Table 5.
Diet indices in childhood and allergy outcomes.
| References | Exposure | Outcomes |
|---|---|---|
| KIDMED—Mediterranean Diet Quality Index for children and teenagers | ||
| Grigoropoulou et al. (106) | Greece N = 1,125 Age assessed: 10–12 years |
Asthma 1-unit increase in the Kidmed index was associated with 16% lower likelihood of having asthma symptoms Greater adherence to MD was inversely associated with “ever wheeze” (O: 0.88; 95% CI, 0.78, 0.98) and wheeze when exercise w (OR: 0.79; 95% CI, 0.67, 0.93). |
| Chatzi et al. (99) | Spain N = 460 Age assessed: 6.5 years |
Persistent wheeze, atopic wheeze (current wheeze and atopy), atopy (sensitization to ≥1/6 common aeroallergens) No statistical significant effect was seen. |
| Alphantonogeorgos et al. (101) | Greece Urban (Athens, n = 700) or rural environment (n = 425) Age assessed: 10–12 years |
Asthma, any asthmatic symptom Adherence to the Kidmed index was negatively associated with asthma symptoms (standardized beta = −0.224, p < 0.001). |
| Arvaniti et al. (102) | Greece N = 700 Age assessed: 10–12 years |
Ever asthma, any asthma symptoms, ever wheeze, exercise induced wheeze, night cough Greater adherence to MD inversely associated with ever asthma (p = 0.002), any asthma symptoms (P < 0.001), ever wheeze (p < 0.001), exercise induced wheeze (p = 0.004). One-unit increase in KidMed score was associated with 14% lower likelihood of having asthma. |
| Chatzi et al. (104) | Greece N = 690 Age assessed: 7–18 years |
Respiratory and allergic symptoms over the past 12 months, skin prick tests to 10 aeroallergens, any wheezing in the past, atopic wheeze, current wheezing, nocturnal dry cough, any rhinitis in the past, atopic rhinitis, current allergic rhinitis, current seasonal rhinitis, atopy High level of adherence to MD was inversely related to Allergic rhintis ever OR 0.34 (0.18–0.64) p < 0.01 Allergic rhinitis with atopy OR 0.39 (0.13–0.97) Current allergic h = rhinitis OR 0.49 (0.24–0.99) p < 0.05 Nocturnal cough apart from cold in the last 12 months OR 0.49 (0.23–0.96) No significant effect seen for wheezing and atopy |
| EPIC—European Prospective Investigation into Cancer and Nutrition Cohort—Mediterranean diet score | ||
| Castro-Rodriguez et al. (107) | Spain N = 1,784 Age assessed: 08 ± 0.8 years |
Current wheezing Highest quartile of EPIC scores associated with a reduction in current wheeze 0.54 (0.33–0.88) |
| de Batlle et al. (108) | Mexico N = 1,476 Age assessed: 6–7 years |
Asthma ever, wheeze ever, current wheeze, rhinitis ever, sneezing ever, current sneezing, current itchy-watery eyes. rhinitis related outcomes by ISAAC questionnaire Adherence to the EPIC scores (2nd and 3rd tertile compared with 1st tertile) inversely associated with asthma ever OR 0.60 (0.40–0.91), wheezing ever OR 0.64 (0.47–0.87), current Sneezing OR 0.71 (0.52–0.96) and current itchy-watery eyes OR 0.63 (0.42–0.95) |
| Garcia-Marcos L et al. (109) | Spain N = 20,106 Age assessed: 6–7 years |
Current occasional asthma, current severe asthma, rhinoconjunctivitis Every 1 unit increase in EPIC score showed a protective effect on current severe asthma in girls (adjusted OR 0.90, 95% CI: 0.82–0.98) |
| Suarez-Varela et al. (110) | Spain N = 20,106 Age assessed: 6–7 years |
Atopic dermatitis No association between EPIC diet scores and atopic dermatitis |
| Tamay et al. (111) | Turkey N = 9,875 Age assessed: 6–7 years |
Allergic rhinitis, lifetime rhinitis, current rhinitis, current rhinoconjunctivitis, physician-diagnosed allergic rhinitis No association between EPIC diet scores and any of the outcomes studied |
| Akcay et al. (112) | Turkey N = 9,991 Age assessed: 13–14 years |
Wheeze ever, wheezing in last 12 months, lifetime doctor diagnosed asthma prevalence No association between EPIC diet scores and any of the outcomes studied |
| Rice et al. (113) | Peru N = 287 asthmatic + 96 controls Age assessed: 9–19 years |
Asthma status (asthma control, FEV1), allergic rhinitis, atopy No association between EPIC scores and asthma control, FEV1, allergic rhinitis, or atopic status |
| Romieu et al. (114) | Mexico N = 158 asthmatic + 50 controls Age assessed: 6–14 years |
Pulmonary function was measured and nasal lavage collected and analyzed. No significant difference between the asthmatic and the non-asthmatic children. |
| Gonzalez et al. (115) | Spain N = 7,454 Age assessed: 6–7 years N = 7,391 Age assessed: 13–14 years |
6–7 years: Asthma current asthma, severe asthma, and exercise-induced asthma 13–14 years: Asthma current asthma, severe asthma, and exercise-induced asthma 6–7 years: Increased EPIC diet scores were associated with a higher risk of severe asthma (odds ratios = 2.26, 95% CI: 1.21–4.22 in the 2nd quartile, but not in the 3rd and 4th) in girls. There was no significant relationship for the other asthma categories |
| Diet inflammatory index | ||
| De Castro et al. (116) | Portugal N = 501 Age assessed: 7–12 years |
Asthma The effect of indoor pollution on asthma outcomes was more severe in those with a pro-inflammatory diet (OR = 1.44, 95% CI: 1.01–2.21; and OR = 1.29, 95% CI: 1.03–1.68, respectively) compared to those having an anti-inflammatory diet. No direct effect of DII on asthma outcomes were reported. |
| Han et al. (117) | USA N = 8,175 Age assessed: 6–17 years |
Current asthma, current wheeze, lung function measures Higher Diet inflammatory index scores were associated with high fractional exhaled nitric oxide (a marker of eosinophilic airway inflammation; OR = 2.38, 95% CI = 1.13–5.02; Ptrend = 0.05) in children. The DII was not associated with lung function or current asthma |