Gloria García-Hernández

Relationship of asthma and rhinoconjunctivitis with obesity, exercise and Mediterranean diet in Spanish schoolchildren

Background: Although several studies have investigated the influence of diet on asthma in schoolchildren, none of them has evaluated how obesity can modify this effect. A study was undertaken to evaluate the association of various foods and a Mediterranean diet with the prevalence of asthma and rhinoconjunctivitis, adjusting for obesity and exercise. Methods: A cross-sectional study was performed in 20 106 schoolchildren aged 6–7 years from eight Spanish cities. Using the ISAAC phase III questionnaire, parents reported chest and nose symptoms, food intake, weight, height and other factors, including exercise. A Mediterranean diet score was developed. A distinction was made between current occasional asthma (COA) and current severe asthma (CSA). Results: Independent of the amount of exercise, each Mediterranean score unit had a small but protective effect on CSA in girls (adjusted OR 0.90, 95% CI 0.82 to 0.98). Exercise was a protective factor for COA and rhinoconjunctivitis in girls and boys (the more exercise, the more protection). Obesity was a risk factor for CSA in girls (adjusted OR 2.35, 95% CI 1.51 to 3.64). Individually, a more frequent intake (1–2 times/week and ⩾3 times/week vs never/occasionally) of seafood (adjusted ORs 0.63 (95% CI 0.44 to 0.91) and 0.53 (95% CI 0.35 to 0.80)) and cereals (adjusted OR 0.56 (95% CI 0.30 to 1.02) and 0.39 (95% CI 0.23 to 0.68)) were protective factors for CSA, while fast food was a risk factor (adjusted ORs 1.64 (95% CI 1.28 to 2.10) and 2.26 (95% CI 1.09 to 4.68)). Seafood (adjusted ORs 0.74 (95% CI 0.60 to 0.92) and 0.67 (95% CI 0.53 to 0.85)) and fruit (adjusted ORs 0.76 (95% CI 0.60 to 0.97) and 0.71 (95% CI 0.57 to 0.88)) were protective factors for rhinoconjunctivitis. Conclusions: A Mediterranean diet has a potentially protective effect in girls aged 6–7 years with CSA. Obesity is a risk factor for this type of asthma only in girls.

Variaciones geográficas en la prevalencia de síntomas de asma en los niños y adolescentes españoles. International Study of Asthma and Allergies in Childhood (ISAAC) fase III España

Objetivo: Analizar las variaciones geograficas en la prevalencia de sintomas relacionados con el asma en ninos y adolescentes espanoles. Poblacion y metodos: Durante los anos 2001 y 2002, el International Study of Asthma and Allergies in Childhood (ISAAC) fase III estudio a 28.445 ninos de 6-7 anos de 10 areas (A Coruna, Asturias, Barcelona, Bilbao, Cartagena, Castellon, Madrid, Pamplona, San Sebastian y Valencia) y 31.257 adolescentes de 13-14 anos de 11 areas (las anteriores mas Valladolid) espanolas. Los sintomas de asma se recogieron en un cuestionario escrito completado por los padres de los ninos o por los propios adolescentes. Las variaciones geograficas de las prevalencias de los sintomas se analizaron con un modelo de regresion logistica y su correspondencia por edad mediante correlacion lineal. Resultados: La prevalencia de sibilancias recientes (ultimos 12 meses) vario entre el 7,1 y el 12,9% a los 6-7 anos, y entre el 7,1 y el 15,3% a los 13-14 anos. El riesgo mas elevado (odds ratio [OR] respecto al area de menor prevalencia) de presentar sibilancias recientes correspondio a los ninos de A Coruna (OR = 1,96; intervalo de confianza [IC] del 95%, 1,65-2,33) y Bilbao (OR = 1,83; IC del 95%, 1,54-2,18) y los adolescentes de A Coruna (OR = 2,38; IC del 95%, 2,04-2,79) y Asturias (OR = 2,37; IC del 95%, 2,03-2,77). Se comprobo una fuerte correlacion por edad en las prevalencias de sibilancias recientes de cada area geografica (r = 0,72). Conclusiones: En Espana existen, desde edades tempranas, variaciones geograficas notables en la prevalencia de sintomas de asma. Estos son mas frecuentes en los ninos y adolescentes que habitan en la fachada atlantica del pais.

[Geographic variation in the prevalence of asthma symptoms in Spanish children and adolescents. International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3, Spain].

OBJECTIVE To analyze geographic variations in the prevalence of symptoms related to asthma in Spanish children and adolescents. POPULATION AND METHODS In 2001 and 2002, the Spanish arm of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3 collected information on 28 445 children in the age bracket of 6-7 years in 10 metropolitan areas (A Coruña, Asturias, Barcelona, Bilbao, Cartagena, Castellón, Madrid, Pamplona, San Sebastián, and Valencia) and on 31 257 adolescents in the bracket 13-14 years in 11 areas (the previously named areas plus Valladolid). An asthma symptom questionnaire was filled in by parents or the adolescents themselves. Differences in symptoms between geographic areas were analyzed by fitting a logistic regression model. The relationship between symptoms and age was analyzed by linear correlation. RESULTS The prevalence of recent wheezing (last 12 months) ranged from 7.1% to 12.9% among 6-7-year-olds and from 7.1% to 15.3% among the 13-14-year-olds. The greatest risk of recent wheezing was observed for children in A Coruña (odds ratio [OR] =1.96 in comparison with the area of lowest prevalence; 95% confidence interval [CI], 1.65-2.33) and Bilbao (OR=1.83; 95% CI, 1.54-2.18) and for adolescents in A Coruña (OR=2.38; 95% CI, 2.04-2.79) and Asturias (OR=2.37; 95% CI, 2.03-2.77). A strong correlation (r=0.72) was observed between the prevalence of recent wheezing and age in each of the geographic areas. CONCLUSIONS Considerable geographic variation in the prevalence of asthma symptoms can be seen in Spain even among young children. Symptoms are more frequent in children and adolescents who live on the Spain s northern Atlantic coast.

Asthma phenotypes identified by latent class analysis in the ISAAC phase II Spain study

Classification of respiratory symptoms may help to identify different underlying asthma phenotypes reflecting differences in aetiology and prognosis of wheezing disease among children.

Asthma attributable to atopy: does it depend on the allergen supply?

The use of the population attributable fraction (PAF) of asthma owing to atopy has not been widely used in epidemiological studies on childhood asthma, especially to compare regions of the same country. The present study includes 1039 children from Cartagena, Spain (Mediterranean coast) and 663 from Madrid (centre of Spanish plateau) using the ISAAC phase II methodology (questionnaire and prick test to the most common allergens). While there were no differences in asthma symptoms between school children (aged 10–11 yr) from Madrid and Cartagena, atopy to any allergen was significantly higher in those from Madrid (40.9% vs. 29.3%, respectively, p < 0.0001). However, children from Madrid were mainly positive to pollen allergy whereas those from Cartagena were positive for mite allergy. PAF of all the different asthma symptoms owing to atopy (any positive skin test) and PAF of current wheezing owing to a more severe atopy (three positive wheals) were higher in children from Cartagena than those from Madrid (45.5% vs. 28.6% and 14.2% vs. 6.2%, respectively). Per cent of previous year wheezing attributable to atopy to specific allergens varied among those cities and was higher for D. pteronissinus, D. farinae, cat, and olive tree in children from Cartagena, and – conversely – higher for mixed grasses, mixed trees and Alternaria in those from Madrid. All of these differences remained significant even after adjusting for risk factors. PAF for asthma owing to atopy could be very different within the same country, probably depending on the allergen supply which may depend on environmental factors such as the climate.

Early exposure to paracetamol or to antibiotics and eczema at school age: Modification by asthma and rhinoconjunctivitis

Garcia‐Marcos L, González‐Díaz C, Garvajal‐Urueña I, Pac‐Sa MR, Busquets‐Monge RM, Suárez‐Varela MM, Batlles‐Garrido J, Blanco‐Quirós A, Varela ÁL.‐S., García‐Hernández G, Aguinaga‐Ontoso I. Early exposure to paracetamol or to antibiotics and eczema at school age: modification by asthma and rhinoconjunctivitis.
Pediatr Allergy Immunol 2010.
© 2010 John Wiley & Sons A/S

Risk factors for bronchiolitis, recurrent wheezing, and related hospitalization in preterm infants during the first year of life

Airway diseases are highly prevalent in infants and cause significant morbidity. We aimed to determine the incidence and risk factors for respiratory morbidity in a Spanish cohort of moderate‐to‐late preterm (MLP) infants prospectively followed during their first year of life.

Asthma and rhinoconjunctivitis comorbidity: United airway disease or inherited target organs?

Garcia‐Marcos L, Ruiz TR, Garcia‐Hernandez G, Suarez‐Varela MM, Valverde‐Molina J, Sanchez‐Solis M. Asthma and rhinoconjunctivitis comorbidity: United airway disease or inherited target organs?
Pediatr Allergy Immunol 2010: 21: e142–e148.
© 2009 The Authors
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