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Re: Need advise-14 year old underweight

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Hi Maia,

have you already contacted Dr. Antova? Maybe she has some good ideas of what

you can do with the limited sources in Bulgaria.

Peace

Torsten, dad of Fiona 6wcf

e-mail: torstenkrafft@...

Subject: CF: Nutrition and respiratory health in children

Thorax 2003;58:231-236

© 2003 BMJ Publishing GroupÊ & British Thoracic

Society

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----

PAEDIATRICS

Nutrition and respiratory health in children in six

Central and Eastern European countries

T Antova1, S Pattenden2, B Nikiforov1, G S Leonardi2,

B Boeva1, T Fletcher2, P Rudnai3, H Slachtova4, C

Tabak5, R Zlotkowska6, D Houthuijs5, B Brunekreef7 and

J Holikova8

1 National Center of Hygiene, Medical Ecology and

Nutrition, Sofia, Bulgaria

2 London School of Hygiene and Tropical Medicine,

London, UK

3 National Institute of Environmental Health,

Budapest, Hungary

4 Regional Institute of Hygiene, Ostrava, Czech

Republic

5 National Institute of Public Health and the

Environment (RIVM), Bilthoven, The Netherlands

6 Institute of Occupational Medicine and Environmental

Health, Sosnowiec, Poland

7 Institute for Risk Assessment Sciences, Utrecht

University, Utrecht, The Netherlands

8 Institute of Public Health, Banska Bystrica, Slovak

Republic

Correspondence to:

Dr T Antova, National Center of Hygiene, Medical

Ecology and Nutrition, Blvd D Nestorov 15, Sofia 1431,

Bulgaria;

t.antova@...

ABSTRACT

Background: The results of studies on the effect of

nutrition on respiratory diseases are inconsistent.

The role of nutrition in children's respiratory health

was therefore analysed within the cross sectional

Central European Study on Air Pollution and

Respiratory Health (CESAR).

Method: A total of 20 271 children aged 7-11 were

surveyed in six European countries. Respiratory health

and food intake were assessed using questionnaires.

Associations between four symptoms and nutritional

factors were evaluated using logistic regression,

controlling for area plus other potential confounders.

Results: All symptoms showed initial associations with

nutritional factors. Low consumption of fish and of

summer and winter fruit were the most consistent

predictors. In a fully adjusted model low fish intake

remained a significant independent predictor of

persistent cough (OR=1.18; 95% CI 1.04 to 1.34),

wheeze ever (OR=1.14; 95% CI 1.03 to 1.25) and current

wheeze (OR=1.21; 95% CI 1.06 to 1.39) and a weaker

predictor of winter cough (OR=1.10; 95% CI 0.99 to

1.23). Low summer fruit intake was a predictor of

winter cough (OR=1.40; 95% CI 1.10 to 1.79) and

persistent cough (OR=1.35; 95% CI 1.01 to 1.82). Low

winter fruit intake was associated with winter cough

(OR=1.28; 95% CI 1.09 to 1.51). Associations between

symptoms and vegetable intake were inconsistent. Low

summer intake was significantly associated with winter

cough (OR=1.23; 95% CI 1.03 to 1.47) but, overall,

winter intake had inverse associations with both

coughs. Associations between winter vegetable intake

and wheeze varied considerably between countries.

Conclusion: A number of associations were found

between respiratory symptoms and low intake of fish,

fruit and vegetables in children. Low fish intake was

the most consistent predictor of poor respiratory

health. Fruit and vegetable intake showed stronger

associations with cough than with wheeze.

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