Mediterranean diet in the Castilian plains: Dietary patterns and childhood asthma in 6–7-year-old children from the province of Salamanca

Main Article Content

María Domínguez
María Concepción Vega-Hernández
Teresa De la Calle Cabrera
Sonia Arriba-Méndez
Francisco Javier Pellegrini-Belinchón

Keywords

asthma, children, dietary patterns, Global Asthma Network, Mediterranean diet

Abstract

Salamanca is the only Spanish center with no coastal line participating in the Global Asthma Network phase-I study. Questionnaires were collected from 6–7-year-old 2388 children and analyzed in particular for their diet and asthma symptoms as part of this study. The prevalence of current asthma (CA) was 9%, doctor-confirmed asthma (DCA) was 7%, and current severe asthma (CSA) accounted to 2.9%. Two Mediterranean Diet Scores (MDS) were performed to evaluate adherence of these children to the Mediterranean diet. Principal component analysis generated four dietary patterns. The relationship between asthma and each food type, MDS, and dietary patterns was assessed using multivariate adjusted logistic regression. Adherence to the Mediterranean diet by Salamanca’s children and prevalence of asthma in Salamanca were similar to the findings of coastal located centers of other studies. High punctuation in MDS was associated with high prevalence of asthma. Higher scores for the pattern “Fats and sugar” was associated with less current asthma but not with DCA or CSA. These findings might be due to improvement in the diet of asthma children, reverse causation factor, how the questionnaire collected information about diet, and perhaps the manner in which the scores were constructed. The complexity of interconnections between nutrients, foods, and dietary patterns, and the heterogeneous nature of asthma, makes it difficult to identify single factor that affected its development. Our findings require corroboration by additional studies.

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References

1. Carvajal-Uruena I, Garcia-Marcos L, Busquets-Monge R, Morales Suarez-Varela M, Garcia de Andoin N, Batlles-Garrido J, et al. Geographic variation in the prevalence of asthma symptoms in Spanish children and adolescents. International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3, Spain]. Arch Bronconeumol. 2005 Dec 41(12):659–62. 10.1016/s1579-2129(06)60333-9

2. Asher MI. Worldwide variations in the prevalence of asthma symptoms: The International Study of Asthma and Allergies in Childhood (ISAAC). Eur Respir J. 1998;12(2):315–35. 10.1183/09031936.98.12020315

3. Pearce N, Sunyer J, Cheng S, Chinn S, Bjorksten B, Burr M, et al. Comparison of asthma prevalence in the ISAAC and the ECRHS. ISAAC Steering Committee and the European Community Respiratory Health Survey. International Study of Asthma and Allergies in Childhood. Eur Respir J. 2000;16(3):420–6. 10.1183/9031936.00.16337700

4. Global Asthma Network. The Global Asthma Report 2018 [Internet]. Auckland, New Zealand; 2018. [cited 2021 Jun 15]. Available from: www.globalasthmareport.org

5. Instituto Nacional de Estadística. Demografía y población. Tablas del Instituto Nacional de Estadística [Internet]. 2020 [cited 2021 Jun 11]. Available from: www.ine.es

6. Ellwood P, Asher MI, Billo NE, Bissell K, Chiang C-YY, Ellwood EM, et al. The Global Asthma Network rationale and methods for phase I global surveillance: Prevalence, severity, management and risk factors. Eur Respir J. 2017;49(1):1601605. 10.1183/13993003.01605-2016

7. Ellwood P, Ellwood E, Rutter C, Perez-Fernandez V, Morales E, García-Marcos L, et al. Clinical Medicine Communication Global Asthma Network phase i surveillance: Geographical coverage and response rates. J Clin Med. 2020;9(11):3688. 10.3390/jcm9113688

8. Lv N, Xiao L, Ma J. Dietary pattern and asthma: A systematic review and meta-analysis. J Asthma Allergy. 2014;7:105–21. 10.2147/JAA.S49960

9. Nurmatov U, Devereux G, Sheikh A. Nutrients and foods for the primary prevention of asthma and allergy: Systematic review and meta-analysis. J Allergy Clin Immunol. 2011 Mar;127(3): 724-33.e1-30. 10.1016/j.jaci.2010.11.001

10. Statovci D, Aguilera M, MacSharry J, Melgar S. The impact of western diet and nutrients on the microbiota and immune response at mucosal interfaces. Front Immunol. 2017;8:838. 10.3389/fimmu.2017.00838

11. Sozańska B, Sikorska-Szaflik H. Diet modifications in primary prevention of asthma. Where do we stand? Nutrients. 2021; 13(1):173. 10.3390/nu13010173

12. David LA, Maurice CF, Carmody RN, Gootenberg DB, Button JE, Wolfe BE, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature. 2014;505(7484):559–63. 10.1038/nature12820

13. Sofi F, Abbate R, Gensini GF, Casini A. Accruing evidence on benefits of adherence to the Mediterranean diet on health: An updated systematic review and meta-analysis. Am J Clin Nutr. 2010;92(5):1189–96. 10.3945/ajcn.2010.29673

14. García-Marcos L, Castro-Rodriguez JA, Weinmayr G, Panagiotakos DB, Priftis KN, Nagel G. Influence of Medi-terranean diet on asthma in children: A systematic review and meta-analysis. Pediatr Allergy Immunol. 2013 Jun;24(4):330–8. 10.1111/pai.12071

15. 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(7):949–61. 10.1002/ppul.24338

16. 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. 10.3389/fped.2017.00072

17. Tapsell LC, Neale EP, Satija A, Hu FB. Foods, nutrients, and dietary patterns: Interconnections and implications for dietary guidelines. Adv Nutr. 2016;7(3):445–54. 10.3945/an.115.011718

18. Instituto Nacional de Estadística. Encuesta Europea de Salud 2020 [Internet]. [cited 2021 May 21]. Available from: https://www.ine.es

19. Global Asthma Network. Methods. [Internet] 2016. [cited 2021 Jun 21]. Available from: http://globalasthmanetwork.org/surveillance/manual

20. Psaltopoulou T, Naska A, Orfanos P, Trichopoulos D, Mountokalakis T, Trichopoulou A. Olive oil, the Mediterranean diet, and arterial blood pressure: The Greek European Prospective Investigation into Cancer and Nutrition (EPIC) study. Am J Clin Nutr. 2004;80(4):1012–8. 10.1093/ajcn/80.4.1012

21. García-Marcos L, Canflanca IM, Garrido JB, Varela ALS, Garcia-Hernandez G, Grima FG, et al. Relationship of asthma and rhinoconjunctivitis with obesity, exercise and Mediterranean diet in Spanish schoolchildren. Thorax. 2007; 62(6):503–8. 10.1136/thx.2006.060020

22. García-Marcos Barbero P. Epidemiología del asma y dermatitis atópica en escolares de Cartagena: “Global Asthma Network.” Dissertation, Universidad de Murcia (University of Murcia), Murcia, Spain; 2017. Available from: https://digitum.um.es/digitum/handle/10201/55479

23. De la Calle Cabrera T. Evolución de las sibilancias en los primeros 10 años de vida en la provincia de Salamanca. Factores de riesgo asociados. Dissertation, Universidad de Salamanca, Salamanca, Spain; 2020. Available from: https://gredos.usal.es/handle/10366/145325

24. Gonzalez Barcala FJ, Pertega S, Bamonde L, Garnelo L, Perez Castro T, Sampedro M, et al. Mediterranean diet and asthma in Spanish schoolchildren. Pediatr Allergy Immunol. 2010;21(7):1021–7. 10.1111/j.1399-3038.2010.01080.x

25. Byers T, Treiber F, Gunter E, Coates R, Sowell A, Leonard S, et al. The accuracy of parental reports of their children’s intake of fruits and vegetables: Validation of a food frequency questionnaire with serum levels of carotenoids and vitamins C, A, and E. Epidemiology. 1993;4(4):350–5. PMid: 8347746. Available from: https://journals.lww.com/epidem/Abstract/1993/07000/The_Accuracy_of_Parental_Reports_of_Their.11.aspx

26. Hoffmann K, Schulze MB, Schienkiewitz A, Nöthlings U, Boeing H. Application of a new statistical method to derive dietary patterns in nutritional epidemiology. Am J Epidemiol. 2004;159(10):935–44. 10.1093/aje/kwh134

27. Bernadette Moore J, Sutton EH, Hancock N. Sugar reduction in yogurt products sold in the UK between 2016 and 2019. Nutrients. 2020;12(1):171. 10.3390/nu12010171

28. Boulton J, Hashem KM, Jenner KH, Lloyd-Williams F, Bromley H, Capewell S. How much sugar is hidden in drinks marketed to children? A survey of fruit juices, juice drinks and smoothies. BMJ Open. 2016;6(3):e010330. 10.1136/bmjopen-2015-010330