Longitudinal study of diet quality and change in asthma symptoms in adults, according to smoking status
Longitudinal study of diet quality and change in asthma symptoms in adults, according to smoking status
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DOI：
10.1017/s0007114517000368
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发表时间：
2017-02-01
影响因子：
3.6
通讯作者：
Varraso, Raphaelle
中科院分区：
文献类型：
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作者：
Li, Zhen;Kesse-Guyot, Emmanuelle;Varraso, Raphaelle
据推测，西方国家哮喘患病率的增加与生活方式因素的变化有关，包括饮食不良。然而，人们对饮食质量与哮喘之间的关系知之甚少。在饮食与哮喘的关系中，BMI作为一种潜在的调节因子的作用需要澄清;此外，非饮食来源的氧化剂（如吸烟）的潜在影响也值得研究。我们调查了饮食质量和哮喘症状变化之间的关系，并评估了吸烟对哮喘的影响，同时将BMI作为一个潜在的中介因素。使用法国前瞻性哮喘遗传学和环境流行病学研究的数据，我们使用2010年替代健康饮食指数（AHEI-2010）评估了基线时的饮食质量和哮喘症状的变化（稳定（参考）、恶化、改善;平均随访时间：7年）。中介分析被用来解开总的和直接的影响和间接影响介导的BMI。分析包括969名成人（平均年龄43岁; 49%为男性; 42%曾患哮喘）。我们观察到吸烟和AHEI-2010对哮喘症状变化的显著交互作用（P-for（交互作用）= 0.04）。在从不吸烟者（n 499）中，我们观察到AHEI-2010（每10分增量）对症状改善的积极总效应（多变量OR 1.39; 95% CI 1.07，1.80）和积极直接效应（OR 1.41; 95% CI 1.09，1.80）。未观察到BMI介导的间接效应（OR 0.99; 95% CI 0.91，1.07）。在以前和现在的吸烟者中，所有影响都没有统计学意义。在从不吸烟者中，随着时间的推移，更好的饮食质量与哮喘症状的改善相关，与BMI无关。
It has been hypothesised that increased asthma prevalence in westernised countries is associated with changes in lifestyle factors, including a poorer diet. However, little is known regarding the association between diet quality and asthma. In the diet-asthma association, the role of BMI as a potential mediator needs clarification; moreover, potential effect modification by non-diet sources of oxidants, such as smoking, merits investigation. We investigated the association between diet quality and change in asthma symptoms, as well as assessed effect modification by smoking, while accounting for BMI as a potential mediator. Using data from the French prospective Epidemiological study on the Genetics and Environment of Asthma study, we assessed diet quality using the Alternate Healthy Eating Index 2010 (AHEI-2010) at baseline and change in asthma symptoms (stable (reference), worsening, improved; mean follow-up time: 7 years). Mediation analysis was used to disentangle total and direct effects and the indirect effect mediated by BMI. The analyses included 969 adults (mean age 43 years; 49% men; 42% ever asthma). We observed a significant interaction between smoking and AHEI-2010 on change in asthma symptoms (P-for (interaction) = 0.04). Among never smokers (n 499), we observed a positive total effect (multivariable OR 1.39; 95% CI 1.07, 1.80) and a positive direct effect (OR 1.41; 95% CI 1.09, 1.80) of the AHEI-2010 (per ten-point increment) on improved symptoms. No indirect effect mediated through BMI was observed (OR 0.99; 95% CI 0.91, 1.07). Among former and current smokers, all effects were statistically non-significant. Better diet quality was associated with improved asthma symptoms over time in never smokers, independently of BMI.