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Original Article


Diet and Prevalence of Atopic Eczema in 6 to 7-Year-Old Schoolchildren in Spain: ISAAC Phase III


M Morales Suárez-Varela,1,2,3 L García-Marcos Álvarez,4 MD Kogan,5 J Costa Ferreira,6 A Martínez Gimeno,7 I Aguinaga Ontoso,8 C González Díaz,9 A Arnedo Pena,10 B Domínguez Aurrecoechea,11 R María Busquets Monge,12 A Blanco Quiros,13 J Batlles Garrido,14 N García de Andoain,15 Á López-Silvarrey Varela,16 A García Merino,17 N Gimeno Clemente,1,2 A Llopis González1,2

1Unit of Public Health, Hygiene, and Environmental Care, Department of Preventive Medicine, University of Valencia, Valencia, Spain
2CIBER Epidemiology and Public Health (CIBERESP), Spain
3Research Foundation, Hospital Universitario “Dr. Peset”, Valencia, Spain
4Unit of Clinical Research (Cartagena) and Department of Pediatrics, University of Murcia, Murcia, Spain
5HRSA, Maternal and Child Health Bureau, Rockville, USA
6 School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
7Section of Pediatric Pneumo-Allergy, Hospital Infantil 12 de Octubre, Madrid, Spain
8Department of Health Sciences. Public University of Navarre, Navarre, Spain
9Department of Pediatrics, Hospital of Basurto, Bilbao, Spain
10Section of Epidemiology. Centre of Public Health. Regional Ministry of Health, Castellón, Castellón, Spain
11Health Centre of Otero, Oviedo, Oviedo, Spain
12Department of Pediatrics, Hospital del Mar, Barcelona, Spain
13Department of Pediatrics, University of Valladolid, Valladolid, Spain
14Department of Pediatrics, Hospital Torrecárdenas, Almería, Spain
15Department of Pediatrics, Hospital de Donostia, San Sebastián, Spain
16Foundation María José Jove, A Coruña, Spain
17Health Centre of Moreda, Health Service of Principado de Asturias, Spain

J Investig Allergol Clin Immunol 2010; Vol. 20(6): 469-475



Background: The prevalence of atopic dermatitis (AD), a chronic skin disease, has increased substantially in recent decades, and different factors have been implicated in its etiology. Although dietary habits are being investigated, few conclusive findings have been reported. Nevertheless, increased consumption of polyunsaturated fatty acids (PUFA) and a diet poor in antioxidants have been related to AD.

Objectives: The objectives of this study were to investigate the association between AD, the intake of different foods, and the effect of a Mediterranean diet among Spanish schoolchildren aged 6 to 7.

Methods: We performed a cross-sectional study with 20 106 schoolchildren aged 6-7 years from 10 different areas of Spain. The participation rate was 76.50%. The prevalence of AD was assessed using the International Study of Asthma and Allergies in Childhood questionnaire and the criteria of the Spanish Academy of Dermatology. To calculate the Mediterranean diet score, we classified food into 2 groups: Mediterranean food, including fruit, seafood, vegetables, pulses, cereals, pasta, rice, and potatoes; and non-Mediterranean food, including meat, milk, and fast food.

Results: Milk was negatively associated with AD. Butter and nuts also were negatively associated, although statistical significance was only reached when these foods were consumed 3 or more times a week.

Conclusions: We found no association between the Mediterranean diet score and AD and a positive association between AD and obesity.

Key words: Atopic dermatitis. Children. ISAAC phase III. Mediterranean diet.