JACN Did you know that you can get alerts when a new issue is online?
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Miyake, Y.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Miyake, Y.
Journal of the American College of Nutrition, Vol. 26, No. 3, 279-287 (2007)
Published by the American College of Nutrition

Fish and Fat Intake and Prevalence of Allergic Rhinitis in Japanese Females: the Osaka Maternal and Child Health Study

Yoshihiro Miyake, MD, PhD, Satoshi Sasaki, MD, PhD, Keiko Tanaka, DDS, PhD, Yukihiro Ohya, MD, PhD, Shoichi Miyamoto, MBA, Ichiro Matsunaga, ME, Toshiaki Yoshida, PhD, Yoshio Hirota, MD, PhD, Hajime Oda, MD, PhD and the Osaka Maternal and Child Health Study Group*

Department of Public Health, Faculty of Medicine, Fukuoka University, Fukuoka (Y.M., K.T.)
Nutritional Epidemiology Program, National Institute of Health and Nutrition, Tokyo (S.S.)
Division of Allergy, Department of Medical Specialties, National Center for Child Health and Development, Tokyo (Y.O)
Department of Public Health, Osaka City University School of Medicine, Osaka (S.M., Y.H.)
Osaka Prefectural Institute of Public Health, Osaka (I.M., T.Y., H.O.), JAPAN

Address reprint requests to: Yoshihiro Miyake, MD, PhD, Department of Public Health, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, JAPAN, E-mail: miyake-y{at}cis.fukuoka-u.ac.jp


   ABSTRACT
TOP
 FOOTNOTES
 ABSTRACT
INTRODUCTION
 SUBJECTS AND METHODS
 RESULTS
 APPENDIX
 ACKNOWLEDGMENTS
 REFERENCES
 
Objective: It remains uncertain whether intake of fish or n-3 polyunsaturated fatty acids is preventive against allergic disorders. This cross-sectional study investigated the association of intake of selected high-fat foods and specific types of fatty acids with the prevalence of allergic rhinitis in Japan where intake of fish is high.

Methods: Study subjects were 1002 Japanese pregnant females. Allergic rhinitis (including cedar pollinosis) was defined as present if subjects had received drug treatment at some point during the previous 12 months. Information on dietary factors was collected using a validated self-administered diet history questionnaire. Adjustment was made for age, gestation, parity, cigarette smoking, passive smoking at home and at work, indoor domestic pets, family history of asthma, atopic eczema, and allergic rhinitis, family income, education, mite antigen level in house dust, changes in diet in the previous month, season when data were collected, and body mass index.

Results: There was a tendency for an inverse dose-response association between fish intake and allergic rhinitis although the adjusted odds ratio for comparison of the highest with the lowest quartile was not statistically significant (p for trend = 0.09). Intake of eicosapentaenoic and docosahexaenoic acids was independently associated with a decreased prevalence of allergic rhinitis: the multivariate odds ratio for the highest quartile was 0.56 (95% confidence interval: 0.32–0.96, p for trend = 0.03). Intake of n-6 polyunsaturated fatty acids in the third quartile but not the second and fourth quartiles showed a tendency for an inverse association with the prevalence of allergic rhinitis. No measurable relationship was found between consumption of meat, eggs, dairy products, total fat, saturated, monounsaturated, and n-3 polyunsaturated fatty acids, and cholesterol or the ratio of n-3 to n-6 polyunsaturated fatty acids and allergic rhinitis.

Conclusion: Our findings suggest that the intake of eicosapentaenoic and docosahexaenoic acids may be associated with a reduced prevalence of allergic rhinitis.

Key words: allergic rhinitis, cross-sectional study, fat, fish, Japanese females


   INTRODUCTION
TOP
 FOOTNOTES
 ABSTRACT
 INTRODUCTION
SUBJECTS AND METHODS
 RESULTS
 APPENDIX
 ACKNOWLEDGMENTS
 REFERENCES
 
The etiology of allergic rhinitis is though to be largely environmental. Japanese cedar pollinosis is a common allergic disorder in Japan caused by inhalation of the pollen of the Japanese cedar. The age-adjusted prevalence value of Japanese cedar pollinosis was 19.4% throughout Japan [1]. The prevalence of allergic rhinitis in urban areas is higher than that in rural areas [1–3]. Therefore, factors associated with the traditional Japanese, but not Western, lifestyle may be protective against allergic rhinitis. In particular, Japanese people consume a much larger quantity of fish than Western populations.

Epidemiological evidence is inconclusive regarding the association of intake of fish or n-3 polyunsaturated fatty acids with allergic disorders. A significant inverse relationship between eating fish more than once a week and the prevalence of bronchial hyperresponsiveness and that between oily fish intake and current asthma were reported in 2 cross-sectional studies in Australian children, respectively [4, 5]. A case-referent study in Norway showed that among female adults with moderate to severe atopic dermatitis, intake of docosahexaenoic and eicosapentaenoic acids was lower than in the reference group [6]. The Oslo Birth Cohort Study found that fish consumption in the first year of life was related to a reduced risk of allergic rhinitis, but not asthma, at the age of 4 years [7]. An intervention study in Australian high-risk infants demonstrated that supplementation with n-3 fatty acids resulted in a 9.8% reduction in the prevalence of any wheeze during the first 18 months of life [8]. In contrast, a significant positive association of oily fish intake with the prevalence of asthma but not allergic rhinitis among adolescents was found in a cross-sectional study in Taiwan [9]. A significantly higher prevalence of asthma was noted among Japanese children who ate fish 1 to 2 times a week than among those who ate fish 1 to 2 times a month [10]. Several epidemiological studies reported no association of fish intake with any allergic disorders [11–15]. An association of the ratio of n-3 to n-6 polyunsaturated fatty acids with allergic rhinitis among German adults was shown in 2 epidemiological studies, but the results were inconsistent [16, 17]. There is limited epidemiological information regarding the relationship of the intake of total fat, saturated fatty acids, monounsaturated fatty acids, and n-6 polyunsaturated fatty acids with allergic rhinitis [16–18].

Therefore, we wished to investigate the association of intake of selected high-fat foods and specific types of fatty acids with the prevalence of allergic rhinitis in Japan. We examined these issues in a cross-sectional study among Japanese pregnant females using baseline data from the Osaka Maternal and Child Health Study (OMCHS).


   SUBJECTS AND METHODS
TOP
 FOOTNOTES
 ABSTRACT
 INTRODUCTION
 SUBJECTS AND METHODS
RESULTS
 APPENDIX
 ACKNOWLEDGMENTS
 REFERENCES
 
Study Population
The OMCHS is an ongoing prospective cohort study that assesses preventive and risk factors for maternal and child health problems such as allergic disorders and postpartum depression. Details of the OMCHS have been described elsewhere [19]. In brief, the OMCHS is composed of a baseline survey completed by pregnant females and several post-natal follow-up surveys. Eligible females were those who became pregnant in Neyagawa City, which is 1 of the 44 municipalities in Osaka Prefecture, a metropolis in Japan with a total population of approximately 8.8 million. Of the 3639 eligible females in Neyagawa City, 627 (17.2%) participated in this study between November 2001 and March 2003. Eight pregnant females who did not live in Neyagawa City but who had become aware of the present study at an obstetric clinic before August 2002 decided by themselves to participate in this study. Also, there were 77 participants who received explanations regarding the OMCHS from public health nurses in 6 other municipalities between August 2002 and March 2003. From October 2002 to March 2003, 290 participants were recruited from a university hospital and three obstetric hospitals in 3 other municipalities; these women were recommended for participation in the OMCHS by an obstetrician. Finally, a total of 1002 pregnant women gave their fully informed consent in writing and completed the baseline survey. The ethics committees of the Osaka City University School of Medicine and the Osaka Prefectural Institute of Public Health approved the OMCHS.

Measurements
In the baseline survey, each participant filled out a set of 2 self-administered questionnaires and collected 2 dust samples from a 1 m2 area of bedclothes and flooring for 1 minute using a vacuum cleaner fitted with a collection apparatus. Participants then mailed these materials to the data management center. Research technicians completed missing or illogical data by telephone interview.

A validated self-administered diet history questionnaire was used to assess dietary habits over a period of 1 month. The structure and validity of the questionnaire were described in detail elsewhere [20, 21]. In this instrument, intake of 147 food items was calculated using an ad-hoc computer algorithm developed to analyze the questionnaire. Because composition values for dietary fatty acids were not available in the standard Japanese food composition table, they were obtained from the fatty acid food composition table of Japanese foods developed for Japanese populations [22]. Energy-adjusted intake by the residual approach was used for the analyses [23].

A second self-administered questionnaire inquired about age, gestation, parity, smoking habits, passive smoking exposure, personal history of allergic rhinitis, family history of asthma, atopic eczema, and allergic rhinitis, indoor domestic pets, family income, education, weight, height, and changes in diet in the previous 1 month. Allergic rhinitis (including Japanese cedar pollinosis) was defined as present when subjects had been treated with medications at some time in the previous 12 months. A family history of asthma, atopic eczema, and allergic rhinitis (including Japanese cedar pollinosis) was considered to be present if 1 or more parents or siblings of the study subject had manifested any of these allergic disorders. Body mass index was calculated by dividing self-reported body weight (kg) by the square of self-reported height (m).

Antigen levels from extracts of fine dust fractions were measured by a double-antibody sandwich enzyme-linked immunosorbent assay using a soluble antigen prepared from whole Dermatophagoides farinae mite bodies as a reference standard and were expressed as antigen equivalent in µg/m2 of surface area (Mitey checker®, Shinto Fine Co., Ltd., Osaka, Japan) [24, 25]. Antigen levels were semi-quantitatively classified with scores of– (<2 µg/m2), ± (5 µg/m2), + (10 to 15 µg/m2), and ++ (> 35 µg/m2). In the present study, we used only antigen levels in the sample collected from bedclothes because the correlation between antigen levels from bedclothes and flooring was almost collinear (Spearman correlation coefficient = 0.54, p < 0.0001).

Statistical Analysis
Intake of selected foods rich in fat and specific types of fatty acids was categorized at quartile points based on the distribution of all study subjects. Age was divided into 3 categories (< 29, 29–31, and 32+ years); gestation into 3 (< 15, 15–20, and 21+ weeks); parity into 2 (0 and 1+); cigarette smoking into 3 (never, former, and current); passive smoking at home into 3 (never, former, and current); passive smoking at work into 3 (never, former, and current); family income into 3 (JPY < 4,000,000, 4,000,000–5,999,999, and 6,000,000+/year); education into 3 (< 13, 13–14, and 15+ years); dust mite antigen levels into 4 (–, ±, +, and ++); changes in diet in the previous 1 month into 3 (none or seldom, slight, and substantial); and season when data were collected into 4 (spring, summer, fall, and winter). Body mass index was used as a continuous variable.

Logistic regression analysis was used to estimate crude odds ratios (ORs) and 95% confidence intervals (CIs) and to control for the potential confounding effects of selected factors. Trend of association was assessed by a logistic regression model assigning scores to the levels of the independent variable. A p value < 0.05 was considered to indicate statistical significance. All computations were performed using the SAS software package version 8.2 (SAS Institute, Inc., Cary, NC).


   RESULTS
TOP
 FOOTNOTES
 ABSTRACT
 INTRODUCTION
 SUBJECTS AND METHODS
 RESULTS
APPENDIX
 ACKNOWLEDGMENTS
 REFERENCES
 
Among 1002 pregnant females, 141 participants (14.1%) had used medications for allergic rhinitis (including Japanese cedar pollinosis) at some time in the previous 12 months. The mean age was 29.8 years and 30% of subjects were from 29 to 31 years of age (Table 1). About 70% of the women took part in this study by the 20th week of gestation. About half had a parity of 1 or more. Many more participants had a family history of allergic rhinitis than a family history of asthma or atopic eczema. Slight or substantial changes in diet in the previous 1 month were reported by 702 pregnant females due to nausea gravidarum (585 females), maternal and fetal health (107 females), and other reasons (10 females). Mean daily total energy and energy-adjusted fish consumption were 6815 kJ and 48.3 g, respectively (Table 2).


View this table:
[in this window]
[in a new window]

  		Table 1. Distribution of Selected Characteristics in 1002 Pregnant Females, OMCHS, Japan

 

View this table:
[in this window]
[in a new window]

  		Table 2. Distribution of Daily Food and Nutrient Intake in 1002 Pregnant Females, OMCHS, Japan1

 
Table 3 shows crude and adjusted ORs and 95% CIs for the prevalence of allergic rhinitis according to dietary intake of selected foods high in fatty acids. Neither an inverse dose-response relationship between fish intake and the crude prevalence of allergic rhinitis nor the crude OR for comparison of the highest with the lowest quartile reached statistical significance (p for trend = 0.09). There was no evident association of consumption of meat, eggs, and dairy products with the crude prevalence of allergic rhinitis. Adjustment for age, gestation, parity, cigarette smoking, passive smoking at home and at work, indoor domestic pets, family history of asthma, atopic eczema, and allergic rhinitis, family income, education, mite antigen level in house dust, changes in diet in the past 1 month, the season when data were collected, and body mass index did not appreciably change these results.


View this table:
[in this window]
[in a new window]

  		Table 3. Odds Ratios (ORs) and 95% Confidence Intervals (CIs) for Allergic Rhinitis by Quartiles of Intake of Selected Foods High in Fat, OMCHS, Japan

 
Crude and adjusted ORs and 95% CIs for associations with specific types of fatty acids and cholesterol are presented in Table 4. For the sum of dietary intake of eicosapentaenoic and docosahexaenoic acids, the crude ORs for comparison of the fourth with the first quartile were statistically significant, showing a clear inverse dose-response relationship. After adjustment for the confounders under investigation, the inverse relationship remained significant, albeit slightly attenuated: the multivariate ORs for comparison of the third and fourth with the first quartile were 0.56 and 0.56 (95% CI = 0.33–0.94 and 0.32–0.96, respectively). Significant inverse dose-response associations were observed between individual intake of elcosapentaenoic and docosahexaenoic acids and the prevalence of allergic rhinitis in the multivariate model (p for trend = 0.05 and 0.04, respectively). Compared with n-6 polyunsaturated fatty acid intake in the first quartile, its consumption in the third quartile but not the second and fourth quartiles was marginally significantly related to a decreased prevalence of allergic rhinitis although the linear trend was not statistically significant in the multivariate model (p for trend = 0.47). Consumption of total fat, saturated fatty, monounsaturated fatty, and n-3 polyunsaturated fatty acids, and cholesterol and the ratio of n-3 to n-6 polyunsaturated fatty acids were not independently associated with the prevalence of allergic rhinitis.


View this table:
[in this window]
[in a new window]

  		Table 4. Odds Ratios (ORs) and 95% Confidence Intervals (CIs) for Allergic Rhinitis by Quartiles of Specific Types of Dietary Fat, OMCHS, Japan

 

   DISCUSSION
 
The present study found that intake of eicosapentaenoic and docosahexaenoic acids was independently associated with a decreased prevalence of allergic rhinitis. The current study failed to verify a clear inverse association between fish intake and the prevalence of allergic rhinitis although the linear trend was of statistically borderline significance. Intake of n-6 polyunsaturated fatty acids in the third quartile but not the second and fourth quartiles showed a tendency for an inverse association with the prevalence of allergic rhinitis. There was no measurable relationship of consumption of meat, eggs, dairy products, total fat, saturated, monounsaturated, and n-3 polyunsaturated fatty acids, and cholesterol or the ratio of n-3 to n-6 polyunsaturated fatty acids with allergic rhinitis. A previous cross-sectional study in Japanese women found that intake of n-6 polyunsaturated fatty acids was positively associated with seasonal allergic rhinoconjunctivitis in spring whereas there were no statistically significant relationships between consumption of saturated, monounsaturated, and n-3 polyunsaturated fatty acids and symptoms of allergic rhinoconjunctivitis [18]. In a case-control study in German adults, intake of oleic acid was positively associated with hay fever whereas intake of eicosapentaenoic acid was inversely related to hay fever although there was no evident association with saturated or n-6 polyunsaturated fatty acids [17]. A cross-sectional study among German adults demonstrated that a high red cell membrane level of eicosapentaenoic acid was inversely associated with allergic rhinitis whereas there was an inverse relationship between {alpha}-linolenic acid intake and allergic rhinitis [26]. No association was found between fish intake and allergic rhinitis in a cross-sectional study in Italian children and a case-control study in Finnish children [12, 13]. The present results are partially consistent with these findings.

The differences between Japanese and Western diets should be taken into consideration when interpreting our results. In particular, intake of eicosapentaenoic and docosahexaenoic acids in Japan was much higher than in Western countries. In 20 Canadian pregnant women, mean intake of {alpha}-linolenic, eicosapentaenoic and docosahexaenoic acids was estimated to be 1295, 35, and 82 mg/day, respectively, which was determined by direct quantitation of duplicate food collections [27]. The corresponding figures in 85 middle-aged Japanese women were 1589, 314, and 571 mg/day, respectively, which were obtained from 7-day weighed diet records [28]. The values of both eicosapentaenoic and docosahexaenoic acids among Canadian pregnant women were about half of the median values of the first quartile of eicosapentaenoic and docosahexaenoic acid intake in our population. Among middle-aged Japanese women, values were nearly the same as the median values of the fourth quartile intake of these nutrients in our subjects.

Our findings of an inverse association between intake of eicosapentaenoic and docosahexaenoic acids and the prevalence of allergic rhinitis may be ascribed to anti-inflammatory effects of marine-derived n-3 polyunsaturated fatty acids. Arachidonic acid-derived inflammatory mediators, prostaglandin E2 and leukotriene B4, are factors that control the severity of allergic inflammation [29]. Prostaglandin E2 influences the Th1 to Th2 ratios and subsequently inhibits interferon-{gamma} production, with no effect on IL-4, thus stimulating IgE synthesis [29]. Eicosapentaenoic acid can inhibit arachidonic acid metabolism competitively via enzymatic pathways and, thus, can suppress production of n-6 eicosanoid inflammatory mediators [30]. n-3 Fatty acids may also affect immune cell function by modulating cytokine, Ig and adhesion molecule production [29]. The present findings are partially compatible with this hypothesis although data on these molecules were not available in the present study. A clinical trial demonstrated that the proportions of eicosapentaenoic and docosahexaenoic acids in plasma phospholipids and neutrophil lipids increased significantly after supplementation with eicosapentaenoic or docosahexaenoic acid and that docosahexaenoic acid supplementation decreased T lymphocyte activation [31]. We could not use a direct marker of fat intake such as plasma and erythrocyte concentrations of fatty acids in this study, however. On the other hand, previous studies among healthy humans reported that fish oil supplementation (2.4 g/day) suppressed the production of IL-2 [32, 33]. Two intervention studies demonstrated that there were no effects of supplementation with {gamma}-linolenic, eicosapentaenoic, and docosahexaenoic acids on the production of IL-2 and interferon-{gamma} [34, 35].

In the current study, intake of fish was not statistically significantly related to a decreased prevalence of allergic rhinitis. Unrecognized active agents in fish might have counteracted the advantage of intake of fish against allergic rhinitis. For example, methylmercury and dioxins are accumulated in fish and shellfish through the marine food web. Lack of association between intake of n-3 polyunsaturated fatty acids and allergic rhinitis in this study could be attributed to our finding that there was no relationship between {alpha}-linolenic acid intake and allergic rhinitis (data not shown). We also cannot confirm the hypothesis that a balance between n-3 and n-6 polyunsaturated fatty acid metabolism is important in the manifestation of allergic disorders. In a case-control study of German adults, a significant inverse dose-response association between the ratio of n-6 to n-3 polyunsaturated fatty acids and the risk of hay fever was reported [17]. On the other hand, a cross-sectional study showed that a high n-6 to n-3 ratio was significantly positively related to hay fever in males and that the ratio was not statistically significantly associated with hay fever in females [16]. In the typical Western diet, 20- to 25-fold more n-6 fats than n-3 fats are consumed [30]. The median values of the ratio of n-3 to n-6 polyunsaturated fatty acids were 0.145, 0.145, and 0.206 in control subjects in the case-control German study [17], females in the cross-sectional German study [16], and the present study, respectively. A clear inverse association between the ratio of n-3 to n-6 fatty acids and allergic rhinitis may be substantiated when consumption of n-3 polyunsaturated fatty acids is very low.

The present study had several methodological strengths. Study subjects were homogeneous in terms of all being pregnant and having the same residential background. Extensive data on potential confounding factors were controlled for. However, we did not incorporate external factors such as aeroallergens and air pollution. Intake of dietary variables under investigation was estimated using a self-administered semiquantitative dietary assessment questionnaire. Since we did not assess the real dietary habits of the subjects, the chance of misclassification might be inevitable. According to validation tests, the correlation coefficients for nutrient intake between those estimated from the diet history questionnaire and those observed by a 3-day dietary record were 0.75, 0.50, 0.37, and 0.49 for saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, and cholesterol, respectively, in women [20]. A highly positive correlation was also observed between marine-origin n-3 polyunsaturated fatty acid intake estimated by the diet history questionnaire and the corresponding concentration in the serum phospholipid fraction (r = 0.51 and 0.69 in men and women, respectively) [21]. Allergic rhinitis sufferers might not be aware of the ill effects of diet. Such an assumption would lead to bias toward the null. Our diet history questionnaire was designed to assess recent dietary intake, i.e. for 1 month prior to completing the questionnaire. This disadvantage is likely to be alleviated after adjustment for the season when data were collected, however. Changes in diet in the past 1 month were controlled for because pregnant females are likely to change their diet for reasons such as nausea gravidarum. Information on intake of trans fatty acids was not available in this study although an ecological study in European adolescents found a positive association between trans fatty acids and the prevalence of allergic rhinoconjunctivitis [36].

Other weaknesses also should be borne in mind. In Neyagawa City, the participation rate was low (17.2%). We were not able to evaluate a difference between participants and non-participants in Neyagawa City, because data on personal characteristics among the non-participants were not available. Regarding the remaining 375 participants, who were not residents of Neyagawa City, we were not able to calculate the participation rate because the exact number of eligible subjects was not available. Also, we could not compare participants with non-participants in the 4 collaborating hospitals and 6 municipalities. Our subjects were an unrepresentative sample of Japanese females in the general population, and the present findings may not be generalized. In fact, educational levels were higher in the present study population than in the general population. According to the 2000 population census of Japan, the proportions of females aged 30 to 34 years in Osaka Prefecture with years of education of < 13, 13–14, 15+, and unknown were 49.2, 32.3, 13.6, and 4.9%, respectively [37]. The corresponding figures for the current study were 32.2, 41.2, 26.6, and 0.0%, respectively. Japanese cedar pollinosis is a seasonal disorder with a high prevalence and is often undiagnosed [1]. We did not use validated diagnostic criteria such as those reported in the International Study of Asthma and Allergies in Childhood. Because the definition of allergic rhinitis was based on drug treatment, there was a loss of milder sufferers. Moreover, females who want to become pregnant or who are pregnant might tend to avoid drugs. The consequence would have been an underestimation of values in our results. The lack of a significant inverse association between fish intake and allergic rhinitis might be attributed to an insufficient statistical power. If the analysis had been able to include the total study population of 1600 pregnant women, the inverse association would have reached the level of significance.

A relationship between pregnancy and a shift to the Th2 side of the immune response has been indicated [38] whereas the importance of the role of NK and IL-12, IL-15, and IL-18 tripods in successful or failed pregnancy in humans was suggested beyond the Th1/Th2 paradigm [39]. Rhinitis symptoms during pregnancy may be attributed to the hormonal changes in pregnancy. However, rhinitis solely ascribed to pregnancy may not be a distinct entity because most pregnant women do not have significant nasal symptoms [38]. In the present study, 105 of 141 current allergic rhinitis sufferers (74.5%) had been treated with medications at some time for 1 or more years.

In conclusion, our findings suggest that intake of eicosapentaenoic and docosahexaenoic acids may be associated with a reduced prevalence of allergic rhinitis although we have not found any evidence to indicate that n-6 fatty acids are related to an increased prevalence of allergic rhinitis. There was a tendency for an inverse association between fish intake and allergic rhinitis. The present results regarding intake of eicosapentaenoic and docosahexaenoic acids may support existing recommendations for intake of these nutrients in adults such as a minimum combined intake of 500 mg/day eicosapentaenoic and docosahexaenoic acids for cardiovascular health based on the International Society for the Study of Fatty Acids and Lipids 2004 although the outcome under study is allergic rhinitis. Because this was a cross-sectional study, we could not establish a cause and effect relationship for the associations under study. Further evaluation in prospective studies may clarify the relation between dietary intake of fatty acids and foods high in fatty acids and allergic rhinitis.


   APPENDIX
TOP
 FOOTNOTES
 ABSTRACT
 INTRODUCTION
 SUBJECTS AND METHODS
 RESULTS
 APPENDIX
ACKNOWLEDGMENTS
 REFERENCES
 
Space limitations preclude the inclusion as authors of the following members of the Osaka Maternal and Child Health Study Group:

Drs. Hideharu Kanzaki and Mitsuyoshi Kitada, Department of Obstetrics and Gynecology, Kansai Medical University; Dr. Yorihiko Horikoshi, Department of Obstetrics and Gynecology, Kansai Medical University Kori; Drs. Osamu Ishiko, Yuichiro Nakai, Junko Nishio, and Seiichi Yamamasu, Department of Obstetorics and Gynecology, Osaka City University Graduate School of Medicine; Dr. Jinsuke Yasuda, Department of Obstetrics and Gynecology, Matsushita Memorial Hospital; Dr. Seigo Kawai, Department of Obstetrics and Gynecology, Hoshigaoka Koseinenkin Hospital; Dr. Kazumi Yanagihara, Yanagihara Clinic; Dr. Koji Wakuda, Department of Obstetrics and Gynecology, Fujimoto Hospital; Dr. Tokio Kawashima, Kyohritsu Women's Clinic; Dr. Katsuhiko Narimoto, Ishida Hospital Obstetrics, Gynecology; Dr. Yoshihiko Iwasa, Iwasa Women's Clinic; Dr. Katsuhiko Orino, Orino Lady's Clinic; Dr. Itsuo Tsunetoh, Tsunetoh Obstetrics and Gynecology; Dr. Junichi Yoshida, Yoshida Clinic; Dr. Junichi Iito, Iito Obstetrics and Gynecology Clinic; Dr. Takuzi Kaneko, Kaneko Sanfujinka; Dr. Takao Kamiya, Kamiya Ladies Clinic; Dr. Hiroyuki Kuribayashi, Kuribayashi Clinic; Dr. Takeshi Taniguchi, Taniguchi Hospital; Dr. Hideo Takemura, Kosaka Women's Hospital; and Dr. Yasuhiko Morimoto, Aizenbashi Hospital.


   ACKNOWLEDGMENTS
TOP
 FOOTNOTES
 ABSTRACT
 INTRODUCTION
 SUBJECTS AND METHODS
 RESULTS
 APPENDIX
 ACKNOWLEDGMENTS
REFERENCES
 
The authors would like to acknowledge the Neyagawa City Government, Hirakata City Government, Katano City Government, Shijonawate City Government, Kaizuka City Government, Takaishi City Government, Hannan City Government, Neyagawa City Medical Association, Hirakata City Medical Association, and the Kadoma City Medical Association for their valuable support; and Ms Tomoko Shibazaki, Nahoko Nishimura, and Naomi Takaoka for their assistance. This study was supported by a Grant-in-Aid (13770206, 16790351) for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology and Health and Labour Sciences Research Grants, Research on Allergic Disease and Immunology from the Ministry of Health, Labour, and Welfare, Japan.


   FOOTNOTES
TOP
 FOOTNOTES
ABSTRACT
 INTRODUCTION
 SUBJECTS AND METHODS
 RESULTS
 APPENDIX
 ACKNOWLEDGMENTS
 REFERENCES
 
* Other members of the Study Group are listed in the Appendix. Back

There is no conflict of interest.

Received March 19, 2005. Accepted August 18, 2006.


   REFERENCES
TOP
 FOOTNOTES
 ABSTRACT
 INTRODUCTION
 SUBJECTS AND METHODS
 RESULTS
 APPENDIX
 ACKNOWLEDGMENTS
 REFERENCES
 

  1. Okuda M: Epidemiology of Japanese cedar pollinosis throughout Japan.Ann Allergy Asthma Immunol91 :288 –296,2003 .[Medline]
  2. Strachan D, Sibbald B, Weiland S, Aït-Khaled N, Anabwani G, Anderson HR, Asher MI, Beasley R, Björkstén B, Burr M, Clayton T, Crane J, Ellwood P, Keil U, Lai C, Mallol J, Martinez F, Mitchell E, Montefort S, Pearce N, Robertson C, Shah J, Stewart A, von Mutius E, Williams H: Worldwide variations in prevalence of symptoms of allergic rhinoconjunctivitis in children: the International Study of Asthma and Allergies in Childhood (ISAAC).Pediatr Allergy Immunol8 :161 –176,1997 .[Medline]
  3. Miyake Y, Yura A, Iki M: Breastfeeding and the prevalence of symptoms of allergic disorders in Japanese adolescents.Clin Exp Allergy33 :312 –316,2003 .[Medline]
  4. Peat JK, Salome CM, Woolcock AJ: Factors associated with bronchial hyperresponsiveness in Australian adults and children.Eur Respir J5 :921 –929,1992 .[Abstract]
  5. Hodge L, Salome CM, Peat JK, Haby MM, Xuan W, Woolcock AJ: Consumption of oily fish and childhood asthma risk.Med J Aust164 :137 –140,1996 .[Medline]
  6. Solvoll K, Søyland E, Sandstad B, Drevon CA: Dietary habits among patients with atopic dermatitis.Eur J Clin Nutr54 :93 –97,2000 .[Medline]
  7. Nafstad P, Nystad W, Magnus P, Jaakkola JJK: Asthma and allergic rhinitis at 4 years of age in relation to fish consumption in infancy.J Asthma40 :343 –348,2003 .[Medline]
  8. Mihrshahi S, Peat JK, Marks GB, Mellis CM, Tovey ER, Webb K, Britton WJ, Leeder SR, the CAPS team: Eighteen-month outcomes of house dust mite avoidance and dietary fatty acid modification in the Childhood Asthma Prevention Study (CAPS).J Allergy Clin Immunol111 :162 –168,2003 .[Medline]
  9. Huang SL, Lin KC, Pan WH: Dietary factors associated with physician-diagnosed asthma and allergic rhinitis in teenagers: analyses of the first Nutrition and Health Survey in Taiwan.Clin Exp Allergy31 :259 –264,2001 .[Medline]
  10. Takemura Y, Sakurai Y, Honjo S, Tokimatsu A, Gibo M, Hara, Kusakari A, Kugai N: The relationship between fish intake and the prevalence of asthma: the Tokorozawa childhood asthma and pollinosis study.Prev Med34 :221 –225,2002 .[Medline]
  11. Woods RK, Walters EH, Raven JM, Wolfe R, Ireland PD, Thien FC, Abramson MJ: Food and nutrient intakes and asthma risk in young adults.Am J Clin Nutr78 :414 –421,2003 .[Abstract/Free Full Text]
  12. 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 J22 :772 –780,2003 .[Abstract/Free Full Text]
  13. Dunder T, Kuikka L, Turtinen J, Räsänen L, Uhari M: Diet, serum fatty acids, and atopic diseases in childhood.Allergy56 :425 –428,2001 .[Medline]
  14. Hijazi N, Abalkhail B, Seaton A: Diet and childhood asthma in a society in transition: a study in urban and rural Saudi Arabia.Thorax55 :775 –779,2000 .[Abstract/Free Full Text]
  15. Fluge Ø, Omenaas E, Eide GE, Gulsvik A: Fish consumption and respiratory symptoms among young adults in a Norwegian community.Eur Respir J12 :336 –340,1998 .[Abstract]
  16. Trak-Fellermeier MA, Brasche S, Winkler G, Koletzko B, Heinrich J: Food and fatty acid intake and atopic disease in adults.Eur Respir J23 :575 –582,2004 .[Abstract/Free Full Text]
  17. Nagel G, Nieters A, Becker N, Linseisen J: The influence of the dietary intake of fatty acids and antioxidants on hay fever in adults.Allergy58 :1277 –1284,2003 .[Medline]
  18. Wakai K, Okamoto K, Tamakoshi A, Lin Y, Nakayama T, Ohno Y: Seasonal allergic rhinoconjunctivitis and fatty acid intake: a cross-sectional study in Japan.Ann Epidemiol11 :59 –64,2001 .[Medline]
  19. Miyake Y, Miyamoto S, Ohya Y, Sasaki S, Matsunaga I, Yoshida T, Hirota Y, Oda H, Osaka Maternal and Child Health Study Group: Relationship between active and passive smoking and total serum IgE levels in Japanese women: baseline data from the Osaka Maternal and Child Health Study.Int Arch Allergy Immunol135 :221 –228,2004 .[Medline]
  20. Sasaki S, Yanagibori R, Amano K: Self-administered diet history questionnaire developed for health education: a relative validation of the test-version by comparison with 3-day diet record in women.J Epidemiol8 :203 –215,1998 .[Medline]
  21. Sasaki S, Ushio F, Amano K, Morihara M, Todoriki T, Uehara Y, Toyooka E: Serum biomarker-based validation of a self-administered diet history questionnaire for Japanese subjects.J Nutr Sci Vitaminol46 :285 –296,2000 .[Medline]
  22. Sasaki S, Kobayashi M, Tsugane S: Development of substituted fatty acid food composition table for the use in nutritional epidemiologic studies for Japanese populations: its methodological backgrounds and the evaluation.J Epidemiol9 :190 –207,1999 .[Medline]
  23. Willett W, Stampfer MJ: Total energy intake: implications for epidemiologic analyses.Am J Epidemiol124 :17 –27,1986 .[Free Full Text]
  24. Konishi E, Uehara K: Antigen levels of Dermatophagoides mites (Acari: Pyroglyphidae) in dust samples collected in homes of allergic patients.J Med Entomol31 :394 –399,1994 .[Medline]
  25. Takai T, Yuuki T, Okumura Y, Mori A, Okudaira H: Determination of the N- and C-terminal sequences required to bind human IgE of the major house dust mite allergen Der f 2 and epitope mapping for monoclonal antibodies.Mol Immunol34 :255 –261,1997 .[Medline]
  26. Hoff S, Seiler H, Heinrich J, Kompauer I, Nieters A, Becker N, Nagel G, Gedrich K, Karg G, Wolfram G, Linseisen J: Allergic sensitisation and allergic rhinitis are associated with n-3 polyunsaturated fatty acids in the diet and in red blood cell membranes.Eur J Clin Nutr59 :1071 –1080,2005 .[Medline]
  27. Denomme J, Stark KD, Holub BJ: Directly quantitated dietary (n-3) fatty acid intakes of pregnant Canadian women are lower than current dietary recommendations.J Nutr135 :206 –211,2005 .[Abstract/Free Full Text]
  28. Kuriki K, Nagaya T, Tokudome Y, Imaeda N, Fujiwara N, Sato J, Goto C, Ikeda M, Maki S, Tajima K, Tokudome S: Plasma concentrations of (n-3) highly unsaturated fatty acids are good biomarkers of relative dietary fatty acid intakes: a cross-sectional study.J Nutr133 :3643 –3650,2003 .[Abstract/Free Full Text]
  29. Kankaanpää P, Sütas Y, Salminen S, Lichtenstein A, Isolauri E: Dietary fatty acids and allergy.Ann Med31 :282 –287,1999 .[Medline]
  30. James MJ, Gibson RA, Cleland LG: Dietary polyunsaturated fatty acids and inflammatory mediator production.Am J Clin Nutr71(Suppl) :343S –348S,2000 .[Abstract/Free Full Text]
  31. Kew S, Mesa MD, Tricon S, Buckley R, Minihane AM, Yaqoob P: Effects of oils rich in eicosapentaenoic and docosahexaenoic acids on immune cell composition and function in healthy humans.Am J Clin Nutr79 :674 –681,2004 .[Abstract/Free Full Text]
  32. Meydani SN, Endres S, Woods MM, Goldin BR, Soo C, Morrill-Labrode A, Dinarello CA, Gorbach SL: Oral (n-3) fatty acid supplementation suppresses cytokine production and lymphocyte proliferation: comparison between young and older women.J Nutr121 :547 –555,1991 .[Abstract/Free Full Text]
  33. Virella G, Fourspring K, Hyman B, Haskill-Stroud R, Long L, Virella I, La Via M, Gross AJ, Lopes-Virella M: Immunosuppressive effects of fish oil in normal human volunteers: correlation with the in vitro effects of eicosapentanoic acid on human lymphocytes.Clin Immunol Immunopathol61 :161 –176,1991 .[Medline]
  34. Thies F, Nebe-von-Caron G, Powell JR, Yaqoob P, Newsholme EA, Calder PC: Dietary supplementation with gamma-linolenic acid or fish oil decreases T lymphocyte proliferation in healthy older humans.J Nutr131 :1918 –1927,2001 .[Abstract/Free Full Text]
  35. Yaqoob P, Pala HS, Cortina-Borja M, Newsholme EA, Calder PC: Encapsulated fish oil enriched in alpha-tocopherol alters plasma phospholipid and mononuclear cell fatty acid compositions but not mononuclear cell functions.Eur J Clin Invest30 :260 –274,2000 .[Medline]
  36. Weiland SK, von Mutius E, Hüsing A, Asher MI: Intake of trans fatty acids and prevalence of childhood asthma and allergies in Europe.Lancet353 :2040 –2041,1999 .[Medline]
  37. Statistic Bureau, Ministry of Public Management, Home Affairs, Posts and Telecommunications, Japan: "2000 Population Census of Japan, Vol. 3-2-27, Labour Force Status of Population, Industry (Major Groups) of Employed Persons, and Education. Osaka-fu" [Japanese]. Tokyo: Statistic Bureau, Ministry of Public Management, Home Affairs, Posts and Telecommunications, Japan,2002 .
  38. Palmer GW, Claman HN: Pregnancy and immunology: selected aspects.Ann Allergy Asthma Immunol89 :350 –359,2002 .[Medline]
  39. Chaouat G, Ledée-Bataille N, Dubanchet S, Zourbas S, Sandra O, Martal J: TH1/TH2 paradigm in pregnancy: paradigm lost? Cytokines in pregnancy/early abortion: reexamining the TH1/TH2 paradigm.Int Arch Allergy Immunol134 :93 –119,2004 .[Medline]




This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Miyake, Y.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Miyake, Y.

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS