PMC:4137988 / 14325-16633 JSONTXT

{"project":"2_test","denotations":[{"id":"25143747-22362860-55576516","span":{"begin":200,"end":202},"obj":"22362860"},{"id":"25143747-20003306-55576517","span":{"begin":203,"end":205},"obj":"20003306"},{"id":"25143747-22362860-55576518","span":{"begin":268,"end":270},"obj":"22362860"},{"id":"25143747-22195687-55576519","span":{"begin":271,"end":273},"obj":"22195687"},{"id":"25143747-20561232-55576519","span":{"begin":271,"end":273},"obj":"20561232"},{"id":"25143747-21457335-55576519","span":{"begin":271,"end":273},"obj":"21457335"},{"id":"25143747-18492525-55576519","span":{"begin":271,"end":273},"obj":"18492525"},{"id":"25143747-18198206-55576519","span":{"begin":271,"end":273},"obj":"18198206"},{"id":"25143747-17412780-55576519","span":{"begin":271,"end":273},"obj":"17412780"},{"id":"25143747-17251311-55576519","span":{"begin":271,"end":273},"obj":"17251311"},{"id":"25143747-23555072-55576520","span":{"begin":308,"end":310},"obj":"23555072"},{"id":"25143747-20003306-55576521","span":{"begin":328,"end":330},"obj":"20003306"},{"id":"25143747-18782109-55576522","span":{"begin":331,"end":333},"obj":"18782109"},{"id":"25143747-22374563-55576523","span":{"begin":352,"end":354},"obj":"22374563"},{"id":"25143747-20522849-55576524","span":{"begin":370,"end":372},"obj":"20522849"},{"id":"25143747-23578354-55576525","span":{"begin":638,"end":640},"obj":"23578354"},{"id":"25143747-23578354-55576526","span":{"begin":1367,"end":1369},"obj":"23578354"},{"id":"25143747-22362860-55576527","span":{"begin":1470,"end":1472},"obj":"22362860"},{"id":"25143747-23555072-55576528","span":{"begin":1473,"end":1475},"obj":"23555072"},{"id":"25143747-22374563-55576529","span":{"begin":1476,"end":1478},"obj":"22374563"},{"id":"25143747-20003306-55576530","span":{"begin":1526,"end":1528},"obj":"20003306"},{"id":"25143747-22195687-55576531","span":{"begin":1536,"end":1538},"obj":"22195687"},{"id":"25143747-20561232-55576532","span":{"begin":1539,"end":1541},"obj":"20561232"},{"id":"25143747-20561232-55576533","span":{"begin":2009,"end":2011},"obj":"20561232"}],"text":"Child dietary patterns and asthma\nThe main characteristics and results of the 14 studies in children, published between 2006 and 2013, are shown in Table 3. Twelve studies were cross-sectional and two32,33 were cohort studies. Nine of them were conducted in Europe,19,32,34–40 three in America (one in Brazil41 and two in Mexico33,42), and one in Asia.43 One other study44 was an international study conducted in 20 countries. All studies examined both boys and girls with sample sizes ranging from 158 (cohort) to 50,004 (cross-sectional).\nEight of these studies (shown in the footnote to Table 2) were included in a recent meta-analysis14 to investigate whether the Mediterranean diet has a protective effect on ever asthma and current wheeze and whether these relationships were specific to the Mediterranean regions. The meta-analytic results showed adherence to the Mediterranean diet was negatively associated with current wheeze (OR 0.79, 95% CI 0.66–0.94; P=0.009) and current severe wheeze (OR 0.66, 95% CI 0.48–0.90; P=0.008) in Mediterranean regions, and with ever asthma (OR 0.86, 95% CI 0.75–0.98; P=0.027) in non-Mediterranean regions. When considering all regions together, the authors concluded adherence to the Mediterranean diet tended to have a protective effect on current wheeze and ever asthma but not on current severe wheeze.\nThe meta-analysis14 excluded six studies for the following reasons: three studies derived dietary patterns a posteriori,32,41,43 one measured lung function as the lone outcome,33 and two34,35 reported data published in other studies that were included in the meta-analysis. The limited additional studies on dietary patterns and child asthma or wheeze precluded another meta-analysis. Among these six studies, five found either a beneficial effect of the Mediterranean diet or a detrimental effect of an unhealthy (eg, Western) pattern. Interestingly, one study reported that the Mediterranean diet was a risk factor for severe asthma in girls aged 6–7 years.35 The authors speculated this could be due to a reverse causal effect (families of children with severe asthma may improve their diet) and residual confounding.\nOverall, the meta-analysis and six additional studies suggest that the Mediterranean diet is potentially protective against child asthma."}