Association Between Adherence to the Mediterranean Diet and Asthma in Peruvian Children.
OBJECTIVE
Adherence to a Mediterranean diet pattern may be associated with lower asthma prevalence in children. We sought to corroborate these findings in Peruvian children.


METHODS
This case-control study included children of ages 9-19 years living in Lima, Peru. A food frequency questionnaire (FFQ) was completed and diet pattern was analyzed using a modified Mediterranean diet score (MDS). Primary analysis investigated the relationship between MDS and asthma status. Maternal education, age, sex, and body mass index category were included in multivariate model. Secondary outcomes included asthma control, forced expiratory volume in 1 s (FEV1), allergic rhinitis, and atopic status.


RESULTS
287 participants with asthma and 96 controls without asthma completed a FFQ. Mean age was 13.5 years. According to the asthma control test (ACT), 86 % of those with asthma were controlled (score >19). MDS scores ranged 6-18 (median 15). In adjusted analysis, being above the median MDS scores was associated with decreased odds of asthma [OR = 0.55, 95 % CI (0.33, 0.92), p = 0.02]. Among children whose mothers completed secondary education, being above the median MDS significantly decreased the odds of asthma [OR = 0.31, 95 % CI (0.14, 0.71), p < 0.01], whereas among those whose mothers did not complete secondary education there was no protective effect [OR = 0.86, 95 % CI (0.43, 1.7), p = 0.66]. There was no association between MDS scores and asthma control, FEV1, allergic rhinitis, or atopic status.


CONCLUSIONS
Adherence to the Mediterranean diet was inversely associated with having asthma among children in Lima, Peru. This effect was strongest among children with better educated mothers.
Division of Pediatric Pulmonology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Jessica L
JL
Rice
Biomedical Research Unit, A.B. PRISMA, Lima, Peru.
Karina M
KM
Romero
Biomedical Research Unit, A.B. PRISMA, Lima, Peru.
Rocio M
RM
Galvez Davila
Biomedical Research Unit, A.B. PRISMA, Lima, Peru.
Carla Tarazona
CT
Meza
Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Andrew
A
Bilderback
Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
D'Ann L
DL
Williams
Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Patrick N
PN
Breysse
Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Sonali
S
Bose
Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.|Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.|Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
William
W
Checkley
Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA. nhansel1@jhmi.edu.|Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. nhansel1@jhmi.edu.
Nadia N
NN
Hansel
D000293:Adolescent; D001249:Asthma / Q000453:epidemiology* / Q000503:physiopathology; D016022:Case-Control Studies; D002648:Child; D038441:Diet, Mediterranean / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D065631:Rhinitis, Allergic / Q000453:epidemiology*; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014797:Vital Capacity; D055815:Young Adult
Allergic rhinitis; Atopic; Control; Diet pattern; Food frequency questionnaire; Peru