{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T15:35:49Z","timestamp":1790523349700,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,9,10]],"date-time":"2018-09-10T00:00:00Z","timestamp":1536537600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100010661","name":"Horizon 2020 Framework Programme","doi-asserted-by":"publisher","award":["FOOD\u2010CT\u20102004\u2010506378"],"award-info":[{"award-number":["FOOD\u2010CT\u20102004\u2010506378"]}],"id":[{"id":"10.13039\/100010661","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009362","name":"South London and Maudsley NHS Foundation Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009362","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009360","name":"King\u2019s College London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009360","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010872","name":"King's College Hospital NHS Foundation Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010872","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2018,11]]},"abstract":"Summary<\/jats:title>\n \n Background<\/jats:title>\n \n Dietary patterns defined using principal component analysis (\n PCA<\/jats:styled-content>\n ) offer an alternative to the analysis of individual foods and nutrients and have been linked with asthma and allergic disease. However, results have not been reproducible in different settings.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To identify dietary patterns common to different European countries and examine their associations with asthma and allergic symptoms.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In sixteen study centers in nine European countries, 3206 individuals aged 15\u201077\u00a0years completed a common, internationally validated, food frequency questionnaire and a respiratory symptoms questionnaire. The outcomes of interest were current asthma, asthma symptoms score (derived based on responses to 5 asthma symptom\u2010related questions), atopy (positive skin prick test). Spirometry was used to estimate forced expiratory volume in 1\u00a0second (\n FEV<\/jats:styled-content>\n 1<\/jats:sub>\n ), forced vital capacity (\n FVC<\/jats:styled-content>\n ), the\n FEV<\/jats:styled-content>\n 1<\/jats:sub>\n \/\n FVC<\/jats:styled-content>\n , spirometric restriction (\n FVC<\/jats:styled-content>\n below the lower limit of normal (<\n LLN<\/jats:styled-content>\n )) and\n FEV<\/jats:styled-content>\n 1<\/jats:sub>\n \/\n FVC<\/jats:styled-content>\n <\n LLN<\/jats:styled-content>\n . A novel meta\u2010analytic approach was used to identify dietary patterns using\n PCA<\/jats:styled-content>\n and to examine associations with asthma and allergic symptoms.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Two dietary patterns emerged, generally correlating with the same foods in different countries: one associated with intake of animal proteins and carbohydrates; the other with fruit and vegetables. There was evidence that the former pattern was associated with a higher asthma score (\n RR<\/jats:styled-content>\n 1.63, 95%\n CI<\/jats:styled-content>\n : 1.33\u20102.01), current asthma (\n RR<\/jats:styled-content>\n 2.03, 95%\n CI<\/jats:styled-content>\n : 1.52\u20102.71), wheeze (\n RR<\/jats:styled-content>\n 1.84, 95%\n CI<\/jats:styled-content>\n : 1.30\u20102.60), atopic status (\n RR<\/jats:styled-content>\n 1.68, 95%\n CI<\/jats:styled-content>\n : 1.16\u20102.44) and with decreased lung function, including an\n FVC<\/jats:styled-content>\n <\n LLN<\/jats:styled-content>\n (\n RR<\/jats:styled-content>\n 4.57, 95%\n CI<\/jats:styled-content>\n : 2.27\u20109.21).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Clinical Relevance<\/jats:title>\n Our findings suggest an increase in sensitisation to common allergens, an increase in asthma symptoms, and a reduction in lung function in those eating a diet rich in animal proteins and carbohydrates. We found little evidence of an association between these outcomes and eating a diet rich in fruits and vegetables.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/cea.13243","type":"journal-article","created":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T03:07:59Z","timestamp":1533784079000},"page":"1474-1482","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Dietary patterns and respiratory health in adults from nine European countries\u2014Evidence from the GA\n 2<\/sup>\n LEN study"],"prefix":"10.1111","volume":"48","author":[{"given":"Ioannis","family":"Bakolis","sequence":"first","affiliation":[{"name":"Department of Biostatistics and Health Informatics Institute of Psychiatry, Psychology and Neuroscience King's College London London UK"},{"name":"Centre for Implementation Science Health Services and Population Research Department Institute of Psychiatry, Psychology and Neuroscience King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Hooper","sequence":"additional","affiliation":[{"name":"Centre for Primary Care and Public Health Blizard Institute Barts and The London School of Medicine and Dentistry London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Bachert","sequence":"additional","affiliation":[{"name":"Upper Airway Research Laboratory Ghent University Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bibi","family":"Lange","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tari","family":"Haahtela","sequence":"additional","affiliation":[{"name":"Skin and Allergy Hospital Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Keil","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin Lodz Germany"},{"name":"Institute of Clinical Epidemiology and Biometry W\u00fcrzburg University W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Hofmaier","sequence":"additional","affiliation":[{"name":"Department of Paediatric Pneumology& Immunology Charite \u2013 Universitaatsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wytske","family":"Fokkens","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department Academic Medical Centre Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Rymarczyk","sequence":"additional","affiliation":[{"name":"Clinical Department of Internal Diseases, Allergology and Clinical Immunology Medical University of Silesia Katowice Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christer","family":"Janson","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Respiratory, Allergy and Sleep Research Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter GJ","family":"Burney","sequence":"additional","affiliation":[{"name":"Population Health and Occupational Medicine National Heart and Lung Institute Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Garcia\u2010Larsen","sequence":"additional","affiliation":[{"name":"Population Health and Occupational Medicine National Heart and Lung Institute Imperial College London London UK"},{"name":"Department of International Health Johns Hopkins School of Public Health Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/pai.12071"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.164.10.2104061"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1996.tb122010.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0029665109991753"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2222.2003.01777.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2004.022616"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2004.12.1139"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1079\/NRR2005107"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/52.4.739"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.114.204479"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200506-901OC"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2008.01.023"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00114709"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fct.2014.09.014"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2006.074534"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00130807"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2009.02215.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu7042879"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114509993266"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/80.3.759"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejcn.2011.15"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2006.01184.x"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00202013"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1601432"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/nbu.12124"},{"key":"e_1_2_8_27_1","unstructured":"GethingsLA CharlesD BurneyPGJ Garcia\u2010LarsenV.Nutritional metabolomics: A serum based metabolomics strategy for determining dietary flavanoid intake in human adults. The 12th Annual Conference of the Metabolomics Society2016."},{"key":"e_1_2_8_28_1","volume-title":"Statistical Methods for Meta\u2010Analysis","author":"Hedges LV","year":"1985"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0920-9964(98)00009-7"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0920-9964(98)00011-5"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/pai.12276"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6604678"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2008.104703"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/30.2.334"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2008.01716.x"}],"container-title":["Clinical & Experimental Allergy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcea.13243","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cea.13243","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T13:08:35Z","timestamp":1694869715000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cea.13243"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,10]]},"references-count":35,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1111\/cea.13243"],"URL":"https:\/\/doi.org\/10.1111\/cea.13243","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.733793789.793550081","asserted-by":"object"}]},"ISSN":["0954-7894","1365-2222"],"issn-type":[{"value":"0954-7894","type":"print"},{"value":"1365-2222","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,10]]},"assertion":[{"value":"2017-11-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}