Urban/rural differences in diet and atopy in South Africa.

Abstract:

BACKGROUND:There are large differences in the prevalence of atopic disease between urban and rural areas of developing countries, without good explanation. Diet has been associated with atopic disease, but studies of specific nutrients are contradictory, cross-sectional studies often being unsupported by trials. We investigated diet as an explanation for the difference in the prevalence of atopy between urban and rural areas in South Africa. METHODS:A cross-sectional analysis of food frequency questionnaires and allergen skin tests from 698 children aged 8-13 years, recruited from 24 schools in Cape Province, South Africa, who were taking part in a case-control study of exercise-induced bronchospasm. Food frequency data were analysed with a principal components analysis (PCA). RESULTS:The first two principal components of diet explained 25% of the variance, and discriminated almost perfectly between urban and rural subjects. The 'urban' component of diet was strongly associated with positive skin tests even after adjusting for urban residence. There were no significant associations between individual foods or nutrients and positive skin tests, allowing for multiple testing. CONCLUSIONS:Diet explains part of the difference in prevalence between urban and rural areas. The ability to demonstrate this using PCA, but not by exhaustive analysis of all foods, reflects the value of reducing the number of dietary dimensions. The number of foods and nutrients which can be assessed, and the possibility of confounding and effect modification, make it difficult to identify the features of diet most directly implicated in disease. This may explain inconsistencies in dietary studies.

journal_name

Allergy

journal_title

Allergy

authors

Hooper R,Calvert J,Thompson RL,Deetlefs ME,Burney P

doi

10.1111/j.1398-9995.2008.01627.x

subject

Has Abstract

pub_date

2008-04-01 00:00:00

pages

425-31

issue

4

eissn

0105-4538

issn

1398-9995

pii

ALL1627

journal_volume

63

pub_type

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