Quinindé, Esmeraldas Province Ecuador
| | - Martha E Chico
- />Laboratorio de Investigación FEPIS, Quinindé, Esmeraldas Province Ecuador
| | - Laura C Rodrigues
- />Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Mauricio L Barreto
- />Instituto de Saude Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Philip J Cooper
- />Laboratorio de Investigación FEPIS, Quinindé, Esmeraldas Province Ecuador
- />Centro de Investigación en Enfermedades Infecciosas y Crónicas, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- />Clinical Sciences, St George’s University of London, London, UK
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A sequel of the International Study of Asthma and Allergies in Childhood or a prelude to the Global Asthma Network? J Pediatr (Rio J) 2015; 91:1-3. [PMID: 25211379 DOI: 10.1016/j.jped.2014.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 09/01/2014] [Indexed: 11/21/2022] Open
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Frey U, Latzin P, Usemann J, Maccora J, Zumsteg U, Kriemler S. Asthma and obesity in children: current evidence and potential systems biology approaches. Allergy 2015; 70:26-40. [PMID: 25236686 DOI: 10.1111/all.12525] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2014] [Indexed: 12/14/2022]
Abstract
Both obesity and asthma are highly prevalent, complex diseases modified by multiple factors. Genetic, developmental, lung mechanical, immunological and behavioural factors have all been suggested as playing a causal role between the two entities; however, their complex mechanistic interactions are still poorly understood and evidence of causality in children remains scant. Equally lacking is evidence of effective treatment strategies, despite the fact that imbalances at vulnerable phases in childhood can impact long-term health. This review is targeted at both clinicians frequently faced with the dilemma of how to investigate and treat the obese asthmatic child and researchers interested in the topic. Highlighting the breadth of the spectrum of factors involved, this review collates evidence regarding the investigation and treatment of asthma in obese children, particularly in comparison with current approaches in 'difficult-to-treat' childhood asthma. Finally, the authors propose hypotheses for future research from a systems-based perspective.
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Affiliation(s)
- U. Frey
- University Children's Hospital Basel; UKBB; Basel Switzerland
| | - P. Latzin
- University Children's Hospital Basel; UKBB; Basel Switzerland
| | - J. Usemann
- Department of Paediatric Pneumology and Immunology; Charité University Medical Centre; Berlin Germany
| | - J. Maccora
- University Children's Hospital Basel; UKBB; Basel Switzerland
| | - U. Zumsteg
- University Children's Hospital Basel; UKBB; Basel Switzerland
| | - S. Kriemler
- Swiss Tropical and Public Health Institute; University of Basel; Basel Switzerland
- Epidemiology, Biostatistic and Public Health Institute; University of Zürich; Zürich Switzerland
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A sequel of the International Study of Asthma and Allergies in Childhood or a prelude to the Global Asthma Network? JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2015. [DOI: 10.1016/j.jpedp.2014.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Gomes de Luna MDF, Gomes de Luna JR, Fisher GB, de Almeida PC, Chiesa D, Carlos da Silva MG. Factors associated with asthma in adolescents in the city of Fortaleza, Brazil. J Asthma 2014; 52:485-91. [PMID: 25405360 DOI: 10.3109/02770903.2014.984841] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Asthma is a chronic inflammatory airway disease. In Brazil, little is known about factors associated with this disease. This study aimed to identify factors associated with asthma in 13- to 14-year-old adolescents in Fortaleza, Ceará, Brazil. METHODS It is a cross-sectional population-based study, with a probability sample of 3015 students in 2006-2007. We used the questionnaires about asthma, rhinitis and socio-demographic/environmental factors from the International Study for Asthma and Allergies in Childhood (ISAAC) protocol. Current asthma was defined as physician-diagnosed asthma and wheezing in the previous 12 months. Bivariate analysis was performed between asthma and factors included in the study, using prevalence ratio and Chi-square test. Confidence intervals (95%) and odds ratio (OR) were also calculated. Factors associated with asthma in bivariate analysis were then assessed using logistic regression. RESULTS Final sample was composed by 694 adolescents, 179 with asthma. Rhinoconjunctivitis and consumption of stuffed biscuits and fried snacks three or more times per week were independently and positively associated with asthma; consumption of fruits three or more times per week was negatively associated with asthma. CONCLUSIONS Dietary factors were the most associated with asthma in this study. Besides rhinoconjunctivitis, consumption of stuffed biscuits and fried snacks (foods with high content of saturated fat) three or more times per week were independently associated with asthma as aggravating factors, while the consumption of fruits three or more times per week was associated with asthma as protective factor. Interventions acting on these factors may decrease the occurrence of asthma in this population.
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Tamay Z, Akcay A, Ergin A, Güler N. Dietary habits and prevalence of allergic rhinitis in 6 to 7-year-old schoolchildren in Turkey. Allergol Int 2014; 63:553-62. [PMID: 25056225 DOI: 10.2332/allergolint.13-oa-0661] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 03/24/2014] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The prevalence of allergic rhinitis and other allergies has risen worldwide. Dietary habits are considered to be among the potential risk factors. The aim of this study was to evaluate the prevalence of allergic rhinitis and its relationship with dietary habits and other risk factors among 6 to 7-year-old Turkish schoolchildren. METHODS In this cross-sectional study, a total of 11483 children aged 6-7 years were surveyed. The prevalence of symptoms of allergic rhinitis was assessed using the ISAAC protocol. Dietary information was collected using a food frequency questionnaire. RESULTS Of them, 9875 (50.7% M 49.3% F) questionnaires were appropriately completed. The prevalence rates of lifetime rhinitis, current rhinitis, current rhinoconjunctivitis and physician-diagnosed allergic rhinitis, were 44.3%, 29.2%, 8.5% and 8.1%, respectively. Consumption of rice, and cereals ≥3 times per week showed protective effect on physician-diagnosed allergic rhinitis (aOR = 0.53, 95% CI = 0.32-0.87 and aOR = 0.58, 95% CI = 0.36-0.92). Eating pasta, and chocolates ≥3 times per week showed protective effect on current rhinoconjunctivitis (aOR = 0.45, 95% CI = 0.25-0.79 and aOR = 0.50, 95% CI = 0.29-0.86). Eating lollipops, candies and animal fats ≥3 times per week was positively associated with current rhinoconjunctivitis (aOR = 1.47, 95% CI = 1.00-2.17 and aOR = 2.25, 95% CI = 1.11-4.56). Protective effect of the Mediterranean diet was not significant. CONCLUSIONS Frequent consumption of cereals, rice, pasta and chocolates may have beneficial effect on symptoms of rhinoconjunctivitis. Although dietary habits may affect the prevalence of symptoms of current rhinoconjunctivitis, the Mediterranean diet alone may not be protective against rhinoconjunctivitis.
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Affiliation(s)
- Zeynep Tamay
- Department of Pediatrics, Istanbul Medical Faculty, Istanbul, Turkey
| | - Ahmet Akcay
- Department of Pediatrics, Liv Hospital, Istanbul, Turkey
| | - Ahmet Ergin
- Department of Pediatrics, Pamukkale Medical Faculty, Denizli, Turkey
| | - Nermin Güler
- Department of Pediatrics, Istanbul University, Istanbul, Turkey
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128
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Seyedrezazadeh E, Moghaddam MP, Ansarin K, Vafa MR, Sharma S, Kolahdooz F. Fruit and vegetable intake and risk of wheezing and asthma: a systematic review and meta-analysis. Nutr Rev 2014; 72:411-28. [PMID: 24947126 DOI: 10.1111/nure.12121] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Major bibliographic databases were searched for studies examining the relationship between fruit and vegetable consumption and the risk of wheezing and asthma. Random-effects models were used to pool study results. Subgroup analyses were conducted by fruit and vegetable categories, study design, and age group. Twelve cohorts, 4 population-based case-control studies, and 26 cross-sectional studies published between January 1990 and July 2013 were identified. For the meta-analysis of adults and children, the relative risk (RR) and confidence intervals (CI) when comparing the highest intake group with the lowest intake group were 0.78 (95%CI, 0.70-0.87) for fruit and 0.86 (95%CI, 0.75-0.98) for vegetables. High intake of fruit and vegetables (RR = 0.76; 95%CI, 0.68-0.86 and RR = 0.83; 95%CI, 0.72-0.96) reduced the risk of childhood wheezing. Total intake of fruit and vegetables had a negative association with risk of asthma in adults and children (RR = 0.54; 95%CI, 0.41-0.69). Consuming fruit and vegetables during pregnancy had no association with the risk of asthma in offspring. High intake of fruit and vegetables may reduce the risk of asthma and wheezing in adults and children.
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Affiliation(s)
- Ensiyeh Seyedrezazadeh
- Tuberculosis and Lung Research Disease Center, Tabriz University of Medical Sciences, Tabriz, Iran; School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Silvers WS, Bailey HK. Integrative approach to allergy and asthma using complementary and alternative medicine. Ann Allergy Asthma Immunol 2014; 112:280-5. [PMID: 24679731 DOI: 10.1016/j.anai.2014.01.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 01/23/2014] [Accepted: 01/25/2014] [Indexed: 01/26/2023]
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Abstract
The asthma epidemic of the last few decades may have peaked; studies suggest that the incidence and prevalence of asthma has decreased in some countries in the last few years, although other studies suggest continuing small increases in prevalence. Increasing awareness and changing diagnostic habits make precise evaluation of epidemiologic trends difficult in the absence of a gold-standard test for asthma, and on a global basis uncertainty persists. Trends in prevalence in some populations (eg, immigrants, farming communities) suggest both adverse and beneficial effects of specific environmental factors. Although the effects of indoor allergens, dampness, and mold and of outdoor air pollutants, especially traffic related, have traditionally dominated risk-factor research, more recent epidemiologic and clinical studies have focused on metabolic and nutritional factors, including maternal obesity and vitamin D levels, mode of delivery and its effect on the infant microbiome, fetal and infant growth, the psychosocial environment, and medication use by mother and infant. It is likely that changes in incidence and prevalence are due to multiple factors, each contributing a relatively small effect. Longitudinal studies from pregnancy through childhood to adulthood will yield greater insights into the complex pathways leading to asthma.
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Affiliation(s)
- Malcolm R Sears
- Department of Medicine, Faculty of Health Sciences, de Groote School of Medicine, McMaster University; Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
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131
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Flohr C, Mann J. New insights into the epidemiology of childhood atopic dermatitis. Allergy 2014; 69:3-16. [PMID: 24417229 DOI: 10.1111/all.12270] [Citation(s) in RCA: 303] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2013] [Indexed: 12/31/2022]
Abstract
There is a growing desire to explain the worldwide rise in the prevalence of atopic dermatitis (AD). Trend data on the burden of AD suggest that the picture in the developing world may soon resemble that of wealthier nations, where AD affects over 20% of children. This, combined with significant variations in prevalence within countries, emphasizes the importance of environmental factors. Many hypotheses have been explored, from the modulation of immune priming by hygiene, gut microbiota diversity, and exposure to endotoxins through farm animals to the effects of pollution, climate, and diet. The discovery of the filaggrin skin barrier gene and its importance in AD development and severity has brought the focus on gene-environment interactions and the identification of environmental factors that impact on skin barrier function. This article reviews our current understanding of the epidemiology of AD, with an emphasis on the findings reported in the international literature over the last 5 years.
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Affiliation(s)
- C. Flohr
- Departments of Paediatric Dermatology & Children's Allergies; St John's Institute of Dermatology; Guy's and St Thomas’ Hospitals NHS Foundation Trust and King's College; London UK
| | - J. Mann
- Department of Dermatology; Medway NHS Foundation Trust; Medway Maritime Hospital; Gillingham Kent UK
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132
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Solis-Soto MT, Patiño A, Nowak D, Radon K. Association between environmental factors and current asthma, rhinoconjunctivitis and eczema symptoms in school-aged children from Oropeza Province--Bolivia: a cross-sectional study. Environ Health 2013; 12:95. [PMID: 24192069 PMCID: PMC4228317 DOI: 10.1186/1476-069x-12-95] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 10/30/2013] [Indexed: 05/09/2023]
Abstract
BACKGROUND In recent years, the prevalence of asthma, rhinoconjunctivitis and eczema symptoms in childhood has considerably increased in developing countries including Bolivia, possibly due to changes in lifestyle, environmental and domestic factors. This study aimed to assess the association between environmental factors and asthma, rhinoconjuctivitis and eczema symptoms in school-aged children from Oropeza Province in Chuquisaca, Bolivia. METHODS A cross-sectional study was performed in 2340 children attending the fifth grade in 36 randomly selected elementary schools in Oropeza province. The prevalence of symptoms was determined using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Environmental factors were assessed by the ISAAC environmental questionnaire including questions related to exposure to pets, farm animals, indoor and outdoor pollution, presence of disease vectors at home and precarious household conditions. Generalized linear mixed-effects models were adjusted for age, sex and place of living. RESULTS Thirty seven percent of children reported that at least one of their parents smoked at home. Wood or coal was used as cooking fuel in 19% of the homes and 29% reported intense truck traffic on the street where they lived. With respect to hygiene conditions, 86% reported exposure to dogs, 59% exposure to cats and 36% regular contact to farm animals. More than one precarious household condition was reported by 8% of children. In the adjusted model exposure to dog (adjusted OR 1.4; CI 95% 1.0-1.9), cat (1.2; 1.0-1.5), farm animals (1.5; 1.2-1.8); intense truck traffic (1.3; 1.0-1.6), parents smoking at home (1.2; 1.0-1.5), presence of disease vectors at home (fourth quartile vs. first quartile: 1.6; 1.2-2.3) and two or more precarious household conditions (1.5; 1.0-2.2) were significantly associated with rhinoconjunctivitis symptoms. The associations were similar for asthma and eczema symptoms; however it did not reach the level of statistical significance for all items. CONCLUSION Our results support previous findings reported for poor communities especially in Latin America, showing that lower hygiene conditions did not have protective effect against asthma and rhinoconjunctivitis and eczema symptoms.
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Affiliation(s)
| | - Armando Patiño
- Departmental Service of Health (SEDES) - Chuquisaca, Bolivia, South America
| | - Dennis Nowak
- Institute for Occupational, Social and Environmental Medicine, Occupational and Environmental Epidemiology & Net Teaching Unit, University Hospital Munich (LMU), Munich, Germany
| | - Katja Radon
- Institute for Occupational, Social and Environmental Medicine, Occupational and Environmental Epidemiology & Net Teaching Unit, University Hospital Munich (LMU), Munich, Germany
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Saadeh D, Salameh P, Baldi I, Raherison C. Diet and allergic diseases among population aged 0 to 18 years: myth or reality? Nutrients 2013; 5:3399-423. [PMID: 23995043 PMCID: PMC3798911 DOI: 10.3390/nu5093399] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 08/06/2013] [Accepted: 08/07/2013] [Indexed: 02/06/2023] Open
Abstract
Allergic diseases are an important health problem. However, epidemiological studies concerning childhood diet-related allergic diseases are scarce. This review examines published articles dealing with diet, dietary patterns and nutrition in relation with allergic diseases among population aged 0 to 18 years. Studies and trials were identified using MEDLINE/PubMed and Cochrane Database of Systematic Reviews and were limited to those published in English or French from 1992 until 2012. This manuscript also reviews the evidence for maternal diet during pregnancy and diet during early childhood and their association with childhood atopic diseases, taking into account the methodology used to evaluate dietary patterns. The evidence reviewed is derived from large epidemiological studies exploring the effects of different food categories on asthma, atopic dermatitis, and allergic rhinitis in children. Overall, maternal diet during pregnancy and a childhood diet rich in antioxidants and omega-3 fatty acids are considered as healthy diets that could be protective for allergic diseases in childhood.
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Affiliation(s)
- Danielle Saadeh
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut 6573-14, Lebanon; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +961-70-904-307; Fax: +961-5-463-312
| | - Pascale Salameh
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut 6573-14, Lebanon; E-Mail:
| | - Isabelle Baldi
- Laboratory “Santé Travail Environnement”, INSERM U897, Institute of Public Health, Epidemiology and Development, University Bordeaux Segalen, Bordeaux 33076, France; E-Mails: (I.B.); (C.R.)
| | - Chantal Raherison
- Laboratory “Santé Travail Environnement”, INSERM U897, Institute of Public Health, Epidemiology and Development, University Bordeaux Segalen, Bordeaux 33076, France; E-Mails: (I.B.); (C.R.)
- Department of Respiratory Diseases, Bordeaux University Hospital, Magellan Avenue, Pessac 33604, France
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