Mai X-M, Becker A B, Liem J J, Kozyrskyj A L
Department of Pediatrics and Child Health and Manitoba Institute of Child Health, University of Manitoba, Winnipeg, MB, Canada.
Clin Exp Allergy. 2009 Apr;39(4):556-61. doi: 10.1111/j.1365-2222.2008.03169.x. Epub 2009 Jan 22.
Fast food consumption and childhood asthma have rapidly increased in recent decades. During the same period there has been an increased rate of prolonged breastfeeding.
To evaluate if fast food consumption was associated with asthma in children, and if the proposed protective effect of breastfeeding on asthma was altered by fast food consumption.
This case-control study included 246 children with allergist-diagnosed asthma and 477 non-asthmatic controls at age 8-10 years. Information on fast food consumption and exclusive breastfeeding was obtained from questionnaire data. The association between asthma and fast food consumption was evaluated. Asthma in relation to exclusive breastfeeding was also evaluated, taking into account fast food consumption as a modifying factor.
Children with asthma were more likely to consume fast food than children without asthma [crude odds ratio (OR) 1.70, 95% confidence interval (CI) 1.23-2.34]. In comparison to prolonged exclusive breastfeeding (> or =12 weeks), asthma was positively associated with short-term exclusive breastfeeding (<12 weeks) in children who never or occasionally consumed fast food (crude OR 1.84, 95% CI 1.09-3.11), but not in children who frequently consumed fast food (crude OR 1.07, 95% CI 0.72-1.61). The P-value for this interaction (0.109) was borderline. Children with high fast food consumption who were exclusively breastfed <12 weeks as infants, had greater than a twofold risk of asthma compared with infants who had been exclusively breastfed for a longer time period and who did not become high consumers of fast food in later childhood. These findings were not affected after final adjustment of confounders and covariates.
Fast food consumption is associated with asthma in children and potentially counteracts the protective effect of prolonged breastfeeding on asthma. This may explain the paradoxical phenomenon of parallel increased rates of prolonged breastfeeding and asthma in children. 556-561.
近几十年来,快餐消费和儿童哮喘发病率迅速上升。在同一时期,延长母乳喂养的比例也有所增加。
评估快餐消费是否与儿童哮喘相关,以及快餐消费是否会改变母乳喂养对哮喘的潜在保护作用。
这项病例对照研究纳入了246名经过敏症专科医生诊断为哮喘的儿童和477名8至10岁的非哮喘对照儿童。通过问卷调查数据获取快餐消费和纯母乳喂养的信息。评估哮喘与快餐消费之间的关联。还评估了与纯母乳喂养相关的哮喘情况,并将快餐消费作为一个修正因素考虑在内。
与无哮喘儿童相比,哮喘儿童更有可能食用快餐[粗比值比(OR)1.70,95%置信区间(CI)1.23 - 2.34]。与延长纯母乳喂养(≥12周)相比,在从不或偶尔食用快餐的儿童中,哮喘与短期纯母乳喂养(<12周)呈正相关(粗OR 1.84,95%CI 1.09 - 3.11),但在经常食用快餐的儿童中并非如此(粗OR 1.07,95%CI 0.72 - 1.61)。这种相互作用的P值(0.109)接近临界值。婴儿期纯母乳喂养<12周且快餐消费量高的儿童,与婴儿期纯母乳喂养时间较长且儿童期后期未成为快餐高消费者的儿童相比,患哮喘的风险高出两倍多。在对混杂因素和协变量进行最终调整后,这些结果不受影响。
快餐消费与儿童哮喘相关,并可能抵消延长母乳喂养对哮喘的保护作用。这可能解释了儿童中延长母乳喂养率和哮喘发病率同时上升这一矛盾现象。556 - 561。