Abstract
Background: Allergic conditions have shown an increase in the past few decades. Hygiene, changes in lifestyle, diet and vitamin D have been blamed for this increase.
Objective: To determine the role of environment, diet and vitamin D in atopic diseases in a population of Colombian Afro-descendant children.
Methods: Cross-sectional, descriptive, observational study in 200 Afro-descendant children of rural and urban areas from northern Colombia. Lifestyle and diet were established by questionnaires, atopy was assessed with skin tests and total and specific IgE and vitamin D levels were determined by ELISA.
Results: Atopy was more prevalent in the urban population (24 % versus 7 %, p < 0.001). Blomia tropicalis was the most common allergen (80.6 %). The PCA indicated two dietary patterns. In the rural area children, the consumption of dairy products and fruit/vegetables was higher, and related with a protective effect on atopy (OR, 0.21 [p < 0.027] and OR, 0.11 [ p < 0.04]). A similar pattern was observed with total IgE and vitamin D levels (2450.73 versus 777.56 kU/mL [p < 0.01] and 59.32 ng/mL versus 31.14 ng/mL [p < 0.001], respectively).
Conclusion: Allergic conditions were less prevalent in rural area residents, possibly owing to higher consumption of unpasteurized dairy products and fruit/vegetables, as well as higher levels of vitamin D.
References
Pawankar R, Holgate ST, Lockey RF, Canonica GW, Blaiss, editores. World Allergy Organization (WAO) White Book on Allergy: Update 2013. USA: World Allergy Organization; 2013.
Malone DC, Lawson K a, Smith DH, Arrighi HM, Battista C. A cost of illness study of allergic rhinitis in the United States. J Allergy Clin Immunol. 1997;99(1 Pt 1):22-27. DOI: http://dx.doi.org/10.1016/S0091-6749(97)70296-3
Strachan DP. Hay fever, hygiene, and household size. BMJ. 1989;299(6710):1259-1260. DOI: http://dx.doi.org/10.1136/bmj.299.6710.1259
Rice JL, Romero KM, Galvez-Davila RM, Meza CT, Bilderback A, Williams DL, et al. Association between adherence to the Mediterranean diet and asthma in Peruvian children. Lung. 2015;193(6):893-899. DOI: http://dx.doi.org/10.1007/s00408-015-9792-9
Julia V, Macia L, Dombrowicz D. The impact of diet on asthma and allergic diseases. Nat Rev Immunol. 2015;15(5):308-322. DOI: http://dx.doi.org/10.1038/nri3830
Smith PK, Masilamani M, Li X-M, Sampson HA. The False Alarm hypothesis: Food allergy is associated with high dietary advanced glycation end products and pro-glycating dietary sugars that mimic alarmins. J Allergy Clin Immunol. 2017;139(2):429-437. DOI: http://dx.doi.org/10.1016/j.jaci.2016.05.040
Keeley DJ, Neill P, Gallivan S. Comparison of the prevalence of reversible airways obstruction in rural and urban Zimbabwean children. Thorax. 1991;46(8):549-553. DOI: http://dx.doi.org/10.1136/thx.46.8.549
Ng’ang’a LW, Odhiambo JA, Mungai MW, Gicheha C, Nderitu P, Maingi B, et al. Prevalence of exercise induced bronchospasm in Kenyan school children: an urban-rural comparison. Thorax. 1998;53(11):919-926. DOI: http://dx.doi.org/10.1136/THX.53.11.919
Von-Mutius E, Vercelli D. Farm living: Effects on childhood asthma and allergy. Nat Rev Immunol. 2010;10(12):861-868. DOI: http://dx.doi.org/10.1038/nri2871
Gupta A, Bush A, Hawrylowicz C, Saglani S. Vitamin D and asthma in children. Paediatr Respir Rev. 2012;13(4):236-243;quiz 243. DOI: http://dx.doi.org/10.1016/j.prrv.2011.07.003
Meza-Torres C, Marrugo-Cano J. El papel de la vitamina D en la respuesta inmune y en las enfermedades alérgicas. Rev Ciencias Biomed. 2015;6(2):319-332. DOI: http://dx.doi.org/10.13140/RG.2.2.17141.37606
Clark A, Mach N. Role of vitamin D in the hygiene hypothesis: The interplay between vitamin D, vitamin D receptors, gut microbiota, and immune response. Front Immunol. 2016;7:627. DOI: http://dx.doi.org/10.3389/fimmu.2016.00627
Martínez B, Builes JJ, Gaviria A, Burgos G, Manrique A, Aguirre DP, et al. Population genetic data of 38 autosomal InDels in San Basilio de Palenque, the first free town in America. Forensic Sci Int Genet Suppl Ser. 2013;4(1):37-38. DOI: http://dx.doi.org/10.1016/j.fsigss.2013.10.037
Cassiani A, Mendoza C, Ardila R. Cocina palenquera para el mundo en lengua palenquera. Segunda edición. Colombia: Fundación para el Desarrollo Social; 2014.
IDEAM. Atlas climatológico de Colombia 1981-2010. Disponible en: http://www.ideam.gov.co/web/tiempo-y-clima/atlas#_48_INSTANCE_xoDpvO7rhD5O_%3Dhttp%253A%252F%252Fwww.ideam.gov.co%252FAtlasWeb%252Findex.html%253F
Cade JE, Burley VJ, Warm DL, Thompson RL, Margetts BM. Food-frequency questionnaires: a review of their design, validation and utilisation. Nutr Res Rev. 2002;17(1):5-22. DOI: http://dx.doi.org/10.1079/PHN2001318
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011;96(7):1911-1930. DOI: http://dx.doi.org/10.1210/jc.2011-0385
Adler A, Tager I, Quintero DR. Decreased prevalence of asthma among farm-reared children compared with those who are rural but not farm-reared. J Allergy Clin Immunol. 2005;115(1):67-73. DOI: http://dx.doi.org/10.1016/j.jaci.2004.10.008
Jimenes S, Martínez B, Hernández M, Munera A, Caraballo L. Análisis inmunogenético y antropológico de la población de San Basilio (Colombia). En: Martin-Municio A, Garcia-Barreno P, editores. Polimorfismo génico (HLA) en poblaciones hispanoamericanas. España: Real Academia de Ciencias Exactas, Fisicas y Naturales; 1996.
Del-Castillo-Mathieu N. El léxico negro-africano de San Basilio de Palenque. Thesaurus Bol Instit Caro Cuervo; 1984;39(1-3):79-169.
Hooper R, Calvert J, Thompson RL, Deetlefs ME, Burney P. Urban/rural differences in diet and atopy in South Africa. Allergy. 2008;63(4):425-431. DOI: http://dx.doi.org/10.1111/j.1398-9995.2008.01627.x
Ellwood P, Asher MI, García-Marcos L, Williams H, Keil U, Robertson C, et al. Do fast foods cause asthma, rhinoconjunctivitis and eczema? Global findings from the International Study of Asthma and Allergies in Childhood (ISAAC) phase three. Thorax. 2013;68(4):351-360. DOI: http://dx.doi.org/10.1136/thoraxjnl-2012-202285
Smith PK, Masilamani M, Li XM, Sampson HA. The false alarm hypothesis: Food allergy is associated with high dietary advanced glycation end-products and proglycating dietary sugars that mimic alarmins. J Allergy Clin Immunol. 2017;139(2):429-437. DOI: http://dx.doi.org/10.1016/j.jaci.2016.05.040
Torres-Borrego J, Moreno-Solís G, Molina-Terán AB. Diet for the prevention of asthma and allergies in early childhood: Much ado about something. Allergol Immunopathol (Madr). 2012;40(4):244-252. DOI: http://dx.doi.org/10.1016/j.aller.2011.12.006
Rosenlund H, Kull I, Pershagen G, Wolk A, Wickman M, Bergström A. Fruit and vegetable consumption in relation to allergy: disease-related modification of consumption. J Allergy Clin Immunol. 2011;127(5):1219-1225. DOI: http://dx.doi.org/10.1016/j.jaci.2010.11.019
Lucey JA. Raw Milk Consumption: Risks and benefits. Nutr Today. 2015;50(4):189-193. DOI: http://dx.doi.org/10.1097/NT.0000000000000108
Hyppönen E, Berry DJ, Wjst M, Power C. Serum 25-hydroxyvitamin D and IgE. A significant but nonlinear relationship. Allergy. 2009;64(4):613-620. DOI: http://dx.doi.org/10.1111/j.1398-9995.2008.01865.x
Valderrama-Vergara JF. Encuesta nacional de parasitismo intestinal en población escolar Colombia, 2012-2014, Fase II. Colombia: MINSALUD/Universidad de Antioquía; 2013.
Buendía E, Zakzuk J, Mercado D, Alvarez A, Caraballo L. The IgE response to Ascaris molecular components is associated with clinical indicators of asthma severity. World Allergy Organ J. 2015;8(1):8. DOI: http://dx.doi.org/10.1186/s40413-015-0058-z
Kaufman B, Luna A, Kaushik S, Pan S, Bagiella E, Coley M. Skin pigmentation and vitamin D status: A single-center, cross-sectional study. J Am Acad Dermatol. 2017;76(6):AB237. DOI: http://dx.doi.org/10.1016/j.jaad.2017.04.917

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2017 Revista Alergia México