Abstract
Objetivo
Describir la prevalencia de dermatitis atópica (DA) y conocer las características de la dieta en niños con DA.
Diseño
Estudio descriptivo, transversal.
Emplazamiento
Centros escolares de educación primaria.
Mediciones principales
Se realizó un estudio mediante la utilización del cuestionario validado y estandarizado del estudio ISAAC de fase III, que permite conocer la prevalencia de DA en niños y compararla entre centros. Se acompañó de una encuesta sobre consumo de alimentos. Se calcularon la razón de prevalencia (RP) de DA en relación con el consumo de alimentos y los intervalos de confianza del 95%.
Resultados
Se incluyó en el estudio a un total de 28.448 niños de 6-7 años. La prevalencia de DA clínicamente diagnosticada fue del 15,35% en niños y del 15,24% en niñas. Los alimentos más consumidos fueron la leche y los cereales, seguidos del arroz, la pasta y los huevos. Los alimentos menos consumidos fueron la mantequilla, la margarina y la comida rápida.
Se observó una razón de prevalencia de DA en los niños que consumían pasta (RP = 1,35), pescado (RP = 1,28), cereales (RP = 1,26), huevos (RP = 1,13) y carne (RP = 1,09).
Conclusiones
La prevalencia de DA en España fue del 15,3% asociada con el consumo de alimentos. El consumo de lácteos, cereales y aceite de oliva es adecuado. La ingesta de fruta, verdura, pescado y legumbres es inferior a la aconsejada. Sería necesario realizar futuros estudios sobre el tema.
Palabras clave: Dermatitis atópica, Consumo de alimentos, Niños
Abstract
Objectives
To describe the prevalence of atopic eczema (AE) and to find the characteristics of the diet of children with AE.
Design
Descriptive, transversal study.
Setting
Primary schools.
Main measurements
The study used the standardized and validated questionnaire of the ISAAC phase III study, which finds the prevalence of AE in children and enables inter-centre comparison to be conducted. A questionnaire about food consumption was included. The prevalence ratio (PR) of AE and food consumption (95% confidence intervals) was calculated.
Results
A total of 28 448 children aged 6-7 were included in the study. The prevalence of clinically diagnosed AE was 15.35% in boys and 15.24% in girls. The foods most often consumed were: dairy and cereals, followed by rice, pasta, and eggs. The least consumed were: butter, margarine, and fast food. The PR for children who consumed pasta was (PR=1.35), seafood (PR=1.28), cereals (PR=1.26), eggs (PR=1.13), and meat (PR=1.09).
Conclusions
The prevalence of AE in Spain was 15.3%, and was associated with food consumption. The consumption of dairy products, cereals, and olive oil was appropriate. The intake of fruit, vegetables, seafood, and legumes was below the recommended amounts. Future studies on the question are needed.
Key words: Atopic eczema, Food consumption, Children
Footnotes
Financiación: Instituto de Salud Carlos III, Red de Centros RCESP, C03/09. Fundación Óscar Rava 2001, Barcelona. Departamento de Salud del Gobierno de Navarra. Fundación Rotario Luis Vives 2002-2003, Valencia. Departamento de Salud del Gobierno Autónomo de Murcia. Astra Zeneca. España.
Bibliografía
- 1.The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis and atopic eczema: ISAAC. Lancet. 1998;351:1225–1232. [PubMed] [Google Scholar]
- 2.Carvajal-Ureña I., García-Marcos L., Busquets R., Morales M., García N., Batlles J. Variaciones geográficas en la prevalencia de síntomas de asma en los niños y adolescentes españoles. International Study of Asthma and Allergies in Childhood (ISAAC) fase III España. Arch Bronconeumol. 2005;41:659–666. doi: 10.1016/s1579-2129(06)60333-9. [DOI] [PubMed] [Google Scholar]
- 3.Von Mutius E. The rising trends in asthma and allergic disease. Clin Exp Allergy. 1998;28(Suppl 5):45–49. doi: 10.1046/j.1365-2222.1998.028s5045.x. [DOI] [PubMed] [Google Scholar]
- 4.Tur J.A., Romaguera D., Pons A. Food consumption patterns in a Mediterranean region: does the Mediterranean diet still exist? Ann Nutr Metabol. 2004;48:193–201. doi: 10.1159/000079754. [DOI] [PubMed] [Google Scholar]
- 5.Blanco Quiros A., Díaz Castella J.M., Balaña Vilanova M., Valveny Llobert N. Factores de riesgo y prevalencia familiar de la dermatitis atópica en España (estudio ELIHO) An Pediatr (Barc) 2005;63:480–488. doi: 10.1016/s1695-4033(05)70246-0. [DOI] [PubMed] [Google Scholar]
- 6.Barnetson Ross St C., Rogers M. Childhood atopic eczema. Clinical review. BMJ. 2002;324:1376–1379. doi: 10.1136/bmj.324.7350.1376. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Kankaanpaa P., Nurmela K., Erkkila A., Kalliomaki M., Holmberg-Marttila D., Salminen S. Polyunsaturated fatty acids in maternal diet, breast milk, and serum lipid fatty acids of infants in relation to atopy. Allergy. 2001;56:633–638. doi: 10.1034/j.1398-9995.2001.00965.x. [DOI] [PubMed] [Google Scholar]
- 8.Ellwood P., Asher I., Björksten B., Burr M., Pearce N., Robertson C.F., The ISAAC Phase One Group Diet and asthma, allergic rhinoconjunctivitis and atopic eczema symptom prevalence: an ecological analysis of the International Study of Asthma and Allergies in Childhood (ISAAC) Data. Eur Respir J. 2001;17:436–443. doi: 10.1183/09031936.01.17304360. [DOI] [PubMed] [Google Scholar]
- 9.Heinrich J., Hölscher B., Bolte G., Winkler G. Allergic sensitisation and diet: ecological analysis in selected European cities. Eur Respir J. 2001;17:395–402. doi: 10.1183/09031936.01.17303950. [DOI] [PubMed] [Google Scholar]
- 10.Farchi S., Forastiere F., Agabiti N., Corbo G., Pistelli R., Fortes C. Dietary factors associated with wheezing and allergic rhinitis in children. Eur Respir J. 2003;22:772–780. doi: 10.1183/09031936.03.00006703. [DOI] [PubMed] [Google Scholar]
- 11.Woods R.K., Thien F., Raven J., Walters E.H., Abramson M. Prevalence of food allergies in young adults and their relationship to asthma, nasal allergies, and eczema. Ann Allergy Asthma Immunol. 2002;88:183–189. doi: 10.1016/S1081-1206(10)61994-1. [DOI] [PubMed] [Google Scholar]
- 12.Fogg M., Spergel J.M. Management of food allergies. Expert Opinion Pharmacother. 2003;4:1025–1037. doi: 10.1517/14656566.4.7.1025. [DOI] [PubMed] [Google Scholar]
- 13.Ellwood P., Asher M.I., Beasley R., Clayton T.O., Stewart A.W., ISAAC Steering Committee The International study of asthma and allergies in childhood (ISAAC): phase three rationale and methods. Int J Tuberc Lung Dis. 2005;9:10–16. [PubMed] [Google Scholar]
- 14.Zocchetti C., Consonni D., Bertazzi P.A. Relationship between prevalence rate ratios and odds ratios in cross-sectional studies. Int J Epidemiol. 1997;26:220–223. doi: 10.1093/ije/26.1.220. [DOI] [PubMed] [Google Scholar]
- 15.Weiland S.K., Husing A., Strachan D.P., Rzehak P., Pearce N., ISAAC Phase Study Group Climate and the prevalence of symptoms of asthma, allergic rhinitis and atopic eczema in children. Occup Environ Med. 2004;61:609–615. doi: 10.1136/oem.2002.006809. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Girolomoni G., Abeni D., Masini C., Sera F., Ayala F., Belloni-Fortina A. The epidemiology of atopic dermatitis in Italian school children. Allergy. 2003;58:420–425. doi: 10.1034/j.1398-9995.2003.00112.x. [DOI] [PubMed] [Google Scholar]
- 17.Williams H., Robertson C., Stewart A., Ait-Khaled N., Anabwani G., Anderson R. Worldwide variations in the prevalence of symptoms of atopic eczema in the International Study of Asthma and Allergies in Childhood. J Allergy Clin Immunol. 1999;103:125–138. doi: 10.1016/s0091-6749(99)70536-1. [DOI] [PubMed] [Google Scholar]
- 18.Rufino P.M., Muñoz P., Gómez E. Frecuencia de consumo de alimentos en los adolescentes escolarizados de Cantabria. Comparación con el documento de consenso Guías Alimentarias para la población española. Gac Sanit. 1999;13:449–455. doi: 10.1016/s0213-9111(99)71405-6. [DOI] [PubMed] [Google Scholar]
- 19.Aranceta J., Serra-Majem L., on behalf of the working party for the development of food-based Dietary guidelines for the Spanish Population Dietary guidelines for the Spanish Population. Public Health Nutrition. 2001;4:1403–1408. doi: 10.1079/phn2001228. [DOI] [PubMed] [Google Scholar]
- 20.Jarvinen K.M., Turpeinen M., Suomalainen H. Concurrent cereal allergy in children with cow's milk allergy manifested with atopic dermatitis. Clin Exp Allergy. 2003;33:1060–1066. doi: 10.1046/j.1365-2222.2003.01741.x. [DOI] [PubMed] [Google Scholar]
- 21.Martelli A., De Chiara A., Corvo M., Restani P., Fiocchi A. Beef allergy in children with cow's milk allergy: cow's milk allergy in children with beef allergy. Ann Allergy Asthma Immunol. 2002;89 6(Suppl 1):38–43. doi: 10.1016/s1081-1206(10)62121-7. [DOI] [PubMed] [Google Scholar]
- 22.Johnston G.A., Bilbao R.M., Graham-Brown R.A.C. The use of dietary manipulation by parents of children with atopic dermatitis. Br J Dermatol. 2004;150:1186–1189. doi: 10.1111/j.1365-2133.2004.05888.x. [DOI] [PubMed] [Google Scholar]
- 23.Bielsa I. Dermatitis atópica. FMC. 2002;9:719–729. [Google Scholar]
- 24.Aroca García M.D., Menarguez Puche J.F., Luna Rodríguez C., Alcántara Muñoz P.A., Herranz Valera J.J., Canteras Jordana M. Hábitos alimentarios y patrones de consumo en una zona de salud. Aten Primaria. 1997;19:72–79. [PubMed] [Google Scholar]
- 25.Kanny G. Atopic dermatitis in children and food allergy: combination or causality? Should avoidance diets be initiated? AnnDermatol Venereol. 2005;13(1):S90–103. [PubMed] [Google Scholar]
- 26.Kanny G., Moneret-Vautrin D.A., Flabbee J., Beaudouin E., Morisset M., Thevenin F. Population study of food allergy in France. J Allergy Clin Immunol. 2001;108:133–140. doi: 10.1067/mai.2001.116427. [DOI] [PubMed] [Google Scholar]
- 27.Hodge L., Salome C.M., Peat J.K., Haby M.M., Xuan W., Woolcock A.J. Consumption of oily fish and childhood asthma risk. Med J Aust. 1996;164:137–140. doi: 10.5694/j.1326-5377.1996.tb122010.x. [DOI] [PubMed] [Google Scholar]
- 28.Roos G., Johansson L., Kasmel A., Klumniene J., Prätälä R. Disparities in vegetable and fruit consumption: European cases from the north to the south. Public Health Nutrition. 2000;4:35–43. doi: 10.1079/phn200048. [DOI] [PubMed] [Google Scholar]
- 29.Trichopoulou A., Costacou T., Bamia C., Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med. 2003:2599–2608. doi: 10.1056/NEJMoa025039. [DOI] [PubMed] [Google Scholar]