Fundación Hospital Universitario Metropolitano de Barranquilla, Barranquilla, Colombia.
Population Health and Occupational Disease Group, NHLI Imperial College London, London, UK.
Lung. 2017 Dec;195(6):683-692. doi: 10.1007/s00408-017-0044-z. Epub 2017 Aug 28.
The burden of childhood asthma and its risk factors is an important but neglected public health challenge in Latin America. We investigated the association between allergic symptoms and dietary intake in children from this region.
As part of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase III, questionnaire collected dietary intake was investigated in relation to risk of parental/child reported current wheeze (primary outcome) and rhino-conjunctivitis and eczema. Per-country adjusted logistic regressions were performed, and combined effect sizes were calculated with meta-analyses.
143,967 children from 11 countries had complete data. In children aged 6-7 years, current wheeze was negatively associated with higher fruit intake (adjusted odds ratio [aOR] 0.65; 95% CI 0.74, 0.97). Current rhino-conjunctivitis and eczema were statistically negatively associated with fruit intake (aOR 0.72; 95% CI 0.64, 0.82; and OR 0.64, 95% CI 0.56, 0.74, respectively). Vegetable intake was negatively associated with risk of symptoms in younger children, but these associations were attenuated in the 13-14 years old group. Fastfood/burger intake was positively associated with all three outcomes in the older children.
A higher intake of fruits and vegetables was associated with a lower prevalence of allergic symptoms in Latin American children. Conversely, intake of fastfood was positively associated with a higher prevalence of wheeze in adolescents. Improved dietary habits in children might help reduce the epidemic of allergic symptoms in Latin America. Food interventions in asthmatic children are needed to evaluate the possible public health impact of a better diet on respiratory health.
儿童哮喘负担及其危险因素是拉丁美洲一个重要但被忽视的公共卫生挑战。我们研究了该地区儿童过敏症状与饮食摄入之间的关系。
作为国际儿童哮喘和过敏研究(ISAAC)第三阶段的一部分,调查了与父母/儿童报告的当前喘息(主要结局)以及鼻结膜炎和湿疹风险相关的饮食摄入。针对每个国家进行了调整后的逻辑回归分析,并进行了荟萃分析计算合并效应量。
来自 11 个国家的 143967 名儿童具有完整的数据。在 6-7 岁儿童中,当前喘息与较高的水果摄入量呈负相关(调整后的优势比[aOR]0.65;95%CI0.74,0.97)。当前鼻结膜炎和湿疹与水果摄入呈统计学负相关(aOR0.72;95%CI0.64,0.82;和 OR0.64,95%CI0.56,0.74,分别)。蔬菜摄入与较小年龄组儿童的症状风险呈负相关,但在 13-14 岁年龄组中这些关联减弱。在较大的儿童中,快餐/汉堡包摄入与所有三种结果均呈正相关。
拉丁美洲儿童摄入更多的水果和蔬菜与过敏症状的发生率较低相关。相反,快餐的摄入与青少年喘息的发生率升高呈正相关。改善儿童的饮食习惯可能有助于减少拉丁美洲过敏症状的流行。需要对哮喘儿童进行饮食干预,以评估更好的饮食对呼吸健康的可能公共卫生影响。