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      Association of Antioxidants With Allergic Rhinitis in Children From Seoul

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          Abstract

          Purpose

          The prevalence of allergic diseases has risen over the last few decades. Many factors, including environmental factors such as those related to diet, have been considered. Among dietary factors, intake of antioxidant-related nutrients has been associated with the risk of allergic disease. We investigated the association of antioxidant nutritional status with allergic rhinitis (AR) in Korean schoolchildren aged 6-12 years.

          Methods

          Subjects were 4,554 children in Seoul, Korea. The risk of allergic disease was measured using the Korean version of the International Study of Asthma and Allergies in Childhood, and dietary intake was measured by a semi-quantitative food frequency questionnaire. Intake of vitamins A (including retinol and β-carotene), C, and E was used in the analysis.

          Results

          Vitamin C intake was negatively associated with an increased risk of current symptoms (adjusted odds ratio, 0.886; 95% confidence interval, 0.806-0.973). There was no association between AR and intake of vitamin A, retinol, β-carotene, or vitamin E. Total serum IgE level and sensitization to allergen did not differ according to nutrient intake.

          Conclusions

          The group of children with increased vitamin C consumption had fewer AR symptoms, despite the lack of a difference in total serum IgE level or allergen sensitization. These findings suggest that nutrient intake, especially that of vitamin C, influences AR symptoms.

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          Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee.

          Neil Pearce, Philippa Ellwood (1998)
          Systematic international comparisons of the prevalences of asthma and other allergic disorders in children are needed for better understanding of their global epidemiology, to generate new hypotheses, and to assess existing hypotheses of possible causes. We investigated worldwide prevalence of asthma, allergic rhinoconjunctivitis, and atopic eczema. We studied 463,801 children aged 13-14 years in 155 collaborating centres in 56 countries. Children self-reported, through one-page questionnaires, symptoms of these three atopic disorders. In 99 centres in 42 countries, a video asthma questionnaire was also used for 304,796 children. We found differences of between 20-fold and 60-fold between centres in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema, with four-fold to 12-fold variations between the 10th and 90th percentiles for the different disorders. For asthma symptoms, the highest 12-month prevalences were from centres in the UK, Australia, New Zealand, and Republic of Ireland, followed by most centres in North, Central, and South America; the lowest prevalences were from centres in several Eastern European countries, Indonesia, Greece, China, Taiwan, Uzbekistan, India, and Ethiopia. For allergic rhinoconjunctivitis, the centres with the highest prevalences were scattered across the world. The centres with the lowest prevalences were similar to those for asthma symptoms. For atopic eczema, the highest prevalences came from scattered centres, including some from Scandinavia and Africa that were not among centres with the highest asthma prevalences; the lowest prevalence rates of atopic eczema were similar in centres, as for asthma symptoms. The variation in the prevalences of asthma, allergic rhinoconjunctivitis, and atopic-eczema symptoms is striking between different centres throughout the world. These findings will form the basis of further studies to investigate factors that potentially lead to these international patterns.
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            Diet as a risk factor for atopy and asthma.

            Anthony Seaton, Graham Devereux (2005)
            It has been hypothesized that decreasing antioxidant (fruit and vegetables), increased n-6 polyunsaturated fatty acid (PUFA; (margarine, vegetable oil), and decreased n-3 PUFA (oily fish) intakes have contributed to the recent increases in asthma and atopic disease. Epidemiologic studies in adults and children have reported beneficial associations between dietary antioxidants and lipids and parameters of asthma and atopic disease. The associations with n-6 and n-3 PUFA appear to be very complex and might differ between asthma and atopic dermatitis. Dietary antioxidants are probably exerting antioxidant and nonantioxidant immunomodulatory effects. Dietary lipids exert numerous complex effects on proinflammatory and immunologic pathways. It has also been suggested that atopic dermatitis is associated with an enzyme defect in lipid metabolism. In spite of this, the results of interventional supplementation studies in established disease have been disappointing, and there is now increasing interest in the possibility that dietary antioxidant and lipid intakes might be important in determining expression of disease during pregnancy and early childhood and that dietary interventions should be targeted at these groups. It also seems likely that there is individual variation in the responses of individuals to lipid, and probably antioxidant, supplementation. Further research to determine whether dietary intervention can reduce the risk of asthma and atopic disease is justified.
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              Protective effect of fruits, vegetables and the Mediterranean diet on asthma and allergies among children in Crete.

              Leda Chatzi, Gianna Apostolaki, Ioannis Bibakis … (2007)
              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. 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. 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. 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.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Allergy Asthma Immunol Res
                Journal ID (iso-abbrev): Allergy Asthma Immunol Res
                Journal ID (publisher-id): AAIR
                Title: Allergy, Asthma & Immunology Research
                Publisher: The Korean Academy of Asthma, Allergy and Clinical Immunology; The Korean Academy of Pediatric Allergy and Respiratory Disease
                ISSN (Print): 2092-7355
                ISSN (Electronic): 2092-7363
                Publication date (Print): March 2013
                Publication date (Electronic): 07 November 2012
                Volume: 5
                Issue: 2
                Pages: 81-87
                Affiliations
                [1 ]Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
                [2 ]Department of Food and Nutrition, College of Human Ecology, Kyung Hee University, Seoul, Korea.
                [3 ]Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
                [4 ]Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
                [5 ]Research Center for Standization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
                [6 ]Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
                [7 ]Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea.
                [8 ]Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea.
                [9 ]Department of Pediatrics, Inje University Seoul Paik Hospital, Seoul, Korea.
                [10 ]Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
                [11 ]Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea.
                [12 ]Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
                Author notes
                Correspondence to: Soo-Jong Hong, MD, PhD, Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea. Tel: +82-2-3010-3379; Fax: +82-2-473-3725; sjhong@ 123456amc.seoul.kr
                Co-corresponding author: Se-Young Oh, PhD, Department of Food and Nutrition, College of Human Ecology, Kyung Hee University, 26 Kyunghee-daero, Dongdaemun-gu, Seoul 130-701, Korea. Tel: +82-2-961-0649; Fax: +82-2-959-0649; seyoung@ 123456khu.ac.kr

                Ju-Hee Seo and Sung-Ok Kwon contributed equally to this work and should be considered co-first authors.

                Article
                DOI: 10.4168/aair.2013.5.2.81
                PMC ID: 3579096
                PubMed ID: 23450181
                SO-VID: d0a68fb0-31d9-429d-adda-8dc76149b0c2
                Copyright © Copyright © 2013 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 17 October 2011
                Date revision received : 11 May 2012
                Date accepted : 26 June 2012
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Immunology
                Keywords: allergic rhinitis,antioxidant,vitamin c
                Data availability:
                ScienceOpen disciplines: Immunology
                Keywords: allergic rhinitis, antioxidant, vitamin c

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