McCloud Emily, Papoutsakis Constantina
National Jewish Health, Denver, CO, USA.
J Am Diet Assoc. 2011 Jul;111(7):1052-64. doi: 10.1016/j.jada.2011.04.005.
Asthma is the most common chronic disease in children. Prevalence has increased in the past 2 decades and has reached a plateau of approximately 9% of children in the United States, affecting about 6.7 million children. The increased prevalence of childhood asthma has paralleled the increased prevalence in childhood obesity. Changes in diet have also been implicated in the increased prevalence of asthma, among other risk factors. The main symptoms of asthma (ie, wheezing, coughing, and chest tightness) require medical evaluation and monitoring. The cornerstone of asthma management is medication therapy, frequently consisting of inhaled bronchodilators and corticosteroids and, when needed, therapy of corticosteroids by mouth. As part of the multidisciplinary management of this chronic disease, nutrition assessment and follow-up in childhood asthma is necessary to identify and address relevant nutrition-related problems. These problems can involve food-medication interactions, obesity, gastroesophageal reflux disease, food allergies, and other issues; therefore, individualized medical nutrition therapy is warranted. Finally, counseling to achieve a healthy balanced diet is recommended for overall health and weight management. A recent but small number of descriptive investigations agree that adherence to a Mediterranean dietary pattern can be associated with a decreased risk of current asthma symptoms in children. Although this evidence is promising, food interventions are required to substantiate an evidence-based foundation for medical nutrition therapy in childhood asthma. At this time, there is no known health risk if a Mediterranean diet is adopted.
哮喘是儿童最常见的慢性疾病。在过去20年中，哮喘患病率有所上升，在美国已达到约9%的儿童患病比例，影响了约670万儿童。儿童哮喘患病率的上升与儿童肥胖率的上升同步。除其他风险因素外，饮食变化也被认为与哮喘患病率上升有关。哮喘的主要症状（即喘息、咳嗽和胸闷）需要医学评估和监测。哮喘管理的基石是药物治疗，通常包括吸入性支气管扩张剂和皮质类固醇，必要时还包括口服皮质类固醇治疗。作为这种慢性病多学科管理的一部分，对儿童哮喘进行营养评估和随访，以识别和解决相关的营养相关问题是必要的。这些问题可能涉及食物与药物相互作用、肥胖、胃食管反流病、食物过敏和其他问题；因此，有必要进行个体化的医学营养治疗。最后，建议进行咨询以实现健康的均衡饮食，以促进整体健康和体重管理。最近少数描述性研究一致认为，坚持地中海饮食模式可能与降低儿童当前哮喘症状的风险有关。尽管这一证据很有前景，但仍需要食物干预来为儿童哮喘的医学营养治疗奠定循证基础。目前，采用地中海饮食没有已知的健康风险。
