Adherence to the Mediterranean diet and fresh fruit intake are associated with improved asthma control

Abstract

Background: The traditional Mediterranean diet is claimed to possess antioxidant and immune‐regulatory properties in several chronic diseases. Typical Mediterranean foods have recently been associated with improvement of symptoms of asthma and rhinitis in children. However the effect of adherence to Mediterranean diet on adult asthma outcomes is unknown. We aimed to investigate the association between adherence to Mediterranean diet and asthma control.Methods: Cross sectional study of 174 asthmatics, mean (SD) age of 40 (15) years. The patients were defined as controlled, in contrast to noncontrolled, if they showed FEV1 ≥ 80% of predicted, exhaled nitric oxide (NO) ≤35 ppb, and Asthma Control Questionnaire score <1. Dietary intake was obtained by a food frequency questionnaire, and Mediterranean diet was assessed by alternate Mediterranean Diet (aMED) Score. Logistic regression models adjusting for confounders were performed to estimate the association between Mediterranean diet and asthma control.Results: Controlled asthmatics (23%) had significantly higher aMED Score, intake of fresh fruit, and lower intake of ethanol compared to noncontrolled (77%). High adherence to Mediterranean diet reduced 78% the risk of noncontrolled asthma after adjusting for gender, age, education, inhaled corticosteroids and energy intake (OR = 0.22; 95% CI = 0.05–0.85; P‐trend = 0.028). The higher intake of fresh fruit decreased the probability of having noncontrolled asthma (OR = 0.29; 95% CI = 0.10–0.83; P‐trend = 0.015), while the higher intake of ethanol had the opposite effect (OR = 3.16; 95% CI = 1.10–9.11; P‐trend = 0.035).Conclusion: High adherence to traditional Mediterranean diet increased the likelihood of asthma to be under control in adults. The study introduces a novel link between diet and asthma control, as measured by symptoms, lung function and exhaled NO.

Padrão alimentar, asma e sibilo atópico e não atópico em crianças e adolescentes: estudo SCAALA, Salvador, Bahia, Brasil

“…O maior tercil de consumo do padrão alimentar também reduziu a ocorrência de asma, em geral, em 36% (OR = 0,64; IC95%: 0,49-0,83) e asma atópica em 50% (OR = 0,50; IC95%: 0,28-0,89). Foram realizadas associações entre os outros três padrões alimentares retidos na análise fatorial por componentes principais 18 , mas nenhum deles se mostrou associado a sibilo ou asma (dados não apresentados).…”

“…Tradicionalmente os estudos que avaliam a dieta e sua relação com as enfermidades consideravam os efeitos de alimentos ou nutrientes de modo isolados, entretanto, o ato de se alimentar abarca uma complexidade cuja representação do consumo pode ser bem evidenciada em estudos que adotam os padrões dietéticos 15,16 , os quais refletem o consumo habitual de alimentos e nutrientes, além de constituírem em abordagem para a avaliação da relação entre dieta e doenças crônicas 16,17,18 . Assim, ratifica-se a importância de avaliar aspectos que possam interferir na prevalência da doença, tais como o padrão alimentar.…”

Dietary patterns and risk of asthma: results from three countries in European Community Respiratory Health Survey-II

“…Fish, fruits and vegetables are essential components of a Mediterranean diet, which other recent work has found to be associated with improved asthma control in adults (27) , lower risk of current severe asthma in girls aged 6-7 years (28) and lower risk of allergic rhinitis in children aged 7-18 years (29) . Fish in the diet is a source of n-3 fatty acids, which may compete with the pro-inflammatory properties of n-6 fatty acids (30,31) .…”

Can dietary interventions improve asthma control?

“…2 Likewise, among Portuguese adults with asthma, a strong association was reported between the Mediterranean diet score and a composite measure of asthma control. 4 In the current issue of the PCRJ, Bime and colleagues analysed the cross-sectional association between soy genistein intake with baseline lung function and asthma control among 300 asthmatic adults with poor asthma control. 5 They also examined the longitudinal association between baseline soy genistein intake and asthma control over a 6-month period.…”

“…3 Risk prediction is growing in importance -both to the individual and at the public health level. Risk scores already exist to predict, for example, the risk of future cardiovascular events, 4 development of diabetes, 5 and lung cancer. 6 UK general practices now routinely use risk-stratification tools to identify -and then target with preventive care -patients at highest risk of hospitalisation.…”