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Shah S, Kim HS, Hong YC, Park H, Ha M, Kim Y, Lee JH, Ha EH. Infantile allergic diseases: a cohort study prenatal fish intake and mercury exposure context. BMC Public Health 2024; 24:568. [PMID: 38388869 PMCID: PMC10885545 DOI: 10.1186/s12889-024-18008-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Allergic diseases (ADs) have been increasingly reported in infants and children over the last decade. Diet, especially the inclusion of fish intake, may help to lower the risk of ADs. However, fish also, can bioaccumulate environmental contaminants such as mercury. Hence, our study aims to determine what effects the type and frequency of fish intake have on ADs in six-month-old infants, independently and jointly with mercury exposure. METHODS This study is part of the prospective birth cohort: Mothers and Children's Environmental Health (MOCEH) study in South Korea. Data was collected on prenatal fish intake, prenatal mercury concentration and ADs for infants aged six months for 590 eligible mother-infant pairs. Logistic regression analysis was conducted to evaluate the risk of prenatal fish intake and mercury concentration on ADs in infants. Finally, interaction between fish intake and mercury concentration affecting ADs in infants was evaluated. Hazard ratios of prenatal fish intake on ADs in 6 month old infants were calculated by prenatal mercury exposure. RESULTS Logistic regression analysis showed that white fish (OR: 0.53; 95% CI 0.30-0.94; P < 0.05) intake frequency, once a week significantly decreased the risk of ADs in infants. Stratification analysis showed that consuming white fish once a week significantly reduced the hazard of ADs (HR: 0.44; 95% CI 0.21-0.92; P < 0.05) in infants in the high-mercury (≥ 50th percentile) exposure group. CONCLUSION The result indicates that prenatal white fish intake at least once a week reduces the risk of ADs in infants, especially in the group with high prenatal mercury exposure.
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Affiliation(s)
- Surabhi Shah
- Department of Environmental Medicine, Ewha Womans University College of Medicine, 808-1, Magok-dong, Gangseo-gu, 07804, Seoul, Republic of Korea
| | - Hae Soon Kim
- Department of Pediatrics, Ewha Womans University College of Medicine, 808-1, Magok-dong, Gangseo-gu, 07804, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Hyesook Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
- System Health & Engineering Major in Graduate School (BK21 Plus Program), Ewha Womans University, Seoul, Republic of Korea
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Ji Hyen Lee
- Department of Pediatrics, Ewha Womans University College of Medicine, 808-1, Magok-dong, Gangseo-gu, 07804, Seoul, Republic of Korea.
| | - Eun-Hee Ha
- Department of Environmental Medicine, Ewha Womans University College of Medicine, 808-1, Magok-dong, Gangseo-gu, 07804, Seoul, Republic of Korea.
- System Health & Engineering Major in Graduate School (BK21 Plus Program), Ewha Womans University, Seoul, Republic of Korea.
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Murata T, Kyozuka H, Fukuda T, Imaizumi K, Isogami H, Yasuda S, Yamaguchi A, Sato A, Ogata Y, Shinoki K, Hosoya M, Yasumura S, Hashimoto K, Nishigori H, Fujimori K. Maternal magnesium intake and childhood wheezing in offspring at 3 years of age: the Japan Environment and Children's Study. Br J Nutr 2023; 130:1973-1981. [PMID: 37232101 DOI: 10.1017/s0007114523000922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This study evaluated the association between maternal magnesium intake (MMI) and childhood wheezing incidence in 3-year-old offspring. We hypothesised that higher MMI imparts anti-inflammatory and antioxidant effects that decrease childhood wheezing incidence in offspring. Data of 79 907 women (singleton pregnancy, ≥ 22 weeks) from the Japan Environment and Children's Study (enrolled between 2011 and 2014) were analysed. Participants were categorised into quintiles of MMI (< 148·00, 148·00-187·99, 188·00-228·99, 229·00-289·99 and ≥ 290·00 mg/d), quintiles of adjusted MMI for daily energy intake (aMMI) (< 0·107, 0·107-0·119, 0·120-0·132, 0·133-0·149 and ≥ 0·150 mg/kcal) and MMI levels either below or above the ideal value (< 310·00 or ≥ 310·00 mg/d). Multivariable logistic regression analysis was performed to calculate OR for the incidence of childhood wheezing in offspring among participants in each MMI category, with the lowest MMI group considered the reference group. Maternal demographic, socio-economic, medical and other nutrient intake backgrounds were considered potential confounding factors. The adjusted OR (aOR) for childhood wheezing in the offspring of women with the highest MMI was 1·09 (95 % CI, 1·00, 1·20), whereas that calculated based on aMMI categories and offspring of women with above-ideal MMI levels remained unchanged. The highest MMI was associated with slightly increased childhood wheezing incidence in the offspring. MMI during pregnancy had an insignificant clinical impact on this incidence; moreover, modifying MMI would not significantly improve childhood wheezing incidence in offspring. Therefore, further studies should clarify the association between other prenatal factors and childhood wheezing incidence in offspring.
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Affiliation(s)
- Tsuyoshi Murata
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima960-1295, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima960-1295, Japan
| | - Hyo Kyozuka
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima960-1295, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima960-1295, Japan
| | - Toma Fukuda
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima960-1295, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima960-1295, Japan
| | - Karin Imaizumi
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima960-1295, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima960-1295, Japan
| | - Hirotaka Isogami
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima960-1295, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima960-1295, Japan
| | - Shun Yasuda
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima960-1295, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima960-1295, Japan
| | - Akiko Yamaguchi
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima960-1295, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima960-1295, Japan
| | - Akiko Sato
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima960-1295, Japan
| | - Yuka Ogata
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima960-1295, Japan
| | - Kosei Shinoki
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima960-1295, Japan
| | - Mitsuaki Hosoya
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima960-1295, Japan
- Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima960-1295, Japan
| | - Seiji Yasumura
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima960-1295, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima960-1295, Japan
| | - Koichi Hashimoto
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima960-1295, Japan
- Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima960-1295, Japan
| | - Hidekazu Nishigori
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima960-1295, Japan
- Fukushima Medical Center for Children and Women, Fukushima Medical University, 1 Hikarigaoka, Fukushima960-1295, Japan
| | - Keiya Fujimori
- Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima960-1295, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima960-1295, Japan
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Cao J, Liu M, Wang Z, Huang Y, Zheng K. Interaction between Serum Cotinine and Magnesium Intake with Childhood Asthma: A Cross-Sectional Study. Int Arch Allergy Immunol 2023; 184:1090-1098. [PMID: 37598672 DOI: 10.1159/000531730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/19/2023] [Indexed: 08/22/2023] Open
Abstract
INTRODUCTION Serum cotinine and magnesium intake are often associated with childhood asthma. This study evaluated the interaction between serum cotinine and magnesium intake and childhood asthma. METHODS This cross-sectional study included 14,159 subjects from the National Health and Nutrition Examination Survey 2005-2018. Serum cotinine levels were classified according to the lower quartile: ≤0.2089 ng/mL as low level and >0.2089 ng/mL as high level. Magnesium intake was categorized as high (>98 mg/1,000 kcal) or low level (≤98 mg/1,000 kcal) based on the upper quartile. Weighted logistic regression analyses were adopted to analyze the association between cotinine, magnesium intake, and childhood asthma. Additionally, the combined effect of cotinine and magnesium intake on childhood asthma risk was examined. The stratified analyses were based on gender, body mass index, and family history of asthma to further examine the relationship between cotinine, magnesium intake, and childhood asthma. RESULTS The prevalence of asthma was approximately 17.56%. Compared to low-level cotinine, high-level cotinine was associated with asthma (odds ratio [OR] = 1.25, 95% confidence interval (CI): 1.04-1.50). Low-level magnesium intake was related to asthma compared with high-level magnesium intake (OR = 1.21, 95% CI: 1.04-1.40). Using interaction analysis, we also found that the combined effect of cotinine and magnesium intake was associated with childhood asthma risk, and the interaction between high-level cotinine and low-level magnesium intake was associated with the highest risk of childhood asthma (OR = 1.35, 95% CI: 1.04-1.74). Additionally, this interaction was also found in males, overweight/non-overweight, and those with family history of asthma. CONCLUSION There was an interaction between serum cotinine and magnesium intake on childhood asthma. The results suggested that implementing smoking bans in certain settings (e.g., communities, schools) and promoting the consumption of magnesium-rich foods may be effective strategies for preventing childhood asthma.
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Affiliation(s)
- Jianwei Cao
- Kangyi VIP Clinic, Zhongshan People's Hospital, Zhongshan, China
| | - Meiling Liu
- Department of Pediatrics, Zhongshan People's Hospital, Zhongshan, China
| | - Zhongquan Wang
- Kangyi VIP Clinic, Zhongshan People's Hospital, Zhongshan, China
| | - Ying Huang
- The First School of Clinical Medicine, Guangdong Medical University, Zhanjiang, China
| | - Kaijun Zheng
- Department of Pediatrics, Zhongshan People's Hospital, Zhongshan, China
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Williams EJ, Berthon BS, Stoodley I, Williams LM, Wood LG. Nutrition in Asthma. Semin Respir Crit Care Med 2022; 43:646-661. [PMID: 35272384 DOI: 10.1055/s-0042-1742385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
An emerging body of evidence suggests that diet plays an important role in both the development and management of asthma. The relationship between dietary intake and asthma risk has been explored in epidemiological studies, though intervention trials examining the effects of nutrient intake and dietary patterns on asthma management are scarce. Evidence for diets high in fruits and vegetables, antioxidants, omega-3 fatty acids and soluble fiber such as the Mediterranean diet is conflicting. However, some studies suggest that these diets may reduce the risk of asthma, particularly in young children, and could have positive effects on disease management. In contrast, a Westernized dietary pattern, high in saturated fatty acids, refined grains, and sugars may promote an inflammatory environment resulting in the onset of disease and worsening of asthma outcomes. This review will summarize the state of the evidence for the impact of whole dietary patterns, as well as individual nutrients on the prevalence and management of asthma.
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Affiliation(s)
- Evan J Williams
- Hunter Medical Research Institute and School of Biomedical Science and Pharmacy, The University of Newcastle, Callaghan, Australia
| | - Bronwyn S Berthon
- Hunter Medical Research Institute and School of Biomedical Science and Pharmacy, The University of Newcastle, Callaghan, Australia
| | - Isobel Stoodley
- Hunter Medical Research Institute and School of Biomedical Science and Pharmacy, The University of Newcastle, Callaghan, Australia
| | - Lily M Williams
- Hunter Medical Research Institute and School of Biomedical Science and Pharmacy, The University of Newcastle, Callaghan, Australia
| | - Lisa G Wood
- Hunter Medical Research Institute and School of Biomedical Science and Pharmacy, The University of Newcastle, Callaghan, Australia
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Lee J, Lee SH, Gu GJ, Choi JH, Jeong KT, Lee JK, Kim SH. Alterations of lung microbial communities in obese allergic asthma and metabolic potential. PLoS One 2021; 16:e0256848. [PMID: 34710121 PMCID: PMC8553092 DOI: 10.1371/journal.pone.0256848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 08/17/2021] [Indexed: 12/24/2022] Open
Abstract
In recent years, there has been a rapid increase in microbiome studies to explore microbial alterations causing disease status and unveil disease pathogenesis derived from microbiome environmental modifications. Convincing evidence of lung microbial changes involving asthma has been collected; however, whether lung microbial changes under obesity leads to severe asthma in a state of allergen exposure has not been studied sufficiently. Here, we measured bacterial alterations in the lung of an allergen mouse model induced by a high fat diet (HFD) by using 16S rRNA gene sequencing. A total of 33 pathogen‑free 3‑week‑old male C57BL/6 mice were used, and they divided randomly into two groups. The Chow diet (n = 16) and high fat diet (n = 17) was administrated for 70 days. Mice were sensitized with PBS or Dermatophagoides pteronyssinus extract (Der.p), and concentration levels of total IgE and Der.p-IgE in the blood were measured to quantify immune responses. Although there were no meaningful differences in bacterial species richness in the HFD mouse group, momentous changes of bacterial diversity in the HFD mouse group were identified after the mouse group was exposed to allergens. At a genus level, the fluctuations of taxonomic relative abundances in several bacteria such as Ralstonia, Lactobacillus, Bradyrhizobium, Gaiella, PAC001932_g, Pseudolabrys, and Staphylococcus were conspicuously observed in the HFD mouse group exposed to allergens. Also, we predicted metabolic signatures occurring under microbial alterations in the Chow group versus the Chow group exposed to allergens, as well as in the HFD mouse group versus the HFD group exposed to allergens. We then compared their similarities and differences. Metabolic functions associated with macrophages such as propanoate metabolism, butanoate metabolism, and glycine-serine-threonine metabolism were identified in the HFD group versus the Chow group. These results provide new insights into the understanding of a microbiome community of obese allergic asthma, and shed light on the functional roles of lung microbiota inducing the pathogenesis of severe asthma.
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Affiliation(s)
- Jongan Lee
- Division of Allergy and Respiratory Diseases Research, Department of Chronic Disease Convergence Research, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Sung-hee Lee
- Division of Allergy and Respiratory Diseases Research, Department of Chronic Disease Convergence Research, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Gyo Jeong Gu
- Division of Allergy and Respiratory Diseases Research, Department of Chronic Disease Convergence Research, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Ji hyun Choi
- Division of Allergy and Respiratory Diseases Research, Department of Chronic Disease Convergence Research, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Kyu-Tae Jeong
- Division of Allergy and Respiratory Diseases Research, Department of Chronic Disease Convergence Research, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Jeom-Kyu Lee
- Division of Allergy and Respiratory Diseases Research, Department of Chronic Disease Convergence Research, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Seung Hyun Kim
- Division of Allergy and Respiratory Diseases Research, Department of Chronic Disease Convergence Research, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
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Hamazaki K, Tsuchida A, Takamori A, Tanaka T, Ito M, Inadera H. Dietary intake of fish and ω-3 polyunsaturated fatty acids and physician-diagnosed allergy in Japanese population: The Japan Environment and Children's Study. Nutrition 2018; 61:194-201. [PMID: 30822751 DOI: 10.1016/j.nut.2018.11.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/27/2018] [Accepted: 11/17/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Emerging evidence from epidemiologic studies and clinical trials indicates that ω-3 polyunsaturated fatty acids (PUFAs) may have a preventive or therapeutic effect on allergy, although the results remain controversial. The aim of this study was to investigate the association between intake of fish and ω-3 PUFAs with risk for lifetime prevalence of physician-diagnosed allergy in a Japanese population. METHODS Study participants were 78 621 pregnant women and 42 831 male partners from The Japan Environment and Children's Study. History of physician-diagnosed allergy (asthma, allergic rhinitis/pollinosis, allergic conjunctivitis, or atopic dermatitis) was determined by self-administered questionnaire survey. Dietary intake of fish and ω-3 PUFAs was estimated using a food frequency questionnaire. RESULTS Contrary to our hypothesis, an increased risk for allergy was found by multivariable logistic regression in females, especially in allergic rhinitis/pollinosis, allergic conjunctivitis, or atopic dermatitis for fish intake and in allergic rhinitis/pollinosis or allergic conjunctivitis for ω-3 PUFAs. As for male partners, risk for allergic rhinitis/pollinosis or atopic dermatitis was increased for both fish and ω-3 PUFA intake. No statistically significant results were observed for the risk for asthma in either women or men. CONCLUSION Fish and ω-3 PUFA intake were associated with increased risk for some allergic diseases. Further research is warranted to confirm these findings in individuals with high fish consumption.
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Affiliation(s)
- Kei Hamazaki
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan.
| | - Akiko Tsuchida
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Ayako Takamori
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Tomomi Tanaka
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan; Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Mika Ito
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
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8
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Guilleminault L, Williams EJ, Scott HA, Berthon BS, Jensen M, Wood LG. Diet and Asthma: Is It Time to Adapt Our Message? Nutrients 2017; 9:E1227. [PMID: 29117118 PMCID: PMC5707699 DOI: 10.3390/nu9111227] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 10/30/2017] [Accepted: 11/06/2017] [Indexed: 12/21/2022] Open
Abstract
Asthma is a chronic respiratory disorder which is associated with airway inflammation. Environmental factors, in association with genetic susceptibility, play a critical role in asthma pathophysiology. Inhaled allergens, smoke exposure, indoor and outdoor air pollution are common triggers of asthma symptoms. Although the role of diet has clearly established mechanisms in diseases such as cardiovascular disease, type 2 diabetes, and cancer, it is not commonly identified as a causal factor in asthma. However, some dietary patterns, such as the Western diet, which includes a high intake of refined grains, processed and red meats, and desserts, have pro-inflammatory effects. On the contrary, the Mediterranean diet, with high intake of fruits and vegetables has anti-inflammatory properties. The influence of food on asthma outcomes is of growing interest, but dietary habits of asthma patients are not commonly investigated in clinical practice. In this review, we focus on the impact of diet on asthma risk and asthma control. We also detail the influence of diet on obese patients with asthma.
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Affiliation(s)
- Laurent Guilleminault
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Evan J Williams
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Hayley A Scott
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Bronwyn S Berthon
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Megan Jensen
- Priority Research Centre Grow Up Well, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Lisa G Wood
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia.
- Priority Research Centre Grow Up Well, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia.
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Yeh GY, Horwitz R. Integrative Medicine for Respiratory Conditions: Asthma and Chronic Obstructive Pulmonary Disease. Med Clin North Am 2017; 101:925-941. [PMID: 28802471 PMCID: PMC5654539 DOI: 10.1016/j.mcna.2017.04.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Asthma and chronic obstructive pulmonary disease are 2 common chronic respiratory disorders in primary care that cause considerable morbidity and mortality. This article reviews disease pathophysiology and outlines an integrative, multidimensional approach to the evaluation and management of these conditions, including pharmacotreatment, nutrition, supplements, self-care strategies, mind-body therapies, and other integrative modalities.
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Affiliation(s)
- Gloria Y Yeh
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, 1309 Beacon Street, Brookline, MA 02446, USA.
| | - Randy Horwitz
- Arizona Center for Integrative Medicine, Department of Medicine, University of Arizona College of Medicine, PO Box 245153, Tucson, AZ 85724-5153, USA
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Statovci D, Aguilera M, MacSharry J, Melgar S. The Impact of Western Diet and Nutrients on the Microbiota and Immune Response at Mucosal Interfaces. Front Immunol 2017; 8:838. [PMID: 28804483 PMCID: PMC5532387 DOI: 10.3389/fimmu.2017.00838] [Citation(s) in RCA: 280] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 07/03/2017] [Indexed: 12/11/2022] Open
Abstract
Recent findings point toward diet having a major impact on human health. Diets can either affect the gut microbiota resulting in alterations in the host’s physiological responses or by directly targeting the host response. The microbial community in the mammalian gut is a complex and dynamic system crucial for the development and maturation of both systemic and mucosal immune responses. Therefore, the complex interaction between available nutrients, the microbiota, and the immune system are central regulators in maintaining homeostasis and fighting against invading pathogens at mucosal sites. Westernized diet, defined as high dietary intake of saturated fats and sucrose and low intake of fiber, represent a growing health risk contributing to the increased occurrence of metabolic diseases, e.g., diabetes and obesity in countries adapting a westernized lifestyle. Inflammatory bowel diseases (IBD) and asthma are chronic mucosal inflammatory conditions of unknown etiology with increasing prevalence worldwide. These conditions have a multifactorial etiology including genetic factors, environmental factors, and dysregulated immune responses. Their increased prevalence cannot solely be attributed to genetic considerations implying that other factors such as diet can be a major contributor. Recent reports indicate that the gut microbiota and modifications thereof, due to a consumption of a diet high in saturated fats and low in fibers, can trigger factors regulating the development and/or progression of both conditions. While asthma is a disease of the airways, increasing evidence indicates a link between the gut and airways in disease development. Herein, we provide a comprehensive review on the impact of westernized diet and associated nutrients on immune cell responses and the microbiota and how these can influence the pathology of IBD and asthma.
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Affiliation(s)
- Donjete Statovci
- APC Microbiome Institute, University College Cork, Cork, Ireland
| | - Mònica Aguilera
- APC Microbiome Institute, University College Cork, Cork, Ireland
| | - John MacSharry
- APC Microbiome Institute, University College Cork, Cork, Ireland.,School of Microbiology, University College Cork, Cork, Ireland
| | - Silvia Melgar
- APC Microbiome Institute, University College Cork, Cork, Ireland
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Berthon BS, Wood LG. Nutrition and respiratory health--feature review. Nutrients 2015; 7:1618-43. [PMID: 25751820 PMCID: PMC4377870 DOI: 10.3390/nu7031618] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 02/15/2015] [Accepted: 02/15/2015] [Indexed: 01/08/2023] Open
Abstract
Diet and nutrition may be important modifiable risk factors for the development, progression and management of obstructive lung diseases such as asthma and chronic obstructive pulmonary disease (COPD). This review examines the relationship between dietary patterns, nutrient intake and weight status in obstructive lung diseases, at different life stages, from in-utero influences through childhood and into adulthood. In vitro and animal studies suggest important roles for various nutrients, some of which are supported by epidemiological studies. However, few well-designed human intervention trials are available to definitively assess the efficacy of different approaches to nutritional management of respiratory diseases. Evidence for the impact of higher intakes of fruit and vegetables is amongst the strongest, yet other dietary nutrients and dietary patterns require evidence from human clinical studies before conclusions can be made about their effectiveness.
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Affiliation(s)
- Bronwyn S Berthon
- Centre for Asthma and Respiratory Diseases, Level 2, Hunter Medical Research Institute, University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
| | - Lisa G Wood
- Centre for Asthma and Respiratory Diseases, Level 2, Hunter Medical Research Institute, University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
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de Cássia Ribeiro-Silva R, Fiaccone RL, Barreto ML, da Silva LA, Santos LFP, Alcantara-Neves NM. The prevalence of wheezing and its association with serum zinc concentration in children and adolescents in Brazil. J Trace Elem Med Biol 2014; 28:293-7. [PMID: 24686116 DOI: 10.1016/j.jtemb.2014.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 02/26/2014] [Accepted: 02/28/2014] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To assess the influence of zinc serum status on the prevalence of wheezing in a sample of children and adolescents in Northeastern Brazil. RESEARCH METHODS AND PROCEDURES This is a cross-sectional study which included 592 students of 6-12 years old, from the public elementary schools of São Francisco do Conde, Bahia, Northeastern Brazil. Report of wheezing in the past 12 months was collected using a questionnaire of the International Study of Asthma and Allergies in Childhood Program (ISAAC) phase III, adapted to Portuguese. The determination of serum Zn levels was performed using a flame atomic absorption spectrometer. Data on anthropometric status, level of physical activity, pubertal development and socioeconomic information, for each participant were obtained. Multivariate logistic regression analyses were used to assess the associations of interest. RESULTS Of the students, 8.6% (95% CI 6.30-10.9) reported having wheezing. The mean (SD) serum zinc level was 114 (22.9 μg/dL). The results of the multiple logistic regression analysis showed, after adjustments, positive and significant association between low serum zinc levels and wheezing. Students categorized as being below the median for serum Zn concentration presented an almost 1.9-fold increase in the wheezing prevalence ratio (OR=1.9; 95% CI 1.03-3.53). CONCLUSION The main findings of this study suggest that the level of zinc may influence the risk of wheezing in late childhood on the study population.
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Affiliation(s)
- Rita de Cássia Ribeiro-Silva
- Departamento de Ciências da Nutrição, Universidade Federal da Bahia, Av. Araújo Pinho, 32, Canela, CEP: 40110-150 Salvador, Bahia, Brazil.
| | - Rosemeire Leovigildo Fiaccone
- Instituto de Matemática, Universidade Federal da Bahia, Av. Adhemar de Barros, s/n, Ondina, CEP: 40170-110 Salvador, Bahia, Brazil
| | - Maurício Lima Barreto
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Rua Basílio da Gama, s/n, Campus Universitário Canela, CEP: 40110-040 Salvador, Bahia, Brazil
| | - Luce Alves da Silva
- Departamento de Ciências da Nutrição, Universidade Federal da Bahia, Av. Araújo Pinho, 32, Canela, CEP: 40110-150 Salvador, Bahia, Brazil
| | - Luis Fernandes Pereira Santos
- Departamento de Ciências da Nutrição, Universidade Federal da Bahia, Av. Araújo Pinho, 32, Canela, CEP: 40110-150 Salvador, Bahia, Brazil
| | - Neuza Maria Alcantara-Neves
- Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Av. Reitor Miguel Calmon, s/n, CEP: 40110-100 Salvador, Bahia, Brazil
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Kang JW, Kim JH, Yoon JH, Kim CH. The association between serum vitamin D level and immunoglobulin E in Korean adolescents. Int J Pediatr Otorhinolaryngol 2014; 78:817-20. [PMID: 24630983 DOI: 10.1016/j.ijporl.2014.02.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 02/14/2014] [Accepted: 02/17/2014] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Vitamin D has immune modulatory functions, and thus its relationship with allergic disease has been evaluated in a number of studies. However, no concrete link between serum IgE level and vitamin D has been established. Thus, the purpose of study was to confirm the association of serum vitamin D level with the serum IgE (total and Dematophagoides farinae specific IgE) in Korean adolescents. METHODS A total of 365 subjects between 10 and 18 years of age were enrolled through the Korea National Health and Nutrition Examination Survey (KNHANES). Serum levels of vitamin D, total IgE, and Dermatophagoides farinae (Df) specific IgE were measured, and data for potential confounding variables were collected. Multivariate regression analyses were used to determine the independent effects of these variables. RESULTS Levels of both total and Df specific IgE were positively correlated with serum concentration of vitamin D (Spearman's rho (R)=0.126, p=0.016; R=0.152, p=0.004, respectively). These results were confirmed by multivariate linear regression analysis after adjusting for sex, age, and body mass index (coefficient (B): 10.45 95% confidence interval (CI): 0.59-20.31; B: 1.06, 95% CI: 0.31-1.80, respectively). And, the association between serum vitamin D and IgE showed the different results depending on the presence or absence of Df sensitization. CONCLUSIONS Serum concentration of vitamin D was positively associated with levels of both total IgE and Df-specific IgE in Korean adolescents.
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Affiliation(s)
- Ju Wan Kang
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeong Hong Kim
- Departement of Otorhinolaryngology, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Joo-Heon Yoon
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chang-Hoon Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Wendell SG, Baffi C, Holguin F. Fatty acids, inflammation, and asthma. J Allergy Clin Immunol 2014; 133:1255-64. [PMID: 24613565 DOI: 10.1016/j.jaci.2013.12.1087] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 12/23/2013] [Accepted: 12/31/2013] [Indexed: 12/28/2022]
Abstract
Fatty acids and consequently diet play an essential role in the formation of inflammatory mediators involved in the pathogenesis of asthma. Because intake variations of omega-6 (n-6) and omega-3 (n-3) fatty acids ultimately determine cell membrane incorporation, changes in diet have the potential to modify downstream production of inflammatory mediators derived from these compounds. It has long been hypothesized that decreasing the n-6/n-3 ratio could reduce the production of more proinflammatory mediators while increasing the formation of downstream metabolites that can serve to limit or resolve inflammation. In turn, these changes would result in improved asthma outcomes or would lower the risk for asthma incidence. This review will focus on the role of fatty acid inflammatory and resolving mediators and will summarize the clinical and epidemiologic data on how diet and obesity alter fatty acid profiles that can contribute to asthma.
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Affiliation(s)
| | - Cindy Baffi
- Asthma Institute, UPMC, Department of Medicine, Pittsburgh, Pa
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15
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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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Abstract
Diet changes can partly explain the high burden of asthma in industrialised nations. Findings from experimental studies have stimulated many observational studies of the association between vitamins (A, C, D, and E) or nutrients acting as methyl donors (folate, vitamin B12, and choline) and asthma. However, observational studies are susceptible to several sources of bias; well conducted randomised controlled trials (RCTs) are the gold standard to establish whether diet has an effect on asthma. Evidence from observational studies and a few RCTs strongly justifies ongoing and future RCTs in three areas: vitamin D for the prevention or treatment of asthma, choline supplementation as adjuvant treatment for asthma, and vitamin E to prevent the detrimental effects of air pollution in patients with asthma. At present, insufficient evidence exists to recommend supplementation with any vitamin or nutrient acting as a methyl donor to prevent or treat asthma.
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Hatzler L, Hofmaier S, Papadopoulos NG. Allergic airway diseases in childhood - marching from epidemiology to novel concepts of prevention. Pediatr Allergy Immunol 2012; 23:616-22. [PMID: 23106446 DOI: 10.1111/pai.12022] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In the past years, a wide range of epidemiological, clinical, and experimental studies have produced remarkable advances in the field of respiratory allergies in childhood. By the recent investigations on epidemiological trends, risk factors, and prevention of asthma and allergic rhinitis, various exiting concepts have been challenged, and novel innovative approaches have been developed. Pediatric Allergy and Immunology (PAI), with a number of highly relevant contributions between 2010 and 2012, has become an important forum in this area. The prevalence of asthma in some developed countries may have reached a plateau, while in developing countries, where the prevalence was previously low, allergic diseases are still on the increase. A wide array of risk and protective factors, including hygiene, infections, outdoor and indoor air pollution, allergen exposure, breast-feeding practices, nutrition, and obesity, play a multifaceted role in shaping the observed worldwide trends of respiratory allergies. Under the guidance of recent research, prediction and prevention strategies in the clinical practice are progressively changing, the focus moving away from avoidance of allergen exposure and toward tolerance induction.
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Affiliation(s)
- Laura Hatzler
- Department of Paediatric Pneumology and Immunology, Charité University Medical Centre, Berlin, Germany
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18
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Horwitz RJ. The Allergic Patient. Integr Med (Encinitas) 2012. [DOI: 10.1016/b978-1-4377-1793-8.00029-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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van Oeffelen AAM, Bekkers MBM, Smit HA, Kerkhof M, Koppelman GH, Haveman-Nies A, van der A DL, Jansen EHJM, Wijga AH. Serum micronutrient concentrations and childhood asthma: the PIAMA birth cohort study. Pediatr Allergy Immunol 2011; 22:784-93. [PMID: 21929603 DOI: 10.1111/j.1399-3038.2011.01190.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Research suggests an influence of micronutrients on childhood asthma. So far, evidence mainly originates from cross-sectional studies using nutrient intake data, which is not an accurate measure of nutrient status. This study aimed to investigate the cross-sectional and prospective associations between serum concentrations of magnesium, vitamin D, selenium, and zinc and prevalence of (severe) asthma, atopy, and bronchial hyperresponsiveness (BHR) in childhood. METHODS In the Prevention and Incidence of Asthma and Mite Allergy birth cohort study, serum nutrient concentrations were available for a 4-yr-old subgroup (n = 372) and for a different 8-yr-old subgroup (n = 328). Yearly questionnaires inquired about asthma prevalence until 8 yr of age. Allergic sensitization was measured at 4 and 8 yr of age; BHR was measured at 8 yr of age. Data were analyzed with logistic regression and generalized estimating equations models. RESULTS There was a consistent (non-significant) inverse association between serum magnesium concentrations and asthma prevalence. Serum vitamin D concentrations measured at age 4 were inversely associated with asthma at ages 4-8 [e.g., cross-sectional association between vitamin D tertile 3 vs. 1 and severe asthma: odds ratio (OR): 0.49, 95% confidence interval (CI): 0.25-0.95], whereas vitamin D measured at age 8 was positively associated with asthma at age 8 (e.g., cross-sectional association between vitamin D tertile 3 vs. 1 and severe asthma: OR: 2.14, 95% CI: 0.67-6.82). CONCLUSIONS Our study contributes to the evidence that children with higher serum magnesium concentrations are less likely to have asthma. The associations between serum vitamin D concentrations and asthma were age-dependent.
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Affiliation(s)
- A A M van Oeffelen
- Department of Human Nutrition, Wageningen University, Wageningen, The Netherlands
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The influence of environment, as represented by diet and air pollution, upon incidence and prevalence of wheezing illnesses in young children. Curr Opin Allergy Clin Immunol 2011; 11:144-9. [PMID: 21368621 DOI: 10.1097/aci.0b013e3283445950] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to consider the collective influence of factors affecting recurrent wheezing in young children. RECENT FINDINGS Specific allergen sensitization, upper respiratory infections, genetic polymorphisms and environmental factors have collectively been reported in the prevalence of and induction of recurrent wheezing in young children. Two examples of environmental factors are diet and exposure to air pollution, both of which are potentially modifiable. Recent investigations provide evidence that a 'Mediterranean diet' and a diet that emphasizes polyunsaturated fatty acids during pregnancy and early infancy, as well as breastfeeding, may be protective for wheezing, and that exposure to traffic-related pollution may be an independent factor in the incidence of wheezing in young children. SUMMARY Recent studies of early childhood wheezing demonstrate a potentially protective effect of diet and exposure to air pollution as a significant risk factor. An evaluation of collective factors influencing the presence of disease may help to broaden the clinical assessment and give parents and physicians the opportunity to potentially modify circumstances that promote the incidence of recurrent wheezing in infants and preschool aged children.
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Scholtens S, Wijga AH. Overweight and asthma in pre-school children. Pediatr Allergy Immunol 2011; 22:344. [PMID: 21457339 DOI: 10.1111/j.1399-3038.2010.01083.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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