Diet and asthma: looking back, moving forward.
Diet and asthma: looking back, moving forward.
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DOI：
10.1186/1465-9921-10-49
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发表时间：
2009-06-12
影响因子：
5.8
通讯作者：
Asher MI
中科院分区：
文献类型：
--
作者：
Kim JH;Ellwood PE;Asher MI
哮喘是一种日益严重的全球健康负担，特别是在西方世界。公共卫生干预措施，以减少其流行率或严重程度，饮食和营养已被确定为潜在的因素。随着饮食的快速变化成为西化的标志之一，营养可能在影响哮喘复杂的遗传学和发育病理生理学方面发挥关键作用。本综述调查卫生，抗氧化剂，脂质和其他营养素，食物类型和饮食模式，母乳喂养，益生菌和肠道菌群，维生素D，产妇饮食和遗传学的假设。早期的假说分析了人口水平的趋势，并侧重于主要的饮食因素，如抗氧化剂和脂质。最近，人们研究了超出个别营养素的更大的饮食模式，如肥胖、快餐和地中海饮食。尽管有一些有希望的假设和发现，但还没有确凿的证据表明特定的营养素，食物类型或饮食模式在儿童早期对哮喘患病率的作用。然而，饮食与胎儿和儿童的发育有关。当婴儿的免疫系统不成熟时，母乳喂养提供免疫保护，并对儿童早期喘息有适度的保护作用。此外，母亲的饮食可能是胎儿气道和免疫系统发育的重要因素。由于哮喘是一种基因-环境相互作用的复杂疾病，母亲的饮食可能在胎儿气道对环境损伤的异常反应中起表观遗传作用。最近的假说显示出生物学方法的前景，其中饮食因素对个体生理学和免疫学的影响在扩展到更大的人群研究之前进行了分析。因此，从流行病学家到遗传学家再到免疫学家，各种团体在研究这个谜时都需要合作。现在很明显，这种多学科的方法是需要向前迈进，了解饮食因素和哮喘的相互作用的复杂性。
Asthma is an increasing global health burden, especially in the western world. Public health interventions are sought to lessen its prevalence or severity, and diet and nutrition have been identified as potential factors. With rapid changes in diet being one of the hallmarks of westernization, nutrition may play a key role in affecting the complex genetics and developmental pathophysiology of asthma. The present review investigates hypotheses about hygiene, antioxidants, lipids and other nutrients, food types and dietary patterns, breastfeeding, probiotics and intestinal microbiota, vitamin D, maternal diet, and genetics. Early hypotheses analyzed population level trends and focused on major dietary factors such as antioxidants and lipids. More recently, larger dietary patterns beyond individual nutrients have been investigated such as obesity, fast foods, and the Mediterranean diet. Despite some promising hypotheses and findings, there has been no conclusive evidence about the role of specific nutrients, food types, or dietary patterns past early childhood on asthma prevalence. However, diet has been linked to the development of the fetus and child. Breastfeeding provides immunological protection when the infant's immune system is immature and a modest protective effect against wheeze in early childhood. Moreover, maternal diet may be a significant factor in the development of the fetal airway and immune system. As asthma is a complex disease of gene-environment interactions, maternal diet may play an epigenetic role in sensitizing fetal airways to respond abnormally to environmental insults. Recent hypotheses show promise in a biological approach in which the effects of dietary factors on individual physiology and immunology are analyzed before expansion into larger population studies. Thus, collaboration is required by various groups in studying this enigma from epidemiologists to geneticists to immunologists. It is now apparent that this multidisciplinary approach is required to move forward and understand the complexity of the interaction of dietary factors and asthma.
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