Associations between Mediterranean diet and respiratory health or allergy at 8 years in French children from the PARIS cohort

Abstract

BackgroundThe Mediterranean diet (MD) has known health benefits but its impact on respiratory health and allergy during childhood is unclear. As part of the PARIS birth cohort follow-up, we aimed to investigate the adherence of children to the MD in association with respiratory and allergic morbidity at school age.MethodsDiet was assessed using food frequency questionnaire filled in by parents at 8 years. The adherence to the MD was evaluated using the KIDMED index (low: ≤3, moderate: 4-7, high: ≥8). Current asthma, hay fever and eczema were defined based on symptoms, doctor’s diagnosis and medications documented during the health check-up at 8 years. In addition, specific IgE levels were measured, and respiratory tests were performed. Associations of the KIDMED index with respiratory/allergic morbidity were studied using multivariable logistic/linear regression models adjusted for potential confounders, including physical activity.ResultsA total of 964 children were included, 36% with low adherence to the MD, 55% with moderate adherence, and 9% had high adherence. Socioeconomic characteristics and feeding/eating habits were identified as determinants of MD adherence. Compared to low MD adherence, a moderate and high MD adherence were associated to a decrease risk of being sensitized at 8 years (adjusted OR [aOR] = 0.71, 95% CI: 0.52-0.97 and aOR=0.50, 95% CI: 0.29-0.88, respectively). High MD adherence was also beneficial regarding FEV1 (adjusted β=+52mL, 95% CI: 5-99), FVC (adjusted β=+61mL, 95% CI: 5-116) and decreased risk of suffering from current asthma (aOR=0.18, 95% CI: 0.04-0.77). No significant association of MD adherence with current eczema, current hay fever, FEV1/FVC ratio and FeNO was found.ConclusionsThis study highlights the important role of diet on respiratory and allergic morbidity in children. Higher MD adherence at school age was associated with lower risk of asthma and sensitization and better lung function parameters.