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Background Asthma, a chronic inflammatory disease, affects approximately 300 million people globally, with its prevalence on the rise. While high-income countries report higher rates, low-income nations are also significantly impacted. Asthma’s burden on healthcare systems is substantial, leading to about 15 million disability-adjusted life years lost annually. Childhood asthma prevalence varies worldwide, with rates of 10.1% in Brazil, 5.35% in India, 10.6% in Oman, and 6% in Iran. Factors contributing to asthma include genetic predisposition, socioeconomic status, infections, and dietary intake. Emerging evidence suggests a potential link between Western dietary patterns and childhood asthma, particularly as dietary habits shift rapidly in the Middle East.
About the Study Conducted in early 2020 as part of the Global Asthma Network (GAN), this cross-sectional study investigated the association between Western dietary patterns and asthma symptoms in children and adolescents. Utilizing cluster sampling, the study included 7,214 children aged 6-7 years and 3,026 adolescents aged 13-14 years from 36 elementary and 48 high schools, with response rates of 71.3% and 83.5%, respectively. Due to the COVID-19 pandemic, data collection involved online questionnaires supplemented by pre-pandemic paper questionnaires.
Participants completed the GAN questionnaire, adapted from the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, which assessed asthma symptoms and dietary intake over the past 12 months. The questionnaire’s reliability was confirmed with a Cronbach’s alpha of 0.862. A Western dietary pattern score was calculated based on the consumption of nine food groups, and participants were categorized into tertiles. Additional data on height, weight, ethnicity, and screen time were collected to calculate body mass index (BMI). Statistical analyses were conducted using STATA software, adjusting for confounders like BMI, television watching, and computer use. The study received ethical approval from Shahid Sadoughi University’s ethics committee, with informed consent obtained from all participants.
Study Results Among the 7,667 participants, 324 had doctor-confirmed asthma, with 58.02% being boys. Similarly, 61.7% of those with medication-prescribed asthma were boys. Children with doctor-diagnosed asthma were generally older than those without asthma. The study revealed significant differences in ethnicity distribution between children with and without medication-prescribed asthma. A notable finding was the higher intake of fast foods, soft drinks, and sauce among children with doctor-diagnosed asthma. Likewise, children on asthma medication reported higher consumption of margarine, fast foods, and sauce.
The study explored the relationship between adherence to a Western dietary pattern and asthma outcomes. While no significant association was found between adherence to a Western diet and current asthma in girls or the overall population, a significant negative trend was observed in boys. After adjusting for confounders, this trend remained significant. Furthermore, higher adherence to a Western dietary pattern was linked to an increased risk of wheezing in the past 12 months for the entire population and boys. This relationship persisted even after adjusting for age and sex, with children in the highest adherence tertile having a 24% higher chance of developing wheezing compared to those in the lowest tertile.
Conclusions The study concluded that adherence to a Western dietary pattern is significantly associated with higher wheezing rates in children, particularly in boys. These findings align with other research linking Western diets to wheezing. However, no significant association was found between a Western diet and current asthma, doctor-confirmed asthma, or the use of asthma medication. Further research is needed to confirm these findings and explore the underlying mechanisms, especially in regions experiencing rapid dietary changes.
Journal Reference Emrani, A.S., Sasanfar, B., Jowshan, M.R., et al. (2024). Association between a Western diet and asthma among children and adolescents. Scientific Reports. DOI: 10.1038/s41598-024-64008-5.
