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Review paper

Importance of diet in children and adolescents with obesity and asthma

Monika Soczewka
1, 2
,
Andrzej Kędzia
1
,
Bogda Skowrońska
1
,
Elżbieta Niechciał
1

  1. Department of Paediatric Diabetes, Auxology, and Obesity, Poznan University of Medical Sciences, Poznan, Poland
  2. Doctoral School, Poznan University of Medical Sciences, Poznan, Poland
Pediatr Endocrinol Diabetes Metab 2024; 30 (2): 91-96
Online publish date: 2024/07/07
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Introduction

Obesity and asthma are 2 extremely prevalent diseases in children and adolescents around the world, which are linked. The prevalence of obesity-related diseases in children is increasing in most developed and developing countries. Hence, childhood obesity has become a global pandemic and a major public health crisis [1]. According to the World Health Organisation (WHO), in 2020, an estimated 39 million children under the age of 5 years were overweight or obese, and over 340 million individuals aged 5–19 years were overweight or obese in 2016 [2, 3]. The COVID-19 pandemic and its related lockdown measures indisputably played a major negative role in the global fight against childhood obesity. During this period most children and adolescents experienced high levels of stress and had difficulties maintaining healthy habits, which together contributed to sedentary lifestyles and unhealthily eating. In the United States, for example, the prevalence of unhealthy behaviours in children aged 5–11 years rose from 19% to 26% [4].

In parallel, since the 1980s, the incidence of asthma has also been steadily increasing in proportion to the spread of Western dietary patterns. Nowadays, asthma is one of the most common chronic diseases seen among children and adolescents. The recent Global Asthma Study (GAN) phase reported that the global prevalence of asthma was 11% in children aged 6–7 years and 9.1% among children aged 13–14 years [5].

Obesity is linked to a greater asthma morbidity, and it increases the risk of severity of the disease course. The TENOR study showed that around 31% of children with severe asthma were obese [6]. The association between these 2 disorders has not yet been fully elucidated; however, several putative factors have been proposed, including airway smooth muscle dysfunction from thoracic restriction, obesity-related inflammation affecting the lung, or steroid resistance induced by excessive body weight. Moreover, the importance of dietary characteristics is taken into account in the pathogenesis of both conditions [7].

The dietary strategy in children is not only limited to reducing energy intake, but also is based on healthy food choices. This method achieves long-term weight reduction. It promotes both metabolic and mental health [8]. In patients with asthma and obesity disease, specific dietary components such as fat, sugar, and low nutrient content may be a determinant of chronic inflammation [9].

Recommended diet models

The favourable effect of healthy eating habits was already noted by Hippocrates, the father of modern medicine with his famous quote: “Let food be thy medicine and medicine be thy food” [10]. Recently, researchers and clinicians put more emphasis on the influence of nutritional habits in diseases. Commonly, a diet dominated by processed high-fat dairy products is believed to have a negative impact on general health, while the low glycaemic index diet (LGI) and the Mediterranean diet (MD) are examples of anti-inflammatory diets, which help in reducing systematic inflammation in the body by reducing levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumour necrosis factor α (TNF-α) [11].

The beneficial effect of LGI on inflammation in adolescents with excessive body weight has been reported by Rouchani et al. In the intervention study, 50 obese and overweight adolescent females followed an LGI diet for 10 weeks. At the end of this period a significant decrease in inflammatory markers, particularly CRP and IL-6 levels, was observed in the study participants on the LGI diet [12]. Similarly, Iannuzzi et al. also confirmed the positive influence of an LGI diet on CRP levels in children with obesity [13]. Moreover, an LGI diet seems to have a favourable metabolic effect compared to a high glycaemic index (HGI) eating pattern. In the study investigating the effects of 2 different diets on anthropometric and biochemical parameters, participants were randomly selected either to follow a hypocaloric LGI or a hypocaloric HGI diet. After 6 months of study, reductions in body weight, blood pressure, and CRP were seen in both groups. However, a significant decrease in waist circumference and triglyceride levels was only noted in children on the LGI diet [14].

MD is recognised as a model of healthy eating due to its beneficial effects on health and better quality of life [15]. MD is characterised by daily consumption of carbohydrates, primarily whole grain products; moderate consumption of milk and milk products, mainly low-fat cheese and yogurt; moderate consumption of eggs and moderately high consumption of fish; moderate consumption of red meat; and high consumption of fruits, vegetables, legumes, nuts. Olive oil should be used as the primary source of fat. Consumption of unprocessed and fresh foods is recommended. Occasional sweets, soft drinks, and packaged foods may be included. The main source of hydration should be water [16].

MD based on plant-based products has been linked to reduced symptoms in children diagnosed with asthma [1720]. Romieu et al. demonstrated that following a Mediterranean diet in children with asthma had a positive effect on lung function, FEV1 (forced expiratory volume during the first second of expiration) and FVC (forced vital capacity) [21]. Calatayud-Sáez, on the other hand, observed a significant improvement in the severity of infections, asthma attacks, hospitalisations, and medication use after a year of following the MD [22].

Plant-derived proteins contain n-3 PUFA (polyunsaturated fatty acids), which are characterised by anti-inflammatory effects. Thus, they exert a positive effect on asthma control. In contrast, animal proteins, such as red meat, contain primarily n-6 PUFA with pro-inflammatory effects. Therefore, anti-inflammatory diets should take into account livestock farming practices, for example, organic meat and dairy have higher levels of anti-inflammatory PUFA-3. In addition, polycyclic aromatic hydrocarbons and heterocyclic amines develop in meat prepared at high temperatures, leading to pro-inflammatory products [23].

A diet based on vegetables, fruits, and whole grains and limiting high-fat meat and dairy products is associated with a reduced risk of asthma. Researchers studied Peruvian children and proved a reduced risk of asthma with increased consumption of vegetables, fruits, legumes, pasta, cereals, potatoes, and reduced consumption of meat [24].

Vegetable consumption is also associated with the incidence of asthma. Likura et al. claimed that the anti-inflammatory properties of flavonoids in vegetables disappear when heated, explaining the correlation between well-controlled asthma and raw vegetable consumption [25, 26]. The European Academy of Allergy and Clinical Immunology has highlighted that increasing the consumption of fruits and vegetables might be helpful in reduction of asthma risk in children [27, 28]. In particular, apples and oranges have the most significant effect of reduction of asthma occurrence. High intake was defined as consuming fruit once a day or half a cup or less of fruit or vegetables each day [26]. Seyedrezaazadeh et al. showed an association between increased expiratory volume in one second, reduced incidence of wheezing, and reduced risk of asthma with consumption of fruit and vegetables once a day [29]. Fruit and vegetables are considered to alleviate asthma symptoms. Their consumption is inversely related to the onset of wheezing symptoms in children, and long-term fruit consumption (2 to 8 years on average) is inversely correlated with asthma symptoms. Researchers also observed an inverse relationship between fruit consumption ≥ 3 times a week and asthma wheezing and severe asthma symptoms in children aged 6 to 7 years old [26]. Similar conclusions were also drawn for young people [30]. In addition, several studies show a concomitant reduction in pro-inflammatory cytokine levels and an increase in anti-inflammatory markers associated with fruit and vegetable consumption. It was inversely proportional to the number of neutrophils in the airways of asthma patients [31, 32].

Woods et al. investigated the role of dairy in asthma control. In this study, a positive correlation between low-fat cheese and ricotta cheese consumption and bronchial hyperresponsiveness was noted [33]. Hass et al. tested whether milk consumption affects lung function in asthmatic patients. They found that there is a deterioration in the diffusing capacity of carbon monoxide into the lungs after consuming whole milk [34]. Yusoff et al. conducted an 8-week study in 22 asthmatic children. The participants did not consume milk or eggs during the study period. At the end of the intervention, an improvement in peak expiratory flow was observed [35]. Dairy products may be involved in the development or course of asthma as a result of reactions to milk proteins or milk lipids, but the exact mechanisms are still unknown [34]. The positive correlation between dairy product consumption and pro-inflammatory interleukin (IL)-17F levels (p < 0.05) indicates that the inflammatory process associated with IL-17F may have a significant impact in the development of asthma [36].

MD shows a preventive effect in the onset of symptoms and exacerbation of asthma, infections, hospital admissions, and medication use. In particular, fibre intake is associated with improved lung function [37]. Fibre intake affects the gut microbiome, producing metabolites that alter metabolic and immune responses. Lactobacillus and Bifidobacterium, as a result of dietary fibre fermentation, form short-chain fatty acids (butyrate, acetate, propionate), reducing the expression of inflammatory cytokines [38, 39]. Dietary fibre reduces blood glucose levels and increases levels of anti-inflammatory adiponectin [37]. It also increases the thickness of the intestinal barrier, preventing proteins from entering the bloodstream, triggering an immune response [40]. Due to the benefits of fibre consumption, 2 servings of fruit and 5 servings of vegetables should be included in the diet daily [41].

Table I shows sources of anti-inflammatory substances showing positive effects in asthma and obesity [37].

Table I

Beneficial effect of antioxidants from the diet

NutrientDietary sourceEffect on asthma and obesity diseaseReferences
Vitamin CLemon, orange, pepper, tomato, spinach, broccoli, radicchioAntioxidant and anti-inflammatory effects[42, 43]
Vitamin AMilk, eggs, orange-yellow fruits and vegetablesAntioxidant and anti-inflammatory effects[44, 45]
Vitamin EVegetable oils, seeds, nuts, green vegetablesAntioxidant and anti-inflammatory effects[46, 47]
FlavonoidsCabbage, salad, tomatoes, grapes, applesAntioxidant and anti-inflammatory effects[26]

Western diet – an inadvisable dietary model

The Western diet (WD) is based mainly on the consumption of animal products and the restriction of vegetables, oats, grains, and legumes. WD increases the possibility of asthma in children [42, 43]. An increased risk of wheezing and asthma appeared in school-aged children whose diets were low in fibre and high in saturated fatty acids [44]. Shi et al. conducted a study on the Qatari population and showed that consumption of energy-rich foods (desserts, fast food, soft drinks) was likely to be associated with asthma, as opposed to a diet rich in grains, lean meat, fish, and vegetables [45]. A high proportion of take-out products has also been linked to bronchial hyperresponsiveness; especially systematic consumption of hamburgers has been implicated in the emergence of asthma symptoms [46]. Another study, conducted in Australia on 202 patients with severe asthma, showed that their diets were predominantly high in fat and low in fibre, in contrast to their healthy counterparts [47]. Additionally, Oddy et al. proved that WD in adolescents results in elevated CRP levels [48]. Khayyatzadeh et al. reached similar conclusions by studying 670 Iranian adolescent girls [49]. In turn, Gonzalez-Gil et al. studied 16,228 subjects aged 2–10 years and proved that mayonnaise and sugar-containing drinks increase hs-CRP levels [50].

According to dietary guidelines, the daily intake of saturated fatty acids should be < 10% of total energy intake [26]. However, the American Heart Association recommends reducing saturated fatty acid intake to < 7% of total energy intake [51].

The HELENA study aimed to identify gender-specific dietary patterns (DP) and assess the association with overweight/obesity in adolescents in Europe. As a result, 3 DPs were identified in boys (snacks and bread, MD, and breakfast) and 4 DPs in girls (convenience, vegetable products and eggs, Western products, and breakfast). The association between DP and overweight/obesity highlights that adolescents with lower adherence to the breakfast DP had higher odds of being overweight/obesity. In European adolescents, the breakfast DP positively characterised by breakfast cereals, fruit, milk, and dairy and negatively characterised by sugar-sweetened beverages in boys and negatively characterised by cereals (pasta, rice, and others) in girls, was inversely associated with overweight/obesity [52].

Weight reduction

In obese and asthmatic patients, a diet high in sugar and fat and low in nutrients contributes to the development of chronic inflammation [53]. In a 10-week, randomised, controlled study of 28 obese children aged 8–17 years with asthma were enrolled and randomly assigned to a control group or a weight-reduction group using diet. Asthma Control Questionnaire scores, lung function, plasma, and systemic inflammation were assessed in both groups at baseline and after the intervention. At the end of the study period, dietary intervention resulted in significant weight loss, which improved static lung function and asthma control. However, systemic inflammation and airway inflammation were unchanged in both cohorts. This study highlighted the role of diet-induced weight loss and the significant improvement in clinical outcomes in children with obesity and asthma [54].

In both obesity and asthma, impaired levels of adiponectin, visfatin, leptin, and resistin are observed [55]. Magron et al. showed that children with obesity and asthma had the highest levels of IL-2, TNF-α, and leptin and the lowest levels of adiponectin, compared to the other study participants. In a group of 88 children, the researchers measured levels of IL-6, CRP, and TNF-α. Obesity and asthma were shown to amplify the body's pro-inflammatory state, as high leptin levels potentiated the Th1 response, while low adiponectin levels had an inhibitory effect on IL-10 secretion [56]. Castro-Rodríguez et al. showed a positive correlation of body mass index (BMI) with the prevalence of asthma in girls and boys. Girls between the ages of 6 and 11 years who were overweight or obese were 7 times more likely to develop asthma between the ages of 11 and 13 years [57]. Subsequently, weight reduction has a beneficial effect on improving lung function and asthma symptoms and reducing the need for medication [58].

Evaluation of dietary nutrients is one of the additional therapeutic options in children with obesity and asthma. Studies have shown that omega-3 fatty acids, fish, fresh vegetables, fruit, and low saturated fatty acids lead to a reduced risk of asthma and improved control of already established asthma [59]. In particular, the intake of omega-3 fatty acids is proven to be important by modulating anti-inflammatory mechanisms [60]. In addition, it has been proven that supplementation with omega-3 fatty acids before physical activity can neutralise asthma symptoms [61].

An essential element in the treatment of obesity is dietary modification, but to date no single standardised dietary strategy has been developed. Also, Poland is facing the scourge of overweight and obesity among paediatric populations. Therefore, on the basis of this evidence, Polish Societies recently provided nutritional recommendations for children and adolescents with obesity. The position of the Polish Paediatric Society, the Polish Paediatric Obesity Society, the Polish Society of Paediatric Endocrinology and Diabetology, the College of Family Physicians in Poland, and the Polish Society for the Study of Obesity recommend a stepwise approach to weight control, taking into account the age of the child, the severity of obesity, and the presence of concomitant diseases. A permanent change in the lifestyle of the entire family should be sought. It has been proven that breakfast avoidance, snacking between meals, irregular meals, insufficient intake of fruit and vegetables, and a sedentary lifestyle lead to obesity. In all children with obesity, a well-balanced low-energy diet should be implemented after consultation with a nutritionist. In addition, the effectiveness of a modified carbohydrate diet (based on low glycaemic index products), a low-carbohydrate diet, but also a diet with standard macronutrient ratios in optimal proportions, has been confirmed [62].

Table II presents current nutritional recommendations for children and adolescents with obesity in Poland [62].

Table II

Eating behaviour recommendations and other modifications lifestyles for Polish children and adolescents with obesity [62]

Recommendations for eating behaviour
  • 5 meals a day (3 main meals and 2 complementary meals), without snacking between meals

  • Each meal should contain protein, carbohydrates, and healthy fats

  • Eating at consistent times every 3–4 hours

  • Not skipping breakfast and meals during school hours

  • Fruits (2–3 servings per day), vegetables (≥3 servings per day, lots of green vegetables)

  • Dairy products, preferably unsweetened (≥2–3 servings per day)

  • Avoiding high-energy products with low nutritional content (e.g. sweetened or energy drinks, fast food, high-energy snacks [e.g. chips, sticks], additives [e.g. mayonnaise])

  • Encouraging people to drink water instead of sweetened beverages

  • Encouraging reading of food labels, choosing products without added sugars

  • Encouraging the family to eat together as often as possible

  • Limiting eating out, especially at fast-food restaurants

  • Adjusting portion sizes according to age

  • Avoiding watching TV or using a tablet or smartphone while eating

Physical activity recommendations
  • Daily ≥60 min of aerobic physical activity of moderate to vigorous intensity

  • Limit time spent in front of a screen outside of school to 1–2 h per day

  • Engaging children and parents/guardians in age-appropriate play and exercise and individual abilities of the child

Behavioural recommendations
  • Identifying disorders such as depression, eating disorders, body image problems, anxiety

Summary

Therapeutic strategies in children with obesity and asthma should include nutritional interventions. These are known to have a positive effect on the course of both disease entities. Weight reduction itself is also important, as is the dietary model used. The recommended dietary model is the Mediterranean diet, with a low glycaemic index based on, for example, plenty of vegetables and fruits. In contrast, a Western diet, rich in saturated fatty acids, contributes to increased inflammation. Obese children have a high risk of inflammation that can affect their future lives, which is why dietary care is so important and healthy food choices are so important.

Conflict of interest

not declared.

Funding

no external funding.

Ethics approval

not applicable.

References

1 

FNCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet 2017; 390: 2627–2642. 10.1016/S0140-6736(17)32129-3.

2 

NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet 2017; 390: 2627–2642. 10.1016/S0140-6736(17)32129-3.

3 

Obesity and overweight [Internet], [cited 2023 Jul 22]. Available at: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.

4 

Woolford SJ, Sidell M, Li X, et al. Changes in Body Mass Index Among Children and Adolescents During the COVID-19 Pandemic. JAMA 2021; 326: 1434–1436. 10.1001/jama.2021.15036.

5 

García-Marcos L, Asher MI, Pearce N, et al. The burden of asthma, hay fever and eczema in children in 25 countries: GAN Phase I study. Eur Respir J 2022; 60: 2102866. 10.1183/13993003.02866-2021.

6 

Schatz M, Hsu JW, Zeiger RS, et al. Phenotypes determined by cluster analysis in severe or difficult-to-treat asthma. J Allergy Clin Immunol 2014; 133: 1549–1556. 10.1016/j.jaci.2013.10.006.

7 

Škrgat S, Harlander M, Janić M. Obesity and Insulin Resistance in Asthma Pathogenesis and Clinical Outcomes. Biomedicines 2024; 12: 173. 10.3390/biomedicines12010173.

8 

Koliaki C, Spinos T, Spinou M, et al. Defining the Optimal Dietary Approach for Safe, Effective and Sustainable Weight Loss in Overweight and Obese Adults. Healthcare (Basel) 2018; 6: 73. 10.3390/healthcare6030073.

9 

Di Genova L, Penta L, Biscarini A, et al. Children with Obesity and Asthma: Which Are the Best Options for Their Management? Nutrients 2018; 10: 1634. 10.3390/nu10111634.

10 

Grammaticos PC, Diamantis A. Useful known and unknown views of the father of modern medicine, Hippocrates and his teacher Democritus. Hell J Nucl Med 2008; 11: 2–4.

11 

Barragán-Vázquez S, Ariza AC, Ramírez Silva I, et al. Pro-Inflammatory Diet Is Associated with Adiposity during Childhood and with Adipokines and Inflammatory Markers at 11 Years in Mexican Children. Nutrients 2020; 12: 3658. 10.3390/nu12123658.

12 

Rouhani MH, Kelishadi R, Hashemipour M, et al. The Impact of a Low Glycemic Index Diet on Inflammatory Markers and Serum Adiponectin Concentration in Adolescent Overweight and Obese Girls: A Randomized Clinical Trial. Horm Metab Res 2016; 48: 251–256. 10.1055/s-0042-100467.

13 

Iannuzzi A, Licenziati MR, Vacca M, et al. Comparison of two diets of varying glycemic index on carotid subclinical atherosclerosis in obese children. Heart Vessels 2009; 24: 419–424. 10.1007/s00380-008-1138-6.

14 

Parillo M, Licenziati MR, Vacca M, et al. Metabolic changes after a hypocaloric, low-glycemic-index diet in obese children. J Endocrinol Invest 2012; 35: 629–633. 10.3275/7909.

15 

Sofi F, Cesari F, Abbate R, et al. Adherence to Mediterranean diet and health status: meta-analysis. BMJ 2008; 337: a1344. 10.1136/bmj.a1344.

16 

Trichopoulou A, Costacou T, Bamia C, et al. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 2003; 348: 2599–2608. 10.1056/NEJMoa025039.

17 

Guglani L, Joseph CL. Asthma and diet: could food be thy medicine? Indian Pediatr 2015; 52: 21–22.

18 

Lv N, Xiao L, Ma J. Dietary pattern and asthma: a systematic review and meta-analysis. J Asthma Allergy 2014; 7: 105–121. 10.2147/JAA.S49960.

19 

Garcia-Marcos L, Castro-Rodriguez JA, Weinmayr G, et al. Influence of Mediterranean diet on asthma in children: a systematic review and meta-analysis. Pediatr Allergy Immunol 2013; 24: 330–338. 10.1111/pai.12071.

20 

McCormack MC, Appel L, White K, et al. Healthy eating better breathing: a dietary intervention study in asthma. Am J Respir Crit Care Med NY 2015; 191: A1744.

21 

Romieu I, Barraza-Villarreal A, Escamilla-Núñez C, et al. Dietary intake, lung function and airway inflammation in Mexico City school children exposed to air pollutants. Respir Res 2009; 10: 122. 10.1186/1465-9921-10-122.

22 

Calatayud-Sáez FM, Calatayud B, Calatayud A. Effects of the Mediterranean Diet on Morbidity from Inflammatory and Recurrent Diseases with Special Reference to Childhood Asthma. Nutrients 2022; 14: 936. 10.3390/nu14050936.

23 

Ricker MA, Haas WC. Anti-Inflammatory Diet in Clinical Practice: A Review. Nutr Clin Pract 2017; 32: 318–325. 10.1177/0884533617700353.

24 

Rice JL, Romero KM, Galvez Davila RM, et al. Association Between Adherence to the Mediterranean Diet and Asthma in Peruvian Children. Lung 2015; 193: 893–899. 10.1007/s00408-015-9792-9.

25 

Iikura M, Yi S, Ichimura Y, et al. Effect of lifestyle on asthma control in Japanese patients: importance of periodical exercise and raw vegetable diet. PLoS One 2013; 8: e68290. 10.1371/journal.pone.0068290.

26 

Alwarith J, Kahleova H, Crosby L, et al. The role of nutrition in asthma prevention and treatment. Nutr Rev 2020; 78: 928–938. 10.1093/nutrit/nuaa005.

27 

Garcia-Larsen V, Del Giacco SR, Moreira A, et al. Asthma and dietary intake: an overview of systematic reviews. Allergy 2016; 71: 433–442. 10.1111/all.12800.

28 

Thorsteinsdottir F, Maslova E, Jacobsen R, et al. Exposure to Vitamin D Fortification Policy in Prenatal Life and the Risk of Childhood Asthma: Results From the D-Tect Study. Nutrients 2019; 11: 924. 10.3390/nu11040924.

29 

Seyedrezazadeh E, Moghaddam MP, Ansarin K, et al. Fruit and vegetable intake and risk of wheezing and asthma: a systematic review and meta-analysis. Nutr Rev 2014; 72: 411–428. 10.1111/nure.12121.

30 

Ellwood P, Asher MI, García-Marcos L, 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: 351–360. 10.1136/thoraxjnl-2012-202285.

31 

Wood LG, Garg ML, Powell H, et al. Lycopene-rich treatments modify noneosinophilic airway inflammation in asthma: proof of concept. Free Radic Res 2008; 42: 94–102. 10.1080/10715760701767307.

32 

Baines KJ, Wood LG, Gibson PG. The nutrigenomics of asthma: molecular mechanisms of airway neutrophilia following dietary antioxidant withdrawal. OMICS 2009; 13: 355–365. 10.1089/omi.2009.0042.

33 

Woods RK, Walters EH, Raven JM, et al. Food and nutrient intakes and asthma risk in young adults. Am J Clin Nutr 2003; 78: 414–421. 10.1093/ajcn/78.3.414.

34 

Haas F, Bishop MC, Salazar-Schicchi J, et al. Effect of milk ingestion on pulmonary function in healthy and asthmatic subjects. J Asthma 1991; 28: 349–355. 10.3109/02770909109089462.

35 

Yusoff NA, Hampton SM, Dickerson JW, et al. The effects of exclusion of dietary egg and milk in the management of asthmatic children: a pilot study. J R Soc Promot Health 2004; 124: 74–80. 10.1177/146642400412400211.

36 

Han YY, Forno E, Brehm JM, et al. Diet, interleukin-17, and childhood asthma in Puerto Ricans. Ann Allergy Asthma Immunol 2015; 115: 288–293.e1. 10.1016/j.anai.2015.07.020.

37 

Calcaterra V, Verduci E, Ghezzi M, et al. Pediatric Obesity-Related Asthma: The Role of Nutrition and Nutrients in Prevention and Treatment. Nutrients 2021; 13: 3708. 10.3390/nu13113708.

38 

McAleer JP, Kolls JK. Contributions of the intestinal microbiome in lung immunity. Eur J Immunol 2018; 48: 39–49. 10.1002/eji.201646721.

39 

Wood LG. Diet, Obesity, and Asthma. Ann Am Thorac Soc 2017; 14 (Suppl. 5): S332–S338. 10.1513/AnnalsATS.201702-124AW.

40 

Farshchi MK, Azad FJ, Salari R, et al. A Viewpoint on the Leaky Gut Syndrome to Treat Allergic Asthma: A Novel Opinion. J Evid Based Complementary Altern Med 2017; 22: 378–380. 10.1177/2156587216682169.

41 

Wood LG, Garg ML, Smart JM, et al. Manipulating antioxidant intake in asthma: a randomized controlled trial. Am J Clin Nutr 2012; 96: 534–543. 10.3945/ajcn.111.032623.

42 

Patel S, Custovic A, Smith JA, et al. Cross-sectional association of dietary patterns with asthma and atopic sensitization in childhood–in a cohort study. Pediatr Allergy Immunol 2014; 25: 565–571. 10.1111/pai.12276.

43 

Venter C, Meyer RW, Nwaru BI, et al. EAACI position paper: Influence of dietary fatty acids on asthma, food allergy, and atopic dermatitis. Allergy 2019; 74: 1429–1444. 10.1111/all.13764.

44 

Sozańska B, Sikorska-Szaflik H. Diet Modifications in Primary Prevention of Asthma. Where Do We Stand? Nutrients 2021; 13: 173. 10.3390/nu13010173.

45 

Shi Z, El-Obeid T, Meftah Z, et al. Fast food and sweet intake pattern is directly associated with the prevalence of asthma in a Qatari population. Eur J Clin Nutr 2022; 76: 428–433. 10.1038/s41430-021-00959-6.

46 

Wickens K, Barry D, Friezema A, et al. Fast foods–are they a risk factor for asthma? Allergy 2005; 60: 1537–1541. 10.1111/j.1398-9995.2005.00945.x.

47 

Berthon BS, Macdonald-Wicks LK, Gibson PG, et al. Investigation of the association between dietary intake, disease severity and airway inflammation in asthma. Respirology 2013; 18: 447–454. 10.1111/resp.12015.

48 

Oddy WH, Allen KL, Trapp GSA, et al. Dietary patterns, body mass index and inflammation: Pathways to depression and mental health problems in adolescents. Brain Behav Immun 2018; 69: 428–439. 10.1016/j.bbi.2018.01.002.

49 

Khayyatzadeh SS, Bagherniya M, Fazeli M, et al. A Western dietary pattern is associated with elevated level of high sensitive C-reactive protein among adolescent girls. Eur J Clin Invest 2018; 48: 10.1111/eci.12897. 10.1111/eci.12897.

50 

González-Gil EM, Santabárbara J, Russo P, et al. Food intake and inflammation in European children: the IDEFICS study. Eur J Nutr 2016; 55: 2459–2468. 10.1007/s00394-015-1054-3.

51 

US Dept of Agriculture. Dietary guidelines for Americans 2020–2025. Independently Published 2023.

52 

Cacau LT, De Miguel-Etayo P, Santaliestra-Pasías AM, et al. Breakfast Dietary Pattern Is Inversely Associated with Overweight/Obesity in European Adolescents: The HELENA Study. Children (Basel) 2021; 8: 1044. 10.3390/children8111044.

53 

Polak-Szczybyło E. Low-Grade Inflammation and Role of Anti-Inflammatory Diet in Childhood Obesity. Int J Environ Res Public Health 2023; 20: 1682. 10.3390/ijerph20031682.

54 

Jensen ME, Gibson PG, Collins CE, et al. Diet-induced weight loss in obese children with asthma: a randomized controlled trial. Clin Exp Allergy 2013; 43: 775–784. 10.1111/cea.12115.

55 

Magrone T, Jirillo E. Childhood obesity: Immune response and nutritional approaches. Front Immunol [Internet] 2015; 6. Available at: 10.3389/fimmu.2015.00076.

56 

Magrone T, Simone M, Altamura M, et al. Characterization of the immune inflammatory profile in obese asthmatic children. Endocr Metab Immune Disord Drug Targets 2014; 14: 187–195. 10.2174/1871530314666140526095211.

57 

Castro-Rodríguez JA, Holberg CJ, Morgan WJ, et al. Increased incidence of asthma like symptoms in girls who become overweight or obese during the school years. Am J Respir Crit Care Med 2001; 163: 1344–1349. 10.1164/ajrccm.163.6.2006140.

58 

McLoughlin RF, Berthon BS, Wood LG. Weight loss in obese children with asthma–is it important? Paediatr Respir Rev 2021; 37: 10–14. 10.1016/j.prrv.2020.02.007.

59 

Nagel G, Weinmayr G, Kleiner A, et al.; ISAAC Phase Two Study Group. Effect of diet on asthma and allergic sensitisation in the International Study on Allergies and Asthma in Childhood (ISAAC) Phase Two. Thorax 2010; 65: 516–522. 10.1136/thx.2009.128256.

60 

Lang JE, Mougey EB, Allayee H, et al. Nutrigenetic response to omega-3 fatty acids in obese asthmatics (NOOA): rationale and methods. Contemp Clin Trials 2013; 34: 326–335. 10.1016/j.cct.2012.12.009.

61 

Mickleborough TD, Murray RL, Ionescu AA, et al. Fish oil supplementation reduces severity of exercise-induced bronchoconstriction in elite athletes. Am J Respir Crit Care Med 2003; 168: 1181–1189. 10.1164/rccm.200303-373OC.

62 

Mazur A, Zachurzok A, Baran J, et al. Otyłość dziecięca: stanowisko Polskiego Towarzystwa Pediatrycznego, Polskiego Towarzystwa Otyłości Dziecięcej, Polskiego Towarzystwa Endokrynologii i Diabetologii Dziecięcej, Kolegium Lekarzy Rodzinnych w Polsce oraz Polskiego Towarzystwa Badań nad Otyłością. Med Prakt Pediatr 2023; 1: 1–43.

 
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