Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
Department of Sustainable Health, Faculty Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands.
Eur J Nutr. 2023 Jun;62(4):1635-1645. doi: 10.1007/s00394-023-03091-2. Epub 2023 Feb 4.
Dietary factors have been suggested as drivers of the rising prevalence of adult-onset asthma, but evidence is inconclusive, possibly due to the complex interrelation with obesity. We aim to explore the relation of diet quality and food intake with incident adult-onset asthma in normal weight and overweight adults of the prospective population-based Lifelines Cohort Study.
Incident adult-onset asthma was defined as self-reported asthma at ± 4-year follow-up, in adults free of airway disease at baseline. Diet quality scores and food group intake were assessed at baseline. Log-binomial regression analyses were used to estimate adjusted relative risks (RR) between dietary intake (per portion) and incident adult-onset asthma, in categories of BMI (cutoff: 25 kg/m).
477 incident asthma cases (75% female, 62% overweight) and 34,698 controls (60% female, 53% overweight) were identified. Diet quality-assessed by the Lifelines Diet Score and Mediterranean Diet Score-was not associated with incident adult-onset asthma in the two BMI groups. Although the dietary intake of several food groups differed between cases and controls, after adjustment for confounders only few remained associated with adult-onset asthma, including red and processed meat (RR: 0.93 per 15 g intake; 95% CI 0.86-0.99) in the normal weight group and intake of cheese (RR 1.09 per 20 g intake; 95% CI 1.00-1.17) and vegetables (RR 1.10 per 50 g intake; 95% CI 1.00-1.21) in the overweight group.
The results of this study question the role of food as a 'simple' predictor of adult-onset asthma and call for an integrative approach, including a range of modifiable lifestyle factors and further asthma phenotyping.
饮食因素被认为是成人哮喘发病率上升的驱动因素，但证据尚不明确，这可能是由于其与肥胖的复杂相互关系所致。我们旨在探讨在莱夫兰生活队列研究的前瞻性人群中，正常体重和超重成年人的饮食质量和食物摄入量与成人后发哮喘的关系。
成人后发哮喘定义为在基线时无气道疾病的成年人在随访±4 年内报告的哮喘。在基线时评估饮食质量评分和食物组摄入量。使用对数二项式回归分析来估计膳食摄入量（每份）与成人后发哮喘之间的调整相对风险（RR），分类为 BMI（截断值：25kg/m）。
确定了 477 例哮喘病例（75%为女性，62%为超重）和 34698 例对照（60%为女性，53%为超重）。通过莱夫兰饮食评分和地中海饮食评分评估的饮食质量与两个 BMI 组的成人后发哮喘无关。尽管病例组和对照组之间几种食物组的摄入量存在差异，但在调整混杂因素后，只有少数食物与成人后发哮喘相关，包括在正常体重组中，每摄入 15 克红肉和加工肉（RR：0.93；95%CI：0.86-0.99）和超重组中每摄入 20 克奶酪（RR：1.09；95%CI：1.00-1.17）和每摄入 50 克蔬菜（RR：1.10；95%CI：1.00-1.21）。
本研究的结果对食物作为成人后发哮喘的“简单”预测因子的作用提出了质疑，并呼吁采取综合方法，包括一系列可改变的生活方式因素和进一步的哮喘表型分析。
