Background Pharyngeal bacteria are exposed to different sugar conditions depending on the diet of the child. We hypothesized that dietary factors such as daily intake of carbohydrates could be associated with pneumococcal carriage and the occurrence of otitis media in children. Methods Our study design was a cross-sectional study among 1006 children attending child day care centers. Parents filled in a food frequency questionnaire. Oropharyngeal swabs were collected from each child. The primary outcome was the occurrence of pneumococcal carriage and the secondary outcome the number of acute otitis media episodes during life. Principal component analysis was used to group dietary intake into nine factors. The models were adjusted for age, gender of the child and educational level of the mother. Results The dietary factor which included high consumption of sweet pastries and jam was associated with an increased risk of pneumococcal carriage (OR 1.17, 95% CI 1.01 to 1.36, P-value 0.04). The factor including frequent consumption of fruit and berries was associated with a decreased risk of acute otitis (regression coefficient ？0.51, 95% CI ？0.98 to ？0.03, P = 0.04). A high intake of consumption of sweets and snacks (OR 1.36, 95% CI 1.03 to 1.80, P = 0.03) was associated with an increased risk of caries. Conclusions Diet was associated with a risk of pneumococcal carriage and the occurrence of otitis media. Diet may thus be a modifiable risk factor for the occurrence of acute otitis media.
References
[1]
Syrj？nen RK, Kilpi TM, Kaijalainen TH, Herva EE, Takala AK (2001) Nasopharyngeal carriage of Streptococcus pneumoniae in Finnish children younger than 2 years old. J Infect Dis 184: 451–459 JID010089 [pii];10.1086/322048 [doi].
[2]
Leino T, Hoti F, Syrj？nen R, Tanskanen A, Auranen K (2008) Clustering of serotypes in a longitudinal study of Streptococcus pneumoniae carriage in three day care centres. BMC Infect Dis 8: 173 1471-2334-8-173 [pii];10.1186/1471-2334-8-173 [doi].
[3]
Kilpi T, Herva E, Kaijalainen T, Syrj？nen R, Takala AK (2001) Bacteriology of acute otitis media in a cohort of Finnish children followed for the first two years of life. Pediatr Infect Dis J 20: 654–662. doi: 10.1097/00006454-200107000-00004
[4]
Marshall TA, Levy SM, Broffitt B, Warren JJ, Eichenberger-Gilmore JM, et al. (2003) Dental caries and beverage consumption in young children. Pediatrics 112: e184–e191. doi: 10.1542/peds.112.3.e184
[5]
Kontiokari T, Laitinen J, J？rvi L, Pokka T, Sundqvist K, et al. (2003) Dietary factors protecting women from urinary tract infection. Am J Clin Nutr 77: 600–604.
[6]
Kontiokari T, Sundqvist K, Nuutinen M, Pokka T, Koskela M, et al. (2001) Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. BMJ 322: 1571. doi: 10.1136/bmj.322.7302.1571
[7]
Salo J, Uhari M, Helminen M, Korppi M, Nieminen T, et al. (2012) Cranberry juice for the prevention of recurrences of urinary tract infections in children: a randomized placebo-controlled trial. Clin Infect Dis 54: 340–346 cir801 [pii];10.1093/cid/cir801 [doi].
[8]
Uhari M, Kontiokari T, Koskela M, Niemel？ M (1996) Xylitol chewing gum in prevention of acute otitis media: double blind randomised trial. BMJ 313: 1180–1184. doi: 10.1136/bmj.313.7066.1180
[9]
Rueda AM, Ormond M, Gore M, Matloobi M, Giordano TP, et al. (2010) Hyperglycemia in diabetics and non-diabetics: effect on the risk for and severity of pneumococcal pneumonia. J Infect 60: 99–105 S0163-4453(09)00387-9 [pii];10.1016/j.jinf.2009.12.003 [doi].
[10]
Touger-Decker R, van LC (2003) Sugars and dental caries. Am J Clin Nutr 78: 881S–892S.
[11]
O’Brien KL, Bronsdon MA, Dagan R, Yagupsky P, Janco J, et al. (2001) Evaluation of a medium (STGG) for transport and optimal recovery of Streptococcus pneumoniae from nasopharyngeal secretions collected during field studies. J Clin Microbiol 39: 1021–1024 10.1128/JCM.39.3.1021-1024.2001 [doi].
[12]
Uhari M, M？ntysaari K, Niemel？ M (1996) A meta-analytic review of the risk factors for acute otitis media. Clin Infect Dis 22: 1079–1083. doi: 10.1093/clinids/22.6.1079
[13]
Niemel？ M, Pihakari O, Pokka T, Uhari M (2000) Pacifier as a risk factor for acute otitis media: A randomized, controlled trial of parental counseling. Pediatrics 106: 483–488. doi: 10.1542/peds.106.3.483
[14]
Sipil？ M, Karma P, Pukander J, Timonen M, Kataja M (1988) The Bayesian approach to the evaluation of risk factors in acute and recurrent acute otitis media. Acta Otolaryngol 106: 94–101. doi: 10.3109/00016488809107375
[15]
Vadeboncoeur C, Pelletier M (1997) The phosphoenolpyruvate:sugar phosphotransferase system of oral streptococci and its role in the control of sugar metabolism. FEMS Microbiol Rev 19: 187–207. S0168-6445(96)00029-0 [pii].
[16]
Kurola P, Tapiainen T, Sevander J, Kaijalainen T, Leinonen M, et al. (2011) Effect of xylitol and other carbon sources on Streptococcus pneumoniae biofilm formation and gene expression in vitro. APMIS 119: 135–142 10.1111/j.1600-0463.2010.02703.x [doi].
[17]
M？kinen KK, Bennett CA, Hujoel PP, Isokangas PJ, Isotupa KP, et al. (1995) Xylitol chewing gums and caries rates: a 40-month cohort study. J Dent Res 74: 1904–1913. doi: 10.1177/00220345950740121501
[18]
Mosby TT, Cosgrove M, Sarkardei S, Platt KL, Kaina B (2012) Nutrition in adult and childhood cancer: role of carcinogens and anti-carcinogens. Anticancer Res 32: 4171–4192. 32/10/4171 [pii].
[19]
Duarte S, Gregoire S, Singh AP, Vorsa N, Schaich K, et al. (2006) Inhibitory effects of cranberry polyphenols on formation and acidogenicity of Streptococcus mutans biofilms. FEMS Microbiol Lett 257: 50–56 FML147 [pii];10.1111/j.1574-6968.2006.00147.x [doi].
[20]
Koo H, Duarte S, Murata RM, Scott-Anne K, Gregoire S, et al. (2010) Influence of cranberry proanthocyanidins on formation of biofilms by Streptococcus mutans on saliva-coated apatitic surface and on dental caries development in vivo. Caries Res 44: 116–126 000296306 [pii];10.1159/000296306 [doi].
Watt JP, O’Brien KL, Katz S, Bronsdon MA, Elliott J, et al. (2004) Nasopharyngeal versus oropharyngeal sampling for detection of pneumococcal carriage in adults. J Clin Microbiol 42: 4974–4976 42/11/4974 [pii];10.1128/JCM.42.11.4974-4976.2004 [doi].
[23]
Greenberg D, Broides A, Blancovich I, Peled N, Givon-Lavi N, et al. (2004) Relative importance of nasopharyngeal versus oropharyngeal sampling for isolation of Streptococcus pneumoniae and Haemophilus influenzae from healthy and sick individuals varies with age. J Clin Microbiol 42: 4604–4609 42/10/4604 [pii];10.1128/JCM.42.10.4604-4609.2004 [doi].
[24]
Ministry of Education and Culture Finland (2010) Suomen v？est？n koulutustason vahvuudet ja heikkoudet.
[25]
Kytt？l？ P., Ovaskainen M., and Kronberg-Kippil？ C. (2008) The diet of Finnish preschoolers.
[26]
Eskola J, Kilpi T, Palmu A, Jokinen J, Haapakoski J, et al. (2001) Efficacy of a pneumococcal conjugate vaccine against acute otitis media. N Engl J Med 344: 403–409 10.1056/NEJM200102083440602 [doi].
[27]
Veenhoven R, Bogaert D, Uiterwaal C, Brouwer C, Kiezebrink H, et al. (2003) Effect of conjugate pneumococcal vaccine followed by polysaccharide pneumococcal vaccine on recurrent acute otitis media: a randomised study. Lancet 361: 2189–2195 S0140-6736(03)13772-5 [pii];10.1016/S0140-6736(03)13772-5 [doi].
[28]
Grimes CA, Riddell LJ, Campbell KJ, Nowson CA (2013) Dietary salt intake, sugar-sweetened beverage consumption, and obesity risk. Pediatrics 131: 14–21 peds.2012-1628 [pii];10.1542/peds.2012-1628 [doi].
