Prevention of asthma

Abstract

Environmental factors which have changed in the last decade or so appear to be largely responsible for the increase in the prevalence of asthma in affluent countries. It should, therefore, be possible to design interventions to reverse these recent trends and reduce the incidence of asthma. Primary preventive strategies have the potential not only to reduce acquisition of sensitization to common allergens and the risk that symptoms will develop subsequently, but also to reduce morbidity in those who already have persistent disease. There is accumulating epidemiological evidence that a dietary exess of sodium and omega-6 fatty acids, a dietary deficiency of antioxidant vitamins and omega-3 fatty acids, reduced rates of breastfeeding and exposure to allergens and environmental tobacco smoke are all involved in the aetiology of asthma. The modification of these factors has the potential to reduce the incidence and thus the prevalence of this disease. Environmental intervention should be particularly effective in children who have inherited or acquired characteristics which put them at high risk of developing asthma. With the evidence now available, it seems reasonable to assume that interventions which are based on our current knowledge of risk factors could achieve a 50% reduction in the prevalence of asthma in the next generation of children. Eur Respir J., 1996; 9, 1545-1555 Environmental factors which have changed in the last two decades appear to be largely responsible for an increased prevalence of asthma in affluent countries [1][2][3][4][5][6]. This implies that it is possible to design interventions to reverse these trends and reduce the incidence of asthma. Primary preventive strategies have the potential to reduce rates of acquisition of sensitization to common allergens and the risk that symptoms will subsequently develop and also to reduce morbidity in those who already have persistent disease. This review examines the evidence that there are avoidable factors which, if modified, have the potential to reduce the incidence and, thus, the prevalence of asthma. Reducing the prevalence of asthmaApplied epidemiological studies can provide a systematic approach to reducing the prevalence of asthma. As many as 25% of children in affluent countries now report that they have wheezed in the last year [7][8][9][10], although only half this number have an asthmatic illness which has clinical importance. Data from studies which have measured the burden and distribution of asthma and which have quantified the aetiological factors can be used to estimate the fraction of illness that is attributable to modifiable risk factors [11], but different types of studies will be needed in the future to estimate the effectiveness and the economic implications of preventive interventions.

Do early intake of fish and fish oil protect against eczema and doctor-diagnosed asthma at 2 years of age? A cohort study

“…Inclusion in the control cohort began in September 2000, and the interventional programme started in a separate cohort in July 2002, and is still in progress 17. Targets for primary intervention during pregnancy and the first 2 years of the children's life were reduced tobacco exposure, reduced housing dampness, and increased intake of cod liver oil and oily fish 18 19…”

Higher occurrence of asthma-related symptoms in an urban than a suburban area in adults, but not in children

“…No evidence could be found for a confounding effect of family size or having older brothers or sisters. Information regarding dietary risk factors [16], such as fruit, ®sh and salt intake, was only available in the 5±8 and 12±15 yr old children, but no relevant differences in such habits were recorded between the urban and suburban areas.…”

Mehrfach ungesättigte Fettsäuren PUFA: Ein wichtiger Bestandteil in Zellstoffwechsel und Ernährung

“…Auch bei Asthma sollen n-3-Fettsäu-ren, die mit Antioxidantien kombiniert werden, eine präventive Funktion ausüben [61]. VENUTA et al berichten über eine doppelblinde Studie an 20 Kindern mit rezidivierenden respiratorischen Infekten [62].…”