Mediterranean diet in the Castilian plains: Dietary patterns and childhood asthma in 6-7-year-old children from the province of Salamanca.

Salamanca is the only Spanish center with no coastal line participating in the Global Asthma Network phase-I study. Questionnaires were collected from 6-7-year-old 2388 children and analyzed in particular for their diet and asthma symptoms as part of this study. The prevalence of current asthma (CA) was 9%, doctor-confirmed asthma (DCA) was 7%, and current severe asthma (CSA) accounted to 2.9%. Two Mediterranean Diet Scores (MDS) were performed to evaluate adherence of these children to the Mediterranean diet. Principal component analysis generated four dietary patterns. The relationship between asthma and each food type, MDS, and dietary patterns was assessed using multivariate adjusted logistic regression. Adherence to the Mediterranean diet by Salamanca's children and prevalence of asthma in Salamanca were similar to the findings of coastal located centers of other studies. High punctuation in MDS was associated with high prevalence of asthma. Higher scores for the pattern "Fats and sugar" was associated with less current asthma but not with DCA or CSA. These findings might be due to improvement in the diet of asthma children, reverse causation factor, how the questionnaire collected information about diet, and perhaps the manner in which the scores were constructed. The complexity of interconnections between nutrients, foods, and dietary patterns, and the heterogeneous nature of asthma, makes it difficult to identify single factor that affected its development. Our findings require corroboration by additional studies.

Childhood wheezing phenotypes and their association to perinatal factors: a longitudinal study.

INTRODUCTION: Multiple gestational and early life factors have been described as the variables that increase the risk for each phenotype of infantile wheezing. Our objective was to study the evolution of wheezing in a cohort of children followed up to 9-10 years of age and its relationship with different perinatal risk factors. METHODS: A longitudinal study was made on the evolution of wheezing, over time, in 1164 children from Salamanca (Spain) included in the International Study of Wheezing in Infants, when the children were 12 months old. They were classified into three phenotypes: transient early wheezing (last episode before 3 years of age), early persistent wheezing (start before 3 years age and persisting thereafter), and late-onset wheezing (first episode after 3 years of age). Univariate and multivariable analyses were performed to establish associations between the different phenotypes and perinatal factors. RESULTS: Data were obtained corresponding to a total of 531 children. Of these, 169 (31.8%) had experienced transient early wheezing, 100 (18.8%) early persistent wheezing, 28 (5.3%) late-onset wheezing, and 234 (44.1%) had never experienced wheezing. Cesarean delivery, early exposure to infections, the presence of atopic eczema, and a smoking father were associated with transient early wheezing. Early persistent wheezing was associated with a family history of allergy, smoking, and obstetric diseases. Exclusive breastfeeding was identified as a protective factor in both transient and persistent early wheezing. Late-onset wheezing was associated with the male gender and with maternal history of rhinitis and eczema. CONCLUSIONS: Wheezing phenotypes were associated with different risk perinatal factors. Knowledge in the field is essential in order to influence the modifiable factors.