Abstract
BackgroundPharyngeal bacteria are exposed to different sugar conditions depending on the diet of the child. We hypothesized that dietary factors such as daily intake of carbohydrates could be associated with pneumococcal carriage and the occurrence of otitis media in children.MethodsOur study design was a cross-sectional study among 1006 children attending child day care centers. Parents filled in a food frequency questionnaire. Oropharyngeal swabs were collected from each child. The primary outcome was the occurrence of pneumococcal carriage and the secondary outcome the number of acute otitis media episodes during life. Principal component analysis was used to group dietary intake into nine factors. The models were adjusted for age, gender of the child and educational level of the mother.ResultsThe dietary factor which included high consumption of sweet pastries and jam was associated with an increased risk of pneumococcal carriage (OR 1.17, 95% CI 1.01 to 1.36, P-value 0.04). The factor including frequent consumption of fruit and berries was associated with a decreased risk of acute otitis (regression coefficient −0.51, 95% CI −0.98 to −0.03, P = 0.04). A high intake of consumption of sweets and snacks (OR 1.36, 95% CI 1.03 to 1.80, P = 0.03) was associated with an increased risk of caries.ConclusionsDiet was associated with a risk of pneumococcal carriage and the occurrence of otitis media. Diet may thus be a modifiable risk factor for the occurrence of acute otitis media.
Highlights
A significant proportion of children carry Streptococcus pneumoniae asymptomatically [1]
Especially concerning increased consumption of sucrose, have been linked with dental caries [4], the consumption of berry juices has been associated with a decreased risk of urinary tract infections in children and women [5,6,7], and regular use of xylitol reduces the risk of otitis media in children [8]
Poor glycemic control has been associated with an increased risk of pneumococcal pneumonia among patients with diabetes, while among non-diabetic patients hyperglycemia at the time of a pneumococcal pneumonia episode is associated with increased severity and mortality [9]
Summary
A significant proportion of children carry Streptococcus pneumoniae asymptomatically [1]. Nasopharyngeal carriage of S. pneumoniae is more common among children with respiratory infection, but carriage does not automatically lead to infection, and difference in its occurrence between healthy and symptomatic children is small [1]. Especially concerning increased consumption of sucrose, have been linked with dental caries [4], the consumption of berry juices has been associated with a decreased risk of urinary tract infections in children and women [5,6,7], and regular use of xylitol reduces the risk of otitis media in children [8]. We hypothesized that dietary factors such as daily intake of carbohydrates could be associated with pneumococcal carriage and the occurrence of otitis media in children
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