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Govindaraju T, Man M, Owen AJ, Carroll M, Borg BM, Smith CL, Gao CX, Brown D, Poland D, Allgood S, Ikin JF, Abramson MJ, McCaffrey TA, Lane TJ. Does diet quality moderate the long-term effects of discrete but extreme PM 2.5 exposure on respiratory symptoms? A study of the Hazelwood coalmine fire. ENVIRONMENTAL RESEARCH 2024; 252:119014. [PMID: 38685296 DOI: 10.1016/j.envres.2024.119014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/02/2024]
Abstract
In 2014, a fire at an open cut coalmine in regional Victoria, Australia burned for 6 weeks. Residents of the nearby town of Morwell were exposed to smoke, which included high levels of fine particulate matter (PM2.5). We investigated whether the long-term effects of PM2.5 on respiratory health were moderated by diet quality. A cross-sectional analysis was conducted of data collected 8.5 years after the mine fire from 282 residents of Morwell and 166 residents from the nearby unexposed town of Sale. Primary outcomes were respiratory symptoms. Exposure was coalmine fire-related PM2.5 and diet quality was assessed as Australian Recommended Food Score (ARFS) derived using the Australian Eating Survey (AES). The moderating effect of diet quality on respiratory outcomes associated with PM2.5 was assessed using logistic regression models, adjusting for potential confounders. Diet quality was poor in this sample, with 60% in the lowest category of overall diet quality. Overall diet quality and fruit and vegetable quality significantly attenuated the association between PM2.5 and prevalence of chronic cough and phlegm. Sauce/condiment intake was associated with a greater effect of PM2.5 on COPD prevalence. No other moderating effects were significant. The moderating effects of overall diet quality and vegetable and fruit intake aligned with a priori hypotheses, suggesting potential protective benefits. While more evidence is needed to confirm these findings, improving diets, especially fruit and vegetable intake, may provide some protection against the effects of smoke exposure from fire events.
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Affiliation(s)
- Thara Govindaraju
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Martin Man
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Matthew Carroll
- Monash Rural Health Churchill, Monash University, Churchill, Victoria, Australia
| | - Brigitte M Borg
- Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia
| | - Catherine L Smith
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Caroline X Gao
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Orygen, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - David Brown
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - David Poland
- Monash Rural Health Churchill, Monash University, Churchill, Victoria, Australia
| | - Shantelle Allgood
- Monash Rural Health Churchill, Monash University, Churchill, Victoria, Australia
| | - Jillian F Ikin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tracy A McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
| | - Tyler J Lane
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
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2
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Georgakou AV, Ekström S, Andersson N, Hallberg J, Wolk A, Håkansson N, Georgelis A, Melén E, Kull I, Sdona E, Bergström A. Mediterranean-type diet in school age in relation to asthma and lung function up to young adulthood. Clin Exp Allergy 2024; 54:518-520. [PMID: 38616294 DOI: 10.1111/cea.14483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/27/2024] [Accepted: 04/02/2024] [Indexed: 04/16/2024]
Affiliation(s)
- Athina V Georgakou
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jenny Hallberg
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Håkansson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Antonios Georgelis
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Erik Melén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Inger Kull
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Emmanouela Sdona
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
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Soczewka M, Kędzia A, Skowrońska B, Niechciał E. Importance of diet in children and adolescents with obesity and asthma. Pediatr Endocrinol Diabetes Metab 2024; 30:91-96. [PMID: 39026486 PMCID: PMC11249804 DOI: 10.5114/pedm.2024.140936] [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: 02/14/2023] [Accepted: 04/11/2023] [Indexed: 07/20/2024]
Abstract
Both obesity and asthma are increasingly being diagnosed in the childhood population. Obesity is linked to a greater asthma morbidity, and it increases the risk of severity of the disease course. The association between these 2 disorders has not yet been fully elucidated; however, several putative factors have been proposed related to mechanical and inflammatory aspects of obesity. Diet is an important adjustable element in obesity and asthma management. An unhealthy diet based on processed food is likely to promote chronic inflammation in both conditions; hence, appropriate nutrition should be an integral part of the children's therapy. This review discusses dietary models that have a positive impact on patient health.
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Affiliation(s)
- Monika Soczewka
- Department of Paediatric Diabetes, Auxology, and Obesity, Poznan University of Medical Sciences, Poznan, Poland
- Doctoral School, Poznan University of Medical Sciences, Poznan, Poland
| | - Andrzej Kędzia
- Department of Paediatric Diabetes, Auxology, and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Bogda Skowrońska
- Department of Paediatric Diabetes, Auxology, and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Elżbieta Niechciał
- Department of Paediatric Diabetes, Auxology, and Obesity, Poznan University of Medical Sciences, Poznan, Poland
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Clemente-Suárez VJ, Mielgo-Ayuso J, Ramos-Campo DJ, Beltran-Velasco AI, Martínez-Guardado I, Navarro Jimenez E, Redondo-Flórez L, Yáñez-Sepúlveda R, Tornero-Aguilera JF. Basis of preventive and non-pharmacological interventions in asthma. Front Public Health 2023; 11:1172391. [PMID: 37920579 PMCID: PMC10619920 DOI: 10.3389/fpubh.2023.1172391] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 09/18/2023] [Indexed: 11/04/2023] Open
Abstract
Asthma is one of the most common atopic disorders in all stages of life. Its etiology is likely due to a complex interaction between genetic, environmental, and lifestyle factors. Due to this, different non-pharmacological interventions can be implemented to reduce or alleviate the symptoms caused by this disease. Thus, the present narrative review aimed to analyze the preventive and non-pharmacological interventions such as physical exercise, physiotherapy, nutritional, ergonutritional, and psychological strategies in asthma treatment. To reach these aims, an extensive narrative review was conducted. The databases used were MedLine (PubMed), Cochrane (Wiley), Embase, PsychINFO, and CinAhl. Asthma is an immune-mediated inflammatory condition characterized by increased responsiveness to bronchoconstrictor stimuli. Different factors have been shown to play an important role in the pathogenesis of asthma, however, the treatments used to reduce its incidence are more controversial. Physical activity is focused on the benefits that aerobic training can provide, while physiotherapy interventions recommend breathing exercises to improve the quality of life of patients. Nutritional interventions are targeted on implement diets that prioritize the consumption of fruits and vegetables and supplementation with antioxidants. Psychological interventions have been proposed as an essential non-pharmacological tool to reduce the emotional problems associated with asthma.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain
- Studies Centre in Applied Combat (CESCA), Toledo, Spain
| | - Juan Mielgo-Ayuso
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, Burgos, Spain
| | - Domingo Jesús Ramos-Campo
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | | | - Ismael Martínez-Guardado
- BRABE Group, Department of Psychology, Faculty of Life and Natural Sciences, Universidad Camilo José Cela, Madrid, Spain
| | | | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | | | - Jose Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain
- Studies Centre in Applied Combat (CESCA), Toledo, Spain
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Brigham E, Hashimoto A, Alexis NE. Air Pollution and Diet: Potential Interacting Exposures in Asthma. Curr Allergy Asthma Rep 2023; 23:541-553. [PMID: 37440094 DOI: 10.1007/s11882-023-01101-1] [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] [Accepted: 05/17/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE OF REVIEW To provide a review of emerging literature describing the impact of diet on the respiratory response to air pollution in asthma. RECENT FINDINGS Asthma phenotyping (observable characteristics) and endotyping (mechanistic pathways) have increased the specificity of diagnostic and treatment pathways and opened the doors to the identification of subphenotypes with enhanced susceptibility to exposures and interventions. Mechanisms underlying the airway immune response to air pollution are still being defined but include oxidative stress, inflammation, and activation of adaptive and innate immune responses, with genetic susceptibility highlighted. Of these, neutrophil recruitment and activation appear prominent; however, understanding neutrophil function in response to pollutant exposures is a research gap. Diet may play a role in asthma pathogenesis and morbidity; therefore, diet modification is a potential target opportunity to protect against pollutant-induced lung injury. In particular, in vivo and in vitro data suggest the potential for diet to modify the inflammatory response in the airways, including impacts on neutrophil recruitment and function. Murine models provide compelling results in regard to the potential for dietary components (including fiber, antioxidants, and omega-3 fatty acids) to buffer against the inflammatory response to air pollution in the lung. Precision lifestyle approaches to asthma management and respiratory protection in the context of air pollution exposures may evolve to include diet, pending the results of further epidemiologic and causal investigation and with neutrophil recruitment and activation as a candidate mechanism.
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Affiliation(s)
- Emily Brigham
- Division of Respirology, University of British Columbia, Vancouver, BC, Canada.
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.
| | - Alisa Hashimoto
- Faculty of Science, University of British Columbia, BC, Vancouver, Canada
| | - Neil E Alexis
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
- Department of Pediatrics, Division of Allergy, Immunology, Rheumatology and Infectious Disease, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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6
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Qian K, Xu H, Chen Z, Zheng Y. Advances in pulmonary rehabilitation for children with bronchial asthma. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:518-525. [PMID: 37643985 PMCID: PMC10495252 DOI: 10.3724/zdxbyxb-2023-0081] [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: 02/21/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023]
Abstract
Bronchial asthma is a heterogeneous disease characterized by chronic airway inflammation and airway hyperresponsiveness. With the development of the whole-life-cycle health concept, the focus of treatment for bronchial asthma in children has gradually shifted from pharmacological control to an integrated management model of functional rehabilitation and pharmacological assistance. As a non-pharmacological integrated approach, pulmonary rehabilitation plays an equally important role in the management of childhood asthma as pharmacological treatments. Breathing techniques such as Buteyko breathing, pursed lip breathing, diaphragmatic breathing training, threshold-pressure inspiratory muscle training and yoga breathing can improve lung function indicators such as forced expiratory volume in first second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and maximal voluntary ventilation (MVV) in children. Comprehensive pre-exercise assessment, development of exercise prescriptions, and implementation and evaluation of exercise effects can improve physical fitness, neuromuscular coordination, and self-confidence of children with asthma. The comprehensive interventions of health education, psychological support and nutritional intervention can improve the compliance and effectiveness of rehabilitation training. This article reviews the research progress on respiratory training, physical exercise, and comprehensive interventions in the pulmonary rehabilitation of asthmatic children, to provide theoretical basis and practical guidance for the scientific and rational management of pulmonary rehabilitation of asthmatic children in clinical settings.
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Affiliation(s)
- Kongjia Qian
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.
| | - Hongzhen Xu
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.
| | - Zhimin Chen
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Ying Zheng
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
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7
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Rosser F, Balmes J. Ozone and childhood respiratory health: A primer for US pediatric providers and a call for a more protective standard. Pediatr Pulmonol 2023; 58:1355-1366. [PMID: 36815617 PMCID: PMC10121852 DOI: 10.1002/ppul.26368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/30/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023]
Abstract
Ground level ozone is a potent respiratory toxicant with decades of accumulated data demonstrating respiratory harms to children. Despite the ubiquity of ozone in the United States, impacting both urban and rural communities, the associated harms of exposure to this important air pollutant are often infrequently or inadequately covered during medical training including pulmonary specialization. Thus, many providers caring for children's respiratory health may have limited knowledge of the harms which may result in reduced discussion of ozone pollution during clinical encounters. Further, the current US air quality standard for ozone does not adequately protect children. In this nonsystematic review, we present basic background information for healthcare providers caring for children's respiratory health, review the US process for setting air quality standards, discuss the respiratory harms of ozone for healthy children and those with underlying respiratory disease, highlight the urgent need for a more protective ozone standard to adequately protect children's respiratory health, review impacts of climate change on ozone levels, and provide information for discussion in clinical encounters.
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Affiliation(s)
- Franziska Rosser
- Department of Pediatrics, Division of Pulmonary Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, PA
| | - John Balmes
- Department of Medicine, University of California, San Francisco, San Francisco, CA
- School of Public Health, University of California, Berkeley, CA
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Talaei M, Emmett PM, Granell R, Tabatabaeian H, Northstone K, Bergström A, Shaheen SO. Dietary patterns, lung function and asthma in childhood: a longitudinal study. Respir Res 2023; 24:82. [PMID: 36927379 PMCID: PMC10022039 DOI: 10.1186/s12931-023-02383-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Longitudinal epidemiological data are scarce examining the relationship between dietary patterns and respiratory outcomes in childhood. We investigated whether three distinct dietary patterns in mid-childhood were associated with lung function and incident asthma in adolescence. METHODS In the Avon Longitudinal Study of Parents and Children, 'processed', 'traditional', and 'health-conscious' dietary patterns were identified using principal components analysis from food frequency questionnaires at 7 years of age. Post-bronchodilator forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and forced expiratory flow at 25-75% of FVC (FEF25-75) were measured at 15.5 years and were transformed to z-scores based on the Global Lung Function Initiative curves. Incident asthma was defined by new cases of doctor-diagnosed asthma at age 11 or 14 years. RESULTS In multivariable-adjusted models, the 'health-conscious' pattern was positively associated with FEV1 (regression coefficient comparing top versus bottom quartile of pattern score 0.16, 95% CI 0.01 to 0.31, P for trend 0.04) and FVC (0.18, 95% CI 0.04 to 0.33, P for trend 0.02), while the 'processed' pattern was negatively associated with FVC (- 0.17, 95% CI - 0.33 to - 0.01, P for trend 0.03). Associations between the 'health-conscious' and 'processed' patterns and lung function were modified by SCGB1A1 and GPX4 gene polymorphisms. We found no evidence of an association between the 'traditional' pattern and lung function, nor between any pattern and FEF25-75 or incident asthma. CONCLUSIONS A 'health-conscious' diet in mid-childhood was associated with higher subsequent lung function, while a diet high in processed food was associated with lower lung function.
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Affiliation(s)
- Mohammad Talaei
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
| | - Pauline M Emmett
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Raquel Granell
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Hossein Tabatabaeian
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - Kate Northstone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Seif O Shaheen
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
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9
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Zhang H, Xia Y, Zhang X, Chang Q, Zhao Y. Carbohydrate intake quality and gestational diabetes mellitus, and the modifying effect of air pollution. Front Nutr 2023; 9:992472. [PMID: 36687724 PMCID: PMC9849808 DOI: 10.3389/fnut.2022.992472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/15/2022] [Indexed: 01/07/2023] Open
Abstract
Background Nutritional management is the cornerstone of gestational diabetes mellitus (GDM) prevention. High quality instead of low quantity of carbohydrate intake has been paying attention in controlling glycemia. Air pollution exposure can be interacted with dietary sourced nutrients, which may modify the associations with GDM. This study aims to explore the associations between overall quality of carbohydrate intake and GDM as well as the modifying effect of prenatal air pollution exposure. Methods Carbohydrate quality index (CQI) was calculated was calculated by summing scores of the four components; Land use regression prediction models were used to assess the air pollution exposure levels. GDM definition was based on 75 g glucose tolerance test results. Associations between pre-pregnancy CQI, pre-natal air pollution as well as the modifying effect on GDM were explored based on a birth cohort in China. Results A total of 3,183 participants were included, of which 784 (24.63%) were diagnosed with GDM. Higher pre-pregnancy CQI was associated with a lower incidence of GDM [odds ratio (OR) = 0.75, 95% confidence interval (CI): 0.56-0.99, P for trend = 0.04], especially for higher fasting blood glucose related GDM (OR = 0.66, 95% CI: 0.47, 0.91). Higher air pollution exposure before and during pregnancy was associated with a greater risk of GDM. Higher exposure to particulate matter with an aerodynamic diameter of < 2.5 μm (P for interaction < 0.01), particulate matter with an aerodynamic diameter of < 10 μm (P for interaction < 0.01), and sulfur dioxide (P for interaction = 0.02) during pregnancy decreased the beneficial effect of high pre-pregnancy CQI on GDM. Conclusion CQI related dietary interventions pre-pregnancy to prevent GDM incidence should be considered. Women who are planning to be pregnant should avoid high exposure to air pollution during pregnancy.
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Affiliation(s)
- Hehua Zhang
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiangsu Zhang
- International Education School, China Medical University, Shenyang, China
| | - Qing Chang
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhong Zhao
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China,Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China,*Correspondence: Yuhong Zhao, ,
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10
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Singh B, Eshaghian E, Chuang J, Covasa M. Do Diet and Dietary Supplements Mitigate Clinical Outcomes in COVID-19? Nutrients 2022; 14:nu14091909. [PMID: 35565876 PMCID: PMC9104892 DOI: 10.3390/nu14091909] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 02/07/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) has caused a pandemic and upheaval that health authorities and citizens around the globe are still grappling with to this day. While public health measures, vaccine development, and new therapeutics have made great strides in understanding and managing the pandemic, there has been an increasing focus on the potential roles of diet and supplementation in disease prevention and adjuvant treatment. In the literature, the impact of nutrition on other respiratory illnesses, including the common cold, pneumonia, and influenza, has been widely demonstrated in both animal and human models. However, there is much less research on the impact related to COVID-19. The present study discusses the potential uses of diets, vitamins, and supplements, including the Mediterranean diet, glutathione, zinc, and traditional Chinese medicine, in the prevention of infection and severe illness. The evidence demonstrating the efficacy of diet supplementation on infection risk, disease duration, severity, and recovery is mixed and inconsistent. More clinical trials are necessary in order to clearly demonstrate the contribution of nutrition and to guide potential therapeutic protocols.
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Affiliation(s)
- Bhavdeep Singh
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA 91766, USA; (B.S.); (E.E.); (J.C.)
| | - Eli Eshaghian
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA 91766, USA; (B.S.); (E.E.); (J.C.)
| | - Judith Chuang
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA 91766, USA; (B.S.); (E.E.); (J.C.)
| | - Mihai Covasa
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA 91766, USA; (B.S.); (E.E.); (J.C.)
- Department of Biomedical Sciences, College of Medicine and Biological Sciences, University of Suceava, 7200229 Suceava, Romania
- Correspondence:
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11
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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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12
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Amazouz H, Roda C, Beydon N, Lezmi G, Bourgoin-Heck M, Just J, Momas I, Rancière F. Mediterranean diet and lung function, sensitization, and asthma at school age: The PARIS cohort. Pediatr Allergy Immunol 2021; 32:1437-1444. [PMID: 33914969 DOI: 10.1111/pai.13527] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND The Mediterranean diet (MD) has known health benefits, but its specific impact on allergy development is unclear. As part of the PARIS birth cohort follow-up, we aimed to investigate the adherence of 8-year-old children to the MD and its association with allergic/respiratory morbidity at school age. METHODS Diet was assessed using a food frequency questionnaire completed by the parents. Adherence to the MD was assessed based on two scores: the KIDMED index and the Mediterranean Diet Score (MDS). Current allergic diseases (asthma, rhinitis, eczema), lung function indices (FEV1 and FVC), FeNO and specific IgE levels were determined during a health check-up at 8 years. Associations between levels of adherence to the MD and respiratory/allergic morbidity were studied using multivariable logistic and linear regression models adjusted for potential confounders. RESULTS A total of 975 children were included in the present study, 35.6% with low adherence to the MD, 55.7% with moderate adherence and 8.7% with high adherence according to the KIDMED index. High family socioeconomic status, any breastfeeding at 6 months and consumption of organic food were associated with higher adherence to the MD. Compared with low adherence, high adherence was associated with lower risk of asthma and sensitization at 8 years, as well as higher FEV1 and FVC. CONCLUSION This study suggests a protective effect of high adherence to the MD on allergic and respiratory morbidity at school age. These results need to be confirmed by further longitudinal analyses. A healthy diet may prevent allergic and respiratory morbidity in school-aged children.
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Affiliation(s)
- Hélène Amazouz
- HERA Team, CRESS, Université de Paris, Inserm, INRAE, Paris, France
| | - Célina Roda
- HERA Team, CRESS, Université de Paris, Inserm, INRAE, Paris, France.,Faculté de Pharmacie de Paris, Université de Paris, Paris, France
| | - Nicole Beydon
- Unité Fonctionnelle de Physiologie-Explorations Fonctionnelles Repiratoires (EFR), AP-HP, Hôpital Armand-Trousseau, Paris, France
| | - Guillaume Lezmi
- Service de Pneumologie et d'Allergologie Pédiatriques, AP-HP, Hôpital Necker-Enfants Malades, Paris, France
| | - Mélisande Bourgoin-Heck
- Service d'Allergologie Pédiatrique, AP-HP, Hôpital d'Enfants Armand-Trousseau, Paris, France
| | - Jocelyne Just
- Service d'Allergologie Pédiatrique, AP-HP, Hôpital d'Enfants Armand-Trousseau, Paris, France
| | - Isabelle Momas
- HERA Team, CRESS, Université de Paris, Inserm, INRAE, Paris, France.,Faculté de Pharmacie de Paris, Université de Paris, Paris, France.,Cellule Cohorte, Mairie de Paris, Direction de l'Action Sociale de l'Enfance et de la Santé, Paris, France
| | - Fanny Rancière
- HERA Team, CRESS, Université de Paris, Inserm, INRAE, Paris, France.,Faculté de Pharmacie de Paris, Université de Paris, Paris, France
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13
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Alwarith J, Kahleova H, Crosby L, Brooks A, Brandon L, Levin SM, Barnard ND. The role of nutrition in asthma prevention and treatment. Nutr Rev 2021; 78:928-938. [PMID: 32167552 PMCID: PMC7550896 DOI: 10.1093/nutrit/nuaa005] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Asthma is a chronic respiratory condition characterized by airway inflammation and hyperreactivity. Prevalence has continued to rise in recent decades as Western dietary patterns have become more pervasive. Evidence suggests that diets emphasizing the consumption of plant-based foods might protect against asthma development and improve asthma symptoms through their effects on systemic inflammation, oxidation, and microbial composition. Additionally, increased fruit and vegetable intake, reduced animal product consumption, and weight management might mediate cytokine release, free radical damage, and immune responses involved in the development and course of asthma. The specific aim of this review paper is to examine the current literature on the associations between dietary factors and asthma risk and control in children and adults. Clinical trials examining the mechanism(s) by which dietary factors influence asthma outcomes are necessary to identify the potential use of nutritional therapy in the prevention and management of asthma.
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Affiliation(s)
- Jihad Alwarith
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | - Hana Kahleova
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | - Lee Crosby
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | - Alexa Brooks
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | | | - Susan M Levin
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | - Neal D Barnard
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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14
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Parental Education and the Association between Fruit and Vegetable Consumption and Asthma in Adolescents: The Greek Global Asthma Network (GAN) Study. CHILDREN-BASEL 2021; 8:children8040304. [PMID: 33923381 PMCID: PMC8071508 DOI: 10.3390/children8040304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/11/2021] [Accepted: 04/13/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Evidence suggests that nutritional factors, such as consumption of fruits and vegetables, along with socioeconomic factors such as parental education level, are associated with asthma prevalence. Our study examined the role of parental education in the association between fruit and vegetable consumption and adolescent asthma. METHODS 1934 adolescents (mean age: 12.7 years, standard deviation: 0.6 years, boys: 47.5%) and their parents were voluntarily enrolled and completed a validated questionnaire assessing current asthma status, fruit and vegetable consumption and parental educational level. Participants were categorized as high or low intake for five food groups: fruits, cooked vegetables, raw vegetables, all vegetables (cooked and raw), and all three food groups together (fruits and all vegetables). RESULTS Adolescents who were high consumers of all three food groups (fruits, cooked and raw vegetables) were less likely to have asthma, adjusted for several confounders (adjusted odds ratio (aOR): 0.53, 95% confidence interval (CI): 0.25-0.97). Moreover, in adolescents who had parents with tertiary education and were in the high consumption of all three food groups, the inverse association was almost twofold higher than the one for adolescents with parents of primary/secondary education (aOR: 0.35, 95% CI: (0.21-0.89) and aOR: 0.61, 95% CI: (0.47-0.93) respectively). CONCLUSIONS Our findings highlight the importance of the adoption of a diet rich in fruits and vegetables for all asthmatic adolescents and emphasize the important role of parental influences in this association.
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15
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Bédard A, Li Z, Ait-hadad W, Camargo CA, Leynaert B, Pison C, Dumas O, Varraso R. The Role of Nutritional Factors in Asthma: Challenges and Opportunities for Epidemiological Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063013. [PMID: 33804200 PMCID: PMC7999662 DOI: 10.3390/ijerph18063013] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/04/2021] [Accepted: 03/09/2021] [Indexed: 12/12/2022]
Abstract
The prevalence of asthma has nearly doubled over the last decades. Twentieth century changes in environmental and lifestyle factors, including changes in dietary habits, physical activity and the obesity epidemic, have been suggested to play a role in the increase of asthma prevalence and uncontrolled asthma worldwide. A large body of evidence has suggested that obesity is a likely risk factor for asthma, but mechanisms are still unclear. Regarding diet and physical activity, the literature remains inconclusive. Although the investigation of nutritional factors as a whole (i.e., the “diet, physical activity and body composition” triad) is highly relevant in terms of understanding underlying mechanisms, as well as designing effective public health interventions, their combined effects across the life course has not received a lot of attention. In this review, we discuss the state of the art regarding the role of nutritional factors in asthma, for each window of exposure. We focus on the methodological and conceptual challenges encountered in the investigation of the complex time-dependent interrelations between nutritional factors and asthma and its control, and their interaction with other determinants of asthma. Lastly, we provide guidance on how to address these challenges, as well as suggestions for future research.
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Affiliation(s)
- Annabelle Bédard
- Université Paris-Saclay, UVSQ, University Paris-Sud, Inserm, Équipe d’Épidémiologie Respiratoire Intégrative, CESP, 94807 Villejuif, France; (W.A.-h.); (B.L.); (O.D.); (R.V.)
- Correspondence:
| | - Zhen Li
- Clinical Research Centre, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200092, China;
| | - Wassila Ait-hadad
- Université Paris-Saclay, UVSQ, University Paris-Sud, Inserm, Équipe d’Épidémiologie Respiratoire Intégrative, CESP, 94807 Villejuif, France; (W.A.-h.); (B.L.); (O.D.); (R.V.)
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA;
| | - Bénédicte Leynaert
- Université Paris-Saclay, UVSQ, University Paris-Sud, Inserm, Équipe d’Épidémiologie Respiratoire Intégrative, CESP, 94807 Villejuif, France; (W.A.-h.); (B.L.); (O.D.); (R.V.)
| | - Christophe Pison
- Service Hospitalier Universitaire Pneumologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Laboratoire de Bioénergétique Fondamentale et Appliquée, Inserm 1055, Université Grenoble Alpes, 38400 Grenoble, France;
| | - Orianne Dumas
- Université Paris-Saclay, UVSQ, University Paris-Sud, Inserm, Équipe d’Épidémiologie Respiratoire Intégrative, CESP, 94807 Villejuif, France; (W.A.-h.); (B.L.); (O.D.); (R.V.)
| | - Raphaëlle Varraso
- Université Paris-Saclay, UVSQ, University Paris-Sud, Inserm, Équipe d’Épidémiologie Respiratoire Intégrative, CESP, 94807 Villejuif, France; (W.A.-h.); (B.L.); (O.D.); (R.V.)
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16
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[Diet and asthma: Better eating for better breathing?]. Rev Mal Respir 2021; 38:278-288. [PMID: 33676796 DOI: 10.1016/j.rmr.2021.02.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/13/2020] [Indexed: 11/22/2022]
Abstract
Inhaled therapies are the cornerstone of asthma treatment. However, according to national and international guidelines, non-pharmacological interventions should not be neglected in asthma. It has been demonstrated that a healthy diet is beneficial to general health. Recently, the effect of diet on asthma has been highlighted in many studies. Two diets have been particularly studied: the Mediterranean diet (high in fruits and vegetables and low in fat) and the Western diet (high in saturated fat and low in fruits and vegetables). A beneficial effect of the Mediterranean diet and deleterious effect of the Western diet on the development or control of asthma has been shown in some studies even after adjustment for overweight. Study findings have not been unanimous, probably related to the complexity of conducting studies on a diet that may change from day to day for any individual subject. In addition, the effect of physical exercise, which is known to be beneficial in asthma, is rarely taken into account in these studies. However, studies on diet are becoming more complex with the use of specific dietary indices, which should bring interesting data in the future.
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17
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Tiwari D, Gupta P. Nuclear Receptors in Asthma: Empowering Classical Molecules Against a Contemporary Ailment. Front Immunol 2021; 11:594433. [PMID: 33574813 PMCID: PMC7870687 DOI: 10.3389/fimmu.2020.594433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/09/2020] [Indexed: 02/06/2023] Open
Abstract
The escalation in living standards and adoption of 'Western lifestyle' has an allied effect on the increased allergy and asthma burden in both developed and developing countries. Current scientific reports bespeak an association between allergic diseases and metabolic dysfunction; hinting toward the critical requirement of organized lifestyle and dietary habits. The ubiquitous nuclear receptors (NRs) translate metabolic stimuli into gene regulatory signals, integrating diet inflences to overall developmental and physiological processes. As a consequence of such promising attributes, nuclear receptors have historically been at the cutting edge of pharmacy world. This review discusses the recent findings that feature the cardinal importance of nuclear receptors and how they can be instrumental in modulating current asthma pharmacology. Further, it highlights a possible future employment of therapy involving dietary supplements and synthetic ligands that would engage NRs and aid in eliminating both asthma and linked comorbidities. Therefore, uncovering new and evolving roles through analysis of genomic changes would represent a feasible approach in both prevention and alleviation of asthma.
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Affiliation(s)
| | - Pawan Gupta
- Department of Molecular Biology, Council of Scientific and Industrial Research, Institute of Microbial Technology, Chandigarh, India
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18
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Li Y, Huang X, Liu Q, Li W, Yang B, Chen Y, Lin W, Zhang JJ. Changes in children's respiratory morbidity and residential exposure factors over 25 years in Chongqing, China. J Thorac Dis 2020; 12:6356-6364. [PMID: 33209474 PMCID: PMC7656426 DOI: 10.21037/jtd-19-crh-aq-005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background Respiratory morbidity and mortality during childhood remains a major challenge for global health. Due to the rapid economic development in Chongqing, we expect substantial temporal changes in respiratory health status and environmental risk factors in children. By leveraging a historical dataset, this study aims to assess the changes in prevalence of respiratory symptoms and diseases, residential exposure factors, and their associations in school-age children over a period of 25 years. Methods This study involved two cross-sectional surveys conducted in Chongqing with a 25-year interval (2017 vs. 1993). Purpose sampling was used to conduct questionnaire surveys on school-age children in both surveys. Information collected include children’s respiratory health outcomes, family residential exposures, demographic information, and parental respiratory disease history. The changes of residential exposures as well as demographics were determined by chi-square test. Odds ratios were calculated to compare the prevalence of children’s respiratory symptoms and diseases between the two periods. Associations between children’s respiratory outcomes and exposure indicators were assessed using multivariate logistic regressions. Results The majority of residential exposure indicators improved in 2017, including sleep in shared room, cooking with coal, poor kitchen ventilation, cooking frequency, and parental smoking. Compared to the 1993 study, the adjusted risk for children’s wheezing was lower (OR: 0.38, 95% CI: 0.29, 0.49), but the risk for bronchitis was higher (OR: 1.89, 95% CI: 1.54, 2.31) in the 2017 study. Poor kitchen ventilation and parental smoking were linked to an increased risk of children’s wheezing (OR: 1.39, 95% CI: 1.02, 1.90) and bronchitis (OR: 1.51, 95% CI: 1.02, 2.21), respectively, while heating in winter was linked to an increased risk of phlegm (OR: 1.40, 95% CI: 1.03, 1.90) and wheezing (OR: 1.47, 95% CI: 1.07, 2.01) in the 1993 study. However, these residential exposure factors were no longer associated with the children’s respiratory diseases in the 2017 study. Conclusions Our study found improvement of residential exposures in Chongqing, a decline of prevalence of children’s wheezing but an increase of that of bronchitis from 1993 to 2017. Poor kitchen ventilation, heating in winter, and parental smoking were significant risk factors in the 1993 survey but, with significantly reduced prevalence in 2017, were not significantly associated with children’s respiratory morbidity in the latter survey.
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Affiliation(s)
- Yueyue Li
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Xin Huang
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Qin Liu
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Wenyan Li
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Bo Yang
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Yiwen Chen
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Weiwei Lin
- School of Public Health, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Sun Yat-sen University, Guangzhou, China
| | - Junfeng Jim Zhang
- Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, NC, USA.,Global Health Research Center, Duke Kunshan University, Kunshan, China.,Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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19
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Li W, Liu Q, Chen Y, Yang B, Huang X, Li Y, Zhang JJ. Effects of indoor environment and lifestyle on respiratory health of children in Chongqing, China. J Thorac Dis 2020; 12:6327-6341. [PMID: 33209472 PMCID: PMC7656398 DOI: 10.21037/jtd.2020.03.102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The prevalence of certain respiratory diseases of children in China appears to be on the rise in recent decades. This study aims to explore residential environmental factors that may affect respiratory diseases and lung function of children and to assess the effects of lifestyle (diet and exercise) on lung function. Methods The study was conducted in Chongqing, southwest of China in June, 2017. Information on respiratory diseases was obtained from 2,126 primary school children through a family questionnaire by purposive sampling. In addition, a random sample of 771 children participating in the family-questionnaire was selected for physical measurements and lung function test as well as lifestyle questionnaire survey. Chi-square test and multivariate logistic regressions were used to analyze the relationship between indoor environment and children's respiratory diseases. The effects of indoor environment and lifestyle on lung function indices were analyzed by t-test, variance analysis, and univariate and multivariate linear regression methods. Results Among residential environmental factors, indoor ventilation and air circulation were significant associated with children's respiratory health outcomes. The use of air conditioning for more than 8 h/day in summer was a risk factor for asthma with an adjusted odds ratio (AOR) of 1.99, bronchitis (AOR =1.62), and allergic rhinitis (AOR =1.51). Ventilation for less than 12 h per day during summer increased the risk for allergic rhinitis (AOR =1.40). Children living in homes with an opened kitchen had the risk of developing allergic rhinitis 1.51 times higher than children living in homes with a closed kitchen. Indoor dampness and mold were significantly associated with increased risks for childhood asthma (AOR =2.16), bronchitis (AOR =1.55) and allergic rhinitis (AOR =1.55). The frequent use of hygienic incense and mosquito coils also increased the risk for asthma (AOR =2.58) and bronchitis (AOR =1.42) in children. The multiple linear regression results showed that frequent use of air fresheners reduced children's peak expiratory flow (PEF) and small airway function (FEF25-75) after potential influencing factors were adjusted for. Analyses of lifestyle variables showed that increased lung function (FVC, FEV1, FEV3) was associated with increasing consumption of vegetable and fruit as well as increasing time of physical exercise. Conclusions This study identified the following residential risk factors for children's respiratory diseases in Chongqing: poor indoor ventilation, home dampness and mold presence, and frequent use of hygienic incense and mosquito coils. Frequent use of air fresheners is associated with reduced lung function in children. High frequency consumption of vegetables, fruits and dairy products as well as daily exercise for more than 1 hour have positive effects on children's lung development.
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Affiliation(s)
- Wenyan Li
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China
| | - Qin Liu
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China
| | - Yiwen Chen
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China
| | - Bo Yang
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China
| | - Xin Huang
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China
| | - Yueyue Li
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China
| | - Junfeng Jim Zhang
- Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, NC, USA.,Duke Kunshan University, Kunshan 215316, China.,Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
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20
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Gilden R, Friedmann E, Holmes K, Yolton K, Xu Y, Lanphear B, Chen A, Braun J, Spanier A. Gestational Pesticide Exposure and Child Respiratory Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7165. [PMID: 33007939 PMCID: PMC7579149 DOI: 10.3390/ijerph17197165] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/21/2020] [Accepted: 09/24/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Childhood wheeze may be related to pesticide exposure, and diet and genetics (Paroxonase; PON1) may modify the effects of exposure. METHODS We analyzed data from the HOME Study, a prospective pregnancy and birth cohort, to examine the association of gestational urinary organophosphate (OP) and pyrethroid (3PBA) metabolite concentrations with child wheeze, forced expiratory volume in one second (FEV1) at ages 4 and 5 years, and wheeze trajectory patterns through age 8 years. RESULTS Among 367 singletons, the frequency of wheeze ranged from 10.6% to 24.1% at each measurement age. OP and 3PBA metabolite concentrations were not associated with wheeze at 8 years or from birth to 8 years, but there were three significant interactions: (1) maternal daily fruit and vegetable consumption (less than daily consumption and increasing 3PBA was associated with wheeze at age 8 years, OR = 1.40), (2) maternal PON1-108 allele (CT/TT genotypes and high DE was associated with wheeze at age 8 years, OR = 2.13, 2.74) and (3) PON1192 alleles (QR/RR genotypes with higher diethylphosphate (DE) and dialkyl phosphate (DAP) were associated with wheeze at age 8 years, OR = 3.84). Pesticide metabolites were not consistently related to FEV1 or wheeze trajectory. CONCLUSIONS Gestational OP and 3PBA metabolites were associated with child respiratory outcomes in participants with maternal dietary and genetic susceptibility.
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Affiliation(s)
- Robyn Gilden
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD 21201, USA
| | - Erika Friedmann
- Office of Research and Scholarship, University of Maryland School of Nursing, Baltimore, MD 21201, USA; (E.F.); (K.H.)
| | - Katie Holmes
- Office of Research and Scholarship, University of Maryland School of Nursing, Baltimore, MD 21201, USA; (E.F.); (K.H.)
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (K.Y.); (Y.X.)
| | - Yingying Xu
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (K.Y.); (Y.X.)
| | - Bruce Lanphear
- Department of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada;
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA;
| | - Joseph Braun
- Department of Epidemiology, Brown University, Providence, RI 02912, USA;
| | - Adam Spanier
- Department of Pediatrics, Division of General Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
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21
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Tarazona-Meza CE, Hanson C, Pollard SL, Romero Rivero KM, Galvez Davila RM, Talegawkar S, Rojas C, Rice JL, Checkley W, Hansel NN. Dietary patterns and asthma among Peruvian children and adolescents. BMC Pulm Med 2020; 20:63. [PMID: 32171269 PMCID: PMC7071620 DOI: 10.1186/s12890-020-1087-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 02/17/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Asthma is one of the conditions that contributes to the global burden of respiratory diseases and has been previously associated with diet intake. The goal of this study was to determine the relationship between diet, assessed by a developed score, and asthma in Peruvian children. METHODS This study was a cross sectional analysis nested within an unmatched case-control study of children in two peri-urban communities of Lima, Peru. We evaluated 767 children and adolescents (573 with asthma, 194 controls) between 9 and 19 years. Diet was assessed using a food frequency questionnaire (FFQ), with food groups classified as "healthy" or "unhealthy". Asthma control, Lung function and atopy were assessed by Asthma Control Test, Spirometry and InmunoCAP 250 test, respectively. RESULTS Mean age of participants was 13.8 years (SD 2.6). Mean diet score was 5 (SD 1.23; range 2-8). Healthy Diet Score was associated with asthma status [OR 0.83, 95% CI (0.72, 0.95), p = 0.009] in adjusted analysis. Thus, participants with higher HDS, had lower odds of asthma. In sensitivity analyses, when adjusting for atopy, results did not change significantly. [OR 0.85, 95% CI (0.72, 0.99); p = 0.04]. No association between the HDS and asthma control, FEV1, nor FeNO were observed. Atopy did not modify the association between diet and asthma outcomes. CONCLUSIONS In our study cohort, better diet quality was associated with lower odds of asthma, but was not associated with asthma control. Diet modification may be a potential intervention to impact the increasing prevalence of this disease.
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Affiliation(s)
- Carla E Tarazona-Meza
- Center for Non-Communicable Diseases Research and Training, Johns Hopkins University, Baltimore, MD, USA.,Biomedical Research Unit, Asociacion Benefica PRISMA, Carlos Gonzales 251, San Miguel, Lima, Peru
| | - Corrine Hanson
- Division of Medical Nutrition Education, University of Nebraska Medical Center, 984035 Nebraska Medical Center, Omaha, NE, 68198-4035, USA
| | - Suzanne L Pollard
- Center for Non-Communicable Diseases Research and Training, Johns Hopkins University, Baltimore, MD, USA.,Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Johns Hopkins Bayview, 1830 E, Monument, 5th Floor, Baltimore, MD, 21205, USA
| | - Karina M Romero Rivero
- Biomedical Research Unit, Asociacion Benefica PRISMA, Carlos Gonzales 251, San Miguel, Lima, Peru.,Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Johns Hopkins Bayview, 1830 E, Monument, 5th Floor, Baltimore, MD, 21205, USA
| | - Rocio M Galvez Davila
- Biomedical Research Unit, Asociacion Benefica PRISMA, Carlos Gonzales 251, San Miguel, Lima, Peru
| | - Sameera Talegawkar
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, NW. 7th Floor, Washington, DC, 20052, USA
| | - Carlos Rojas
- Monitoring and Evaluation Office, UNICEF Peru, Parque Meliton Porras No. 350, Miraflores, Lima, Peru
| | - Jessica L Rice
- Division of Pediatric Pulmonology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - William Checkley
- Center for Non-Communicable Diseases Research and Training, Johns Hopkins University, Baltimore, MD, USA.,Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Johns Hopkins Bayview, 1830 E, Monument, 5th Floor, Baltimore, MD, 21205, USA
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Johns Hopkins Bayview, 1830 E, Monument, 5th Floor, Baltimore, MD, 21205, USA.
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22
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Venter C, Greenhawt M, Meyer RW, Agostoni C, Reese I, Toit G, Feeney M, Maslin K, Nwaru BI, Roduit C, Untersmayr E, Vlieg‐Boerstra B, Pali‐Schöll I, Roberts GC, Smith P, Akdis CA, Agache I, Ben‐Adallah M, Bischoff S, Frei R, Garn H, Grimshaw K, Hoffmann‐Sommergruber K, Lunjani N, Muraro A, Poulsen LK, Renz H, Sokolowska M, Stanton C, O'Mahony L. EAACI position paper on diet diversity in pregnancy, infancy and childhood: Novel concepts and implications for studies in allergy and asthma. Allergy 2020; 75:497-523. [PMID: 31520486 DOI: 10.1111/all.14051] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/27/2019] [Accepted: 09/09/2019] [Indexed: 02/06/2023]
Abstract
To fully understand the role of diet diversity on allergy outcomes and to set standards for conducting research in this field, the European Academy of Allergy and Clinical Immunology Task Force on Diet and Immunomodulation has systematically explored the association between diet diversity and allergy outcomes. In addition, a detailed narrative review of information on diet quality and diet patterns as they pertain to allergic outcomes is presented. Overall, we recommend that infants of any risk category for allergic disease should have a diverse diet, given no evidence of harm and some potential association of benefit in the prevention of particular allergic outcomes. In order to harmonize methods for future data collection and reporting, the task force members propose relevant definitions and important factors for consideration, when measuring diet diversity in the context of allergy. Consensus was achieved on practice points through the Delphi method. It is hoped that the definitions and considerations described herein will also enable better comparison of future studies and improve mechanistic studies and pathway analysis to understand how diet diversity modulates allergic outcomes.
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Affiliation(s)
- Carina Venter
- Section of Allergy and Immunology Children's Hospital Colorado University of Colorado Denver School of Medicine Aurora CO USA
| | - Matthew Greenhawt
- Section of Allergy and Immunology Children's Hospital Colorado University of Colorado Denver School of Medicine Aurora CO USA
| | | | - Carlo Agostoni
- Fondazione IRCCS Ca' Granda ‐ Ospedale Maggiore Policlinico Milano Italy
- Dipartimento di Scienze Cliniche e di Comunita Universita' degli Studi Milano Italy
| | - Imke Reese
- Dietary Counseling and Nutrition Therapy Centre Munich Germany
| | - George Toit
- Department of Paediatric Allergy Division of Asthma, Allergy and Lung Biology King's College London London UK
- Guy's & St Thomas' Hospital London UK
| | - Mary Feeney
- Department of Paediatric Allergy Division of Asthma, Allergy and Lung Biology King's College London London UK
- Guy's & St Thomas' Hospital London UK
| | | | - Bright I. Nwaru
- Institute of Medicine Krefting Research Centre University of Gothenburg Gothenburg Sweden
| | - Caroline Roduit
- University Children's Hospital Zurich Zurich Switzerland
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
| | - Eva Untersmayr
- Institute for Pathophysiology and Allergy Research Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | | | - Isabella Pali‐Schöll
- Department of Nutrition and Dietetics Hanze University of Applied Sciences Groningen The Netherlands
- Comparative Medicine Messerli Research Institute of the University of Veterinary Medicine Vienna Medical University Vienna Vienna Austria
| | - Graham C. Roberts
- The David Hide Asthma and Allergy Research Centre St Mary’s Hospital Newport UK
- NIHR Biomedical Research Centre University Hospital Southampton NHS Foundation Trust Southampton UK
- Faculty of Medicine Clinical and Experimental Sciences Human Development in Health Academic Units University of Southampton Southampton UK
| | - Peter Smith
- School of Medicine Griffith University Southport QLD Australia
| | - Cezmi A. Akdis
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | | | - Miriam Ben‐Adallah
- Section of Allergy and Immunology Children's Hospital Colorado University of Colorado Denver School of Medicine Aurora CO USA
| | - Stephan Bischoff
- Institute of Nutritional Medicine University of Hohenheim Stuttgart Germany
| | - Remo Frei
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Holger Garn
- Philipps University of Marburg - Medical Faculty Institute of Laboratory Medicine and Pathobiochemistry Universities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL) Marburg Germany
| | - Kate Grimshaw
- Faculty of Medicine Experimental Sciences & Human Development in Health Academic Units University of Southampton Southampton UK
- Department of Dietetics Salford Royal Foundation Trust Salford UK
| | - Karin Hoffmann‐Sommergruber
- Institute for Pathophysiology and Allergy Research Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Nonhlanhla Lunjani
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- University of Cape Town Cape Town South Africa
| | - Antonella Muraro
- Centro di Specializzazione Regionale per lo Studio e la Cura delle Allergie e delle Intolleranze Alimentari presso l'Azienda Ospedaliera Università di Padova Padova Italy
| | - Lars K. Poulsen
- Department of Skin and Allergy Diseases Allergy Clinic Copenhagen University Hospital at Gentofte Copenhagen Denmark
| | - Harald Renz
- Institute of Laboratory Medicine Universities of Giessen and Marburg Lung Center (UGMLC) German Center for Lung Research (DZL) Philipps Universität Marburg Marburg Germany
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | | | - Liam O'Mahony
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Department of Medicine and Microbiology APC Microbiome Ireland National University of Ireland Cork Ireland
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23
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Sdona E, Hallberg J, Andersson N, Ekström S, Rautiainen S, Håkansson N, Wolk A, Kull I, Melén E, Bergström A. Dietary antioxidant intake in school age and lung function development up to adolescence. Eur Respir J 2020; 55:13993003.00990-2019. [PMID: 31806717 PMCID: PMC7031707 DOI: 10.1183/13993003.00990-2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 11/08/2019] [Indexed: 12/12/2022]
Abstract
Dietary antioxidant intake has been hypothesised to influence lung function. The association between total antioxidant capacity (TAC) of the diet at age 8 years and lung function development up to 16 years in 2307 participants from the Swedish population-based birth cohort BAMSE (Children, Allergy, Milieu, Stockholm, Epidemiology) was investigated. Information on TAC was obtained from a food frequency questionnaire at 8 years. Lung function was measured by spirometry at 8 and 16 years, impulse oscillometry (IOS) and exhaled nitric oxide fraction (FeNO) at 16 years. Low lung function was defined as forced expiratory volume in 1 s (FEV1) z-score below the 25th percentile. Longitudinal associations between TAC and lung function were analysed by mixed effect models adjusted for potential confounders. Stratification by asthma at 8 years was performed to examine effect modification. The median TAC intake was 10 067 μmol Trolox equivalents (TE)·g−1, with males having a lower mean compared to females (9963 versus 10 819 μmol TE·g−1). In analyses of lung function change between 8 and 16 years, there were no statistically significant associations between TAC in tertiles and spirometry results for the total study population. Among children with asthma at 8 years (prevalence 7%), higher TAC was associated with higher mean FEV1 (0.46 sd, 95% CI 0.11–0.80) and decreased odds of low lung function at 16 years (OR 0.28, 95% CI 0.12–0.65). There were no associations between TAC and forced vital capacity or IOS/FeNO results. High dietary antioxidant intake in school age may be associated with improved lung function development from school age to adolescence among children with asthma. Dietary antioxidant intake at school age may influence lung function development as measured by FEV1 up to adolescence among children with asthma. In contrast, no association was observed among children without asthma.http://bit.ly/2CzEZ8W
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Affiliation(s)
- Emmanouela Sdona
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jenny Hallberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children's Hospital, Södersjukhuset, Stockholm, Sweden.,Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Susanne Rautiainen
- Global and Sexual Health, Dept of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Niclas Håkansson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Dept of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Inger Kull
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children's Hospital, Södersjukhuset, Stockholm, Sweden.,Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Erik Melén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children's Hospital, Södersjukhuset, Stockholm, Sweden.,Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
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24
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Barthelemy J, Sanchez K, Miller MR, Khreis H. New Opportunities to Mitigate the Burden of Disease Caused by Traffic Related Air Pollution: Antioxidant-Rich Diets and Supplements. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020630. [PMID: 31963738 PMCID: PMC7014349 DOI: 10.3390/ijerph17020630] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/08/2020] [Accepted: 01/14/2020] [Indexed: 12/13/2022]
Abstract
Air pollution is associated with premature mortality and a wide spectrum of diseases. Traffic-related air pollution (TRAP) is one of the most concerning sources of air pollution for human exposure and health. Until TRAP levels can be significantly reduced on a global scale, there is a need for effective shorter-term strategies to prevent the adverse health effects of TRAP. A growing number of studies suggest that increasing antioxidant intake, through diet or supplementation, may reduce this burden of disease. In this paper, we conducted a non-systematic literature review to assess the available evidence on antioxidant-rich diets and antioxidant supplements as a strategy to mitigate adverse health effects of TRAP in human subjects. We identified 11 studies that fit our inclusion criteria; 3 of which investigated antioxidant-rich diets and 8 of which investigated antioxidant supplements. Overall, we found consistent evidence that dietary intake of antioxidants from adherence to the Mediterranean diet and increased fruit and vegetable consumption is effective in mitigating adverse health effects associated with TRAP. In contrast, antioxidant supplements, including fish oil, olive oil, and vitamin C and E supplements, presented conflicting evidence. Further research is needed to determine why antioxidant supplementation has limited efficacy and whether this relates to effective dose, supplement formulation, timing of administration, or population being studied. There is also a need to better ascertain if susceptible populations, such as children, the elderly, asthmatics and occupational workers consistently exposed to TRAP, should be recommended to increase their antioxidant intake to reduce their burden of disease. Policymakers should consider increasing populations' antioxidant intake, through antioxidant-rich diets, as a relatively cheap and easy preventive measure to lower the burden of disease associated with TRAP.
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Affiliation(s)
- Jillian Barthelemy
- Center for Advancing Research in Transportation Emissions, Energy, and Health (CARTEEH), Texas A & M Transportation Institute (TTI), College Station, TX 77843, USA; (J.B.); (K.S.)
| | - Kristen Sanchez
- Center for Advancing Research in Transportation Emissions, Energy, and Health (CARTEEH), Texas A & M Transportation Institute (TTI), College Station, TX 77843, USA; (J.B.); (K.S.)
| | - Mark R. Miller
- Centre for Cardiovascular Science, Queens Medical Research Institute, The University of Edinburgh, Edinburgh EH16 4TJ, UK;
| | - Haneen Khreis
- Center for Advancing Research in Transportation Emissions, Energy, and Health (CARTEEH), Texas A & M Transportation Institute (TTI), College Station, TX 77843, USA; (J.B.); (K.S.)
- Barcelona Institute for Global Health (ISGlobal), Centre for Research in Environmental Epidemiology (CREAL), 08003 Barcelona, Spain
- Correspondence:
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25
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Téllez-Rojo MM, Rothenberg SJ, Texcalac-Sangrador JL, Just AC, Kloog I, Rojas-Saunero LP, Gutiérrez-Avila I, Bautista-Arredondo LF, Tamayo-Ortiz M, Romero M, Hurtado-Díaz M, Schwartz JD, Wright R, Riojas-Rodríguez H. Children's acute respiratory symptoms associated with PM 2.5 estimates in two sequential representative surveys from the Mexico City Metropolitan Area. ENVIRONMENTAL RESEARCH 2020; 180:108868. [PMID: 31711659 DOI: 10.1016/j.envres.2019.108868] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/26/2019] [Accepted: 10/27/2019] [Indexed: 05/22/2023]
Abstract
BACKGROUND Respiratory diseases are a major component of morbidity in children and their symptoms may be spatially and temporally exacerbated by exposure gradients of fine particulate matter (PM2.5) in large polluted urban areas, like the Mexico City Metropolitan Area (MCMA). OBJECTIVES To analyze the association between satellite-derived and interpolated PM2.5 estimates with children's (≤9 years old) acute respiratory symptoms (ARS) in two probabilistic samples representing the MCMA. METHODS We obtained ARS data from the 2006 and 2012 National Surveys for Health and Nutrition (ENSaNut). Two week average exposure to PM2.5 was assessed for each household with spatial estimates from a hybrid model with satellite measurements of aerosol optical depth (AOD-PM2.5) and also with interpolated PM2.5 measurements from ground stations, from the Mexico City monitoring network (MNW-PM2.5). We used survey-adjusted logistic regressions to analyze the association between PM2.5 estimates and ARS reported on children. RESULTS A total of 1,005 and 1,233 children were surveyed in 2006 and 2012 representing 3.1 and 3.5 million children, respectively. For the same years and over the periods of study, the estimated prevalence of ARS decreased from 49.4% (95% CI: 44.9,53.9%) to 37.8% (95% CI: 34,41.7%). AOD-PM2.5 and MNW-PM2.5 estimates were associated with significantly higher reports of ARS in children 0-4 years old [OR2006 = 1.29 (95% (CI): 0.99,1.68) and OR2006 = 1.24 (95% CI: 1.08,1.42), respectively]. We observed positive non-significant associations in 2012 in both age groups and in 2006 for children 5-9 years old. No statistically significant differences in health effect estimates of PM2.5 were found comparing AOD-PM2.5 or MNW-PM2.5 for exposure assessment. CONCLUSIONS Our findings suggest that PM2.5 is a risk factor for the prevalence of ARS in children and expand the growing evidence of the utility of new satellite AOD-based methods for estimating health effects from acute exposure to PM2.5.
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Affiliation(s)
- Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Stephen J Rothenberg
- Department of Environmental Health, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - José Luis Texcalac-Sangrador
- Department of Environmental Health, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Iván Gutiérrez-Avila
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Luis F Bautista-Arredondo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Marcela Tamayo-Ortiz
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico; National Council of Science and Technology Fellowship, Mexico City, Mexico
| | - Martín Romero
- Center for Research in Surveys and Evaluation, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Magali Hurtado-Díaz
- Department of Environmental Health, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Joel D Schwartz
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Robert Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Horacio Riojas-Rodríguez
- Department of Environmental Health, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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26
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D'Auria E, Peroni DG, Sartorio MUA, Verduci E, Zuccotti GV, Venter C. The Role of Diet Diversity and Diet Indices on Allergy Outcomes. Front Pediatr 2020; 8:545. [PMID: 33042906 PMCID: PMC7522364 DOI: 10.3389/fped.2020.00545] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/29/2020] [Indexed: 12/11/2022] Open
Abstract
Nutrients in foods are not eaten in isolation and food intake interacts in a complex manner, affecting health and disease outcomes. For this reason, focusing on the whole "pattern" of dietary intake instead of the single nutrients or groups of nutrients when studying diseases outcomes is increasingly appealing and growing. Diet diversity refers to the variety of foods being eaten, and the terms, diversity or variety, are often used interchangeably. When the overall diet is characterized by healthy foods, diet diversity will reflect a diversity/variety of healthy foods eaten over a period of time. The introduction of solid foods in the 1st year of life is considered a measure of increased diet diversity. Consuming a diverse range of foods and food allergens in the first year of life may increase intake of important nutrients and positively affect the gut microbiome structure and function. Intake of omega-3 fatty acids and fibers/prebiotics may be particularly important but more information is required about dose and which individuals are most likely to benefit. Increased diet diversity in the first year of life is also associated with reduced food allergy outcomes. In addition to diet diversity, diet indices are considered measures of overall diet quality and can be used as a simple assessment of dietary intake. The focus of this paper is to review and critically address the current knowledge of the association between diet diversity and diet indices and allergy outcomes. Based on the current evidence, we recommend the introduction of solid foods, including common allergenic solids, during the 1st year of life, according to the infant's neuro-developmental abilities and familial or cultural habits. For infants with severe AD and/or FA, medical assessment may be advisable before introducing common food allergens into the diet. Limited evidence exist about the role of diet indices in pregnancy and allergic disease in the offspring, and the most promising results indicate a reduction in childhood wheeze and/or asthma intake.
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Affiliation(s)
- Enza D'Auria
- Pediatric Department, Vittore Buzzi Children's Hospital, Universitá degli Studi di Milano, Milan, Italy
| | - Diego G Peroni
- Clinical and Experimental Medicine Department, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Marco Ugo Andrea Sartorio
- Pediatric Department, Vittore Buzzi Children's Hospital, Universitá degli Studi di Milano, Milan, Italy
| | - Elvira Verduci
- Pediatric Department, Vittore Buzzi Children's Hospital, Universitá degli Studi di Milano, Milan, Italy
| | - Gian Vincenzo Zuccotti
- Pediatric Department, Vittore Buzzi Children's Hospital, Universitá degli Studi di Milano, Milan, Italy
| | - Carina Venter
- Section of Allergy and Immunology, Children Hospital Colorado, University of Colorado, Denver, CO, United States
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27
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Evans EW, Koinis-Mitchell D, Kopel SJ, Jelalian E. Lung Function, Dietary Intake, and Weight Status in Children with Persistent Asthma from Low-Income, Urban Communities. Nutrients 2019; 11:E2943. [PMID: 31817051 PMCID: PMC6950281 DOI: 10.3390/nu11122943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/21/2019] [Accepted: 11/27/2019] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Asthma and obesity are prevalent chronic childhood diseases that commonly co-occur in youth from low-income, minority backgrounds. Diet is a known risk factor for obesity; however, its role in asthma/obesity comorbidity is not well established. This analysis examined the association between diet and lung function and effect modification by weight status. METHODS Lung function (FEV1 % predicted), anthropometric, and dietary data were collected from 95 children, ages 7-9 years old with persistent asthma, from low-income, urban communities in the United States. Associations between lung function, diet and weight status were examined using multivariable linear regression. RESULTS There were no significant differences in dietary intake between children with persistent asthma with and without obesity; however, >85% of participants did not meet recommendations for fruit, vegetable, and whole grain intake for their age and sex. Only intake of fruit (whole fruit and juice) was significantly associated with FEV1 % predicted (-3.36; 95% CI: -6.5 to -0.2). CONCLUSIONS Diet quality was poor in this sample, independent of weight status. More research is needed to understand the relationship between diet, lung function, and weight status, so that interventions can be developed to concurrently address obesity and weight.
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Affiliation(s)
- E. Whitney Evans
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, RI 02903, USA;
- Department of Psychiatry and Human Behavior, Brown University Alpert School of Medicine, Providence, RI 02903, USA
| | - Daphne Koinis-Mitchell
- Bradley/Hasbro Children’s Research Center, Brown University Medical School, Providence, RI 02903, USA; (D.K.-M.); (S.J.K.)
| | - Sheryl J. Kopel
- Bradley/Hasbro Children’s Research Center, Brown University Medical School, Providence, RI 02903, USA; (D.K.-M.); (S.J.K.)
| | - Elissa Jelalian
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, RI 02903, USA;
- Department of Psychiatry and Human Behavior, Brown University Alpert School of Medicine, Providence, RI 02903, USA
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28
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Zhang Y, Lin J, Fu W, Liu S, Gong C, Dai J. Mediterranean diet during pregnancy and childhood for asthma in children: A systematic review and meta-analysis of observational studies. Pediatr Pulmonol 2019; 54:949-961. [PMID: 30997754 DOI: 10.1002/ppul.24338] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 03/28/2019] [Accepted: 03/31/2019] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To evaluate the relationship between high adherence to the Mediterranean diet in pregnancy and childhood and the risk of asthma and wheeze in children. METHODS We conducted searches of PubMed, EMBASE, and Cochrane Central Register of Controlled Trials from inception to 30 October 2018. Observational studies providing risk estimates and corresponding confidence intervals on the association of high adherence to the Mediterranean diet in pregnancy or childhood and the risk of asthma or wheeze in childhood were included. The methodological quality of all included studies was assessed. Summary odds ratios (OR) were calculated using a random-effects model. RESULTS Eighteen observational studies were included in this review. All studies were of moderate to high quality. The pooled data suggested high adherence to the Mediterranean diet during pregnancy was associated with a reduced incidence of wheeze in the first 12 months (OR, 0.92; 95% confidence interval [CI], 0.88-0.95; P < 0.001), and there was an inverse association between the Mediterranean diet during childhood and the incidence of wheeze in the history (OR, 0.51; 95% CI, 0.37-0.70; P = 0.001) and current wheeze (OR, 0.97; 95% CI, 0.95-0.99; P = 0.013). However, there was no significant association between high adherence of the Mediterranean diet in pregnancy and childhood and any of the other meta-analysis end points including diagnosed asthma. CONCLUSION High adherence to the Mediterranean diet during pregnancy and childhood may have short-term effects on wheeze in children in early life. However, these findings should be interpreted with caution owing to the heterogeneity of the studies.
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Affiliation(s)
- Yin Zhang
- Respiratory Department, Children's Hospital of Chongqing Medical University, Chongqing, China.,Key Laboratory of Pediatrics in Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Jilei Lin
- Respiratory Department, Children's Hospital of Chongqing Medical University, Chongqing, China.,Key Laboratory of Pediatrics in Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Wenlong Fu
- Respiratory Department, Children's Hospital of Chongqing Medical University, Chongqing, China.,Key Laboratory of Pediatrics in Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Sha Liu
- Respiratory Department, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Caihui Gong
- Respiratory Department, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Jihong Dai
- Respiratory Department, Children's Hospital of Chongqing Medical University, Chongqing, China.,Key Laboratory of Pediatrics in Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
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29
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Brigham EP, Woo H, McCormack M, Rice J, Koehler K, Vulcain T, Wu T, Koch A, Sharma S, Kolahdooz F, Bose S, Hanson C, Romero K, Diette G, Hansel NN. Omega-3 and Omega-6 Intake Modifies Asthma Severity and Response to Indoor Air Pollution in Children. Am J Respir Crit Care Med 2019; 199:1478-1486. [PMID: 30922077 PMCID: PMC6580674 DOI: 10.1164/rccm.201808-1474oc] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 01/30/2019] [Indexed: 01/07/2023] Open
Abstract
Rationale: Higher indoor particulate matter (PM) concentrations are linked with increased asthma morbidity. Dietary intake of fatty acids, also linked with asthma outcomes, may influence this relationship. Objectives: To determine the relationship between omega-3 and omega-6 fatty acid intake and pediatric asthma morbidity, and the association between fatty acid intake and strength of indoor, PM-related asthma symptoms, albuterol use, and systemic inflammation. Methods: Analyses included 135 children with asthma enrolled in the AsthmaDIET Study. At baseline, 3 months, and 6 months, data included: week-long average home indoor concentration of PM ≤2.5 μm in aerodynamic diameter and PM ≤10 μm in aerodynamic diameter, dietary intake of omega-3 and omega-6 fatty acids, daily symptoms, and peripheral blood leukocytes. Asthma severity and lung function were assessed at baseline. Multivariable regression models, adjusted for known confounders, were used to determine associations between each fatty acid and outcomes of interest, with interaction terms (fatty acids × PM) in longitudinal analyses. Measurements and Main Results: Higher omega-6 intake associated with increased odds of increased asthma severity (P = 0.02), and lower FEV1/FVC ratio (P = 0.01). Higher omega-3 intake associated with reduced effect of indoor PM ≤2.5 μm in aerodynamic diameter on symptoms (P < 0.01), whereas higher omega-6 intake associated with amplified effect of indoor PM ≤2.5 μm in aerodynamic diameter on symptoms and circulating neutrophil percentage (P < 0.01). Conclusions: Omega-3 and omega-6 intake are associated with pediatric asthma morbidity and may modify the asthmatic response to indoor PM.
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Affiliation(s)
- Emily P. Brigham
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Han Woo
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Meredith McCormack
- Johns Hopkins University School of Medicine, Baltimore, Maryland
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jessica Rice
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kirsten Koehler
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Tianshi Wu
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Abigail Koch
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | | | - Sonali Bose
- Icahn School of Medicine at Mount Sinai, New York, New York; and
| | | | - Karina Romero
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Gregory Diette
- Johns Hopkins University School of Medicine, Baltimore, Maryland
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Nadia N. Hansel
- Johns Hopkins University School of Medicine, Baltimore, Maryland
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Stevens EL, Rosser F, Forno E, Peden D, Celedón JC. Can the effects of outdoor air pollution on asthma be mitigated? J Allergy Clin Immunol 2019; 143:2016-2018.e1. [PMID: 31029773 PMCID: PMC10838022 DOI: 10.1016/j.jaci.2019.04.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/18/2019] [Accepted: 04/23/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Erica L Stevens
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa
| | - Franziska Rosser
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa
| | - Erick Forno
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa
| | - David Peden
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Juan C Celedón
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa.
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Maternal obesity leads to long-term altered levels of plasma ceramides in the offspring as revealed by a longitudinal lipidomic study in children. Int J Obes (Lond) 2018; 43:1231-1243. [PMID: 30568270 DOI: 10.1038/s41366-018-0291-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 11/21/2018] [Accepted: 11/30/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND/OBJECTIVES Maternal obesity is associated with increased risk of obesity and other symptoms of the metabolic syndrome in the offspring. Nevertheless, the molecular mechanisms and cellular factors underlying this enhanced disease susceptibility remain to be determined. Here, we aimed at identifying changes in plasma lipids in offspring of obese mothers that might underpin, and serve as early biomarkers of, their enhanced metabolic disease risk. SUBJECTS/METHODS We performed a longitudinal lipidomic profiling in plasma samples from normal weight, overweight, and obese pregnant women and their children that participated in the Prenatal Omega-3 Fatty Acid Supplementation, Growth, and Development trial conducted in Mexico. At recruitment women were aged between 18 and 35 years and in week 18-22 of pregnancy. Blood samples were collected at term delivery by venipuncture from mothers and from the umbilical cord of their newborns and from the same infants at 4 years old under non-fasting conditions. Lipidomic profiling was done using ultra-performance liquid chromatography high-resolution mass spectrometry. RESULTS Analysis of the lipidomic data showed that overweight and obese mothers exhibited a significant reduction in the total abundance of ceramides (Cer) in plasma, mainly of Cer (d18:1/20:0), Cer (d18:1/22:0), Cer (d18:1/23:0), and Cer (d18:1/24:0), compared with mothers of normal body weight. This reduction was confirmed by the direct quantification of these and other ceramide species. Similar quantitative differences in the plasma concentration of Cer (d18:1/22:0), Cer (d18:1/23:0), and Cer (d18:1/24:0), were also found between 4-year-old children of overweight and obese mothers compared with children of mothers of normal body weight. Noteworthy, children exhibited equal daily amounts of energy and food intake independently of the BMI of their mothers. CONCLUSIONS Maternal obesity results in long-lasting changes in plasma ceramides in the offspring suggesting that these lipids might be used as early predictors of metabolic disease risk due to maternal obesity.
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Hosseini B, Berthon BS, Saedisomeolia A, Starkey MR, Collison A, Wark PAB, Wood LG. Effects of fruit and vegetable consumption on inflammatory biomarkers and immune cell populations: a systematic literature review and meta-analysis. Am J Clin Nutr 2018; 108:136-155. [PMID: 29931038 DOI: 10.1093/ajcn/nqy082] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 03/28/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Inflammation is associated with an increased risk of a range of chronic diseases. A diet high in fruit and vegetables may help to reduce inflammation, as fruit and vegetables are rich sources of antioxidants and other biologically active substances, which may improve immune function. OBJECTIVE To summarize the evidence, we executed a systematic review and meta-analysis examining the effects of fruit and/or vegetable intake on inflammatory biomarkers and immune cells in humans with different diseases and conditions. Design Electronic databases including PubMed, Cochrane, CINAHL, and EMBASE were systematically searched up to March 2018. RESULTS Eighty-three studies were included. Of these, 71 (86%) were clinical trials, and 12 were observational studies (n = 10 cross-sectional and n = 2 cohort). Amongst the observational research, n = 10 studies found an inverse association between intakes of fruit or vegetables and inflammatory biomarkers. Similarly, the majority of the intervention studies (68%, n = 48) reported beneficial effects of fruit or vegetable intake on ≥1 biomarker of systemic or airway inflammation. A meta-analysis of included studies showed that fruit or vegetable intake decreased circulating levels of C-reactive protein and tumor necrosis factor-α (P < 0.05) and increased the γδ-T cell population (P < 0.05). Conclusions In conclusion, this review suggests that higher intakes of fruit and vegetables lead to both a reduction in proinflammatory mediators and an enhanced immune cell profile.
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Affiliation(s)
- Banafshe Hosseini
- Grow Up Well Priority Research Centre and Priority Research Centre for Healthy Lungs and, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Bronwyn S Berthon
- Grow Up Well Priority Research Centre and Priority Research Centre for Healthy Lungs and, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Ahmad Saedisomeolia
- School of Medicine, Western Sydney University, Sydney, Australia.,School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Malcolm R Starkey
- Grow Up Well Priority Research Centre and Priority Research Centre for Healthy Lungs and, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Adam Collison
- Grow Up Well Priority Research Centre and Priority Research Centre for Healthy Lungs and, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Peter A B Wark
- Grow Up Well Priority Research Centre and Priority Research Centre for Healthy Lungs and, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Lisa G Wood
- Grow Up Well Priority Research Centre and Priority Research Centre for Healthy Lungs and, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
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33
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Levy JI, Quirós-Alcalá L, Fabian MP, Basra K, Hansel NN. Established and Emerging Environmental Contributors to Disparities in Asthma and Chronic Obstructive Pulmonary Disease. CURR EPIDEMIOL REP 2018; 5:114-124. [PMID: 30319934 PMCID: PMC6178976 DOI: 10.1007/s40471-018-0149-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE OF REVIEW Multiple respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD), display significant socioeconomic and racial/ethnic disparities. The objective of this review is to evaluate the evidence supporting a link between disproportionate environmental exposures and these health disparities. RECENT FINDINGS Studies suggest that various co-occurring factors related to the home environment, neighborhood environment, non-modifiable individual factors, and individual behaviors and attributes can increase or modify the risk of adverse respiratory outcomes among socioeconomically-disadvantaged and racially/ethnically diverse populations. Pollutants in the home environment, including particulate matter, nitrogen dioxide, and pesticides, are elevated among lower socioeconomic status populations and have been implicated in the development or exacerbation of respiratory-related conditions. Neighborhood crime and green space are socioeconomically patterned and linked with asthma outcomes through psychosocial pathways. Non-modifiable individual factors such as genetic predisposition cannot explain environmental health disparities but can increase susceptibility to air pollution and other stressors. Individual behaviors and attributes, including obesity and physical activity, contribute to worse outcomes among those with asthma or COPD. SUMMARY The root causes of these multifactorial exposures are complex, but many likely stem from economic forces and racial/ethnic and economic segregation that influence the home environment, neighborhood environment, and access to healthy foods and consumer products. Critical research needs include investigations that characterize exposure to and health implications of numerous stressors simultaneously, both to guard against potential confounding in epidemiological investigations and to consider the cumulative impact of multiple elevated environmental exposures and sociodemographic stressors on health disparities.
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Affiliation(s)
- Jonathan I. Levy
- Department of Environmental Health, Boston University School of Public Health
| | - Lesliam Quirós-Alcalá
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health; Division of Pulmonary & Critical Care Medicine, Johns Hopkins University
| | - M. Patricia Fabian
- Department of Environmental Health, Boston University School of Public Health
| | - Komal Basra
- Department of Environmental Health, Boston University School of Public Health
| | - Nadia N. Hansel
- Division of Pulmonary & Critical Care Medicine, Johns Hopkins University
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34
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Whyand T, Hurst JR, Beckles M, Caplin ME. Pollution and respiratory disease: can diet or supplements help? A review. Respir Res 2018; 19:79. [PMID: 29716592 PMCID: PMC5930792 DOI: 10.1186/s12931-018-0785-0] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 04/19/2018] [Indexed: 02/07/2023] Open
Abstract
Pollution is known to cause and exacerbate a number of chronic respiratory diseases. The World Health Organisation has placed air pollution as the world's largest environmental health risk factor. There has been recent publicity about the role for diet and anti-oxidants in mitigating the effects of pollution, and this review assesses the evidence for alterations in diet, including vitamin supplementation in abrogating the effects of pollution on asthma and other chronic respiratory diseases. We found evidence to suggest that carotenoids, vitamin D and vitamin E help protect against pollution damage which can trigger asthma, COPD and lung cancer initiation. Vitamin C, curcumin, choline and omega-3 fatty acids may also play a role. The Mediterranean diet appears to be of benefit in patients with airways disease and there appears to be a beneficial effect in smokers however there is no direct evidence regarding protecting against air pollution. More studies investigating the effects of nutrition on rapidly rising air pollution are urgently required. However it is very difficult to design such studies due to the confounding factors of diet, obesity, co-morbid illness, medication and environmental exposure.
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Affiliation(s)
- T Whyand
- Centre for Gastroenterology, Royal Free Hospital, London, NW3 2QG, UK
| | - J R Hurst
- UCL Respiratory, University College London, London, UK
| | - M Beckles
- Department of Medicine, Royal Free Hospital, London, UK
| | - M E Caplin
- Centre for Gastroenterology, Royal Free Hospital, London, NW3 2QG, UK.
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35
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Han YY, Forno E, Shivappa N, Wirth MD, Hébert JR, Celedón JC. The Dietary Inflammatory Index and Current Wheeze Among Children and Adults in the United States. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2018; 6:834-841.e2. [PMID: 29426751 PMCID: PMC5948124 DOI: 10.1016/j.jaip.2017.12.029] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/30/2017] [Accepted: 12/30/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND A proinflammatory diet may increase allergic airway inflammation by affecting innate and adaptive immune responses. OBJECTIVE In this study, we examine the relation between the diet's inflammatory potential, measured by the Dietary Inflammatory Index (DII), and current asthma, current wheeze, and lung function in U.S. children and adults. METHODS We analyzed data from 8,175 children (aged 6-17 years) and 22,294 adults (aged 18-79 years) who participated in the 2007-2012 National Health and Nutrition Examination Survey. The DII was calculated by nutrient intake based on 24-hour dietary recalls, and normalized as per 1,000 calories of food consumed to account for total energy intake. Multivariable regression models were used for the analysis of the DII and current asthma, current wheeze, and lung function measures. RESULTS Higher DII (a proinflammatory diet) was associated with current wheeze among adults (eg, odds ratio [OR] for quartile 4 vs 1, OR = 1.41, 95% confidence interval [CI] = 1.17-1.70; Ptrend < .01) and among children with high fractional exhaled nitric oxide (a marker of eosinophilic airway inflammation; OR = 2.38, 95% CI = 1.13-5.02; Ptrend = .05). The DII also was associated with decreased forced expiratory volume in 1 second and forced vital capacity in adults without asthma or wheezing. The DII was not associated with lung function in children or current asthma in either age group. CONCLUSIONS Our findings suggest that a proinflammatory diet, assessed by the DII, increases the odds of current wheeze in adults and children with allergic (atopic) wheeze. These results further support testing dietary interventions as part of the management of asthma.
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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
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC; Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC; Connecting Health Innovations, Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Michael D Wirth
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC; Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC; Connecting Health Innovations, Cancer Prevention and Control Program, University of South Carolina, Columbia, SC; College of Nursing, University of South Carolina, Columbia, SC
| | - James R Hébert
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC; Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC; Connecting Health Innovations, Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - 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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36
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Han YY, Forno E, Alvarez M, Colón-Semidey A, Acosta-Perez E, Canino G, Celedón JC. Diet, Lung Function, and Asthma Exacerbations in Puerto Rican Children. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2017; 30:202-209. [PMID: 29279788 DOI: 10.1089/ped.2017.0803] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 09/11/2017] [Indexed: 12/20/2022]
Abstract
Changes in dietary patterns may partly explain the epidemic of asthma in industrialized countries. The objective of this study was to examine the relationship between dietary patterns and lung function and asthma exacerbations in Puerto Rican children. This is a case-control study of 678 Puerto Rican children (ages 6-14 years) in San Juan (Puerto Rico). All participants completed a respiratory health questionnaire and a 75-item food frequency questionnaire. Food items were aggregated into 7 groups: fruits, vegetables, grains, protein, dairy, fats, and sweets. Logistic regression was used to evaluate consumption frequency of each group and asthma. Based on the results, a dietary score was created [range from -2 (unhealthy diet: high consumption of dairy and sweets, low consumption of vegetables and grains) to 2 (healthy diet: high consumption of vegetables and grains and low consumption of dairy and sweet)]. Multivariable linear or logistic regression was used to assess the relationship between dietary score and lung function or asthma exacerbations. After adjustment for covariates, a healthier diet (each 1-point increment in dietary score) was associated with significantly higher %predicted forced expiratory volume in the first second (FEV1) and %predicted forced vital capacity (FVC) in control subjects. Dietary pattern alone was not associated with asthma exacerbations, but children with an unhealthy diet and vitamin D insufficiency (plasma 25(OH)D <30 ng/mL) had higher odds of ≥1 severe asthma exacerbation [odds ratio (OR) = 3.4, 95% confidence interval (CI) = 1.5-7.5] or ≥1 hospitalization due to asthma (OR = 3.9, 95% CI = 1.6-9.8, OR = 3.4, 95% CI = 1.5-7.5) than children who ate a healthy diet and were vitamin D sufficient. A healthy diet, with frequent consumption of vegetables and grains and low consumption of dairy products and sweets, was associated with higher lung function (as measured by FEV1 and FVC). Vitamin D insufficiency, together with an unhealthy diet, may have detrimental effects on asthma exacerbations in children.
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Affiliation(s)
- Yueh-Ying Han
- Division of Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Erick Forno
- Division of Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Maria Alvarez
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Angel Colón-Semidey
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Edna Acosta-Perez
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Juan C Celedón
- Division of Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania
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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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Does adherence to the Mediterranean dietary pattern reduce asthma symptoms in children? A systematic review of observational studies. Public Health Nutr 2017; 20:2722-2734. [PMID: 28803594 DOI: 10.1017/s1368980017001823] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The purpose of the present systematic review was to synthesize evidence from the literature to assess efficacy of the Mediterranean dietary pattern in childhood asthma. Design/Setting A systematic search of six databases, three clinical trial registries and hand-search of peer-reviewed articles was conducted up to 29 October 2016. Inclusion criteria included exposure to a Mediterranean dietary pattern, measurement of asthma symptoms and study population of children aged <18 years. Quality assessment was conducted. Due to significant heterogeneity, meta-analysis was not feasible. RESULTS Of the 436 articles identified, after removal of duplicates and based on inclusion criteria, fifteen observational studies conducted in Mediterranean and non-Mediterranean countries were relevant. No randomized controlled trials were retrieved. Twelve studies reported an inverse association between adherence to a Mediterranean dietary pattern and asthma in children, two studies showed no association and one study showed an increase in asthma symptoms. In fourteen out of fifteen studies, quality assessment checks revealed good reliability and validity among study methodologies. CONCLUSIONS The current systematic review revealed a consistent inverse relationship (protective) between a Mediterranean dietary pattern and asthma in children. Future well-designed randomized controlled trials are needed to provide solid evidence. Nevertheless, the existing level of evidence adds to the public health message relating to the beneficial effects of a Mediterranean-type diet in children suffering with asthma.
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Koman PD, Mancuso P. Ozone Exposure, Cardiopulmonary Health, and Obesity: A Substantive Review. Chem Res Toxicol 2017; 30:1384-1395. [PMID: 28574698 DOI: 10.1021/acs.chemrestox.7b00077] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
From 1999-2014, obesity prevalence increased among adults and youth. Obese individuals may be uniquely susceptible to the proinflammatory effects of ozone because obese humans and animals have been shown to experience a greater decline in lung function than normal-weight subjects. Obesity is independently associated with limitations in lung mechanics with increased ozone dose. However, few epidemiologic studies have examined the interaction between excess weight and ozone exposure among adults. Using PubMed keyword searches and reference lists, we reviewed epidemiologic evidence to identify potential response-modifying factors and determine if obese or overweight adults are at increased risk of ozone-related health effects. We initially identified 170 studies, of which seven studies met the criteria of examining the interaction of excess weight and ozone exposure on cardiopulmonary outcomes in adults, including four short-term ozone exposure studies in controlled laboratory settings and three community epidemiologic studies. In the studies identified, obesity was associated with decreased lung function and increased inflammatory mediators. Results were inconclusive about the effect modification when data were stratified by sex. Obese and overweight populations should be considered as candidate at-risk groups for epidemiologic studies of cardiopulmonary health related to air pollution exposures. Air pollution is a modifiable risk factor that may decrease lung function among obese individuals with implications for environmental and occupational health policy.
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Affiliation(s)
- Patricia D Koman
- Department of Environmental Health Sciences, ‡Nutritional Sciences, and §Graduate Program in Immunology, School of Public Health, University of Michigan , Ann Arbor, Michigan 48109, United States
| | - Peter Mancuso
- Department of Environmental Health Sciences, ‡Nutritional Sciences, and §Graduate Program in Immunology, School of Public Health, University of Michigan , Ann Arbor, Michigan 48109, United States
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40
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Hosseini B, Berthon BS, Wark P, Wood LG. Effects of Fruit and Vegetable Consumption on Risk of Asthma, Wheezing and Immune Responses: A Systematic Review and Meta-Analysis. Nutrients 2017; 9:nu9040341. [PMID: 28353635 PMCID: PMC5409680 DOI: 10.3390/nu9040341] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 03/09/2017] [Accepted: 03/24/2017] [Indexed: 12/25/2022] Open
Abstract
Evidence suggests that reduced intake of fruit and vegetables may play a critical role in the development of asthma and allergies. The present review aimed to summarize the evidence for the association between fruit and vegetable intake, risk of asthma/wheeze and immune responses. Databases including PubMed, Cochrane, CINAHL and EMBASE were searched up to June 2016. Studies that investigated the effects of fruit and vegetable intake on risk of asthma/wheeze and immune responses were considered eligible (n = 58). Studies used cross-sectional (n = 30), cohort (n = 13), case-control (n = 8) and experimental (n = 7) designs. Most of the studies (n = 30) reported beneficial associations of fruit and vegetable consumption with risk of asthma and/or respiratory function, while eight studies found no significant relationship. Some studies (n = 20) reported mixed results, as they found a negative association between fruit only or vegetable only, and asthma. In addition, the meta-analyses in both adults and children showed inverse associations between fruit intake and risk of prevalent wheeze and asthma severity (p < 0.05). Likewise, vegetable intake was negatively associated with risk of prevalent asthma (p < 0.05). Seven studies examined immune responses in relation to fruit and vegetable intake in asthma, with n = 6 showing a protective effect against either systemic or airway inflammation. Fruit and vegetable consumption appears to be protective against asthma.
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Affiliation(s)
- Banafshe Hosseini
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan NSW 2308, Australia.
- Centre for Healthy Lungs, Hunter Medical Research Institute, Newcastle NSW 2308, Australia.
| | - Bronwyn S Berthon
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan NSW 2308, Australia.
- Centre for Healthy Lungs, Hunter Medical Research Institute, Newcastle NSW 2308, Australia.
| | - Peter Wark
- Centre for Healthy Lungs, Hunter Medical Research Institute, Newcastle NSW 2308, Australia.
| | - Lisa G Wood
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan NSW 2308, Australia.
- Centre for Healthy Lungs, Hunter Medical Research Institute, Newcastle NSW 2308, Australia.
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41
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Lin H, Guo Y, Zheng Y, Di Q, Liu T, Xiao J, Li X, Zeng W, Cummings-Vaughn LA, Howard SW, Vaughn MG, Qian ZM, Ma W, Wu F. Long-Term Effects of Ambient PM 2.5 on Hypertension and Blood Pressure and Attributable Risk Among Older Chinese Adults. Hypertension 2017; 69:806-812. [PMID: 28348017 DOI: 10.1161/hypertensionaha.116.08839] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 12/15/2016] [Accepted: 02/24/2017] [Indexed: 11/16/2022]
Abstract
Long-term exposure to ambient fine particulate pollution (PM2.5) has been associated with cardiovascular diseases. Hypertension, a major risk factor for cardiovascular diseases, has also been hypothesized to be linked to PM2.5 However, epidemiological evidence has been mixed. We examined long-term association between ambient PM2.5 and hypertension and blood pressure. We interviewed 12 665 participants aged 50 years and older and measured their blood pressures. Annual average PM2.5 concentrations were estimated for each community using satellite data. We applied 2-level logistic regression models to examine the associations and estimated hypertension burden attributable to ambient PM2.5 For each 10 μg/m3 increase in ambient PM2.5, the adjusted odds ratio of hypertension was 1.14 (95% confidence interval, 1.07-1.22). Stratified analyses found that overweight and obesity could enhance the association, and consumption of fruit was associated with lower risk. We further estimated that 11.75% (95% confidence interval, 5.82%-18.53%) of the hypertension cases (corresponding to 914, 95% confidence interval, 453-1442 cases) could be attributable to ambient PM2.5 in the study population. Findings suggest that long-term exposure to ambient PM2.5 might be an important risk factor of hypertension and is responsible for significant hypertension burden in adults in China. A higher consumption of fruit may mitigate, whereas overweight and obesity could enhance this effect.
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Affiliation(s)
- Hualiang Lin
- From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO
| | - Yanfei Guo
- From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO
| | - Yang Zheng
- From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO
| | - Qian Di
- From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO
| | - Tao Liu
- From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO
| | - Jianpeng Xiao
- From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO
| | - Xing Li
- From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO
| | - Weilin Zeng
- From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO
| | - Lenise A Cummings-Vaughn
- From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO
| | - Steven W Howard
- From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO
| | - Michael G Vaughn
- From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO
| | - Zhengmin Min Qian
- From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO.
| | - Wenjun Ma
- From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO
| | - Fan Wu
- From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO
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Montrose L, Ward TJ, Semmens EO, Cho YH, Brown B, Noonan CW. Dietary intake is associated with respiratory health outcomes and DNA methylation in children with asthma. Allergy Asthma Clin Immunol 2017; 13:12. [PMID: 28261276 PMCID: PMC5327515 DOI: 10.1186/s13223-017-0187-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 02/17/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Asthma is an increasingly common chronic disease among children, and data point toward a complex mechanism involving genetic, environmental and epigenetic factors. Epigenetic modifications such as DNA hypo- or hyper-methylation have been shown to occur in response to environmental exposures including dietary nutrients. METHODS Within the context of the asthma randomized trial of indoor wood smoke (ARTIS) study, we investigated relationships between diet, asthma health measures, and DNA methylation. Asthma health measures included a quality of life instrument, diurnal peak flow variability (dPFV) and forced expiratory volume in the first second (FEV1). Dietary intake was assessed with a food frequency questionnaire. Methylation levels of LINE-1 repetitive element and two promoter CpG sites for interferon gamma (IFNγ, -186 and -54) from buccal cell DNA were measured using pyrosequencing assays. RESULTS Data were collected on 32 children with asthma living in western Montana who were recruited to the ARTIS study. Selenium and several methyl donor dietary nutrients were positively associated with the asthma quality of life measure. Intake of methyl donating nutrients including folate was positively associated LINE-1 methylation and negatively associated with IFNγ CpG-186. Higher levels of LINE-1 methylation were associated with greater dPFV. CONCLUSION We identified several nutrients that were associated with improved quality of life measures among children with asthma. The IFNγ promoter CpG site -186 but not -54 was associated with the intake of selected dietary nutrients. However, in this small population of children with asthma, the IFNγ promoter CpG sites were not associated with respiratory health measures so it remains unclear through which epigenetic mechanism these nutrients are impacting the quality of life measure. These findings add to the evidence that dietary nutrients, particularly foods containing methyl donors, may be important for epigenetic regulation as it pertains to the control of asthma. Trial registration ClincialTrials.gov NCT00807183. Registered 10 December 2008.
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Affiliation(s)
- L Montrose
- School of Public Health, University of Michigan, 1420 Washington Heights, Ann Arbor, MI 48109 USA
| | - T J Ward
- Center for Environmental Health Sciences, University of Montana, 32 Campus Drive-159 Skaggs, Missoula, MT 59812 USA
| | - E O Semmens
- Center for Environmental Health Sciences, University of Montana, 32 Campus Drive-159 Skaggs, Missoula, MT 59812 USA
| | - Y H Cho
- Center for Environmental Health Sciences, University of Montana, 32 Campus Drive-159 Skaggs, Missoula, MT 59812 USA
| | - B Brown
- Department of Health and Human Performance, University of Montana, 32 Campus Drive, Missoula, MT 59812 USA
| | - C W Noonan
- Center for Environmental Health Sciences, University of Montana, 32 Campus Drive-159 Skaggs, Missoula, MT 59812 USA
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43
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de Boer A, van de Worp WRPH, Hageman GJ, Bast A. The effect of dietary components on inflammatory lung diseases - a literature review. Int J Food Sci Nutr 2017; 68:771-787. [PMID: 28276906 DOI: 10.1080/09637486.2017.1288199] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Anti-inflammatory treatment in chronic inflammatory lung diseases usually involves glucocorticosteroids. With patients suffering from serious side effects or becoming resistant, specific nutrients, that are suggested to positively influence disease progression, can be considered as new treatment options. The dietary inflammatory index is used to calculate effects of dietary components on inflammation and lung function to identify most potent dietary components, based on 162 articles. The positive effects of n-3 PUFAs and vitamin E on lung function can at least partially be explained by their anti-inflammatory effect. Many other dietary components showed only small or no effects on inflammation and/or lung function, although the number of weighted studies was often too small for a reliable assessment. Optimal beneficial dietary elements might reduce the required amounts of anti-inflammatory treatments, thereby decreasing both side effects and development of resistance as to improve quality of life of patients suffering from chronic inflammatory lung diseases.
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Affiliation(s)
- Alie de Boer
- a Faculty of Humanities and Sciences , Food Claims Centre Venlo, Maastricht University Campus Venlo, Maastricht University , Venlo , The Netherlands
| | - Wouter R P H van de Worp
- b Department of Pharmacology and Toxicology, Faculty of Health Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - Geja J Hageman
- b Department of Pharmacology and Toxicology, Faculty of Health Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - Aalt Bast
- b Department of Pharmacology and Toxicology, Faculty of Health Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands.,c Faculty of Humanities and Sciences , Maastricht University Campus Venlo, Maastricht University , Venlo , The Netherlands
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44
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Castro-Rodriguez JA, Garcia-Marcos L. What Are the Effects of a Mediterranean Diet on Allergies and Asthma in Children? Front Pediatr 2017; 5:72. [PMID: 28484688 PMCID: PMC5399020 DOI: 10.3389/fped.2017.00072] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 03/24/2017] [Indexed: 01/09/2023] Open
Abstract
This review updates the relationship between the adherence to Mediterranean diet (MedDiet) assessed by questionnaire and asthma, allergic rhinitis, or atopic eczema in childhood. It deals with the effect of MedDiet in children on asthma/wheeze, allergic rhinitis, and atopic dermatitis/eczema, and also with the effect of MedDiet consumption by the mother during pregnancy on the inception of asthma/wheeze and allergic diseases in the offspring. Adherence to MedDiet by children themselves seems to have a protective effect on asthma/wheezing symptoms after adjustment for confounders, although the effect is doubtful on lung function and bronchial hyperresponsiveness. By contrast, the vast majority of the studies showed no significant effect of MedDiet on preventing atopic eczema, rhinitis, or atopy. Finally, studies on adherence to MedDiet by the mother during pregnancy showed some protective effect on asthma/wheeze symptoms in the offspring only during the first year of life, but not afterward. Very few studies have shown a protective effect on wheezing, current sneeze, and atopy, and none on eczema. Randomized control trials on the effect of the adherence to MedDiet to prevent (by maternal consumption during pregnancy) or improve (by child consumption) the clinical control of asthma/wheezing, allergic rhinitis, or atopic dermatitis are needed.
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Affiliation(s)
- Jose A Castro-Rodriguez
- Department of Pediatric Pulmonology, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis Garcia-Marcos
- Pediatric Allergy and Pulmonology Units, "Virgen de la Arrixaca" University Children's Hospital, IMIB-Arrixaca Bio-health Research Institute, University of Murcia, Murcia, Spain
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Nayan S, Maby A, Endam LM, Desrosiers M. Dietary modifications for refractory chronic rhinosinusitis? Manipulating diet for the modulation of inflammation. Am J Rhinol Allergy 2016; 29:e170-4. [PMID: 26637564 DOI: 10.2500/ajra.2015.29.4220] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND An endotype of chronic rhinosinusitis (CRS) refractory to medical and surgical management is characterized by persistent T-helper 1/T-helper 17 inflammation of the sinus mucosa, which potentially facilitates colonization with dysbiotic microbial flora. Dietary interventions that target reduction of systemic inflammation are increasingly recommended as adjuncts to ongoing medical therapy in chronic disorders with a strong inflammatory component, such as cardiac disease, diabetes, and metabolic syndrome. Inflammation-reducing dietary modifications may thus be of benefit in patients with refractory CRS (RCRS). OBJECTIVE To identify nonpharmacologic approaches that implicate modification of dietary factors, potentially reducing systemic level of inflammation in RCRS. METHODS A systematic review of the literature was undertaken to identify dietary strategies for reducing inflammation in metabolic syndrome, diabetes, and cardiac disease. Mechanistic-based strategies for reducing systemic inflammation were identified and categorized to identify potential therapeutic avenues, which would be applicable to RCRS. RESULTS Principal mechanisms for altering inflammation at the systemic level via dietary manipulation center around (1) increased consumption of foods with anti-inflammatory properties, and (2) modulation of the gut microbiome to reduce short-chain fatty acid secretion by dysbiotic gut flora. Recommended dietary modifications to reduce systemic markers of inflammation or to improve RCRS include alteration of macronutrient intake, alterations in consumption of meat and fats, consumption of prebiotics and probiotics, and a low-salicylate diet in the context of aspirin-exacerbated respiratory disease. CONCLUSION Dietary modifications may offer a potential nonpharmacologic means of reducing inflammation in patients with RCRS and hence may represent a complementary adjunct to existing medical therapies. Additional prospective studies are required to further validate the concept of dietary modifications in patients with RCRS to support the findings.
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Affiliation(s)
- Smriti Nayan
- Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Canada
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Mediterranean diet and childhood asthma. Allergol Immunopathol (Madr) 2016; 44:99-105. [PMID: 26278484 DOI: 10.1016/j.aller.2015.04.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 04/01/2015] [Accepted: 04/02/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND The incidence of bronchial hyperreactivity has increased to one-third of the population in developed countries, which requires the adoption of preventive and therapeutic measures. The objective of the present study was to assess the effects of a traditional Mediterranean diet on patients diagnosed with childhood asthma and determine if there is a beneficial effect from this dietary intervention. METHODS Prospective before-after comparison study of 50 girls and 54 boys aged 1-5 years, who were enrolled in the 1-year programme "Learning to Eat from the Mediterranean", designed to promote the adoption of a traditional Mediterranean diet. We studied the clinical and therapeutic variables and anthropometric measurements. RESULTS All studied symptomatic indicators (number and intensity of asthmatic attack, infections and hospital admissions) showed a positive and statistically significant evolution of bronchial hyperreactivity from the first weeks of the intervention onwards. Throughout the treatment, 32.2% of patients remained free of crisis, 35.3% of the patients only had one attack throughout the year and 24.9% had two episodes, compared to 4.73 episodes on average in the previous year. The use of inhaled corticosteroids markedly decreased from 3.92 ± 1.61 to 1.11 ± 1.09 times per patient per year (P<0.001) and that of inhaled bronchodilators decreased from 4.14 ± 1.61 to 1.12 ± 1.40 (P<0.001). As a result, the families involved in the programme reported a high level of satisfaction. CONCLUSIONS The adoption of a traditional Mediterranean diet could contribute significantly to the improvement of patients diagnosed with childhood asthma.
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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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Forno E, Gogna M, Cepeda A, Yañez A, Solé D, Cooper P, Avila L, Soto-Quiros M, Castro-Rodriguez JA, Celedón JC. Asthma in Latin America. Thorax 2015; 70:898-905. [PMID: 26103996 DOI: 10.1136/thoraxjnl-2015-207199] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 06/02/2015] [Indexed: 12/20/2022]
Abstract
Consistent with the diversity of Latin America, there is profound variability in asthma burden among and within countries in this region. Regional variation in asthma prevalence is likely multifactorial and due to genetics, perinatal exposures, diet, obesity, tobacco use, indoor and outdoor pollutants, psychosocial stress and microbial or parasitic infections. Similarly, non-uniform progress in asthma management leads to regional variability in disease morbidity. Future studies of distinct asthma phenotypes should follow-up well-characterised Latin American subgroups and examine risk factors that are unique or common in Latin America (eg, stress and violence, parasitic infections and use of biomass fuels for cooking). Because most Latin American countries share the same barriers to asthma management, concerted and multifaceted public health and research efforts are needed, including approaches to curtail tobacco use, campaigns to improve asthma treatment, broadening access to care and clinical trials of non-pharmacological interventions (eg, replacing biomass fuels with gas or electric stoves).
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Affiliation(s)
- Erick Forno
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mudita Gogna
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alfonso Cepeda
- Fundación Hospital Universitario Metropolitano, Laboratorio de Alergia e Inmunología, Universidad Metropolitana, Barranquilla, Barranquilla, Colombia
| | - Anahi Yañez
- Division of Allergy and Immunology, Servicio de Alergia e Inmunología Clínica, Hospital Aeronáutico Central, Buenos Aires, Argentina
| | - Dirceu Solé
- Escola Paulista de Medicina, São Paulo, Brazil
| | - Philip Cooper
- Laboratorio de Investigaciones FEPIS, Quinindé, Esmeraldas, Ecuador Institute of Infection and Immunity, St George's University of London, London, UK
| | | | | | - Jose A Castro-Rodriguez
- Departments of Pediatrics and Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Tognon G, Moreno LA, Mouratidou T, Veidebaum T, Molnár D, Russo P, Siani A, Akhandaf Y, Krogh V, Tornaritis M, Börnhorst C, Hebestreit A, Pigeot I, Lissner L. Adherence to a Mediterranean-like dietary pattern in children from eight European countries. The IDEFICS study. Int J Obes (Lond) 2015; 38 Suppl 2:S108-14. [PMID: 25219407 DOI: 10.1038/ijo.2014.141] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Despite documented benefits of a Mediterranean-like dietary pattern, there is a lack of knowledge about how children from different European countries compare with each other in relation to the adherence to this pattern. In response to this need, we calculated the Mediterranean diet score (MDS) in 2-9-year-old children from the Identification and prevention of dietary- and lifestyle-induced health effects in children and infants (IDEFICS) eight-country study. SUBJECTS AND METHODS Using 24 h dietary recall data obtained during the IDEFICS study (n=7940), an MDS score was calculated based on the age- and sex-specific population median intakes of six food groups (vegetables and legumes, fruit and nuts, cereal grains and potatoes, meat products and dairy products) and the ratio of unsaturated to saturated fats. For fish and seafood, which was consumed by 10% of the population, one point was given to consumers. The percentages of children with high MDS levels (>3) were calculated and stratified by sex, age and by having at least one migrant parent or both native parents. Demographic (sex and age) and socioeconomic characteristics (parental education and income) of children showing high (>3) vs low (⩽3) MDS levels were examined. RESULTS The highest prevalence of children with MDS>3 was found among the Italian pre-school boys (55.9%) and the lowest among the Spanish school-aged girls (26.0%). Higher adherence to a Mediterranean-like dietary pattern was not associated with living in a Mediterranean country or in a highly educated or high-income family, although with some exceptions. Differences in adherence between boys and girls or age groups varied between countries without any general pattern. CONCLUSIONS With the exception of Italian pre-schoolers, similar adherence levels to a Mediterranean-like dietary pattern have been observed among European children.
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Affiliation(s)
- G Tognon
- Public Health Epidemiology Unit, Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) research group, University of Zaragoza, Zaragoza, Spain
| | - T Mouratidou
- GENUD (Growth, Exercise, Nutrition and Development) research group, University of Zaragoza, Zaragoza, Spain
| | - T Veidebaum
- Department of Chronic Disease, National Institute for Health Development, Tallinn, Estonia
| | - D Molnár
- Department of Pediatrics, Medical Faculty, University of Pécs, Pécs, Hungary
| | - P Russo
- Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
| | - A Siani
- Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Y Akhandaf
- Department of Public Health/Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - V Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Tornaritis
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - C Börnhorst
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - A Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - I Pigeot
- 1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - L Lissner
- Public Health Epidemiology Unit, Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
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Editorials. Indian Pediatr 2015. [DOI: 10.1007/s13312-015-0560-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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