Influence of Mediterranean diet on asthma in children: A systematic review and meta-analysis
Article first published online: 11 APR 2013
© 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd
Pediatric Allergy and Immunology
Volume 24, Issue 4, pages 330–338, June 2013
How to Cite
Influence of Mediterranean diet on asthma in children: A systematic review and meta-analysis. Pediatr Allergy Immunol 2013: 00., , , , , .
- Issue published online: 21 MAY 2013
- Article first published online: 11 APR 2013
- Manuscript Accepted: 20 FEB 2013
- Mediterranean diet;
There is epidemiological evidence that Mediterranean diet exposure is associated with lower asthma prevalence in children. We aimed to summarize the available data and to know whether the Mediterranean setting modifies this association.
The literature search, up to May 2012, was on epidemiological studies in the general population of children assessing whether adherence to Mediterranean diet (measured as a score) was associated with the prevalence of ‘current wheeze’; ‘current severe wheeze’; or ‘asthma ever’. Odds ratios (OR) of the eight included studies compared the highest tertile of the score with the lowest. Random-effects meta-analyses for the whole group of studies and stratified by Mediterranean setting (centers <100 Km from the Mediterranean coast) were performed. Differences between strata were assessed using the Q test.
For ‘current wheeze’, there was a negative significant association with the highest tertile of Mediterranean diet score (OR 0.85, 95% CI 0.75–0.98; p = 0.02), driven by Mediterranean centers (0.79, 0.66–0.94, p = 0.009), although the difference with the non-Mediterranean centers (0.91, 0.78–1.05, p = 0.18) was not significant. The results for ‘current severe wheeze’ were as follows: 0.82, 0.55–1.22, p = 0.330 (all); 0.66, 0.48–0.90, p = 0.008 (Mediterranean); and 0.99, 0.79–1.25, p = 0.95 (non-Mediterranean); with the difference between regions being significant. For ‘asthma ever’, the associations were as follows: 0.86, 0.78–0.95, p = 0.004 (all); 0.86, 0.74–1.01, p = 0.06 (Mediterranean); 0.86, 0.75–0.98; p = 0.027 (non-Mediterranean); with the difference between regions being negligible.
Adherence to the Mediterranean diet tended to be associated with lower occurrence of the three respiratory outcomes. For current and current severe wheeze, the association was mainly driven by the results in Mediterranean populations.