title: Dietary intake, lung function and airway inflammation in Mexico City school children exposed to air pollutants.
abstract: BACKGROUND
  Air pollutant exposure has been associated with an increase in inflammatory markers and a decline in lung function in asthmatic children. Several studies suggest that dietary intake of fruits and vegetables might modify the adverse effect of air pollutants.
  
  
  METHODS
  A total of 158 asthmatic children recruited at the Children's Hospital of Mexico and 50 non-asthmatic children were followed for 22 weeks. Pulmonary function was measured and nasal lavage collected and analyzed every 2 weeks. Dietary intake was evaluated using a 108-item food frequency questionnaire and a fruit and vegetable index (FVI) and a Mediterranean diet index (MDI) were constructed. The impact of these indices on lung function and interleukin-8 (IL-8) and their interaction with air pollutants were determined using mixed regression models with random intercept and random slope.
  
  
  RESULTS
  FVI was inversely related to IL-8 levels in nasal lavage (p < 0.02) with a significant inverse trend (test for trend p < 0.001), MDI was positively related to lung function (p < 0.05), and children in the highest category of MDI had a higher FEV1 (test for trend p < 0.12) and FVC (test for trend p < 0.06) than children in the lowest category. A significant interaction was observed between FVI and ozone for FEV1 and FVC as was with MDI and ozone for FVC. No effect of diet was observed among healthy children.
  
  
  CONCLUSIONS
  Our results suggest that fruit and vegetable intake and close adherence to the Mediterranean diet have a beneficial effect on inflammatory response and lung function in asthmatic children living in Mexico City.
authors.affiliation: Instituto Nacional de Salud Pública, Cuernavaca, Mexico. iromieu@correo.insp.mx
authors.forename: Isabelle
authors.initials: I
authors.lastname: Romieu
authors.forename: Albino
authors.initials: A
authors.lastname: Barraza-Villarreal
authors.forename: Consuelo
authors.initials: C
authors.lastname: Escamilla-Núñez
authors.forename: Jose L
authors.initials: JL
authors.lastname: Texcalac-Sangrador
authors.forename: Leticia
authors.initials: L
authors.lastname: Hernandez-Cadena
authors.forename: David
authors.initials: D
authors.lastname: Díaz-Sánchez
authors.forename: Jordi
authors.initials: J
authors.lastname: De Batlle
authors.forename: Blanca E
authors.initials: BE
authors.lastname: Del Rio-Navarro
mesh_terms: D000393:Air Pollutants; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D038441:Diet, Mediterranean / Q000706:statistics & numerical data*; D004435:Eating; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008800:Mexico / Q000453:epidemiology; D012129:Respiratory Function Tests / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D013334:Students / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D000393:Air Pollutants