Protective effect of fruits, vegetables and the Mediterranean diet on asthma and allergies among children in Crete
- Leda Chatzi1,
- Gianna Apostolaki1,
- Ioannis Bibakis2,
- Isabel Skypala3,
- Vasilki Bibaki-Liakou2,
- Nikolaos Tzanakis1,
- Manolis Kogevinas1,4,
- Paul Cullinan3
- 1Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
- 2Anti-Tuberculosis Unit, Venezelio General Hospital, Heraklion, Crete, Greece
- 3Royal Brompton Hospital and National Heart and Lung Institute, London, UK
- 4Centre for Research in Environmental Epidemiology, IMIM, Barcelona, Spain
- Correspondence to:
Dr P Cullinan
Department of Occupational and Environmental Medicine, Royal Brompton Hospital and National Heart and Lung Institute, London SW3 6LR, UK;
- Received 29 July 2006
- Accepted 11 January 2007
- Published Online First 5 April 2007
Background: Atopy is not uncommon among children living in rural Crete, but wheeze and rhinitis are rare. A study was undertaken to examine whether this discrepancy could be attributed to a high consumption of fresh fruit and vegetables or adherence to a traditional Mediterranean diet.
Methods: A cross-sectional survey was performed in 690 children aged 7–18 years in rural Crete. Parents completed a questionnaire on their child’s respiratory and allergic symptoms and a 58-item food frequency questionnaire. Adherence to a Mediterranean diet was measured using a scale with 12 dietary items. Children underwent skin prick tests with 10 common aeroallergens.
Results: 80% of children ate fresh fruit (and 68% vegetables) at least twice a day. The intake of grapes, oranges, apples, and fresh tomatoes—the main local products in Crete—had no association with atopy but was protective for wheezing and rhinitis. A high consumption of nuts was found to be inversely associated with wheezing (OR 0.46; 95% CI 0.20 to 0.98), whereas margarine increased the risk of both wheeze (OR 2.19; 95% CI 1.01 to 4.82) and allergic rhinitis (OR 2.10; 95% CI 1.31 to 3.37). A high level of adherence to the Mediterranean diet was protective for allergic rhinitis (OR 0.34; 95% CI 0.18 to 0.64) while a more modest protection was observed for wheezing and atopy.
Conclusion: The results of this study suggest a beneficial effect of commonly consumed fruits, vegetables and nuts, and of a high adherence to a traditional Mediterranean diet during childhood on symptoms of asthma and rhinitis. Diet may explain the relative lack of allergic symptoms in this population.
Published Online First 5 April 2007
Financial support for this study was provided by Medicor and through the Fifth Framework of the European Community (QLK4-CT-2000-00263).
Competing interests: None.