Allergy Asthma Immunol Res.  2013 Mar;5(2):81-87. 10.4168/aair.2013.5.2.81.

Association of Antioxidants With Allergic Rhinitis in Children From Seoul

• Seo JH
• Kwon SO
• Lee SY
• Kim HY
• Kwon JW
• Kim BJ
• Yu J
• Kim HB
• Kim WK
• Jang GC
• Song DJ
• Shim JY
• Oh SY
• Hong SJ

• KMID: 2260342
• DOI: http://doi.org/10.4168/aair.2013.5.2.81

Abstract

PURPOSE
The prevalence of allergic diseases has risen over the last few decades. Many factors, including environmental factors such as those related to diet, have been considered. Among dietary factors, intake of antioxidant-related nutrients has been associated with the risk of allergic disease. We investigated the association of antioxidant nutritional status with allergic rhinitis (AR) in Korean schoolchildren aged 6-12 years.
METHODS
Subjects were 4,554 children in Seoul, Korea. The risk of allergic disease was measured using the Korean version of the International Study of Asthma and Allergies in Childhood, and dietary intake was measured by a semi-quantitative food frequency questionnaire. Intake of vitamins A (including retinol and beta-carotene), C, and E was used in the analysis.
RESULTS
Vitamin C intake was negatively associated with an increased risk of current symptoms (adjusted odds ratio, 0.886; 95% confidence interval, 0.806-0.973). There was no association between AR and intake of vitamin A, retinol, beta-carotene, or vitamin E. Total serum IgE level and sensitization to allergen did not differ according to nutrient intake.
CONCLUSIONS
The group of children with increased vitamin C consumption had fewer AR symptoms, despite the lack of a difference in total serum IgE level or allergen sensitization. These findings suggest that nutrient intake, especially that of vitamin C, influences AR symptoms.

Keyword

Allergic rhinitis; antioxidant; vitamin C

MeSH Terms

Aged
Antioxidants
Ascorbic Acid
Asthma
beta Carotene
Child
Diet
Humans
Hypersensitivity
Immunoglobulin E
Korea
Nutritional Status
Odds Ratio
Prevalence
Rhinitis
Rhinitis, Allergic, Perennial
Vitamin A
Vitamin E
Vitamins
Surveys and Questionnaires
Antioxidants
Ascorbic Acid
Immunoglobulin E
Vitamin A
Vitamin E
Vitamins
beta Carotene

Reference

1. Schatz M. A survey of the burden of allergic rhinitis in the USA. Allergy. 2007. 62:Suppl 85. 9–16.

2. Sly RM. Changing prevalence of allergic rhinitis and asthma. Ann Allergy Asthma Immunol. 1999. 82:233–248. quiz 248-52.

3. Jee HM, Kim KW, Kim CS, Sohn MH, Shin DC, Kim KE. Prevalence of asthma, rhinitis and eczema in Korean children using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires. Pediatr Allergy Respir Dis. 2009. 19:165–172.

4. Patel S, Murray CS, Woodcock A, Simpson A, Custovic A. Dietary antioxidant intake, allergic sensitization and allergic diseases in young children. Allergy. 2009. 64:1766–1772.

5. Kompauer I, Heinrich J, Wolfram G, Linseisen J. Association of carotenoids, tocopherols and vitamin C in plasma with allergic rhinitis and allergic sensitisation in adults. Public Health Nutr. 2006. 9:472–479.

6. Shahar E, Hassoun G, Pollack S. Effect of vitamin E supplementation on the regular treatment of seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 2004. 92:654–658.

7. Garcia-Marcos L, Canflanca IM, Garrido JB, Varela AL, Garcia-Hernandez G, Guillen Grima F, Gonzalez-Diaz C, Carvajal-Urueña I, Arnedo-Pena A, Busquets-Monge RM, Morales Suarez-Varela M, Blanco-Quiros A. Relationship of asthma and rhinoconjunctivitis with obesity, exercise and Mediterranean diet in Spanish schoolchildren. Thorax. 2007. 62:503–508.

8. Hong SJ, Lee MS, Lee SY, Ahn KM, Oh JW, Kim KE, Lee JS, Lee HB. for the Korean ISAAC Study Group, Korean Academy of Pediatric Allergy and Respiratory Disease, Seoul, Korea. High body mass index and dietary pattern are associated with childhood asthma. Pediatr Pulmonol. 2006. 41:1118–1124.

9. Lee SI. Prevalence of childhood asthma in Korea: international study of asthma and allergies in childhood. Allergy Asthma Immunol Res. 2010. 2:61–64.

10. Hijazi N, Abalkhail B, Seaton A. Diet and childhood asthma in a society in transition: a study in urban and rural Saudi Arabia. Thorax. 2000. 55:775–779.

11. Farchi S, Forastiere F, Agabiti N, Corbo G, Pistelli R, Fortes C, Dell'Orco V, Perucci CA. Dietary factors associated with wheezing and allergic rhinitis in children. Eur Respir J. 2003. 22:772–780.

12. Montaño Velázquez BB, Jáuregui-Renaud K, Bañuelos Arias Adel C, Ayala JC, Martínez MD, Campillo Navarrete R, Rosalia IS, Salazar Mdel R, Serrano HA, Mondragón AO, Perez RL. Vitamin E effects on nasal symptoms and serum specific IgE levels in patients with perennial allergic rhinitis. Ann Allergy Asthma Immunol. 2006. 96:45–50.

13. Hong SJ, Lee MS, Sohn MH, Shim JY, Han YS, Park KS, Ahn YM, Son BK, Lee HB. Korean ISAAC Study Group. Self-reported prevalence and risk factors of asthma among Korean adolescents: 5-year follow-up study, 1995-2000. Clin Exp Allergy. 2004. 34:1556–1562.

14. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. Lancet. 1998. 351:1225–1232.

15. Bakkeheim E, Mowinckel P, Carlsen KH, Burney P, Carlsen KC. Altered oxidative state in schoolchildren with asthma and allergic rhinitis. Pediatr Allergy Immunol. 2011. 22:178–185.

16. Marmsjö K, Rosenlund H, Kull I, Håkansson N, Wickman M, Pershagen G, Bergström A. Use of multivitamin supplements in relation to allergic disease in 8-y-old children. Am J Clin Nutr. 2009. 90:1693–1698.

17. Allan K, Kelly FJ, Devereux G. Antioxidants and allergic disease: a case of too little or too much? Clin Exp Allergy. 2010. 40:370–380.

18. Cook DG, Carey IM, Whincup PH, Papacosta O, Chirico S, Bruckdorfer KR, Walker M. Effect of fresh fruit consumption on lung function and wheeze in children. Thorax. 1997. 52:628–633.

19. Shaheen SO, Sterne JA, Thompson RL, Songhurst CE, Margetts BM, Burney PG. Dietary antioxidants and asthma in adults: population-based case-control study. Am J Respir Crit Care Med. 2001. 164:1823–1828.

20. Tabak C, Smit HA, Räsänen L, Fidanza F, Menotti A, Nissinen A, Feskens EJ, Heederik D, Kromhout D. Dietary factors and pulmonary function: a cross sectional study in middle aged men from three European countries. Thorax. 1999. 54:1021–1026.

21. Bowler RP, Crapo JD. Oxidative stress in allergic respiratory diseases. J Allergy Clin Immunol. 2002. 110:349–356.

22. Chatzi L, Apostolaki G, Bibakis I, Skypala I, Bibaki-Liakou V, Tzanakis N, Kogevinas M, Cullinan P. Protective effect of fruits, vegetables and the Mediterranean diet on asthma and allergies among children in Crete. Thorax. 2007. 62:677–683.

23. de Batlle J, Garcia-Aymerich J, Barraza-Villarreal A, Antó JM, Romieu I. Mediterranean diet is associated with reduced asthma and rhinitis in Mexican children. Allergy. 2008. 63:1310–1316.

24. Devereux G, Seaton A. Diet as a risk factor for atopy and asthma. J Allergy Clin Immunol. 2005. 115:1109–1117. quiz 1118.

25. McKeever TM, Lewis SA, Smit H, Burney P, Britton J, Cassano PA. Serum nutrient markers and skin prick testing using data from the Third National Health and Nutrition Examination Survey. J Allergy Clin Immunol. 2004. 114:1398–1402.

26. Forastiere F, Pistelli R, Sestini P, Fortes C, Renzoni E, Rusconi F, Dell'Orco V, Ciccone G, Bisanti L. SIDRIA Collaborative Group, Italy (Italian Studies on Respiratory Disorders in Children and the Environment). Consumption of fresh fruit rich in vitamin C and wheezing symptoms in children. Thorax. 2000. 55:283–288.

27. Jeong YJ, Kim JH, Kang JS, Lee WJ, Hwang YI. Mega-dose vitamin C attenuated lung inflammation in mouse asthma model. Anat Cell Biol. 2010. 43:294–302.

28. Cárcamo JM, Pedraza A, Bórquez-Ojeda O, Golde DW. Vitamin C suppresses TNF alpha-induced NF kappa B activation by inhibiting I kappa B alpha phosphorylation. Biochemistry. 2002. 41:12995–13002.

29. Rubin RN, Navon L, Cassano PA. Relationship of serum antioxidants to asthma prevalence in youth. Am J Respir Crit Care Med. 2004. 169:393–398.

30. Harik-Khan RI, Muller DC, Wise RA. Serum vitamin levels and the risk of asthma in children. Am J Epidemiol. 2004. 159:351–357.

31. Grievink L, Smit HA, Ocké MC, van't Veer P, Kromhout D. Dietary intake of antioxidant (pro)-vitamins, respiratory symptoms and pulmonary function: the MORGEN study. Thorax. 1998. 53:166–171.

32. Kim WK, Kwon JW, Seo JH, Kim HY, Yu J, Kim BJ, Kim HB, Lee SY, Kim KW, Kang MJ, Shin YJ, Hong SJ. Interaction between IL13 genotype and environmental factors in the risk for allergic rhinitis in Korean children. J Allergy Clin Immunol. 2012. 130:421–426.e5.