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Thorax doi:10.1136/thx.2006.069419

Protective effect of fruits, vegetables and the Mediterranean diet on asthma and allergies among children in Crete

  1. Leda Chatzi
  1. 1 Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
    1. Gianna Apostolaki
    1. 1 Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
      1. Ioannis Bibakis
      1. Anti-tuberculosis Unit, Venezelion General Hospital, Heraklion, Crete, Greece
        1. Isobel Skypala
        1. Royal Brompton Hospital, United Kingdom
          1. Vasiliki Bibaki-Liakou
          1. Anti-tuberculosis Unit, Venezelion General Hospital, Heraklion, Crete, Greece
            1. Tzanakis Tzanakis
            1. Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
              1. Manolis Kogevinas
              1. Centre for Research in Environmental Epidemiology, IMIM, Barcelona, Spain
                1. Paul Cullinan (p.cullinan{at}imperial.ac.uk)
                1. Royal Brompton Hospital and National Heart and Lung Institute, London, United Kingdom
                  • Published Online First 5 April 2007

                  Abstract

                  Introduction: Atopy is not uncommon among children living in rural Crete; but wheeze and rhinitis are rare. We examined 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 the child's respiratory and allergic symptoms, and a 58-item food frequency questionnaire. Adherence to a Mediterranean diet was measured through a scale on 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. High consumption of nuts was found to be inversely associated with wheezing (OR, 0.46; 95% CI, 0.20-0.98), whereas margarine increased the risk of both wheeze (OR, 2.19; 95% CI, 1.01-4.82) and allergic rhinitis (OR, 2.10; 95% CI, 1.31-3.37). A high level of adherence to the Mediterranean diet was protective for allergic rhinitis (OR, 0.34; 95% CI, 0.18-0.64) while a more modest protection was observed for wheezing and atopy.

                  Conclusion: Our data 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.


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