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© 2022 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.Environmental exposure plays a major role in the development of allergic diseases. The exposome can be classified into internal (e.g., aging, hormones, and metabolic processes), specific external (e.g., chemical pollutants or lifestyle factors), and general external (e.g., broader socioeconomic and psychological contexts) domains, all of which are interrelated. All the factors we are exposed to, from the moment of conception to death, are part of the external exposome. Several hundreds of thousands of new chemicals have been introduced in modern life without our having a full understanding of their toxic health effects and ways to mitigate these effects. Climate change, air pollution, microplastics, tobacco smoke, changes and loss of biodiversity, alterations in dietary habits, and the microbiome due to modernization, urbanization, and globalization constitute our surrounding environment and external exposome. Some of these factors disrupt the epithelial barriers of the skin and mucosal surfaces, and these disruptions have been linked in the last few decades to the increasing prevalence and severity of allergic and inflammatory diseases such as atopic dermatitis, food allergy, allergic rhinitis, chronic rhinosinusitis, eosinophilic esophagitis, and asthma. The epithelial barrier hypothesis provides a mechanistic explanation of how these factors can explain the rapid increase in allergic and autoimmune diseases. In this review, we discuss factors affecting the planet’s health in the context of the ‘epithelial barrier hypothesis,’ including climate change, pollution, changes and loss of biodiversity, and emphasize the changes in the external exposome in the last few decades and their effects on allergic diseases. In addition, the roles of increased dietary fatty acid consumption and environmental substances (detergents, airborne pollen, ozone, microplastics, nanoparticles, and tobacco) affecting epithelial barriers are discussed. Considering the emerging data from recent studies, we suggest stringent governmental regulations, global policy adjustments, patient education, and the establishment of individualized control measures to mitigate environmental threats and decrease allergic disease.

Objective: During the COVID-19 pandemic, our diet and lifestyle have changed significantly. In this study, it was aimed to determine the changes in diet, body weight and Orthorexia Nervosa (ON) tendency in the pandemic. Method: This cross-sectional study was carried out among adults (n 1/4 945). An online questionnaire was used to determine nutrition, lifestyle factors and ON tendency (via Google Docs). The questionnaire was also shared on social media groups and pages (instagram, twitter and facebook) managed by registered dietitians. Results: During the COVID-19 pandemic individuals' body weight and total food consumption increased by 51.0% and 57.2%, respectively. Increased screen time (OR: 1.912, 95% CI: 1.374-2.661 p < 0.001), sleeping time (OR: 3.630, 95% CI: 2.551-5.166 p < 0.001) and decreased physical activity (OR: 2.051, 95% CI: 1.198-3.509 p < 0.01) were associated with weight gain. The ON tendency increased in all groups according to the change in food consumption status (p < 0.05). Conclusions: Considering the ongoing pandemic, individuals should be provided with adequate nutri-tional support. It is very important to get that support from nutritionists in order to monitor and control body weight and ON tendency. (C) 2022 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Subjective tinnitus is the most common and manifest auditory symptom of an existing pathology in the auditory system. Although the effect of obesity on tinnitus is still uncertain, it is known that increased fat tissue increases the severity and symptoms of tinnitus. In this study, it was aimed to evaluate the effect of weight loss through diet and physical activity on tinnitus.Forty-six obese subjects diagnosed with tinnitus were randomized into the diet + physical activity (PA) (n = 13), diet (n = 16) and the control groups (n = 17). The anthropometric measurements, tinnitus severity scores, tinnitus handicap inventory (THI) scores and short form quality of life (SF-36) scores of the individuals were recorded and compared at the beginning and at the end of the study.In the diet + PA and diet groups; body weight (diet + PA:-6.5 ± 2.6; diet: -4.1 ± 1) tinnitus severity (diet + PA:-11.0 ± 7.0; diet: -9.0 ± 8.7) and THI scores (diet + FA:-15.0 ± 9.5; diet: -14.0 ± 10.0) significantly decreased compared to the control group (p 0.01). This decline was more in those with weight loss of ≥5.0% than those with5.0%. SF-36 score was significantly increased in the diet + PA and diet groups (respectively 10.0 ± 5.5 and 6.0 ± 2.7) compared to the control group (p 0.05).Diet and physical activity intervention ameliorated the tinnitus severity and quality of life in obese patients with tinnitus. However to generalize this findings further studies are needed. REGISTERED UNDER CLINICALTRIALS.NCT00123456.