Mediterranean diet and lung function, sensitization, and asthma at school age: The PARIS cohort

Greater fruit and vegetables consumption, and adherence to a Mediterranean type of diet reduces the risk for asthma in children; a systematic review and meta-analysis

The objective of this study was to explore the relationship between the consumption of fruits, vegetables and adherence to the Mediterranean diet with childhood asthma development and severity. A systematic literature search and synthesis of the results was performed throughout the last two decades. A total of 45 studies were analysed and 392,797 children were included. Greater adherence to a Mediterranean type of diet was inversely associated with asthmatic outcomes (OR:0.71,95% CI:0.54,0.88). Regarding fruits, vegetables consumption, a significant inverse association between increased fruits or vegetable intake and asthma was found (OR:0.82,95% CI:0.77,0.86; 0.84,95% CI:0.77,0.91, respectively). Fruits and vegetables consumption combined was also inversely related to all asthmatic outcomes (OR:0.65,95% CI:0.49,0.78). The level of heterogeneity was moderate-to-high (30%-97%). The present review and meta-analysis show a trend to an inverse association between adherence to the Mediterranean diet or a healthy diet rich in fruits and vegetables and the occurrence of childhood asthma but with a low level of certainty.

Healthy eating index (HEI) as the predictor of asthma: Findings from NHANES

BACKGROUND&AIMS

Previous studies have shown that the formation and development of asthma are closely related to diet. A proper diet can control asthma onset although the precise dietary components involved in preventing or delaying the onset of asthma remain unclear. The healthy eating index (HEI-2015) is a dietary score that measures the overall diet quality as well as the quality of several dietary components. We aimed to explore the relationship between HEI and asthma.

METHODS

This is a cross-sectional study that used data from the 2005 to 2018 National Health and Nutritional Examination Survey (NHANES) in adults (n = 26,567). Our inclusion criteria were adults ≥18 years, completion of asthma-related questionnaires and availability of HEI data. Weighted logistic regression was performed to assess the association between asthma and HEI after adjusting for several covariates.

RESULTS

Patients with asthma were more likely to be female, come from a poorer background, have a raised body mass index (BMI) and a lower HEI total score. Higher HEI total scores were associated with a lower risk of asthma in adults. In addition, eating more whole fruits, more greens and beans, more total protein foods, more seafood and plant proteins, and having a reduced dietary intake of added sugars reduces the risk of asthma. In asthmatic populations, higher HEI scores are associated with older age at onset of asthma.

CONCLUSION

There is an inverse association between the HEI and asthma. This underlines the importance of improving adherence to healthy dietary patterns in the prevention of asthma.

Mediterranean Diet and Airway Inflammation in School-Aged Children

There seems to exist an intricate relationship between airway inflammation, body mass index (BMI), and diet. The intake of specific foods or food groups has been suggested to suppress the oxidative stress and inflammatory processes that characterize airway inflammation, but little is known about dietary patterns and their complex interplay with BMI and airway inflammation. Therefore, this cross-sectional study aimed to explore the association between adherence to the Mediterranean diet (MD), a characteristic European diet, and levels of airway inflammation in school-aged children, taking into account their BMI. This cross-sectional analysis comprised 660 children: 49.1% females, 7-12 years old. Adherence to the MD was assessed through the alternate Mediterranean score (aMED). Higher scores represent a healthier diet (0-8). Airway inflammation was assessed measuring exhaled fractional nitric oxide (eNO). Two categories of BMI were considered: non-overweight/non-obese (p < 85th) and overweight/obese (p ≥ 85th). The associations between diet and airway inflammation were estimated using logistic regression models. Higher scores of the aMED were associated with decreased odds of having eNO ≥ 35 ppb, but only in non-overweight/non-obese children (OR = 0.77; 95% CI, 0.61-0.97). For overweight/obese children, the previous association was not significant (OR = 1.57, 95% CI, 0.88-2.79). Our findings suggest that adherence to the MD is associated with lower levels of airway inflammation among non-overweight/non-obese children.

The Effect of Breastfeeding on Food Allergies in Newborns and Infants

Breastfeeding is the preferred method of infant feeding and its establishment is one of the primary goals for the infant. Allergic diseases are common in childhood, with increased morbidity. Food allergies are also associated with a strong negative impact on health-related quality of life and is a major public health problem. In addition, maternal exclusion of common allergens during pregnancy and/or lactation suggests that supplementation with regular cow's milk formula during the first week of life should be avoided. Breast milk contains many active immune factors, such as cytokines, inflammatory mediators, signaling molecules and soluble receptors, which may also reduce the risk of allergic disease. The prophylactic effects of breastfeeding have been the subject of many studies, some with weak evidence. In this narrative review, we aim to provide an up-to-date account of the effects of prophylactic breastfeeding on food allergy and other common allergies in infants and children up to 5 years of age. Colostrum in particular has been shown to be prophylactic against food allergy. The American Academy of Pediatrics cautions that the relationship between duration of breastfeeding and incidence of food allergy in early childhood is unclear. The protective role of breastfeeding has a positive effect on allergy prevention, which is opposed by the early introduction of solid foods, but larger studies are needed to confirm the evidence. There is evidence that breastfeeding is effective in providing partial protection to infants.

Dietary patterns, lung function and asthma in childhood: a longitudinal study

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.

Oleuropein Prevents OVA-Induced Food Allergy in Mice by Enhancing the Intestinal Epithelial Barrier and Remodeling the Intestinal Flora

SCOPE

This study assesses whether oleuropein prevents ovalbumin (OVA)-induced food allergy (FA) and investigates the underlying mechanisms.

METHODS AND RESULTS

A Balb/c FA mouse model is established and maintained for 7 weeks. The subjects are administered OVA by oral gavage to induce FA and supplemented with different oleuropein doses (1.00-20.00 mg kg^-1 per day) to evaluate its preventative efficacy. The results indicate that oleuropein effectively alleviates OVA-induced allergy symptoms and promotes temperature elevation in sensitized mice. The secretion of serology-specific OVA-immunoglobulin (Ig)E, OVA-IgG, and histamine is inhibited in the sensitized mice. Oleuropein dramatically upregulates the expression of intestinal tight junction (TJ) proteins, regenerating gene (Reg) IIIγ, and interleukin (IL)-22, enhancing the physical and biochemical barrier function of the intestinal epithelium. Additionally, oleuropein improves the immune homeostasis of the intestinal epithelium by affecting the function of mucosal mast cells and regulatory T (Treg) cells. The disordered intestinal flora of the sensitized mice also improves after oleuropein administration.

CONCLUSIONS

These findings suggest that oleuropein prevents FA by enhancing intestinal epithelial barrier function and improving immune homeostasis and intestinal flora in sensitized mice. Therefore, diets rich in oleuropein should be recommended for people with FA.

Butyrate: Connecting the gut-lung axis to the management of pulmonary disorders

Short-chain fatty acids (SCFAs) are metabolites released by bacterial components of the microbiota. These molecules have a wide range of effects in the microbiota itself, but also in host cells in which they are known for contributing to the regulation of cell metabolism, barrier function, and immunological responses. Recent studies indicate that these molecules are important players in the gut-lung axis and highlight the possibility of using strategies that alter their intestinal production to prevent or treat distinct lung inflammatory diseases. Here, we review the effects of the SCFA butyrate and its derivatives in vitro and in vivo on murine models of respiratory disorders, besides discussing the potential therapeutic use of butyrate and the other SCFAs in lung diseases.

The Impact of Dietary Intervention in Obese Children on Asthma Prevention and Control

The prevalence of both asthma and obesity in the pediatric population is steadily increasing, and even the obese-asthma phenotypes are postulated. Obese children with asthma experience more asthma symptoms, more frequent exacerbations, and worse response to treatment; they also report a lower quality of life compared with lean asthmatics. Some of the etiological factors for asthma and obesity may overlap. Perhaps asthma and obesity share a common genetic and immunologic origin. Diet is a compelling modifiable factor in obesity and asthma prevention and control, although the relationship between these two diseases is certainly multifactorial. In this article, we analyze the impact of dietary intervention and weight loss in obese children on asthma prevention and control.

Association between the Severity of Dental Caries and the Degree of Adherence to the Mediterranean Diet in the Pediatric Population

Children who show better eating practices are less likely to suffer from severe caries than those who eat a diet rich in sugars. In the present study, we aimed to establish the relationship between the severity of dental caries and adherence to the Mediterranean diet. A cross-sectional study was carried out in which 263 children aged 2 to 14 years old were examined intraorally to analyze the presence and severity of caries. Children’s parents/caregivers completed the KIDMED questionnaire to determine their degree of adherence to the Mediterranean diet. The results showed that the prevalence of caries is greater than 80% in children with medium or low adherence to the Mediterranean diet, and remains significant at 67% in the high adherence group (p = 0.010). A statistically significant negative correlation of weak magnitude (r = −0.29; p < 0.001) was found between adherence and the number of carious teeth. Caries severity in the first molars is also influenced by adherence to the diet in a statistically significant way. In conclusion, there is an association between adherence to the Mediterranean diet and the prevalence, extension, and severity of caries in the pediatric population.

Does Adherence to the Mediterranean Diet Have a Protective Effect against Asthma and Allergies in Children? A Systematic Review

Dietary pattern may potentially impact on the pathogenesis of asthma and allergies. The Mediterranean Diet (MD) has significant health benefits due to its antioxidant and anti-inflammatory properties. The aim of this systematic review was to investigate the effectiveness of adherence to the MD against asthma and allergies in childhood. Hence, a systematic literature search was conducted on PubMed, ESBCO (Cinahl), Scopus, and the Cochrane Library databases up to 26 January 2022. The total number of articles obtained, after the initial search on the databases was conducted, was 301. Twelve studies were included, after the removal of duplicates and screening for eligibility. Our findings indicated a protective role of the MD against childhood asthma, but they also imply that the MD probably does not affect the development of allergies. Nevertheless, the heterogeneity and limitations of the studies highlight the need for randomized controlled trials that will focus on the pediatric population and hopefully provide more robust evidence.