Diet and asthma in Dutch school children (ISAAC-2)

Cora Tabak ^1*, Alet H Wijga ¹, Gea de Meer ², Nicole A H Janssen ², Bert Brunekreef ³ and Henriette A Smit ¹

¹ National Institute of Public Health and the Environment, Netherlands
² University Utrecht, Netherlands
³ utrecht university, Netherlands

^* To whom correspondence should be addressed. E-mail: cora.tabak{at}rivm.nl.

Accepted 10 October 2005

Abstract

Background: The rise in asthma prevalence in western societies may be related to changed dietary habits. Epidemiological studies in children have shown inverse associations of asthma related outcomes with intake of fruits, vegetables, dairy and whole grain products, and fish. In contrast to most of these studies, we used both questionnaire and clinical data to define asthma.

Methods: Intake of the mentioned foods was studied in relation to asthma in 598 Dutch children aged 8-13 years. Dietary intake was estimated using a parent-completed semi-quantitative food frequency questionnaire. Current wheeze and current asthma were defined based on questionnaire data. Subsequently, more complex end-points were defined using information on bronchial hyperresponsiveness (BHR) and atopic sensitization as well. Linear associations were studied using logistic regression analysis and odds ratios presented for the highest vs. the lowest tertile of intake. In the final models adjustments were made for maternal educational level, foreign descent and total energy intake.

Results: Intake of whole grain products and of fish was inversely associated with asthma. Adjusted odds ratios for the independent associations with whole grains and fish were 0.46 (95%CI=0.19-1.10) and 0.34 (95%CI=0.13-0.85) for current asthma and 0.28 (95%CI=0.08-0.99) and 0.12 (95%CI=0.02-0.66) for atopic asthma with BHR. For current wheeze and atopic wheeze with BHR, respectively, similar results were observed. Intake of (citrus) fruits, vegetables and dairy products showed no clear associations with asthma end-points.

Conclusions: Our findings support a potential protective effect of a high intake of whole grain products and fish against asthma in children.

Keywords: asthma, children, diet, fish, whole grains

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