Margarine Consumption, Asthma, and Allergy in Young Adults: Results of the German National Health Survey 1998
Introduction
To explain the increase in allergic diseases during the past decades in those countries with a Western lifestyle, several hypotheses have been proposed. One states that the increase in consumption of polyunsaturated fatty acids (PUFA) might contribute to the observed increase in allergic diseases 1, 2. Especially, a high intake of n-6 in relation to n-3 PUFA by increased consumption of, e.g., vegetable oil and margarine would enhance the production of IgE by the formation of arachidonic acid-derived eicosanoids and thus promote the development of allergic diseases 3, 4, 5.
Evidence from epidemiologic studies is increasing that consumption of PUFA in the form of an increased ratio of n-6 to n-3 may in fact play a role in allergy development in children. In a cross-sectional study in children aged 3 to 5 years, a high dietary intake of n-6 PUFA, defined as use of polyunsaturated fats on bread and in cooking, was associated with an increased risk of recent asthma (6). Studies on n-3 PUFA further supported the hypothesis: Hodge et al. (7) reported a reduced asthma risk in children consuming oily fish rich in n-3 PUFA and an intervention study showed a reduction in the prevalence of wheeze in 18-month old infants supplemented with dietary n-3 PUFA (8).
Data on the impact of fat consumption and allergy in adults are still rare and conflicting. No relation between the intake of n-3 PUFA and the incidence of asthma in adult women has been observed in a cohort study (9). However, the intake of n-6 PUFA has been shown to be positively related to allergic rhinoconjunctivitis in women (10). In an ecological analysis of data of the European Community Respiratory Health Survey (ECRHS) intake of monounsaturated fatty acids, but not of PUFA, was positively associated with prevalence of allergic sensitization in adults (11).
Since the assessment of nutritional intake of fatty acids is difficult, several studies in children concentrated on the impact of margarine and butter as surrogate marker. The rationale behind it was that margarine may contain up to 10 to 20 times more n-6 PUFA than butter (10).
Cross-sectional studies in Germany among schoolchildren demonstrated a positive association between margarine consumption and the prevalence of hay fever and atopic sensitization 12, 13. The potential adverse effect of margarine intake was also supported by a study of Dunder et al. (14) in Finland where children with an allergic disease had used less butter and consumed more margarine.
Up to now, the effect of margarine intake on allergic diseases in adults has not been studied. Thus, the aim of our study was to analyze the association of allergic diseases with intake of butter and margarine in adults using data from a representative national sample. Use of butter or margarine as bread spread is common in Germany. Therefore, we used frequency of butter and margarine intake as a surrogate marker for intake of different types of fat and different amounts of polyunsaturated fatty acids.
If n-6 PUFA interfere with T-cell differentiation and IgE production, we assume that the effect would be more pronounced in younger age groups at early stages of the pathogenesis.
Against the background of several studies in children we hypothesized that a potential association between frequent intake of margarine rich in n-6 PUFA and allergic diseases should be still detectable in young adults.
Section snippets
Study design
The German National Health Survey 1998 was a cross-sectional study performed between October 1997 and March 1999. The study population comprised 7124 subjects (response rate 61%) aged 18 to 79 years (52% women) of a representative sample of the residential population with regard to age, gender, and community size (15).
Data collection
In the main part of the survey, a self-administered questionnaire, interview by a physician, and medical examination were used to obtain data on disease prevalences, risk factors,
Results
Characteristics of the study subjects are given in Table 1. The body mass index was slightly lower in the youngest age group (mean ± SD 24.0 ± 4.0 kg/m2) compared with the whole study population (mean ± SD 26.7 ± 4.6 kg/m2). Prevalence of obesity defined as body mass index ⩾ 30 kg/m2 was low in that age group (8.0%) compared with study subjects aged 30 to 39 years (13.7%) and 40 to 79 years (27.3%).
Women reported more frequently than men to ever having had hay fever (16.6% vs. 14.3%, p = 0.014)
Discussion
Our results based on data of a representative population sample in Germany showed that young adults eating frequently low-fat margarine alone or in combination with low-fat butter had increased odds for asthma, but not for hay fever, atopic dermatitis and allergic sensitization.
The strengths of our study lie in the representativeness of the study population and in the large sample size. Since we had to rely on self-reported data on allergic diseases, we applied several definitions for current
References (29)
The importance of the ratio of omega-6/omega-3 essential fatty acids
Biomed Pharmacother
(2002)The prevalence of allergic disease and linoleic acid in the diet
J Allergy Clin Immunol
(1999)- et al.
Eighteen-month outcomes of house dust mite avoidance and dietary fatty acid modification in the Childhood Asthma Prevention Study (CAPS)
J Allergy Clin Immunol
(2003) - et al.
Seasonal allergic rhinoconjunctivitis and fatty acid intake: A cross-sectional study in Japan
Ann Epidemiol
(2001) - et al.
Increasing prevalence of hay fever and atopy among children in Leipzig, East Germany
Lancet
(1998) - et al.
Metabolism of trans fatty acids with emphasis on the effects of trans, trans-octadecadienoate on lipid composition, essential fatty acid, and prostaglandins: An overview
Am J Clin Nutr
(1981) - et al.
Selective effects of isomeric cis and trans fatty acids on fatty acyl delta 9 and delta 6 desaturation by human skin fibroblasts
Biochim Biophys Acta
(1983) Trans unsaturated fatty acids in natural products and processed foods
Prog Lipid Res
(1983)- et al.
Intake of trans fatty acids and prevalences of childhood asthma and allergies in Europe
Lancet
(1999) - et al.
Dietary fat and asthma: Is there a connection?
Eur Respir J
(1997)
Dietary fatty acids and allergy
Ann Med
Fatty acids and atopic disease
Pediatr Allergy Immunol
Asthma in preschool children: Prevalence and risk factors
Thorax
Consumption of oily fish and childhood asthma risk
Med J Aust
Cited by (31)
Assessment of dietary intakes of total fat and fatty acids for residents in China in 2015–2018
2021, Journal of Food Composition and AnalysisCitation Excerpt :In France, butter had the highest contribution (29 % of total TFA consumption in adults), followed by cheese (18 % in adults); and in Brazil, TFA originated mainly from margarine (more than a third of total TFA intake) in all age groups; and in Ireland, the major sources of TFA were margarine spreads, cakes, biscuits and fried foods. Taken collectively, high-density foods containing industrially hydrogenated TFA such as butters, margarines, biscuits and fast foods, which had been found to contain up to 40–50 % TFA of total fat, were consumed largely in Western societies (Bolte et al., 2005). Whereas, these products have less consumption in China.
Prevention of food and airway allergy: Consensus of the Italian Society of Preventive and Social Paediatrics, the Italian Society of Paediatric Allergy and Immunology, and Italian Society of Pediatrics
2016, World Allergy Organization JournalCitation Excerpt :The results of these studies, even for the foods they investigate, are contradictory. West et al. evaluate the effect of the administration of antioxidants (β-carotene, vitamin C, vitamin E, copper and zinc) on the development of allergic disease in children [93]. Their results demonstrate a protective effect of vitamin C on the incidence of wheezing and a preventive effect of the contribution of copper on the development of various allergic diseases.
Dietary intake of α-linolenic acid and low ratio of n-6:n-3 PUFA are associated with decreased exhaled NO and improved asthma control
2011, British Journal of NutritionSession 1: Allergic disease - Nutrition as a potential determinant of asthma
2010, Proceedings of the Nutrition Society