The impact of dietary patterns on the risk of asthma in children

Background: Previous research has predominantly focused on the relationship between individual nutrients and asthma. However, diet involves complex interactions among its various components. Dietary pattern analysis can more accurately reflect the impact of overall diet on disease. Methods: Based on the 2011-2020 National Health and Nutrition Examination Survey data base, this study included 7216 children ages 3-17 years. Principal component analysis was used to extract dietary features, and K-means clustering was used to identify typical dietary patterns. Multivariate weighted logistic regression was used to analyze the association between dietary patterns and the risk of asthma. Subgroup analyses were also conducted. Furthermore, ordinal logistic regression was used to explore the relationship between dietary patterns and asthma exacerbation levels. Results: Two primary dietary patterns were identified: a "refined high red meat and high sugar diet pattern" (characterized by high intake of refined grains, red meat, processed meats, solid fats, and added sugars) and a "fruits and vegetables enrichment-balanced diet pattern" (characterized by a balanced diet with adequate intake of fruits and vegetables). After adjusting for covariates, children who followed the refined high red meat and high sugar diet pattern had a 15% higher risk of asthma compared with those who followed the fruits and vegetables enrichment-balanced diet pattern (odds ratio [OR] 1.15; p = 0.04). Notably, in the 3-5-year-old subgroup, the fruits and vegetables enrichment-balanced diet pattern was associated with a 54% reduction in asthma risk (OR 0.46). However, no significant association was found between dietary patterns and asthma exacerbation severity levels (p > 0.05). Conclusion: The refined high red meat and high sugar diet pattern is a modifiable risk factor for childhood asthma, whereas the fruits and vegetables enrichment-balanced diet pattern seems to have a protective effect. Early childhood (ages 3-5 years) may be a critical period for dietary intervention. Analysis of these findings suggests that modifying dietary patterns could be an important strategy for the primary prevention of childhood asthma.