Pollen Food Allergy Syndrome in Allergic March.

The association between pollen food allergy syndrome (PFAS) and allergic march remains unclear. In this prospective cohort study of the general population in Tokyo (T-Child Study), we found that sensitization to Cry j 1 and Fel d 1 at ages 5 and 9 years was associated with an increased risk of PFAS at 13 years old (at 5 years, Cry j 1: adjusted odds ratio aOR, 2.74; 95% confidence interval CI, 1.53-4.91; Fel d 1: aOR, 2.61; 95% CI, 1.31-5.19; at 9 years, Cry j 1: adjusted odds ratio aOR, 4.28; 95% confidence interval CI, 1.98-9.25; Fel d 1: aOR, 2.40; 95% CI, 1.33-4.32). In particular, sensitization to Bet v 1 at ages 5 and 9 years was associated with a strong risk of PFAS at the age of 13 years (at 5 years: aOR, 10.6; 95% CI, 2.64-42.5; at 9 years: aOR, 9.1; 95% CI, 4.71-17.6). PFAS risk by age 13 years was increased by any allergic symptom at 5 or 9 years, a combination of wheezing, eczema, and rhinitis, and Bet v 1 sensitization. Our findings suggest that PFAS may be associated with allergic march.

Dietary supplement use in elementary school children: a Japanese web-based survey.

BACKGROUND: A variety of dietary supplements are commercially available. However, the efficacy and safety of dietary supplement use in children are not well established. Understanding dietary supplement use is important for developing public health policy regarding dietary supplements. This study aimed to investigate the types of dietary supplements used and characteristics of dietary supplement users among Japanese elementary school children. METHOD: We conducted a cross-sectional web-based questionnaire study. Dietary supplement use, socio-demographics, and health-related behaviors were assessed through mother-reported questionnaire. Types of dietary supplements were identified based on ingredient using product barcodes and brand names. Multivariate logistic regression analysis was conducted to investigate the socio-demographics and health-related behaviors associated with supplement use. RESULTS: Among 4933 children, 333 (6.8%) were identified as dietary supplement users. The most common supplement was amino acids or protein (1.4%), followed by n-3 fatty acids or fish oil (1.0%), probiotics (1.0%), multivitamins (0.9%), multivitamin-minerals (0.8%), and botanicals (0.8%). Overall, any dietary supplement use was significantly associated with the highest frequency of sports participation (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.65-4.02), highest household income (OR, 1.87; 95% CI, 1.13-3.10), highest maternal educational level (OR, 1.82; 95% CI, 1.31-2.52), and male sex (OR, 1.38; 95% CI, 1.09-1.75). The highest frequency of sports participation was significantly associated with higher odds of use of amino acids or protein (OR, 6.06; 95% CI, 1.78-20.6) and multivitamins (OR, 3.56; 95% CI, 1.11-11.5), compared to the lowest frequency of sports participation. CONCLUSION: This study showed that Japanese children primarily use non-vitamin, non-mineral supplements. Non-vitamin, non-mineral supplements should thus be included in future studies aimed at monitoring dietary supplement use. We also found that dietary supplement use in children was associated with sports participation. Guidelines for dietary supplement use for children, in particular sport participants, are needed.

Management of Severe Atopic Dermatitis in Pediatric Patients.

Atopic dermatitis is a common, chronic inflammatory skin disorder, present in about 12% of children worldwide. Optimizing management of severe atopic dermatitis in pediatric patients is critical to reduce signs of inflammation, alleviate pruritus and sleep disturbance, minimize the development and/or impact of comorbidities, and improve the patient and caregiver's quality of life. Evaluating the longitudinal severity of pediatric atopic dermatitis is an important component of measuring therapeutic response and long-term management, and is different in clinical practice versus clinical trials. This article describes when and how to use different treatments for pediatric patients with severe atopic dermatitis, including topical medications, phototherapy, and systemic medical therapies (traditional immunosuppressants, biologics, and small molecule inhibitors). It also provides recommendations useful in clinical practice for nonpharmacologic interventions for pediatric patients with severe atopic dermatitis.

Pollen-food allergy syndrome and component sensitization in adolescents: A Japanese population-based study.

Allergic rhino-conjunctivitis with pollen allergy has been prevalent worldwide and Pollen-food allergy syndrome (PFAS) refers to individuals with pollen allergy who develop oral allergy syndrome (OAS) on consuming fruits and vegetables. The prevalence of PFAS varies by region and that in Japanese adolescents remains to be elucidated. In this cross-sectional study, we examined the epidemiological characteristics of PFAS in a general population of Japanese adolescents according to pollen allergy, OAS, and IgE component sensitization. Participants comprised adolescents, at age 13 years, from a prospective birth cohort study in Japan. We administered questionnaires to collect information from parents regarding pollen allergy, PFAS and OAS at each child's age 13 years. ImmunoCAP ISAC was used to assess IgE component sensitization. Among 506 participants with a complete questionnaire and ISAC measurement results, 56.5% had a history of hay fever, 16.0% had a history of OAS, 51.0% had pollen allergy, and 11.7% had a history of PFAS; additionally, 72.7% were sensitized to one or more tree, grass, and/or weed allergens. The most common sensitization (95.7%) among adolescents with pollen allergy was to Japanese cedar (Cry j 1). The most common causal foods were kiwi and pineapple (both 39.0%). Knowledge levels about PFAS were poor among affected adolescents. We found a high prevalence of PFAS among adolescents in Japan. Although it affects approximately 1/10 adolescents in the general population, public awareness regarding PFAS is poor. Interventional strategies are needed to increase knowledge and to prevent PFAS in the general population.

Changes in Dietary Intake in Pregnant Women from Periconception to Pregnancy in the Japan Environment and Children's Study: A Nationwide Japanese Birth Cohort Study.

BACKGROUND: Nutritional requirements increase during pregnancy. However, relatively few studies have examined longitudinal changes in dietary intake from periconception to pregnancy. Here, we investigated changes in the intake of food and nutrients, and compliance with dietary reference intakes (DRIs) in pregnant women. METHODS: The Japan Environment and Children's Study, a nationwide multicenter prospective cohort study, included 30,373 pregnant women who answered a validated food frequency questionnaire repeatedly to assess changes in dietary intake in periconception and pregnancy. Energy-adjusted intakes of food groups and nutrients were described using the density method. The percentage of women not meeting DRIs was calculated. RESULTS: Of all foods groups examined, intake of food significantly increased from periconception to pregnancy for dairy products (mean difference 23.5 g/1000 kcal, 95% confidence interval [CI] 22.0-25.0 g/1000 kcal), confectionaries (2.0 g/1000 kcal, 1.8-2.2 g/1000 kcal), and soft drinks (1.3 g/1000 kcal, 0.3-2.3 g/1000 kcal). Of all nutrients examined, intake was significantly increased for calcium (mean difference 27 mg/1000 kcal, 95% CI 25-29 mg/1000 kcal), vitamin A (15 µgRE/1000 kcal, 13-18 g/1000 kcal), and saturated fat (0.4% energy, 0.4-0.4% energy). The percentage of women not meeting DRIs increased for vitamin B group, vitamin C, saturated fat and salt. CONCLUSION: We found that energy-adjusted intakes of calcium, vitamin A, and saturated fat increased from periconception to pregnancy, while intake of other nutrients did not increase. The percentage of women not meeting DRIs increased for water-soluble vitamins, saturated fat, and salt.

Relationship between dietary fat and fish intake and the prevalence of atopic eczema in pregnant Japanese females: baseline data from the Osaka Maternal and Child Health Study.

Dietary factors may be important in the development of atopic eczema. It remains controversial whether n-3 polyunsaturated fatty acid intake is preventive against allergic disorders and whether n-6 polyunsaturated fatty acid intake increases the risk of allergic disorders. The current cross-sectional study examined the association between intake of fatty acids and foods high in fatty acids and the prevalence of atopic eczema. Study subjects were 1002 pregnant Japanese females. Current atopic eczema and atopic eczema after age 18 were defined as present if subjects had been treated with medications at some time in the previous 12 months and after reaching the age of 18, respectively. Information on dietary factors was collected using a validated self-administered diet history questionnaire. Docosahexaenoic acid intake was statistically significantly related to a decreased prevalence of atopic eczema after age 18 and current atopic eczema. Inverse dose-response relationships with regard to consumption of n-3 polyunsaturated fatty acids, eicosapentaenoic acid, and fish and the ratio of n-3 to n-6 polyunsaturated fatty acids with atopic eczema were not observed although these dietary variables in the second tertile were inversely significantly associated with atopic eczema after age 18. Intake of total fat, saturated fatty acids, monounsaturated fatty acids, n-6 polyunsaturated fatty acids, cholesterol, meat, eggs, or dairy products was not related to either of the outcomes for atopic eczema. Docosahexaenoic acid intake may be associated with a reduced prevalence of atopic eczema in pregnant Japanese females.

Beverage consumption and the prevalence of tooth loss in pregnant Japanese women: the Osaka Maternal and Child Health Study.

Recently, there has been growing interest in the impact of beverage consumption on dental health because changes have occurred in the types and quantities of beverage consumed. This cross-sectional study investigated the relationship between consumption frequencies of various beverages and the prevalence of tooth loss among young adult women. Study subjects were 1002 pregnant Japanese women. Tooth loss was defined as previous extraction of one or more teeth. Dietary habits were evaluated by a validated dietary history questionnaire. Logistic regression analysis was used to estimate the odds ratios and their 95% confidence intervals of tooth loss. Adjustment was made for age, gestation, parity, cigarette smoking, passive smoking at home and at work, family income, education, changes in diet in the previous one month, season when data were collected and body mass index. Of the 1002 subjects, 256 women had lost one or more teeth. Coffee consumption was independently associated with an increased prevalence of tooth loss. When subjects were divided according to consumption of coffee with or without sugar, an increased prevalence of tooth loss was found only in subjects who consumed coffee without addition of sugar. Compared with the lowest consumption of green tea, the intermediate but not the highest consumption of green tea was associated with an increased prevalence of tooth loss. There was no measurable association of intake of milk, black tea, cola, or 100% fruit juice with the prevalence of tooth loss. The findings suggest that coffee consumption might be associated with an increased prevalence of tooth loss among young adult women.

Fish and fat intake and prevalence of allergic rhinitis in Japanese females: the Osaka Maternal and Child Health Study.

OBJECTIVE: It remains uncertain whether intake of fish or n-3 polyunsaturated fatty acids is preventive against allergic disorders. This cross-sectional study investigated the association of intake of selected high-fat foods and specific types of fatty acids with the prevalence of allergic rhinitis in Japan where intake of fish is high. METHODS: Study subjects were 1002 Japanese pregnant females. Allergic rhinitis (including cedar pollinosis) was defined as present if subjects had received drug treatment at some point during the previous 12 months. Information on dietary factors was collected using a validated self-administered diet history questionnaire. Adjustment was made for age, gestation, parity, cigarette smoking, passive smoking at home and at work, indoor domestic pets, family history of asthma, atopic eczema, and allergic rhinitis, family income, education, mite antigen level in house dust, changes in diet in the previous month, season when data were collected, and body mass index. RESULTS: There was a tendency for an inverse dose-response association between fish intake and allergic rhinitis although the adjusted odds ratio for comparison of the highest with the lowest quartile was not statistically significant (p for trend = 0.09). Intake of eicosapentaenoic and docosahexaenoic acids was independently associated with a decreased prevalence of allergic rhinitis: the multivariate odds ratio for the highest quartile was 0.56 (95% confidence interval: 0.32-0.96, p for trend = 0.03). Intake of n-6 polyunsaturated fatty acids in the third quartile but not the second and fourth quartiles showed a tendency for an inverse association with the prevalence of allergic rhinitis. No measurable relationship was found between consumption of meat, eggs, dairy products, total fat, saturated, monounsaturated, and n-3 polyunsaturated fatty acids, and cholesterol or the ratio of n-3 to n-6 polyunsaturated fatty acids and allergic rhinitis. CONCLUSION: Our findings suggest that the intake of eicosapentaenoic and docosahexaenoic acids may be associated with a reduced prevalence of allergic rhinitis.