Publication: Hábitos alimentarios y problemática nutricional en niños con alergia y/o asma en comparación con niños sanos
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2018-02-20
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Universidad Complutense de Madrid
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Abstract
La alergia y el asma son afecciones crónicas con una prevalencia creciente en la población mundial. En España se estima que sólo la cuantía de alérgicos alimentarios alcanza el millón y que el 10% de la población infantil presenta asma, lo que convierte esta última afección en una de las patologías más frecuentes en el país y la segunda de naturaleza crónica en la etapa de los 0 a 14 años. Las alergias respiratorias pueden crear, entre otras patologías atópicas, el asma. En su etiología multifactorial se ven implicados elementos de diversa índole, entre los que se encuentran algunos de carácter inmunitario, genético y ambiental. La confirmación del padecimiento de alergia y asma implica la identificación de los alérgenos y el control de las exacerbaciones y la obstrucción crónica al flujo aéreo, por lo que se hace necesaria la educación tanto de los afectados como de sus familiares, la prevención y control ambiental de sustancias alérgenas, la individualización de la pauta farmacológica y medidas de supervisión. La severidad y persistencia dependen de muchos factores e influyen directamente sobre la calidad de vida del paciente y la de su familia, la tolerancia a la práctica de ejercicio físico, el absentismo y el rendimiento escolar, con la subsiguiente repercusión sobre los gastos sanitarios y, por tanto, económicos del país. Los procesos inflamatorios de la vía respiratoria y la respuesta inmunitaria podrían verse influenciados por la epigenética alimentaria y la alteración de la actividad antioxidante. Son numerosas las hipótesis que se barajan acerca de la relación existente entre la alimentación (lípidos, sustancias antioxidantes como vitamina A, C, E, D, Se y Zn o donantes dietéticos de grupos metilo) y la enfermedad alérgica y asmática, pues la dieta podría funcionar como un factor de modulación de la patogenia, aunque los resultados continúan siendo controvertidos. Es difícil establecer una relación por la naturaleza multifactorial del asma y su dificultad de diagnóstico en edad pediátrica y por el elevado número de casos de asma auto-reportados que aparecen en los estudios epidemiológicos en población infantil. Asimismo, existen varias limitaciones a la hora de valorar la implicación de los factores nutricionales: ausencia de estudios de intervención, heterogeneidad de los diseños, muestras reducidas, diversos momentos de valoración del efecto (pre y post natal), múltiples sintomatologías interrelacionadas (alergia, asma, sibilancias, eccemas…) y obviedad de la importancia de la repercusión de diversos factores de confusión que pudieran intervernir...
Allergy and asthma are chronic conditions with an increasing prevalence in the world population. In Spain it is estimated that only the amount of food allergy reaches one million and that 10% of the child population has asthma, which makes this last condition one of the most frequent pathologies in the country and the second of chronic nature in the stage from 0 to 14 years. Respiratory allergies can create, among other atopic pathologies, asthma. Elements of different types are involved in its multifactorial etiology, among which are some of immunological, genetic and environmental character. The diagnosis of the allergies and asthma involves the identification of allergens and the control of exacerbations and chronic airflow obstruction, so that it is necessary to educate the person affected and their relatives, prevention and environmental control of allergenic substances, the individualization of the pharmacological guideline and supervisory measures. The severity and persistency depend on many factors and directly influence the quality of life of the patients and their family, their tolerance to physical exercise, their absenteeism and school performance, with the subsequent impact on health expenses and, therefore, economics of the country. Inflammatory processes of the airway and immune response may be influenced by dietary epigenetics and altered antioxidant activity. There are many hypotheses about the relationship between diet (lipids, antioxidants such as vitamin A, C, E, D, Se and Zn or dietary donors of methyl groups) and allergic and asthmatic diseases, since diet could function as a factor modulating pathogenesis, although the results remain controversial. It is difficult to establish a relationship due to the multifactorial nature of asthma and its difficulty in diagnosing the pediatric age and the high number of self-reported cases of asthma that appear in epidemiological studies in children. There are also several limitations in assessing the implication of nutritional factors: absence of intervention studies, heterogeneity of designs, reduced samples, different moments of effect evaluation (pre and post natal), multiple interrelated symptoms (allergy, asthma, wheezing, eczema ...) and the importance of the repercussion of various confounding factors that could interfere...
Allergy and asthma are chronic conditions with an increasing prevalence in the world population. In Spain it is estimated that only the amount of food allergy reaches one million and that 10% of the child population has asthma, which makes this last condition one of the most frequent pathologies in the country and the second of chronic nature in the stage from 0 to 14 years. Respiratory allergies can create, among other atopic pathologies, asthma. Elements of different types are involved in its multifactorial etiology, among which are some of immunological, genetic and environmental character. The diagnosis of the allergies and asthma involves the identification of allergens and the control of exacerbations and chronic airflow obstruction, so that it is necessary to educate the person affected and their relatives, prevention and environmental control of allergenic substances, the individualization of the pharmacological guideline and supervisory measures. The severity and persistency depend on many factors and directly influence the quality of life of the patients and their family, their tolerance to physical exercise, their absenteeism and school performance, with the subsequent impact on health expenses and, therefore, economics of the country. Inflammatory processes of the airway and immune response may be influenced by dietary epigenetics and altered antioxidant activity. There are many hypotheses about the relationship between diet (lipids, antioxidants such as vitamin A, C, E, D, Se and Zn or dietary donors of methyl groups) and allergic and asthmatic diseases, since diet could function as a factor modulating pathogenesis, although the results remain controversial. It is difficult to establish a relationship due to the multifactorial nature of asthma and its difficulty in diagnosing the pediatric age and the high number of self-reported cases of asthma that appear in epidemiological studies in children. There are also several limitations in assessing the implication of nutritional factors: absence of intervention studies, heterogeneity of designs, reduced samples, different moments of effect evaluation (pre and post natal), multiple interrelated symptoms (allergy, asthma, wheezing, eczema ...) and the importance of the repercussion of various confounding factors that could interfere...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Farmacia, Departamento de Nutrición y Bromatología I (Nutrición), leída el 19-06-2017