Allergy and Respiratory Research Group Centre for Population Health Sciences, University of Edinburgh, Medical School, Edinburgh, United Kingdom.
J Allergy Clin Immunol. 2011 Mar;127(3):724-33.e1-30. doi: 10.1016/j.jaci.2010.11.001. Epub 2010 Dec 24.
Epidemiologic studies suggest that deficiencies of the nutrients selenium; zinc; vitamins A, C, D, and E; and low fruit and vegetable intake may be associated with the development of asthma and allergic disorders.
To investigate the evidence that nutrient and food intake modifies the risk of children developing allergy.
We systematically searched 11 databases. Studies were critically appraised, and meta-analyses were undertaken.
We identified 62 eligible reports. There were no randomized controlled trials. Studies used cohort (n = 21), case-control (n = 15), or cross-sectional (n = 26) designs. All studies were judged to be at moderate to substantial risk of bias. Meta-analysis revealed that serum vitamin A was lower in children with asthma compared with controls (odds ratio [OR], 0.25; 95% CI, 0.10-0.40). Meta-analyses also showed that high maternal dietary vitamin D and E intakes during pregnancy were protective for the development of wheezing outcomes (OR, 0.56, 95% CI, 0.42-0.73; and OR, 0.68, 95% CI, 0.52-0.88, respectively). Adherence to a Mediterranean diet was protective for persistent wheeze (OR, 0.22; 95% CI, 0.08-0.58) and atopy (OR, 0.55; 95% CI, 0.31-0.97). Seventeen of 22 fruit and vegetable studies reported beneficial associations with asthma and allergic outcomes. Results were not supportive for other allergic outcomes for these vitamins or nutrients, or for any outcomes in relation to vitamin C and selenium.
The available epidemiologic evidence is weak but nonetheless supportive with respect to vitamins A, D, and E; zinc; fruits and vegetables; and a Mediterranean diet for the prevention of asthma. Experimental studies of these exposures are now warranted.
流行病学研究表明，营养元素硒、锌、维生素 A、C、D、E 的缺乏以及水果和蔬菜摄入量低可能与哮喘和过敏性疾病的发展有关。
研究营养物质和食物摄入是否会改变儿童患过敏症的风险。
我们系统地搜索了 11 个数据库。对研究进行了严格评估，并进行了荟萃分析。
我们确定了 62 项符合条件的报告。没有随机对照试验。研究使用了队列（n = 21）、病例对照（n = 15）或横断面（n = 26）设计。所有研究都被认为存在中度到高度偏倚风险。荟萃分析显示，与对照组相比，哮喘儿童的血清维生素 A 水平较低（比值比 [OR]，0.25；95%置信区间 [CI]，0.10-0.40）。荟萃分析还表明，母亲在怀孕期间摄入较高的维生素 D 和 E 饮食对喘息结局的发展具有保护作用（OR，0.56，95%CI，0.42-0.73；和 OR，0.68，95%CI，0.52-0.88）。坚持地中海饮食对持续性喘息（OR，0.22；95%CI，0.08-0.58）和过敏（OR，0.55；95%CI，0.31-0.97）具有保护作用。22 项水果和蔬菜研究中有 17 项报告了与哮喘和过敏结果的有益关联。对于这些维生素或营养素，或对于维生素 C 和硒与任何过敏结果相关的其他过敏结果，结果并不支持。
尽管现有的流行病学证据较弱，但仍支持维生素 A、D、E、锌、水果和蔬菜以及地中海饮食对预防哮喘的作用。现在需要进行这些暴露的实验研究。
