Risk of asthma associated with energy-dense but nutrient-poor dietary pattern in Taiwanese children

Childhood asthma has rapidly increased over the past few decades, possibly due to changes in lifestyle and dietary patterns. We aimed to determine associations between dietary patterns and asthma in schoolchildren in Taiwan. The Nutrition and Health survey in Taiwan Elementary School Children was carried out by using a multi-staged complex sampling design. A total of 2,082 elementary school children with complete data on dietary, lifestyle, demographics and asthma were included in the analysis. We used a Chinese version of the International Study of Asthma and Allergies in Childhood questionnaire to generate an asthma symptom score and to define asthma outcomes. Dietary intake was assessed by a food frequency questionnaire. Reduced rank regression (RRR) was used to identify the dietary pattern associated with the asthma symptoms score. Asthma outcomes included; current asthma, current severe asthma, nocturnal cough, exercise-induced wheeze and asthma ever. The RRR-derived dietary pattern was characterized by high consumption of fast foods, high-fat snacks, candy, and cheese; and low consumption of fruit, vegetables and rice. The RRR-derived dietary pattern was associated with an increased risk of current asthma (OR [95% CI]) (2.42 [1.19-4.93] for Q4/Q1, p-for-trend=0.01), current severe asthma (3.21 [1.11-9.25] for Q3/Q1, 4.45 [1.59-12.5] for Q4/Q1; p-for-trend=0.003), and nocturnal cough (1.79 [1.06-3.05] for Q2/Q1, 1.74 [1.02-2.97] for Q3/Q1, 1.82 [1.07-3.11] for Q4/Q1; p-for-trend=0.049). Our results suggest that a diet with a high intake of fat and simple sugars and low intake of fruit, vegetables and rice is associated with an increased risk of asthma in Taiwanese children.