Asthma control in pregnancy is associated with pre-conception dietary patterns

Abstract

Objective: To examine pre-conception dietary patterns in pregnant asthmatic women and to identify associations between maternal diet and asthma control during pregnancy. Design: Cross-sectional study. Pre-conception food frequency data were collected retrospectively. Asthma control was assessed using the Global Initiative for Asthma guidelines. Dietary patterns were derived using factor analysis. Binary logistic regression analyses were used to test the association between uncontrolled asthma and each dietary pattern (Z-score), with values presented as odds ratio and 95 % confidence interval. Setting: Antenatal clinic in a tertiary hospital, Adelaide, Australia, May 2009-July 2013. Subjects: One hundred and fifty-eight asthmatic pregnant women. Results: Three dietary patterns were identified: (i) 'high protein/fruit' (strong food group loadings for fish, meat, chicken, fruit); (ii) 'high fat/sugar/takeaway' (takeaway foods, crisps, refined grains); and (iii) 'vegetarian-type' (vegetables, fruit, soya milk, whole grains). A 1 SD increase in score on the high fat/sugar/ takeaway pattern was associated with increased likelihood of uncontrolled asthma (adjusted OR = 1·54; 95 % CI 1·07, 2·23; P = 0·022). Women with uncontrolled asthma (n 115) had higher energy-adjusted intakes of saturated fat, monounsaturated fat, carbohydrate, sugar and fibre compared with women with controlled asthma (n 43, all P ≤ 0·05). Conclusions: Pre-pregnancy dietary patterns may influence maternal asthma control. Our work highlights the importance of achieving a healthy diet before pregnancy that is low in saturated fat, sugar and takeaway foods, and therefore higher in lean meats, poultry and fish, as well as fruits, vegetables and whole grains. A healthy dietary pattern should be encouraged in all asthmatic women who are of childbearing age, and should additionally be promoted before pregnancy and beyond. Keywords Pre-conception diet Asthma Factor analysis Dietary patterns Pregnancy AustraliaAsthma is a heterogeneous and complex disease, involving alterations in airway structure and airway inflammation. Worldwide, asthma represents one of the most common chronic diseases to affect pregnancies, affecting between 8 and 13 % of the population (1)(2)(3) . A meta-analysis from 2011 demonstrated that asthma in pregnancy was associated with up to 54 % increased risk for low birth weight, small for gestational age, preterm delivery and pre-eclampsia (4) .A subsequent meta-analysis revealed that asthma exacerbations in pregnancy increased the risk for low birth weight (relative risk (RR) = 3·02; 95 % CI 1·87, 4·89) and compared with women with mild asthma, women with moderate to severe asthma were at increased risk for babies born with low birth weight (RR = 1·15; 95 % CI 1·05, 1·26) or small for gestational age (RR = 1·24; 95 % CI 1·15, 1·35) (5) . These studies suggest that worsening asthma during pregnancy may contribute to poor outcomes for the fetus and that approaches to improve asthma control may be of benefit (6) . In non-pregnant ...

Patterns, predictors and outcomes of asthma control and exacerbations during pregnancy: a prospective cohort study

“…This may be due to a difference in other risk factors such as smoking between obese and overweight women. Furthermore it may also be related to dietary intake in this population as we have reported recently that asthmatic women who consumed a diet high in fat, sugar and refined grains were twice as likely to have uncontrolled asthma during pregnancy regardless of BMI [29]. …”

The Association between Dietary Intake, Asthma, and PCOS in Women from the Australian Longitudinal Study on Women’s Health

“…Poor dietary intake, such as foods high in saturated fats and glucose, contribute to inflammation through pathways involved in oxidative stress and insulin resistance, while foods high in antioxidants (such as fruits and vegetables) or unsaturated fatty acids (such as fish and nuts) are anti-inflammatory [24,25]. In keeping with these dietary effects on inflammation, a high fat/sugar/takeaway dietary pattern was associated with an increased likelihood of uncontrolled asthma in pregnancy [26]; and a high fat intake increased neutrophilic airway inflammation in subjects with asthma [27]. Higher dietary antioxidant intake was associated with improved lung function and asthma control (reviewed in [28]).…”

Padrões alimentares, nutrientes do metabolismo do folato e homocisteína e três desfechos em saúde

“…[8,[32][33][34][35] Dietary patterns analyses consider the totality of a diet and enables the data collected from observational studies to be translated into descriptions of eating behaviors that can inform public health guidelines and recommendations. [36] In this study, the variance in food intake explained by the dietary patterns was similar to the variance explained by the dietary patterns of a group of 327 pregnant women from the Rio de Janeiro, Brazil (25.3%) [20] Higher adherence to dietary patterns consisting of discretionary food items in the prepregnancy period has been linked with negative outcomes for both mother and child, [20] including maternal uncontrolled asthma, [38] gestational diabetes mellitus, [39] preterm delivery, [40] earlier gestation and shorter birth length. [40] However, these same kind of prepregnancy dietary patterns have not been shown to be associated with hypertension [41] nor depressive symptoms [32] in pregnancy, nor with early fetal growth[33] emphasizing the necessity for more studies in this field.…”

“…The explained variances found in the dietary pattern analyses in both studies have been well accepted in the field of nutritional epidemiology. [37][38][39] A study review on 54 papers describing maternal dietary patterns and pregnancy outcomes verified that the patterns were frequently classified as prudent or healthy (healthful, health conscious, fruit and low-fat dairy, cooked vegetables, high-protein/fruit, Mediterranean), traditional (common-Brazilian, Nordic, Southern), or as Western or processed (meats/snacks/sweets, high-fat/sugar/takeaway, junk, snack). The majority of the studies identified by the mentioned review study used FFQs to measure the dietary intake and applied principal component analysis to derive the dietary patterns.…”