Diet quality, asthma and airway inflammation in school-aged children

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Authors Information

1Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
2Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
3Epidemiology Research Unit and Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, Porto, Portugal
4Center for Environmental and Respiratory Health Research (CERH), Population Health, University of Oulu, Oulu, Finland
5Biocenter Oulu, University of Oulu, Oulu, Finland
6Department of Immuno-Allergology, Centro Hospitalar São João, Porto, Portugal 


Published: 08 June 2023
Accepted: 08 June 2023
Received: 27 March 2023


Background. Asthma is a major public health problem, with increasing prevalence in most countries, particularly among children. Poor dietary quality is also increasing in children, and evidence of the overall quality of children’s food patterns effects on asthma is scarce. Methods. This cross-sectional analysis (660 children: 49.1% females, aged 7-12years) evaluated the association between diet quality and asthma (n = 56) and airway inflammation among school-aged children according to body mass index (BMI). Diet quality was assessed through the Healthy Eating Index (HEI)-2015, and categorized by tertiles. Higher scores represent a healthier diet. A questionnaire was used to enquire about self-reported medical diagnosis of asthma and asthma under medication. Lung function and airway reversibility were measured, and airway inflammation assessed measuring exhaled fractional nitric oxide (eNO). Two categories of BMI were considered: non-overweight/obese (p < 85th), (n = 491), and overweight/obese (p ≥ 85th), (n = 169). The associations between diet quality and asthma and airway inflammation were estimated using logistic regression models. Results. Non-overweight/obese children in 2nd tertile of HEI-2015 score had decreased odds of having eNO ≥ 35ppb (OR 0.43, 95%CI 0.19-0.98), medical diagnosis of asthma (OR 0.18; 95%CI 0.04-0.84), and asthma treatment (OR 0.12; 95%CI 0.01-0.95), compared to children in the 1st tertile. Conclusions. Our findings suggest that a higher diet quality associates with lower levels of airway inflammation and reduced prevalence of asthma among non-overweight/obese school-aged children. 

Diet quality; asthma; obesity; Healthy Eating Index; airway inflammation; children.

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