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Published on: August 7, 2017
Dietary phytochemical intake and asthma in children: a case-control study
Renpeng Jiang1, Weihong Liu1, Guangjun Wang2
1Department of Pediatrics, Shandong Provincial Third Hospital, No. 11 Wuying Mountain Middle Road, Tianqiao District, Jinan City, 250031, Shandong Province, China.
Insights
A diet rich in phytochemicals, measured by the Dietary Phytochemical Index (DPI), is linked to reduced asthma risk and improved outcomes in children. Higher DPI correlates with lower inflammation and better asthma control.
Area of Science:
- Pediatric allergy and immunology
- Nutritional science
- Inflammatory disease research
Background:
- Dietary patterns influence asthma risk and severity through anti-inflammatory and antioxidant mechanisms.
- Phytochemicals possess antioxidant and immune-modulating properties beneficial for managing childhood asthma.
- The Dietary Phytochemical Index (DPI) quantifies intake of phytochemical-rich foods.
Purpose of the Study:
- To investigate the association between the Dietary Phytochemical Index (DPI) and asthma-related outcomes in children.
- To evaluate the relationship between DPI and asthma severity, control, quality of life, and inflammation markers.
- To determine if higher DPI intake is linked to a lower prevalence of pediatric asthma.
Main Methods:
- A case-control study involving 300 children (150 with asthma, 150 controls) aged 5-12 years.
- Dietary intake assessed using a validated food frequency questionnaire to calculate DPI.
- Clinical outcomes measured by Pediatric Asthma Severity Score (PASS), Childhood Asthma Control Test (C-ACT), Pediatric Asthma Quality of Life Questionnaire (PAQLQ), and serum C-reactive protein (CRP).
Main Results:
- Children in the highest DPI tertile exhibited significantly lower CRP levels, higher PAQLQ scores, lower PASS scores, and higher C-ACT scores compared to the lowest tertile.
- Increased DPI was significantly associated with reduced inflammation (lower CRP), improved quality of life (higher PAQLQ), decreased asthma severity (lower PASS), and enhanced asthma control (higher C-ACT).
- The highest DPI tertile was associated with substantially lower odds of having asthma, even after adjusting for confounding factors.
Conclusions:
- Greater consumption of phytochemical-rich foods, as indicated by a higher DPI, is associated with a reduced likelihood of pediatric asthma.
- Higher DPI intake correlates with lower systemic inflammation and improved clinical outcomes in children with asthma.
- This study highlights the potential role of diet, specifically phytochemical intake, in the prevention and management of pediatric asthma.
Abstract:
Pediatric asthma is a chronic inflammatory disease marked by bronchial hyperresponsiveness and airflow obstruction. Diet may be associated with asthma risk and severity through anti-inflammatory and antioxidant effects. This research evaluated the connection between the Dietary Phytochemical Index (DPI), which measures the percentage of daily calories from foods high in phytochemicals, and asthma-related outcomes in pediatric populations. In this case-control study with cross-sectional analyses within the asthma group, 300 children aged 5-12 years (150 asthma cases, 150 matched controls) were evaluated. Dietary intake was measured via a validated food frequency questionnaire. DPI was calculated and categorized into tertiles. Clinical outcomes included the Pediatric Asthma Severity Score (PASS), Childhood Asthma Control Test (C-ACT), and Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Serum C-reactive protein (CRP) was measured as an inflammation marker. Children in the highest DPI tertile had lower CRP levels (1.99 vs. 4.02 mg/L), higher PAQLQ scores (4.33 vs. 3.89), lower PASS scores (6.35 vs. 11.14), and higher C-ACT scores (21.45 vs. 13.91; all p < 0.001) than those in the lowest tertile. Higher DPI was associated with lower inflammation (CRP: β = -0.026), higher quality of life (PAQLQ: β = 0.058), lower asthma severity (PASS: β = -0.148), and higher asthma control (C-ACT: β = 0.364; all p < 0.001). The highest DPI tertile was associated with lower odds of asthma (OR = 0.06; 95% CI: 0.03-0.13; p < 0.001) (fully adjusted for age, sex, BMI, physical activity, energy intake, fiber, and vitamin D). Each one-unit DPI increase was associated with 11% lower odds of asthma (OR = 0.89; 95% CI: 0.86-0.91; p < 0.001), with CRP as the primary inflammation marker assessed.
Conclusion:
Greater intake of phytochemical-rich foods is associated with lower odds of asthma, lower inflammation, and better clinical outcomes in children.
What Is Known:
• Dietary patterns rich in anti-inflammatory foods may benefit children with asthma. • Phytochemicals have antioxidant and immune-modulating effects relevant to asthma.
What Is New:
• Higher Dietary Phytochemical Index was associated with substantially lower odds of pediatric asthma. • Higher DPI was also associated with lower asthma severity, better asthma control, and lower CRP. • This is the first study to apply DPI to a pediatric asthma population.
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