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Diet and Nutrients in Asthma and Allergic Disorders

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Immunology".

Deadline for manuscript submissions: closed (5 February 2023) | Viewed by 35700

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Dr. Kostas N. Priftis

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Guest Editor

Paediatric Respiratory and Allergy Department, Paediatric Center of Athens, National and Kapodistrian University of Athens, Athens, Greece
Interests: asthma; allergic diseases; asthma management; lung diseases; spirometry; airway obstruction; pulmonary medicine
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Dr. Konstantinos Douros

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Pediatric Allergy and Respiratory Unit, 3rd Department of Pediatrics, "Attikon" University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
Interests: pediatrics; pediatric allergy; pediatric pulmonology; biostatistics

Special Issue Information

Dear Colleagues,

The prevalence of asthma and allergic disorders has been increasing dramatically during the last few decades, especially among Western and Westernized societies. One of the many proposed explanations for this trend is the change in dietary habits. Diet and nutrients seem to have a key role in the modulation of the immune system and are considered a modifiable risk factor for asthma and allergic disorders.

The numerous nutrients and secondary metabolites of diet can influence various metabolic and immune responses and have a great impact on physiology and immune system homeostasis. A pivotal player in these complex processes is the gut microbiome, as its microbes are responsible for the production of various metabolites that have a key impact on the immune system modulation and activity. Understanding the immunological role of diet and nutrients is crucial in establishing healthy dietary habits to prevent the development of asthma and allergic disorders and may even guide the generation of new therapeutics that target critical molecular pathways.

Our ambition in this Special Issue is to provide new insights towards the understanding of the associations of diet and nutrients with asthma and allergic disorders and we encourage authors to submit their research or reviews that will help to better elucidate this complex issue.

Dr. Kostas N. Priftis
Dr. Konstantinos Douros
Guest Editors

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Keywords

asthma
wheezing
food allergy
prevention
prebirth period
Mediterranean diet
antioxidants
fermentation
macronutrients
micronutrients
tannins
vitamin D
immunomodulation
microbiota

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Published Papers (10 papers)

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Research

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10 pages, 284 KiB

Open AccessArticle

Adherence to an Anti-Inflammatory Diet and Atopic Diseases’ Prevalence in Adolescence: The Greek Global Asthma Network Study

by Dafni Moriki, George Antonogeorgos, Despoina Koumpagioti, Despoina Chaloutsi, Philippa Ellwood, Luis García-Marcos, Kostas N. Priftis, Konstantinos Douros and Demosthenes Panagiotakos

Nutrients 2023, 15(14), 3191; https://doi.org/10.3390/nu15143191 - 19 Jul 2023

Viewed by 2017

Abstract

Objective: Atopic diseases are among the most common morbidities in children and adolescents. The association between adherence to an anti-inflammatory dietary pattern and the prevalence of atopic diseases among adolescents was examined. Methods: A total of 1934 adolescents (boys: 47.5%, mean age (standard deviation): 12.7 (0.6) years) were voluntarily enrolled. Participants completed a validated questionnaire on atopic disease status as well as one assessing dietary habits and other sociodemographic and lifestyle characteristics. A special Diet Anti-inflammatory Index (DAI) score was calculated for the evaluation of adherence to an anti-inflammatory dietary pattern. Results: A total of 6.9% of the participants reported current asthma symptoms, while 25.3% reported rhinitis symptoms and 8.9% reported eczema. Adolescents with high adherence to an anti-inflammatory diet were 58% less likely to have asthma symptoms compared with those with low adherence when adjusted for multiple confounders (p < 0.01). No significant associations were observed between the level of adherence to an anti-inflammatory diet and the prevalence of allergic rhinitis and eczema. Conclusion: An anti-inflammatory diet seems to be independently associated with a lower prevalence of asthma in adolescents. Thus, pediatricians and other healthcare providers should promote anti-inflammatory dietary patterns as a preventive measure for atopic diseases from early stages of life. Full article

(This article belongs to the Special Issue Diet and Nutrients in Asthma and Allergic Disorders)

14 pages, 803 KiB

Open AccessArticle

Food Allergens in Ultra-Processed Foods According to the NOVA Classification System: A Greek Branded Food Level Analysis

by Alexandra Katidi, Stefania Xanthopoulou, Antonis Vlassopoulos, Stamoulis Noutsos, Kostas Priftis and Maria Kapsokefalou

Nutrients 2023, 15(12), 2767; https://doi.org/10.3390/nu15122767 - 16 Jun 2023

Cited by 4 | Viewed by 2018

Abstract

Ultra-processed foods’ (UPFs’) consumption has been positively linked to the presence of allergic symptoms, but it is yet unknown whether this is linked to their nutritional composition or allergen load. This study used the ingredient lists available in the Greek Branded Food Composition Database, HelTH, to classify foods (n = 4587) into four grades of food processing (NOVA1–4) according to the NOVA System. Associations between NOVA grades and the presence of allergens (as an ingredient or trace) were studied. Overall, UPFs (NOVA4) were more likely to contain allergens than unprocessed foods, NOVA1 (76.1% vs. 58.0%). However, nested analyses among similar foods showed that in >90% of cases, processing degree was not linked to allergens’ presence. Recipe/matrix complexity was more strongly linked to allergens’ presence with NOVA4 foods declaring 1.3 allergenic ingredients vs. 0.4 allergenic ingredients in NOVA1 foods (p < 0.01). Exposure to trace allergens was more common for NOVA4 than NOVA1 foods (45.4% vs. 28.7%), but the extent of contamination was similar (2.3 vs. 2.8 trace allergens). Overall, UPFs are more complex mixtures with higher numbers of allergens per food and are more prone to cross-contamination. However, indicating a food’s degree of processing is not sufficient to help identify allergen-free choices within the same subcategory. Full article

(This article belongs to the Special Issue Diet and Nutrients in Asthma and Allergic Disorders)

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14 pages, 688 KiB

Open AccessArticle

The Expansion of the Hellenic Food Thesaurus; Allergens Labelling and Allergens-Free Claims on Greek Branded Food Products

by Alexandra Katidi, Antonis Vlassopoulos, Stefania Xanthopoulou, Barbara Boutopoulou, Dafni Moriki, Olympia Sardeli, José Ángel Rufián-Henares, Konstantinos Douros and Maria Kapsokefalou

Nutrients 2022, 14(16), 3421; https://doi.org/10.3390/nu14163421 - 19 Aug 2022

Cited by 3 | Viewed by 2473

Abstract

Branded food composition databases (BFCDs) are valuable information tools that meet multiple user needs. Recently, recognising allergies and intolerances as an emerging concern for various stakeholders, BFCDs evolve to embed information on allergens. This study aims to expand the Greek BFCD, HelTH, to include allergen information for its 4002 products. A new file was added to the structure of HelTH, and data were curated to record label information. In 68.4% of products, at least one allergen was present in the ingredient list and in 38.9% at least one allergen in a precautionary statement. Milk (38.8%), gluten (32.7%), and soybeans (17.4%) were most commonly declared in the ingredient list; nuts (18.3%), eggs (13.1%), and milk (12.2%) were most commonly declared in precautionary statements. Allergen-free claims were present in 5.3% of the products and referred mostly on gluten and milk. In general, no statistically significant differences were identified between the nutritional composition of allergen-free claimed products and their equivalents. This study delivers an expanded BFCD that provides organised and detailed allergen information; new insights on the presence of food allergens in branded foods and issues of concern regarding allergen declaration that need to be addressed in order to improve label information. Full article

(This article belongs to the Special Issue Diet and Nutrients in Asthma and Allergic Disorders)

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15 pages, 3363 KiB

Open AccessArticle

Maternal High-Fat Diet Aggravates Allergic Asthma in Offspring via Modulating CD4⁺ T-Cell Differentiation

by Hui Lin, Yiran Zhao, Yajie Zhu, Cheng Li, Wei Xu, Xi Chen, Hefeng Huang and Li Jin

Nutrients 2022, 14(12), 2508; https://doi.org/10.3390/nu14122508 - 16 Jun 2022

Cited by 4 | Viewed by 3460

Abstract

Maternal improper nutrition has been reported to trigger respiratory disorders in offspring. Here, we characterized the effects of high-fat environment in the fetal period on mice and human cord blood CD4⁺ T-lymphocytes, and investigated their roles in susceptibility to asthma. Mice born to mothers that consumed a high-fat diet (HFD) throughout the gestation period were sensitized by ovalbumin to establish an experimental asthma model. To further extrapolate to humans, we collected cord blood from neonates of hypercholesterolemic (HC) mothers (n = 18) and control mothers (n = 20). In mice, aggravated airway hyperresponsiveness and inflammation revealed that maternal high-fat diet could lead to exacerbated allergic asthma in adult offspring. It was partially due to augmented activation and proliferation of CD4⁺ T-cells, where upregulated klf2 mRNA levels may be potentially involved. Notably, naïve HFD CD4⁺ T-cells had enhanced T_H2-based immune response both in vivo and in vitro, resulting from DNA hypomethylation of the Il-4 promoter region. Moreover, in human, T_H2 cytokines transcripts were enhanced in CD4⁺ T-cells of the HC group, which was associated with an increased risk of developing allergic diseases at 3 years old. Together, our study indicated that early life improper nutrition-triggered epigenetic changes in T-cells may contribute to long-lasting alterations in allergic diseases. Full article

(This article belongs to the Special Issue Diet and Nutrients in Asthma and Allergic Disorders)

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19 pages, 3045 KiB

Open AccessArticle

Differential Effects of Obesity, Hyperlipidaemia, Dietary Intake and Physical Inactivity on Type I versus Type IV Allergies

by Nathalie Rohmann, Liasita Munthe, Kristina Schlicht, Corinna Geisler, Tobias J. Demetrowitsch, Corinna Bang, Julia Jensen-Kroll, Kathrin Türk, Petra Bacher, Andre Franke, Karin Schwarz, Dominik M. Schulte and Matthias Laudes

Nutrients 2022, 14(11), 2351; https://doi.org/10.3390/nu14112351 - 5 Jun 2022

Cited by 3 | Viewed by 3361

Abstract

Background: Alongside metabolic diseases (esp. obesity), allergic disorders are becoming increasingly prevalent. Since both obesity and allergies are highly impacted by environmental determinants, with this study we assessed the potential link between metabolic implications and two distinct types of allergies. Methods: Using cross-sectional data from the German FoCus cohort, n = 385 allergy cases, either hay fever (=type I allergy, n = 183) or contact allergy (=type IV allergy, n = 202) were compared to age- and sex-matched healthy control subjects (1:1 ratio, in total n = 770) regarding their metabolic phenotype, diet, physical activity, sleep, gut microbial composition, and serum metabolite profile using suitable BMI-adjusted models. Results: Obesity and metabolic alterations were found significantly more prevalent in subjects with allergies. In fact, this relation was more pronounced in contact allergy than hay fever. Subsequent BMI-adjusted analysis reveals particular importance of co-occurring hyperlipidaemia for both allergy types. For contact allergy, we revealed a strong association to the dietary intake of poly-unsaturated fatty acids, particularly α-linolenic acid, as well as the enrichment of the corresponding metabolic pathway. For hay fever, there were no major associations to the diet but to a lower physical activity level, shorter duration of sleep, and an altered gut microbial composition. Finally, genetic predisposition for hyperlipidaemia was associated to both contact allergy and hay fever. Conclusions: Reflected by higher allergy prevalence, our findings indicate an impaired immune response in obesity and hyperlipidaemia, which is differentially regulated in type I and type IV allergies by an unfavourable lifestyle constellation and subsequent microbial and metabolic dysfunctions. Full article

(This article belongs to the Special Issue Diet and Nutrients in Asthma and Allergic Disorders)

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16 pages, 2512 KiB

Open AccessFeature PaperArticle

Influence of Consumption of Two Peruvian Cocoa Populations on Mucosal and Systemic Immune Response in an Allergic Asthma Rat Model

by Marta Périz, Maria J. Rodríguez-Lagunas, Francisco J. Pérez-Cano, Ivan Best, Santiago Pastor-Soplin, Margarida Castell and Malén Massot-Cladera

Nutrients 2022, 14(3), 410; https://doi.org/10.3390/nu14030410 - 18 Jan 2022

Cited by 3 | Viewed by 2665

Abstract

Different cocoa populations have demonstrated a protective role in a rat model of allergic asthma by attenuating the immunoglobulin (Ig) E synthesis and partially protecting against anaphylactic response. The aim of this study was to ascertain the effect of diets containing two native Peruvian cocoa populations (“Amazonas Peru” or APC, and “Criollo de Montaña” or CMC) and an ordinary cocoa (OC) on the bronchial compartment and the systemic and mucosal immune system in the same rat model of allergic asthma. Among other variables, cells and IgA content in the bronchoalveolar lavage fluid (BALF) and serum anti-allergen antibody response were analyzed. The three cocoa populations prevented the increase of the serum specific IgG1 (T helper 2 isotype). The three cocoa diets decreased asthma-induced granulocyte increase in the BALF, which was mainly due to the reduction in the proportion of eosinophils. Moreover, both the OC and CMC diets were able to prevent the leukocyte infiltration caused by asthma induction in both the trachea and nasal cavity and decreased the IgA in both fecal and BALF samples. Overall, these results highlight the potential of different cocoa populations in the prevention of allergic asthma. Full article

(This article belongs to the Special Issue Diet and Nutrients in Asthma and Allergic Disorders)

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25 pages, 2459 KiB

Open AccessEditor’s ChoiceReview

Microbiome and Asthma: Microbial Dysbiosis and the Origins, Phenotypes, Persistence, and Severity of Asthma

by José Valverde-Molina and Luis García-Marcos

Nutrients 2023, 15(3), 486; https://doi.org/10.3390/nu15030486 - 17 Jan 2023

Cited by 32 | Viewed by 6707

Abstract

The importance of the microbiome, and of the gut-lung axis in the origin and persistence of asthma, is an ongoing field of investigation. The process of microbial colonisation in the first three years of life is fundamental for health, with the first hundred days of life being critical. Different factors are associated with early microbial dysbiosis, such as caesarean delivery, artificial lactation and antibiotic therapy, among others. Longitudinal cohort studies on gut and airway microbiome in children have found an association between microbial dysbiosis and asthma at later ages of life. A low α-diversity and relative abundance of certain commensal gut bacterial genera in the first year of life are associated with the development of asthma. Gut microbial dysbiosis, with a lower abundance of Phylum Firmicutes, could be related with increased risk of asthma. Upper airway microbial dysbiosis, especially early colonisation by Moraxella spp., is associated with recurrent viral infections and the development of asthma. Moreover, the bacteria in the respiratory system produce metabolites that may modify the inception of asthma and is progression. The role of the lung microbiome in asthma development has yet to be fully elucidated. Nevertheless, the most consistent finding in studies on lung microbiome is the increased bacterial load and the predominance of proteobacteria, especially Haemophilus spp. and Moraxella catarrhalis. In this review we shall update the knowledge on the association between microbial dysbiosis and the origins of asthma, as well as its persistence, phenotypes, and severity. Full article

(This article belongs to the Special Issue Diet and Nutrients in Asthma and Allergic Disorders)

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17 pages, 972 KiB

Open AccessReview

The Role of the Gut Microbiome in Cow’s Milk Allergy: A Clinical Approach

by Dafni Moriki, Maria Pilar Francino, Despoina Koumpagioti, Barbara Boutopoulou, José Ángel Rufián-Henares, Kostas N. Priftis and Konstantinos Douros

Nutrients 2022, 14(21), 4537; https://doi.org/10.3390/nu14214537 - 28 Oct 2022

Cited by 6 | Viewed by 4444

Abstract

Cow’s milk allergy (CMA) is the most prevalent food allergy (FA) in infancy and early childhood and can be present with various clinical phenotypes. The significant increase in FA rates recorded in recent decades has been associated with environmental and lifestyle changes that limit microbial exposure in early life and induce changes in gut microbiome composition. Gut microbiome is a diverse community of microbes that colonize the gastrointestinal tract (GIT) and perform beneficial functions for the host. This complex ecosystem interacts with the immune system and has a pivotal role in the development of oral tolerance to food antigens. Emerging evidence indicates that alterations of the gut microbiome (dysbiosis) in early life cause immune dysregulation and render the host susceptible to immune-mediated diseases later in life. Therefore, the colonization of the gut by “healthy” microbes that occurs in the first years of life determines the lifelong health of the host. Here, we present current data on the possible role of the gut microbiome in the development of CMA. Furthermore, we discuss how gut microbiome modification might be a potential strategy for CMA prevention and treatment. Full article

(This article belongs to the Special Issue Diet and Nutrients in Asthma and Allergic Disorders)

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16 pages, 4914 KiB

Open AccessReview

Nutrition, Gut Microbiota, and Allergy Development in Infants

by Alejandra Rey-Mariño and M. Pilar Francino

Nutrients 2022, 14(20), 4316; https://doi.org/10.3390/nu14204316 - 15 Oct 2022

Cited by 10 | Viewed by 3651

Abstract

The process of gut microbiota development in infants is currently being challenged by numerous factors associated with the contemporary lifestyle, including diet. A thorough understanding of all aspects of microbiota development will be necessary for engineering strategies that can modulate it in a beneficial direction. The long-term consequences for human development and health of alterations in the succession pattern that forms the gut microbiota are just beginning to be explored and require much further investigation. Nevertheless, it is clear that gut microbiota development in infancy bears strong associations with the risk for allergic disease. A useful understanding of microbial succession in the gut of infants needs to reveal not only changes in taxonomic composition but also the development of functional capacities through time and how these are related to diet and various environmental factors. Metagenomic and metatranscriptomic studies have started to produce insights into the trends of functional repertoire and gene expression change within the first year after birth. This understanding is critical as during this period the most substantial development of the gut microbiota takes place and the relations between gut microbes and host immunity are established. However, further research needs to focus on the impact of diet on these changes and on how diet can be used to counteract the challenges posed by modern lifestyles to microbiota development and reduce the risk of allergic disease. Full article

(This article belongs to the Special Issue Diet and Nutrients in Asthma and Allergic Disorders)

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11 pages, 592 KiB

Open AccessEditor’s ChoiceReview

Does Adherence to the Mediterranean Diet Have a Protective Effect against Asthma and Allergies in Children? A Systematic Review

by Despoina Koumpagioti, Barbara Boutopoulou, Dafni Moriki, Kostas N. Priftis and Konstantinos Douros

Nutrients 2022, 14(8), 1618; https://doi.org/10.3390/nu14081618 - 13 Apr 2022

Cited by 30 | Viewed by 3199

Abstract

Dietary pattern may potentially impact on the pathogenesis of asthma and allergies. The Mediterranean Diet (MD) has significant health benefits due to its antioxidant and anti-inflammatory properties. The aim of this systematic review was to investigate the effectiveness of adherence to the MD against asthma and allergies in childhood. Hence, a systematic literature search was conducted on PubMed, ESBCO (Cinahl), Scopus, and the Cochrane Library databases up to 26 January 2022. The total number of articles obtained, after the initial search on the databases was conducted, was 301. Twelve studies were included, after the removal of duplicates and screening for eligibility. Our findings indicated a protective role of the MD against childhood asthma, but they also imply that the MD probably does not affect the development of allergies. Nevertheless, the heterogeneity and limitations of the studies highlight the need for randomized controlled trials that will focus on the pediatric population and hopefully provide more robust evidence. Full article

(This article belongs to the Special Issue Diet and Nutrients in Asthma and Allergic Disorders)

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