Diet, interleukin-17, and childhood asthma in Puerto Ricans

Han, Yueh‐Ying; Forno, Erick; Brehm, John M.; Acosta‐Pérez, Edna; Alvarez, María; Colón-Semidey, Angel; Rivera-Soto, Winna T; Campos, Hannia; Litonjua, Augusto A.; Alcorn, John F.; Canino, Glorisa; Celedón, Juan C.

doi:10.1016/j.anai.2015.07.020

Cited by 62 publications

(102 citation statements)

References 46 publications

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“…Cross-sectional design was most commonly used (Table 1) with 8 case-control studies (Table 2), 13 cohort studies (Table 3) and 7 clinical trials (Table 4). The majority of studies were conducted in UK ( n = 8) [1,18,22,23,24,25,26,27], but also in Australia ( n = 5) [28,29,30,31,32], Greece ( n = 5) [13,33,34,35,36], Spain ( n = 4) [37,38,39,40], Italy ( n = 4) [9,41,42,43], Brazil ( n = 3) [44,45,46], Netherlands ( n = 3) [21,47,48], USA ( n = 3) [9,49,50], Canada ( n = 2) [20,51], Finland ( n = 2) [52,53], India ( n = 2) [54,55], Japan ( n = 2) [56,57], Mexico ( n = 2) [19,58] Sweden ( n = 2) [17,59], Taiwan [60,61] ( n = 2), Albania [62], China [63], Colombia [64], Germany [7], Ireland [65], Norway [66], Portugal [67…”

Section: Resultsmentioning

confidence: 99%

Effects of Fruit and Vegetable Consumption on Risk of Asthma, Wheezing and Immune Responses: A Systematic Review and Meta-Analysis

et al. 2017

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Evidence suggests that reduced intake of fruit and vegetables may play a critical role in the development of asthma and allergies. The present review aimed to summarize the evidence for the association between fruit and vegetable intake, risk of asthma/wheeze and immune responses. Databases including PubMed, Cochrane, CINAHL and EMBASE were searched up to June 2016. Studies that investigated the effects of fruit and vegetable intake on risk of asthma/wheeze and immune responses were considered eligible (n = 58). Studies used cross-sectional (n = 30), cohort (n = 13), case-control (n = 8) and experimental (n = 7) designs. Most of the studies (n = 30) reported beneficial associations of fruit and vegetable consumption with risk of asthma and/or respiratory function, while eight studies found no significant relationship. Some studies (n = 20) reported mixed results, as they found a negative association between fruit only or vegetable only, and asthma. In addition, the meta-analyses in both adults and children showed inverse associations between fruit intake and risk of prevalent wheeze and asthma severity (p < 0.05). Likewise, vegetable intake was negatively associated with risk of prevalent asthma (p < 0.05). Seven studies examined immune responses in relation to fruit and vegetable intake in asthma, with n = 6 showing a protective effect against either systemic or airway inflammation. Fruit and vegetable consumption appears to be protective against asthma.

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Section: Resultsmentioning

confidence: 99%

Effects of Fruit and Vegetable Consumption on Risk of Asthma, Wheezing and Immune Responses: A Systematic Review and Meta-Analysis

et al. 2017

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“…This could further improve the impact of combined interventions, as dietary patterns such as a “Mediterranean diet” may have beneficial effects on asthma (20). Indeed, we previously showed that a diet characterized by frequent consumption of vegetables and grains, and low consumption of dairy products and sweets, is associated with reduced odds of asthma among Puerto Rican children at school age (adjusted odds ratio (aOR)= 0.64, 95% confidence interval (CI)= 0.53–0.77) (16). Moreover, recent data from the BAMSE cohort show that a diet with high total antioxidant capacity at age 8 years may decrease the risk of developing atopy and atopic asthma in adolescence (21).…”

Section: Discussionmentioning

confidence: 99%

“…On the basis of their prior association with childhood asthma in our study in Puerto Rico, we examined the following variables: age, sex, low household income (defined as <$15,000/year, the median household income for Puerto Rico in 2008–2009) (12), parental (paternal or maternal) history of asthma, exposure to SHS in early life ( in utero or before age 2 years)(13), allergic rhinitis (defined as physician-diagnosed allergic rhinitis and naso-ocular symptoms apart from colds in the previous year) (14), obesity (defined as a BMI z-score ≥95 th percentile)(15), an unhealthy diet (a score of 1 or 2 in a diet scale, indicating higher consumption of sweets and dairy products)(16), and (in children 9 years and older only) lifetime exposure to gun violence (defined as having heard two or more gunshots) (17). Parental asthma, early-life SHS, allergic rhinitis (at age 4 years, when this diagnosis is more common), and obesity (at age 4 years) were defined in BAMSE in the same manner as in the Puerto Rico study.…”

Section: Methodsmentioning

confidence: 99%

Combined effects of multiple risk factors on asthma in school-aged children

Szentpetery

Gruzieva

Forno

et al. 2017

Respiratory Medicine

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Background Little is known about synergistic effects of several risk factors on asthma. We developed a risk score in Puerto Rican children, and then used this score to estimate the combined effects of multiple risk factors on asthma at school age in Puerto Rican and Swedish children. Methods Case-control study in 609 Puerto Rican children (aged 6–14 years) and longitudinal birth cohort study of 2,290 Swedish children followed up to age 12 years (The Children, Allergy, Milieu, Stockholm, Epidemiological Survey [BAMSE] Study). In both cohorts, there was data on parental asthma, sex, obesity, allergic rhinitis, and early-life second-hand smoke (SHS); data on diet and (in children ≥9 years) lifetime exposure to gun violence were also available in the Puerto Rico study. Asthma was defined as physician-diagnosed asthma and ≥1 episode of wheeze in the previous year. Results In a multivariable analysis in Puerto Rican children, male sex, parental asthma, allergic rhinitis, early-life SHS, an unhealthy diet and (in children ≥9 years) gun violence were each significantly associated with asthma. We next created a risk score using these variables (range, 0 to 5–6 in Puerto Rico and 0 to 4 in BAMSE). Compared with Puerto Rican children without any risk factors (i.e. a score of 0), Puerto Rican children with 2, 3, and at least 4 risk factors had 3.6 times (95% CI=1.4–9.2), 10.4 times (95% CI=4.0–27.0), and 21.6 times (95% CI=7.2–64.9) significantly higher odds of asthma, respectively. In BAMSE, the presence of 2, 3, and at least 4 risk factors was significantly associated with 4.1 times (95% CI=2.3–7.4), 6.3 times (95% CI=3.0–13.3), and 17.2 times (95% CI=4.1–73.2) increased odds of asthma at age 12 years. Conclusions Our findings emphasize the multifactorial etiology of asthma, and suggest that concurrent eradication or reduction of several modifiable risk factors may better prevent or reduce the burden of childhood asthma.

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“…Children with dysanapsis had lower FEF 25 (Figure 1), with no significant differences in residual volume (RV)/TLC. In NL, dysanapsis was associated with higher VC (b = 1322 ml; P = 0.034), lower MEF 75% (b = 20.281 L/s; P = 0.018), and no changes in closing volume or closing capacity.…”

Section: Dysanapsis and Other Lung Function Measuresmentioning

confidence: 99%

“…As part of a case-control study of asthma in Puerto Rican subjects, we recruited 1,127 children (618 with asthma and 509 without asthma) living in San Juan, Puerto Rico, and Hartford, Connecticut (the HPR cohort). Details on subject recruitment and study procedures were reported previously (15,(23)(24)(25). A total of 147 children with dysanapsis (79 with and 69 without asthma) and 236 control subjects (120 with and 116 without asthma) and complete data were included in this analysis.…”

Section: Study Populationsmentioning

confidence: 99%

Obesity and Airway Dysanapsis in Children with and without Asthma

Forno

Weiner

Mullen

et al. 2017

Am J Respir Crit Care Med

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Rationale: For unclear reasons, obese children with asthma have higher morbidity and reduced response to inhaled corticosteroids.Objectives: To assess whether childhood obesity is associated with airway dysanapsis (an incongruence between the growth of the lungs and the airways) and whether dysanapsis is associated with asthma morbidity.Methods: We examined the relationship between obesity and dysanapsis in six cohorts of children with and without asthma, as well as the relationship between dysanapsis and clinical outcomes in children with asthma. Adjusted odds ratios (ORs) were calculated for each cohort and in a combined analysis of all cohorts; longitudinal analyses were also performed for cohorts with available data. Hazard ratios (HRs) for clinical outcomes were calculated for children with asthma in the Childhood Asthma Management Program.Measurements and Main Results: Being overweight or obese was associated with dysanapsis in both the cross-sectional (OR, 1.95; 95% confidence interval [CI], 1.62-2.35 [for overweight/obese compared with normal weight children]) and the longitudinal (OR, 4.31; 95% CI, 2.99-6.22 [for children who were overweight/obese at all visits compared with normal weight children]) analyses. Dysanapsis was associated with greater lung volumes (FVC, vital capacity, and total lung capacity) and lesser flows (FEV 1 and forced expiratory flow, midexpiratory phase), and with indicators of ventilation inhomogeneity and anisotropic lung and airway growth. Among overweight/obese children with asthma, dysanapsis was associated with severe disease exacerbations (HR, 1.95; 95% CI, 1.38-2.75) and use of systemic steroids (HR, 3.22; 95% CI, 2.02-5.14).Conclusions: Obesity is associated with airway dysanapsis in children. Dysanapsis is associated with increased morbidity among obese children with asthma and may partly explain their reduced response to inhaled corticosteroids.

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Diet, interleukin-17, and childhood asthma in Puerto Ricans

Cited by 62 publications

References 46 publications

Effects of Fruit and Vegetable Consumption on Risk of Asthma, Wheezing and Immune Responses: A Systematic Review and Meta-Analysis

Effects of Fruit and Vegetable Consumption on Risk of Asthma, Wheezing and Immune Responses: A Systematic Review and Meta-Analysis

Combined effects of multiple risk factors on asthma in school-aged children

Obesity and Airway Dysanapsis in Children with and without Asthma

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