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Copyright ©ERS Journals Ltd 2001
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
1 Dept of Paediatrics, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand, 2 Centre for Allergy Research, Karolinska Institute, Nobels väg 5, Stockholm, Sweden, 3 University of Wales College of Medicine, Temple of Peace and Health, Cathays Park, Cardiff, UK, 4 Centre for Public Health Research, Massey University, Wellington Campus, Wellington, New Zealand and 5 Dept of Respiratory Medicine, Royal Children's Hospital, Flemington Rd, Parkville, Victoria, Australia
CORRESPONDENCE: Philippa Ellwood, ISAAC International Data Centre, Dept of Paediatrics, Faculty of Medical and Health Science, University of Auckland, Private Bag 92019, Auckland, New Zealand. Fax: 64 9 3737602
Keywords: allergic rhinoconjunctivitis, asthma, atopic eczema, children, diet, ISAAC
Received: September 28, 1999
Accepted November 13, 2000
This
work was supported by the Health Research Council of New Zealand, the Asthma
and Respiratory Foundation of New Zealand, the National Child Health Research
Foundation, the Hawke's Bay Medical Research Foundation, the Waikato
Medical Research Foundation, GlaxoWellcome New Zealand and Astra New Zealand,
as well as GlaxoWellcome International Medical Affairs for funding the regional
coordination centres. The Wellington Asthma Research Group is supported by
a Programme Grant from the Health Research Council of New Zealand.
Several studies have suggested that the increasing prevalence of symptoms
of asthma, rhinitis and eczema, could be associated with dietary factors.
In the present paper, a global analysis of prevalence rates of wheeze, allergic
rhinoconjunctivitis and atopic eczema was performed in relation to diet, as
defined by national food intake data.
Analyses were based on the International Study of Asthma and Allergies
in Childhood (ISAAC) data for 6–7 and 13–14 yr
old children. Symptoms of wheeze, allergic rhinoconjunctivitis and atopic
eczema symptom prevalence were regressed against per capita food intake, and
adjusted for gross national product to account for economic development. Dietary
data were based on 1995 Food and Agriculture Organisation of the United Nations
data for 53 of the 56 countries that took part in ISAAC phase I (1994/1995).
The 13–14 year age group showed a consistent pattern of decreases
in symptoms of wheeze (current and severe), allergic rhinoconjunctivitis
and atopic eczema, associated with increased per capita consumption of calories
from cereal and rice, protein from cereals and nuts, starch, as well as vegetables
and vegetable nutrients. The video questionnaire data for 13–14 yr
olds and the ISAAC data for 6–7 yr olds showed similar patterns
for these foods.
A consistent inverse relationship was seen between prevalence rates of
the three conditions and the intake of starch, cereals, and vegetables. If
these findings could be generalised, and if the average daily consumption
of these foods increased, it is speculated that an important decrease in symptom
prevalence may be achieved.
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