Effect of the Mediterranean diet in patients with chronic spontaneous urticaria

Ayvaz, Havva Hilal; Kuyumcu, Aliye

doi:10.1590/1806-9282.20201076

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ORIGINAL ARTICLE • Rev. Assoc. Med. Bras. 67 (5) • June 2021 • https://doi.org/10.1590/1806-9282.20201076 copy

Effect of the Mediterranean diet in patients with chronic spontaneous urticaria

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

Patients with chronic spontaneous urticaria often want to be informed about dietary modifications. There have been many studies evaluating dietary approaches in chronic spontaneous urticaria. In this study, we aimed to investigate the relationship between adherence to the Mediterranean diet and chronic spontaneous urticaria.

METHODS:

In this cross-sectional case-control observational study, 100 patients (70 males and 30 females, mean age: 38.6±13.0 years) with chronic spontaneous urticaria and age- and sex-matched 100 healthy controls 70 males and 30 females, mean age: 38.7±13.8 years) were enrolled. A validated 14-item questionnaire evaluating the Mediterranean diet score was used for the assessment of adherence to the Mediterranean diet. The severity and the control of chronic spontaneous urticaria were assessed by Urticaria Activity Score over 7 days and Urticaria Control Test, respectively.

RESULTS:

The mean Mediterranean diet score in the patient group was 5.40±1.88, whereas in healthy controls it was 6.30±1.39 (p<0.001). The Urticaria Activity Score over 7 days score of the patients was negatively correlated with the Mediterranean diet score, whereas the Urticaria Control Test score was positively correlated.

CONCLUSION:

We reported that adherence to the Mediterranean diet may be an independent factor that decreases the risk of chronic spontaneous urticaria. It may also reduce the severity of chronic spontaneous urticaria symptoms.

KEYWORDS:
Chronic Spontaneous Urticaria; Mediterranean Diet; Clinic activity

Questions	Criteria for 1 point
1. Do you use olive oil as main culinary fat?	Yes
2. How much olive oil do you consume in a given day (including oil used for frying, salads, out-of-house meals, etc.)?	≥4 tbsp
3. How many vegetable servings do you consume per day? (1 serving: 200 g [consider side dishes as half a serving])	≥2 (≥1 portion raw or as a salad)
4. How many fruit units (including natural fruit juices) do you consume per day?	≥3
5. How many servings of red meat, hamburger, or meat products (ham, sausage, etc.) do you consume per day? (1 serving: 100-150 g)	<1
6. How many servings of butter, margarine, or cream do you consume per day? (1 serving: 12 g)	<1
7. How many sweet or carbonated beverages do you drink per day?	<1
8. How much wine do you drink per week?	≥7 glasses
9. How many servings of legumes do you consume per week? (1 serving: 150 g)	≥3
10. How many servings of fish or shellfish do you consume per week? (1 serving 100-150 g of fish or 4-5 units or 200 g of shellfish)	≥3
11. How many times per week do you consume commercial sweets or pastries (not homemade), such as cakes, cookies, biscuits, or custard?	<3
12. How many servings of nuts (including peanuts) do you consume per week? (1 serving 30 g)	≥3
13. Do you preferentially consume chicken, turkey, or rabbit meat instead of veal, pork, hamburger, or sausage?	Yes
14. How many times per week do you consume vegetables, pasta, rice, or other dishes seasoned with sofrito (sauce made with tomato and onion, leek, or garlic and simmered with olive oil)?	≥2

	Patient group (n=100)	Control group (n=100)	p-value
Age, years	38.6±13.0	38.7±13.8	0.983
Female, n (%)	70 (70)	69 (69)	0.878
BMI, kg/m²	24.8±3.82	24.2±4.0	0.306
Waist circumference	83±3.8	85±2.6	0.357
Mediterranean diet score	5.40±1.88	6.30±1.39	<0.001
Smoking, n (%)	34 (34)	43 (43)	0.191
Use of alcohol, n (%)	12 (12)	12 (12)	1.000
Comorbidities
Depression, n (%)	15 (15)	5 (5)	0.018
Asthma, allergies, rhinitis, n (%)	6 (6)	2 (2)	0.149
Diabetes mellitus, n (%)	5 (5)	8 (8)	0.390
Hypothyroidism, n (%)	14 (14)	7 (7)	0.106
Rheumatologic disease, n (%)	5 (5)	1 (1)	0.097
Fibromyalgia, n (%)	14 (14)	5 (5)	0.030
Hypertension, n (%)	6 (6)	5 (5)	0.756
Laboratory parameters
Glucose, mg/dL	97.4±12.3	98.8±15.6	0.945
Creatinine, mg/dL	0.76±0.10	0.73±0.14	0.049
Total cholesterol, mg/dL	196.0±27.0	196.1±25.3	0.975
LDL-C, mg/dL	137.6±29.2	125.6±27.5	0.003
HDL-C, mg/dL	42.52±9.46	48.15±9.23	0.002
Triglyceride, mg/dL	142.1±38.5	146.1±52.8	0.536

	Univariable OR (95%Cl)	p-value	Multivariable OR (95% Cl)	p-value
Mediterranean diet score	1.409 (1.167-1.701)	<0.001	1.433 (1.173-1.752)	<0.001
Depression	0.298 (0.104-0.855)	0.024	0.320 (0.280-0.361)	0.047
Fibromyalgia	0.323 (0.112-0.935)	0.037	0.341 (0.140-0.563)	0.81
Creatinine	0.098 (0.009-1.007)	0.051
LDL-C	0.985 (0.975-0.995)	0.004	0.997 (0.984-1.009)	0.163
HDL-C	1.070 (1.034-1.107)	<0.001	1.049 (1.002-1.098)	0.043

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[1] *Corresponding author: drhhilalayvaz@gmail.com