Background and objectives: Flavonoids are bio-compounds widely found in fruits, vegetables, herbs and red wine. Due to their antioxidant and anti-inflammatory effect in the airways, flavonoids have been suggested to reduce the severity or prevent the risk of lung diseases. The aim of this thesis is to assess the association between asthma (current and past), chronic bronchitis and rhinitis (allergic and non-allergic) and dietary intake of flavonoids (total and the major subclasses: flavanones, anthocyanins, flavan-3-ols, flavonols, flavones, polymers and proanthocyanidins). Methods: Data from Gene-Environment Interaction in Respiratory Diseases (GEIRD), a multi-case control study, was analysed. Subjects aged between 20 and 84 years old were selected from general population. To ascertain dietary intake, the European Prospective Investigation into Cancer and Nutrition Food Frequency Questionnaire (EPIC) was used. Multinomial regression models were used to assess the association between dietary exposures and the relative risk ratio (RRR) of being a case adjusting for age, sex, centre, body mass index, smoking habit, alcohol intake, education, total energy intake, vitamin C and total fruit intake. The subjects included in the analyses were 990, hierarchically defined as follows: subjects with asthma (current, CA, n = 159; past, PA, n = 78), chronic bronchitis (CB, n = 47), allergic rhinitis (allergic, AR, n = 167; non-allergic, NAR, n = 142) and controls (n = 397). Results: An increase of 1 standard deviation of flavanones was associated with a reduced risk of NAR (adjusted RRR=0:68, 95% Confidence Interval (CI) 0:47; 0:97); a similar result was found comparing the highest vs. lowest quartile of flavanones intake (adjusted RRR=0:24, 95% CI 0:10; 0:59). Conclusions: Flavanones, which are mainly contained in citrus fruits, might 5 reduce the risk of NAR. No significant associations were found between dietary intake of flavonoids and CA, PA, CB or AR. 6
Introduzione e obiettivi: I flavonoidi sono bio-composti presenti in quantità consistenti in alcuni tipi di frutta, verdura, erbe e vino rosso. Grazie al loro effetto antiossidante e antinfiammatorio sulle vie aeree, è stato ipotizzato che i flavonoidi possano ridurre la gravità e/o prevenire il rischio di malattie polmonari. Lo scopo di questa tesi è stimare l’associazione tra asma (corrente e in passato), bronchite cronica, rinite (allergica e non) e assunzione di flavonoidi con la dieta (flavonoidi totali e sottoclassi principali: flavanoni, antociani, flavan-3-oli, flavonoli, flavoni, polimeri e proantocianidine). Metodi: Sono stati analizzati i dati dello studio multicaso-controllo Gene-Environment Interaction in Respiratory Diseases (GEIRD). Per lo studio sono stati selezionati soggetti fra i 20 ed i 84 anni di età dalla popolazione generale. Per raccogliere le informazioni sulle abitudini alimentari, è stato utilizzato il questionario EPIC (European Prospective Investigation into Cancer and Nutrition). Si sono utilizzati modelli di regressione multinomiale per valutare l’associazione tra esposizioni dietetiche e il rapporto di rischio relativo (RRR) per ogni patologia, aggiustando per età, sesso, centro, indice di massa corporea, abitudine al fumo, consumo di alcol, istruzione, apporto energetico totale, vitamina C e assunzione totale di frutta. I soggetti inclusi nelle analisi erano 990, gerarchicamente definiti come segue: soggetti con asma (corrente, CA, n = 159; in passato, PA, n = 78), bronchite cronica (CB, n = 47), rinite allergica (allergica, AR, n = 167; non allergica, NAR, n = 142) e controlli (n = 397). Risultati: Un aumento di una deviazione standard nell’assunzione di flavanoni è associato ad un rischio ridotto di NAR (RRR aggiustato = 0:68, intervallo di confidenza al 95% (IC) 0:47; 0:97); un risultato simile è stato trovato confrontando 3 il quartile più alto rispetto a quello più basso dell’assunzione di flavanoni (RRR aggiustato = 0:24, IC al 95% 0:10; 0:59). Conclusioni: I flavanoni, principalmente contenuti negli agrumi, potrebbero ridurre il rischio di NAR. Non sono state trovate associazioni significative tra l’assunzione di flavonoidi e probabilità di sviluppare CA, PA, CB oppure AR. 4
Dietary flavonoids and chronic respiratory diseases in Italian adults
mattioliWriting – Original Draft Preparation
2020-01-01
Abstract
Background and objectives: Flavonoids are bio-compounds widely found in fruits, vegetables, herbs and red wine. Due to their antioxidant and anti-inflammatory effect in the airways, flavonoids have been suggested to reduce the severity or prevent the risk of lung diseases. The aim of this thesis is to assess the association between asthma (current and past), chronic bronchitis and rhinitis (allergic and non-allergic) and dietary intake of flavonoids (total and the major subclasses: flavanones, anthocyanins, flavan-3-ols, flavonols, flavones, polymers and proanthocyanidins). Methods: Data from Gene-Environment Interaction in Respiratory Diseases (GEIRD), a multi-case control study, was analysed. Subjects aged between 20 and 84 years old were selected from general population. To ascertain dietary intake, the European Prospective Investigation into Cancer and Nutrition Food Frequency Questionnaire (EPIC) was used. Multinomial regression models were used to assess the association between dietary exposures and the relative risk ratio (RRR) of being a case adjusting for age, sex, centre, body mass index, smoking habit, alcohol intake, education, total energy intake, vitamin C and total fruit intake. The subjects included in the analyses were 990, hierarchically defined as follows: subjects with asthma (current, CA, n = 159; past, PA, n = 78), chronic bronchitis (CB, n = 47), allergic rhinitis (allergic, AR, n = 167; non-allergic, NAR, n = 142) and controls (n = 397). Results: An increase of 1 standard deviation of flavanones was associated with a reduced risk of NAR (adjusted RRR=0:68, 95% Confidence Interval (CI) 0:47; 0:97); a similar result was found comparing the highest vs. lowest quartile of flavanones intake (adjusted RRR=0:24, 95% CI 0:10; 0:59). Conclusions: Flavanones, which are mainly contained in citrus fruits, might 5 reduce the risk of NAR. No significant associations were found between dietary intake of flavonoids and CA, PA, CB or AR. 6File | Dimensione | Formato | |
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