Allergic Rhinitis and Sinusitis: Nutritional Considerations

Nutritional factors may help prevent allergies. Specifically, longer duration of breast-feeding and avoidance of early introduction of potentially allergenic foods appears to reduce the likelihood that infants will develop allergies. In an Italian study, new mothers were advised to breast-feed their infants and to avoid introducing commonly allergic foods (whole cow's milk, eggs, fish, nuts, and cocoa) during the first year of life. Mothers who did breast-feed were also asked to limit dairy products and avoid eggs in their own diets, as well as to avoid exposure to other sources of allergens (smoking, day care attendance prior to age 2) as much as possible. These interventions greatly reduced allergic symptoms, including allergic rhinitis.⁴

Among individuals with allergic rhinitis, dietary fatty acids and antioxidants can influence the production of allergic mediators, including histamine and leukotrienes, and may thereby play a role in the treatment (and possibly the prophylaxis) of allergic rhinitis and sinusitis.

Some evidence suggests that children who eat less saturated fat and cholesterol and more omega-3 fats have less risk of developing rhinitis. Consumption of butter by children⁵ and of liver by adolescents⁶ has been associated with greater frequency of allergic rhinitis. In contrast, use of an omega-3 fatty acid supplement, paired with a multiple vitamin-mineral formula containing selenium, was shown to decrease the number of episodes of sinus symptoms and acute sinusitis in children.⁷

Limited evidence also suggests that blood levels of vitamins C and E are lower in children with chronic sinusitis than in controls.⁸ The intake of citrus fruit or kiwi fruit, both high in vitamin C, has been associated with lower frequency of rhinitis in children.⁹ Vitamin E has immunologic effects that might improve rhinitis symptoms, including suppression of neutrophil migration and inhibition of immunoglobulin E (IgE) production.⁵ Vitamin E intake from foods was protective against hay fever in an adult population.¹⁰ Patients with hay fever taking vitamin E supplements during pollen season experienced lower nasal symptom scores than those of placebo takers.¹¹ Additional studies are needed to determine if food or supplemental sources of ascorbic acid and vitamin E benefit sufferers of allergic rhinitis.

A botanical treatment called butterbur (Petasites hybridus) significantly reduces both histamine and leukotriene production in sufferers of allergic rhinitis.¹² Benefits have been shown to be similar to those of a prescription antihistamine (cetirizine), without causing cetirizine's sedative side effects.^13,14

Orders

See Basic Diet Orders chapter.

Smoking cessation.

What to Tell the Family

Allergic rhinitis and sinusitis are common yet treatable illnesses. Dietary adjustments may play a role in prevention and, to some extent, in treatment-- and they have no problematic side effects. Women who plan to have children should be encouraged to breast-feed (and withhold any dairy products for the at least the first 6 months of life) and not smoke to decrease the risk of allergic rhinitis and therefore sinusitis in their children. Families should adopt the same changes as the patient to improve their own health and encourage patient compliance.