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Fan Z, Xu M, Chen S, Wang J, Gong Y, Feng X, Yin X. Association of Socioeconomic Status and a Broad Combination of Lifestyle Factors With Adult-Onset Asthma: A Cohort Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:2066-2073. [PMID: 38631523 DOI: 10.1016/j.jaip.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 03/26/2024] [Accepted: 04/05/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND The prevalence of asthma is gradually increasing worldwide, and there are socioeconomic inequalities in the risk of developing asthma. OBJECTIVE To evaluate whether the lifestyle is associated with asthma in adults, as well as whether and to what extent healthy lifestyles may modify socioeconomic status (SES) inequities in asthma. METHODS This study included a total of 223,951 participants from the UK Biobank. Smoking, physical activity, alcohol consumption, healthy diet patterns, sedentary time, and sleep duration items were used to construct the lifestyle score. Income, education, and occupation were used to assess SES. Cases of adult-onset asthma were identified on the basis of electronic health records. The Cox proportional hazards regression was used to explore the association of socioeconomic inequality and lifestyle factors with asthma. RESULTS Compared with the most healthy lifestyle category, the hazard ratios (95% CIs) of the moderately healthy lifestyle and least healthy lifestyle categories for asthma were 1.08 (1.01-1.15) and 1.29 (1.20-1.39), respectively. A significant interaction (Pinteraction < .05) was found between lifestyle categories and SES, and the association between them was more pronounced in participants with low SES (hazard ratioleast healthy vs most healthy, 1.58; 95% CI, 1.40-1.80). The joint analysis revealed that the risk of asthma was highest among participants with the lowest SES and the least healthy lifestyles (hazard ratio, 2.02; 95% CI, 1.74-2.33). CONCLUSIONS Unhealthy lifestyle factors are associated with an increased risk of asthma in adults, and socioeconomically disadvantaged groups are more negatively affected by unhealthy lifestyles. Public health strategies for asthma prevention may need to be tailored according to SES, and social policies to reduce poverty are needed alongside lifestyle interventions in areas of deprivation.
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Affiliation(s)
- Zina Fan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Minzhi Xu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shanquan Chen
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jing Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xinglin Feng
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China.
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Zhang H, Zhang X, Yang H, Yang H, Zhang T, Chen L, Zhao Y, Xia Y. Dietary carbohydrate types, genetic predisposition, and risk of adult-onset asthma: A longitudinal cohort study. Int J Biol Macromol 2024; 261:129824. [PMID: 38290630 DOI: 10.1016/j.ijbiomac.2024.129824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/01/2024]
Abstract
We aimed to investigate the longitudinal associations among carbohydrate intake types, genetic predisposition, and risk adult onset asthma (AOA). A dataset of 96,487 participants from UK Biobank was included with 1830 cases of incident AOA during an average follow-up of 9.68 years. Participants with the highest intake of total sugar, free sugar, and fiber intake, as compared to those with the lowest intake of total sugar, free sugar, and fiber intake, showed a 17 % and 22 % increased risk of incident AOA, and a 16 % decreased risk of AOA, respectively. Substitution of 5 % energy from free sugars with 5 % energy from non-free sugars was associated with a significantly lower risk of AOA (Hazard Ratio [HR] = 0.93, 95 % Confidence Interval [CI]: 0.88, 0.99). Participants with high genetic risk and the highest intake of free sugar showed a 112 % (HR = 2.12, 95%CI: 1.68, 2.68) increased risk of incident AOA. Participants with low genetic risk and highest intake of fiber showed a 50 % (HR = 0.50, 95%CI: 0.39, 0.64) reduced risk of AOA. This study highlights the critical role of carbohydrate types in AOA prevention, with an emphasis on reduced free sugar, moderate non-free sugar, and increased fiber intake.
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Affiliation(s)
- Hehua Zhang
- Clinical Trials and Translation Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiangsu Zhang
- Graduate School of China Medical University, Puhe Road No.77, Shenbei New District, Shenyang, Liaoning province 110122, China
| | - Huijun Yang
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong 250021, China
| | - Honghao Yang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tingjing Zhang
- School of Public Health, Wannan Medical College, Wuhu, China
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuhong Zhao
- Clinical Trials and Translation Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China; Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China; Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
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Koç N, Ersoy N, Yardimci H, Külhaş Çelik İ, Civelek E. Evaluation of Healthy Eating Index and Children's Diet Inflammatory Index according to asthma severity group. BMC Pediatr 2024; 24:127. [PMID: 38365643 PMCID: PMC10874057 DOI: 10.1186/s12887-023-04507-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/22/2023] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Diet may contribute to better asthma control in children by impacting the immune and inflammatory pathophysiology. Therefore, this study aimed to investigate differences in nutrient intake, Children's Dietary Inflammatory Index (C-DII), and dietary quality according to asthma severity. MATERIALS AND METHODS Asthma severity, dietary inflammatory status, and diet quality were assessed in a sample of 202 children with asthma (55.6% males, aged 5-18 years) attending a pediatric allergy outpatient clinic. Asthma severity was evaluated according to the Global Initiative for Asthma criteria and categorized as mild, moderate, or severe. The Children's Dietary Inflammatory Index (C-DII) and Healthy Eating Index (HEI-2010) were calculated based on information collected by the 24-h dietary recall method. Dietary quality was categorized as poor, moderate, or good diet according to HEI-2010. RESULTS The mean age of the participants was 9.6 ± 3.2 years. Children with severe asthma were younger on average (p < 0.05). Children with mild asthma had significantly higher fiber and iron intake than those with moderate asthma (p < 0.05). C-DII values did not differ significantly according to asthma severity (p > 0.05). Dietary quality was evaluated as moderate in 89.1% of the participants and also showed no difference based on asthma severity. CONCLUSIONS These findings suggest that inflammatory status and diet quality may not affect asthma severity in children, highlighting the influence of various genetic and environmental factors on the association between diet and asthma severity. More comprehensive and longitudinal studies are needed to investigate the mechanisms linking diet and asthma.
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Affiliation(s)
- Nevra Koç
- Department of Nutrition and Dietetics, Gülhane Health Sciences of Faculty, Sağlık Bilimleri University, İstanbul, Turkey.
| | - Nursena Ersoy
- Ankara University, Institute of Health Sciences, Ankara, Turkey
| | - Hülya Yardimci
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara, Turkey
| | - İlknur Külhaş Çelik
- Division of Pediatric Allergy Immunology, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Ersoy Civelek
- Division of Pediatric Allergy Immunology, Sağlık Bilimleri University, Ankara City Hospital, Ankara, Turkey
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Brigham E, Hashimoto A, Alexis NE. Air Pollution and Diet: Potential Interacting Exposures in Asthma. Curr Allergy Asthma Rep 2023; 23:541-553. [PMID: 37440094 DOI: 10.1007/s11882-023-01101-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE OF REVIEW To provide a review of emerging literature describing the impact of diet on the respiratory response to air pollution in asthma. RECENT FINDINGS Asthma phenotyping (observable characteristics) and endotyping (mechanistic pathways) have increased the specificity of diagnostic and treatment pathways and opened the doors to the identification of subphenotypes with enhanced susceptibility to exposures and interventions. Mechanisms underlying the airway immune response to air pollution are still being defined but include oxidative stress, inflammation, and activation of adaptive and innate immune responses, with genetic susceptibility highlighted. Of these, neutrophil recruitment and activation appear prominent; however, understanding neutrophil function in response to pollutant exposures is a research gap. Diet may play a role in asthma pathogenesis and morbidity; therefore, diet modification is a potential target opportunity to protect against pollutant-induced lung injury. In particular, in vivo and in vitro data suggest the potential for diet to modify the inflammatory response in the airways, including impacts on neutrophil recruitment and function. Murine models provide compelling results in regard to the potential for dietary components (including fiber, antioxidants, and omega-3 fatty acids) to buffer against the inflammatory response to air pollution in the lung. Precision lifestyle approaches to asthma management and respiratory protection in the context of air pollution exposures may evolve to include diet, pending the results of further epidemiologic and causal investigation and with neutrophil recruitment and activation as a candidate mechanism.
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Affiliation(s)
- Emily Brigham
- Division of Respirology, University of British Columbia, Vancouver, BC, Canada.
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.
| | - Alisa Hashimoto
- Faculty of Science, University of British Columbia, BC, Vancouver, Canada
| | - Neil E Alexis
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
- Department of Pediatrics, Division of Allergy, Immunology, Rheumatology and Infectious Disease, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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