The traditional Mediterranean diet is effective in the prevention and treatment of acute and recurrent inflammatory diseases of childhood

In the recent SARS-CoV-2 pandemic, disease severity was found to be more related to the immune system hyper-response than the invasive or destructive capacity of the virus. Similarly, most common childhood diseases, which are generally recurrent and inflammatory, may be caused by a hyper-response or inability of the immune system. Individuals will react differently to causal noxa and outcomes will depend on the balance and maturity of their immune system. Conventionally, childhood diseases are symptomatically treated with little attention being devoted to balancing and stimulating the maturation of the immune system. Recently, there has been an increase in publications that consider lifestyle as an important factor in the maintenance of health. One controversial angle is an abandonment of the traditional diet and the inclusion of foods that are potentially less well-assimilated by the human species. An increasing number of studies are demonstrating the anti-inflammatory effects of the Mediterranean Diet while illustrating the pro-inflammatory effects of many other food types. We believe that the Traditional Mediterranean Diet consists of foods that support the establishment and maintenance of a healthy microbiota and a mature immune system that, in turn, can aid in the prevention of common inflammatory and recurrent diseases of childhood.

Effects of the Mediterranean Diet on Morbidity from Inflammatory and Recurrent Diseases with Special Reference to Childhood Asthma

Objective: For 15 years, we have been working with a nutritional programme based on the traditional Mediterranean diet (TMD) to complete the treatment of inflammatory and recurrent diseases (IRD), such as childhood asthma. The objective of this study is to verify the effects of TMD in the prevention and treatment of IRD by measuring the incidence of infant morbidity over 8 years. Material and Methods: The number of patients who suffered from IRD each year (just before the pandemic) was determined, as well as the frequentation and the percentage of scheduled and on-demand consultations. Results: The incidence of infant morbidity decreased as they were incorporated into a TMD, and we observed a progressive disappearance of IRD. At the beginning of the study, 20% of the patients had been diagnosed with some type of IRD. At the study’s end, the prevalence of IRD decreased to less than 2%, and the use of drugs and surgical interventions decreased markedly. Conclusions: A diet based on the TMD reduces the incidence of infant morbidity and contributes to the disappearance of IRD, whereas some non-traditional foods with high antigenic power could be involved in the appearance of IRD.

The Upper Airway Nasal Complex: Structural Contribution to Persistent Nasal Obstruction

OBJECTIVE

To determine the contribution of the nasal floor and hard palate morphology to nasal obstruction for nonresponders to prior intranasal surgery.

STUDY DESIGN

Retrospective case-control study.

SETTING

Tertiary academic center.

METHODS

Institutional review board-approved, retrospective institutional database analysis was obtained of a cohort of 575 patients who presented with nasal obstruction over a 21-year period. Of the patients, 89 met inclusion criteria: 52 were placed into the experimental group, defined as having persistent nasal obstruction following endoscopic sinus surgery (ESS), septoplasty, nasal valve repair, and/or turbinoplasty using validated subjective questionnaires, and 37 were placed into the control group, defined as having resolution of subjective nasal obstruction. Computed tomography imaging was presented to 3 blinded experts, who measured numerous nasal airway and hard palate morphology parameters, including anterior nasal floor width, anterior maxillary angle, maxilla width, anterior nasal floor width, and palatal vault height. Standard demographic information, comorbidities, perioperative 22-item Sinonasal Outcome Test (SNOT-22), and follow-up time were also assessed. Wilcox rank sum analysis or t test was performed where appropriate.

RESULTS

Follow-up ranged from 2 to 36 months following surgical intervention. Several skeletal characteristics within the upper airway were significantly associated with persistent nasal obstruction, including acute maxillary angle (P = .035), narrow maxillary width (P = .006), and high arched palate (P = .004).

CONCLUSION

Persistent nasal obstruction may be seen in patients with narrow, high arched hard palate despite prior nasal surgical intervention and may benefit from additional skeletal remodeling procedures such as maxillary expansion.