PT  - JOURNAL ARTICLE
AU  - Leda Chatzi
AU  - Gianna Apostolaki
AU  - Ioannis Bibakis
AU  - Isabel Skypala
AU  - Vasilki Bibaki-Liakou
AU  - Nikolaos Tzanakis
AU  - Manolis Kogevinas
AU  - Paul Cullinan
TI  - Protective effect of fruits, vegetables and the Mediterranean diet on asthma and allergies among children in Crete
AID  - 10.1136/thx.2006.069419
DP  - 2007 Aug 01
TA  - Thorax
PG  - 677--683
VI  - 62
IP  - 8
4099  - http://thorax.bmj.com/content/62/8/677.short
4100  - http://thorax.bmj.com/content/62/8/677.full
SO  - Thorax2007 Aug 01; 62
AB  - 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.