Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece.
Department of Allergy and Clinical Immunology, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston PR2 9HT, UK.
Nutrients. 2022 Apr 27;14(9):1825. doi: 10.3390/nu14091825.
We are currently riding the second wave of the allergy epidemic, which is ongoing in affluent societies, but now also affecting developing countries. This increase in the prevalence of atopy/asthma in the Western world has coincided with a rapid improvement in living conditions and radical changes in lifestyle, suggesting that this upward trend in allergic manifestations may be associated with cultural and environmental factors. Diet is a prominent environmental exposure that has undergone major changes, with a substantial increase in the consumption of processed foods, all across the globe. On this basis, the potential effects of dietary habits on atopy and asthma have been researched rigorously, but even with a considerable body of evidence, clear associations are far from established. Many factors converge to obscure the potential relationship, including methodological, pathophysiological and cultural differences. To date, the most commonly researched, and highly promising, candidate for exerting a protective effect is the so-called Mediterranean diet (MedDi). This dietary pattern has been the subject of investigation since the mid twentieth century, and the evidence regarding its beneficial health effects is overwhelming, although data on a correlation between MedDi and the incidence and severity of asthma and atopy are inconclusive. As the prevalence of asthma appears to be lower in some Mediterranean populations, it can be speculated that the MedDi dietary pattern could indeed have a place in a preventive strategy for asthma/atopy. This is a review of the current evidence of the associations between the constituents of the MedDi and asthma/atopy, with emphasis on the pathophysiological links between MedDi and disease outcomes and the research pitfalls and methodological caveats which may hinder identification of causality. MedDi, as a dietary pattern, rather than short-term supplementation or excessive focus on single nutrient effects, may be a rational option for preventive intervention against atopy and asthma.
我们正处于过敏流行的第二波，这种情况在富裕社会中持续存在，现在也在影响发展中国家。西方世界特应性/哮喘的患病率增加与生活条件的迅速改善和生活方式的根本变化同时发生，这表明过敏表现的这种上升趋势可能与文化和环境因素有关。饮食是一个突出的环境暴露因素，发生了重大变化，全球范围内加工食品的消费大量增加。在此基础上，人们已经严格研究了饮食习惯对特应性和哮喘的潜在影响，但即使有大量证据，明确的关联也远未建立。许多因素汇聚在一起，掩盖了潜在的关系，包括方法学、病理生理学和文化差异。迄今为止，研究最多且极具前景的、可能发挥保护作用的候选因素是所谓的地中海饮食（MedDi）。自 20 世纪中叶以来，人们一直在研究这种饮食模式，其对健康有益的证据令人信服，尽管关于 MedDi 与哮喘和特应性的发病率和严重程度之间相关性的数据尚无定论。由于一些地中海人群中哮喘的患病率似乎较低，因此可以推测 MedDi 饮食模式确实可以在哮喘/特应性的预防策略中占有一席之地。这是对 MedDi 与哮喘/特应性之间关联的现有证据的综述，重点介绍了 MedDi 与疾病结果之间的病理生理学联系，以及可能阻碍因果关系确定的研究陷阱和方法学注意事项。MedDi 作为一种饮食模式，而不是短期补充或过分关注单一营养素的影响，可能是预防特应性和哮喘的合理选择。
