Nutrition and allergic disease

Nutrition and allergic disease
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营养与过敏性疾病

DOI:
10.1111/j.1365-2222.2006.00114.x
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发表时间:
2006
期刊:
影响因子:
3.7
通讯作者:
P. Calder
P. Calder
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Sabine Tricon;S. Willers;H. Smit;P. Burney;G. Devereux;A. Frew;S. Halken;A. Høst;M. Nelson;S. Shaheen;J. Warner;P. Calder

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在过去几十年中,哮喘和过敏性疾病的患病率急剧增加,发病率最高的是儿童。大多数哮喘和相关的特应性疾病都起源于早期生命。因此,必须了解这种疾病的早期生命起源,以便确定预防和早期干预的目标。虽然特应性疾病有遗传决定因素,但这些疾病发病率的增加发生得太快,基因变化无法解释这种增加。这很可能是由于环境影响的变化作用于先前存在的遗传易感性。在过去的20-40年里,环境的变化之一可能是导致最近特应性疾病增加的原因之一是饮食。食物过敏往往是特应性反应的最早表现之一,而对食物的致敏是随后出现呼吸道过敏和哮喘的危险因素。然而,研究饮食限制对预防过敏的影响的研究一直令人失望。另一方面,目前的数据表明,应该鼓励高风险和低风险的特应性婴儿至少进行4-6个月的纯母乳喂养。在低出生体重儿中也观察到哮喘风险的增加,这表明营养不良可能有害地改变胎儿发育。流行病学和免疫学研究还表明,在胎儿和早期改变饮食或补充食物可以减少特应性疾病的发生。目前的饮食假设涉及抗氧化剂、类脂、电解质和益生菌。本报告的目的是:(1)评估分析营养素摄入量和营养状况的最佳方法;(2)审查现有的流行病学证据,证明膳食摄入量(营养素和食物)与过敏性疾病之间存在联系;(3)确定营养补充作为哮喘和过敏预防策略的机会窗口。
The prevalence of asthma and allergic diseases has increased dramatically over the past few decades with the highest incidence occurring in children. Most asthma and related atopic disorders have their origins in early life. Thus, it is imperative to understand the early life origins of the disease in order to identify targets for prevention and early intervention. Although atopic diseases have genetic determinants, the increased incidence of these diseases has occurred far too rapidly for genetic changes to explain the increase. This, most likely, results from changes in environmental influences acting on a pre-existent genetic susceptibility. One of the environmental changes over the last 20–40 years that could have contributed to the recent increase in atopic diseases is diet. Food allergy is often one of the earliest manifestations of atopy, and sensitization to food is a risk factor for the subsequent appearance of respiratory allergy and asthma. However, studies investigating the effects of dietary restrictions on the prevention of allergy have been disappointing. On the other hand, current data suggests that exclusive breastfeeding should be encouraged for at least 4–6 months in infants at both high and low risk of atopy. Increased risk of asthma has also been observed in low birth weight infants, suggesting that under-nutrition can detrimentally alter foetal development. Epidemiological and immunological studies also suggest that dietary modification or supplementation in the foetal and early life could reduce the development of atopic diseases. The current dietary hypotheses relate to antioxidants, lipids, electrolytes and probiotics. The aims of this report are: (i) to assess the best methods to analyse nutrient intake and nutrient status; (ii) to review the existing epidemiological evidence for an association between dietary intake (nutrients and food) and allergic diseases; and (iii) to define the windows of opportunity for nutritional supplementation to be used as a preventative strategy for asthma and allergy.
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