Influence of Mediterranean diet on the symptoms of childhood asthma

DIt has been observed that the incidence of childhood asthma is gradually increasing in developed countries. It is estimated that one-third of the young population will suffer from this disease in the near future. Diagnosing asthma in children is difficult. It consists mainly of checking clinical symptoms: cough, dyspnoea and wheezing. Asthma attack can be provoked by infection of upper respiratory tract, contact with allergens, tobacco smoke, certain medications and physical activity.

Currently the treatment is based on bronchodilators (beta2-agonists), glucocorticosteroids, and anti-leukotrienes. Such a proceeding is effective in the short-term treatment; however long-term observations show that children with asthma in spite of the therapy may have lower growth compared to their peers.

There are many publications about the beneficial effects of the Mediterranean diet on cardiovascular diseases. Researchers from the Spanish Medical University in Ciudad Real decided to investigate the effect of this diet on symptoms of childhood asthma.

The Mediterranean diet was announced spirit cultural heritage of humanity by UNESCO in 2010. It is characterized by high consumption of plant-based foods (fruits, fresh vegetables, whole grains, legumes, olive oil and nuts) and low or moderate consumption of sugars and animal derived food.

The study included 113 children between 1- 5 years old who met childhood asthma criteria, and have been observed in the clinic for at least one year before the trial. The aim of the experiment was to change eating habits of children by introducing implementation of the Mediterranean diet. Children and parents took part in a nutritional education program, visited nutritionist and pediatrician. The control visits were monthly during the first 4 months, and every two months by the rest of the year. The conventional treatment remained unchanged, and the doses of drugs were reduced only when the clinical improvement was observed. For a year, patients were evaluated for: compliance with diet, asthma symptoms, incidence of exacerbations, quantity of drugs supplementation, growth of the child and family satisfaction.

From 113 patients initially qualified to the treatment, 9 children abandoned trial because of inability to comply with diet. Finally 104 patients completed the study, of whom 50 were girls and 54 were boys. The average age was 2.74 years. The results were similar for both sexes. Statistically significant reduction in the number and severity of attacks, respiratory tract infections and hospitalization were reported. 32. 2% of the children during the year had no exacerbations, 35. 3% of children had only one attack and 24. 9% had two, compared to an average of 4. 73 episodes in the previous year.

Patients required lesser doses of drugs. Also the growth and BMI of evaluated children were within the normal range, as well as the degree of family satisfaction.

The researchers expect that Mediterranean diet has beneficial effects because it delivers all the nutrients in the most favorable proportions. Proper balance of omega-3 and omega-6 fatty acids contributes to reducing the level of pro-inflammatory cytokines. Fresh fruits and vegetables contain many vitamins, minerals and antioxidants. In addition, roughage contained in plant products contribute to the development of favorable intestinal flora. Many studies confirm the important role of proper composition of intestinal flora in the modulation of the immune system. Intestinal bacteria stimulate the body to a greater secretion of IgA antibodies, which promotes maintenance of immune tolerance – allergens are neutralized before they penetrate into the body. This plays an important role in the prevention of allergic diseases.

To sum up the Mediterranean diet affects the immune system, inflammatory processes and contributes to better control of asthma among children. It also allows to reduce the cost of treatment by reducing the demand for drugs.

Written by: Agnieszka Grzechnik, Krzysztof Grzechnik, Michał Godzisz

1. F.M. Calatayud-Sáez, B. Calatayud Moscoso del Prado, J.G. Gallego Fernández-Pacheco, C. González-Martín and L.F. Alguacil Merino, Mediterranean diet and childhood asthma, Allergology and Immunopathology (Allergologia et Immunopathologia), 2016-03-01, Volume 44, Issue 2, Pages 99-105
2. Guidelines for the Diagnosis and Management of Asthma [Inter-net]. National Asthma Education and Prevention Program.Expert panel report. Available from:
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4. Calderón TE, Ferrero M, Marino GM, Cordoba A, Beltramo D,Muino JC, et al. Meat-specific IgG and IgA antibodies coexistwith IgE antibodies in sera from allergic patients: clinical asso-ciation and modulation by exclusion diet. J Biol Regul HomeostAgents. 2010;24:261—71.30

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