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Nutrients and foods for the primary prevention of asthma and allergy: systematic review and meta-analysis.
J Allergy Clin Immunol 2011; 127(3):724-33.e1-30JA

Abstract

BACKGROUND

Epidemiologic studies suggest that deficiencies of the nutrients selenium; zinc; vitamins A, C, D, and E; and low fruit and vegetable intake may be associated with the development of asthma and allergic disorders.

OBJECTIVES

To investigate the evidence that nutrient and food intake modifies the risk of children developing allergy.

METHODS

We systematically searched 11 databases. Studies were critically appraised, and meta-analyses were undertaken.

RESULTS

We identified 62 eligible reports. There were no randomized controlled trials. Studies used cohort (n = 21), case-control (n = 15), or cross-sectional (n = 26) designs. All studies were judged to be at moderate to substantial risk of bias. Meta-analysis revealed that serum vitamin A was lower in children with asthma compared with controls (odds ratio [OR], 0.25; 95% CI, 0.10-0.40). Meta-analyses also showed that high maternal dietary vitamin D and E intakes during pregnancy were protective for the development of wheezing outcomes (OR, 0.56, 95% CI, 0.42-0.73; and OR, 0.68, 95% CI, 0.52-0.88, respectively). Adherence to a Mediterranean diet was protective for persistent wheeze (OR, 0.22; 95% CI, 0.08-0.58) and atopy (OR, 0.55; 95% CI, 0.31-0.97). Seventeen of 22 fruit and vegetable studies reported beneficial associations with asthma and allergic outcomes. Results were not supportive for other allergic outcomes for these vitamins or nutrients, or for any outcomes in relation to vitamin C and selenium.

CONCLUSION

The available epidemiologic evidence is weak but nonetheless supportive with respect to vitamins A, D, and E; zinc; fruits and vegetables; and a Mediterranean diet for the prevention of asthma. Experimental studies of these exposures are now warranted.

Authors+Show Affiliations

Allergy and Respiratory Research Group Centre for Population Health Sciences, University of Edinburgh, Medical School, Edinburgh, United Kingdom.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

21185068

Citation

Nurmatov, Ulugbek, et al. "Nutrients and Foods for the Primary Prevention of Asthma and Allergy: Systematic Review and Meta-analysis." The Journal of Allergy and Clinical Immunology, vol. 127, no. 3, 2011, pp. 724-33.e1-30.
Nurmatov U, Devereux G, Sheikh A. Nutrients and foods for the primary prevention of asthma and allergy: systematic review and meta-analysis. J Allergy Clin Immunol. 2011;127(3):724-33.e1-30.
Nurmatov, U., Devereux, G., & Sheikh, A. (2011). Nutrients and foods for the primary prevention of asthma and allergy: systematic review and meta-analysis. The Journal of Allergy and Clinical Immunology, 127(3), pp. 724-33.e1-30. doi:10.1016/j.jaci.2010.11.001.
Nurmatov U, Devereux G, Sheikh A. Nutrients and Foods for the Primary Prevention of Asthma and Allergy: Systematic Review and Meta-analysis. J Allergy Clin Immunol. 2011;127(3):724-33.e1-30. PubMed PMID: 21185068.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutrients and foods for the primary prevention of asthma and allergy: systematic review and meta-analysis. AU - Nurmatov,Ulugbek, AU - Devereux,Graham, AU - Sheikh,Aziz, Y1 - 2010/12/24/ PY - 2010/05/21/received PY - 2010/11/01/revised PY - 2010/11/03/accepted PY - 2010/12/28/entrez PY - 2010/12/28/pubmed PY - 2011/5/26/medline SP - 724-33.e1-30 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 127 IS - 3 N2 - BACKGROUND: Epidemiologic studies suggest that deficiencies of the nutrients selenium; zinc; vitamins A, C, D, and E; and low fruit and vegetable intake may be associated with the development of asthma and allergic disorders. OBJECTIVES: To investigate the evidence that nutrient and food intake modifies the risk of children developing allergy. METHODS: We systematically searched 11 databases. Studies were critically appraised, and meta-analyses were undertaken. RESULTS: We identified 62 eligible reports. There were no randomized controlled trials. Studies used cohort (n = 21), case-control (n = 15), or cross-sectional (n = 26) designs. All studies were judged to be at moderate to substantial risk of bias. Meta-analysis revealed that serum vitamin A was lower in children with asthma compared with controls (odds ratio [OR], 0.25; 95% CI, 0.10-0.40). Meta-analyses also showed that high maternal dietary vitamin D and E intakes during pregnancy were protective for the development of wheezing outcomes (OR, 0.56, 95% CI, 0.42-0.73; and OR, 0.68, 95% CI, 0.52-0.88, respectively). Adherence to a Mediterranean diet was protective for persistent wheeze (OR, 0.22; 95% CI, 0.08-0.58) and atopy (OR, 0.55; 95% CI, 0.31-0.97). Seventeen of 22 fruit and vegetable studies reported beneficial associations with asthma and allergic outcomes. Results were not supportive for other allergic outcomes for these vitamins or nutrients, or for any outcomes in relation to vitamin C and selenium. CONCLUSION: The available epidemiologic evidence is weak but nonetheless supportive with respect to vitamins A, D, and E; zinc; fruits and vegetables; and a Mediterranean diet for the prevention of asthma. Experimental studies of these exposures are now warranted. SN - 1097-6825 UR - https://www.unboundmedicine.com/medline/citation/21185068/Nutrients_and_foods_for_the_primary_prevention_of_asthma_and_allergy:_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(10)01738-0 DB - PRIME DP - Unbound Medicine ER -