Hierarchical analysis of Mediterranean Dietary pattern on atopic diseases’ prevalence in adolescence: The Greek Global Asthma Network study
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Keywords
Adolescents, Allergies, Atopic, Lifestyle, Mediterranean diet
Abstract
Introduction: The contribution of dietary patterns in the occurrence of atopic diseases, mainly asthma, allergic rhinits, and eczema is ambiguous. Our study examined the association between the level of adherence to the Mediterranean diet (MedDiet) and the prevalence of atopic diseases in adolescence.
Methods: A total of 1934 adolescents (boys: 47.5%, mean age [standard variation]: 12.7[0.6] years) enrolled voluntarily. Participants completed a validated questionnaire on atopic disease status, dietary habits, and other sociodemographic and lifestyle characteristics. KIDMED score was used for the evaluation of adherence to the MedDiet. Discriminant analysis was applied to the hierarchy of foods and beverages consumed in relation to the presence of atopic diseases.
Results: Logistic regression analyses revealed that adolescents with moderate and good adherence to the MedDiet had 34 and 60% lower odds of having any asthma symptoms, respectively, and 20 and 41% lower odds of having any allergic rhinitis symptoms, respectively, adjusted for several confounders. The food group with the most important contribution to the MedDiet was cooked and raw vegetables, followed by fruits (Wilk’s λ = 0.881 and λ = 0.957, respectively).
Conclusion: Our study provided evidence for a strong and inverse association between the level of adherence to the MedDiet and the occurrence of asthma and allergic rhinitis symptoms and signified the importance of contribution of fruits and vegetable consumption in this association. Thus, the promotion of MedDiet could be an efficient lifestyle intervention that can contribute to the reduction of the burden of these atopic diseases in adolescents.
References
2. Arvaniti F, Priftis KN, Panagiotakos DB. Dietary habits and asthma: A review. Allergy Asthma Proc. 2010:31(2):e1–10. 10.2500/aap.2010.31.3314
3. Allan K, Devereux G. Diet and asthma: Nutrition implications from prevention to treatment. J Am Diet Assoc. 2011; 111(2):258–68. 10.1016/j.jada.2010.10.048
4. Garcia-Larsen V, Del Giacco SR, Moreira A, Bonini M, Charles D, Reeves T, et al. Asthma and dietary intake: An overview of systematic reviews. Allergy. 2016;71(4):433–42. 10.1111/all.12800
5. 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
6. Alwarith J, Kahleova H, Crosby L, Brooks A, Brandon L, Levin SM, et al. The role of nutrition in asthma prevention and treatment. Nutr Rev. 2020;78(11):928–38. 10.1093/nutrit/nuaa005
7. Willett WC, Sacks F, Trichopoulou A, Drescher G, Ferro-Luzzi A, Helsing E, et al. Mediterranean diet pyramid: A cultural model for healthy eating. Am J Clin Nutr. 1995;61 (6 Suppl):1402S–1406S. 10.1093/ajcn/61.6.1402S
8. Diolintzi A, Panagiotakos DB, Sidossis LS. From Mediterranean diet to Mediterranean lifestyle: A narrative review. Public Health Nutr. 2019;22(14):2703–13. 10.1017/S1368980019000612
9. Gilliland FD, Behrane KT, Li YF, Gauderman WJ, McConnell R, Peters J. Children’s lung function and antioxidant vitamin, fruit, juice, and vegetable intake. Am J Epidemiol. 2003; 158:576–84. 10.1093/aje/kwg181
10. Garcia-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;24(4):330–8. 10.1111/pai.12071
11. Ellwood P, Asher MI, Billo NE, Bissell K, Chiang CY, 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
12. Antonogeorgos G, Priftis KN, Panagiotakos DB, Ellwood P, García-Marcos L, Liakou E, et al. Exploring the relation between atopic diseases and lifestyle patterns among adolescents living in Greece: Evidence from the Greek Global Asthma Network (GAN) cross-sectional study. Children (Basel). 2021;8(10):932. 10.3390/children8100932
13. Validation of Instruments. Global Asthma Network. [cited 2021 10/10]. Available from: http://globalasthmanetwork.org/surveillance/manual/validation.php
14. Serra-Majem L, Ribas L, Ngo J, Ortega RM, García A, Pérez-Rodrigo C, et al. Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean Diet Quality Index in children and adolescents. Public Health Nutr. 2004;7(7):931–5. 10.1079/phn2004556
15. Cole TJ, Bellizi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000;320(7244):1240–3. 10.1136/bmj.320.7244.1240
16. Asher MI, Rutter CE, Bissell K, Chiang CY, Sony AE, Ellwood E, et al. Worldwide trends in the burden of asthma symptoms in school-aged children: Global Asthma Network Phase I cross-sectional study. Lancet. 2021;398(10311):1569–80. 10.1016/S0140-6736(21)01450-1
17. FAOSTAT. [cited 2022 26/4]. Available at https://www.fao.org/faostat/en/#data/FBS/report
18. Chatzi L, Kogevinas M. Prenatal and childhood Mediterranean diet and the development of asthma and allergies in children. Public Health Nutr. 2009;12(9A):1629–34. 10.1017/S1368980009990474
19. Arvaniti F, Priftis KN, Papadimitriou A, Papadopoulos M, Roma E, Kapsokefalou M, et al. Adherence to the Mediterranean type of diet is associated with lower prevalence of asthma symptoms, among 10–12 years old children: The PANACEA study. Pediatr Allergy Immunol. 2011;22(3):283–9. 10.1111/j.1399-3038.2010.01113.x
20. Castro-Rodriguez JA, Ramirez-Hernandez M, Padilla O, Pacheco-Gonzalez RM, Pérez-Fernández V, Garcia-Marcos L. Effect of foods and Mediterranean diet during pregnancy and first years of life on wheezing, rhinitis and dermatitis in preschoolers. Allergol Immunopathol (Madr). 2016;44(5):400–9. 10.1016/j.aller.2015.12.002
21. Malaeb D, Hallit S, Sacre H, Malaeb B, Hallit R, Salameh P. Diet and asthma in Lebanese schoolchildren: A cross-sectional study. Pediatr Pulmonol. 2019;54(6):688–97. 10.1002/ppul.24280
22. Papamichael MM, Itsiopoulos C, Susanto NH, Erbas B. Does adherence to the Mediterranean dietary pattern reduce asthma symptoms in children? A systematic review of observational studies. Public Health Nutr. 2017;20(15):2722–34. 10.1017/S1368980017001823
23. Amazouz H, Roda C, Beydon N, et al. Mediterranean diet and lung function, sensitization, and asthma at school age: The PARIS cohort. Pediatr Allergy Immunol. 2021;32(7):1437–44. 10.1111/pai.13527
24. Rice JL, Romero KM, Galvez Davila RM, Meza CT, Bilderback A, Williams DL, et al. Association between adherence to the Mediterranean diet and asthma in Peruvian children. Lung. 2015;193(6):893–9. 10.1007/s00408-015-9792-9
25. Mazzocchi A, Leone L, Agostoni C, Pali-Schöll I. The secrets of the Mediterranean diet. Does [only] olive oil matter? Nutrients. 2019;11(12):2941. 10.3390/nu11122941
26. 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(4):341. 10.3390/nu9040341
27. Mascarenhas MR. Pediatric anti-inflammatory diet. Pediatr Ann. 2019;48(6):e220–5. 10.3928/19382359-20190515-02
28. Koumpagioti D, Boutopoulou B, Moriki D, Priftis KN, Douros K. Does adherence to the Mediterranean diet have a protective effect against asthma and allergies in children? A systematic review. Nutrients. 2022;14(8):1618. 10.3390/nu14081618
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