Western Diet as an Independent Predictor of Asthma Prevalence and Morbidity

西方饮食是哮喘患病率和发病率的独立预测因素

• 批准号: 8594323
• 负责人: EMILY BRIGHAM
• 金额: $ 7.17万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8594323
• 关键词: Accounting; Acute; Address; Adherence; Adult; Affect; African American; Allergic Disease; Antioxidants; Asthma; Atherosclerosis; Baltimore; Cardiovascular system; Centers for Disease Control and Prevention (U.S.); Cereals; Characteristics; Cities; Clinical; Cohort Studies; Communities; Complex; Dairy Products; Data; Data Analyses; Data Collection; Development; Diagnosis; Diet; Dietary Assessment; Dietary Component; Dietary Fiber; Dietary Intervention; Dietary Practices; Dietary intake; Disease; Dual-Energy X-Ray Absorptiometry; Eating; Elements; Enrollment; Environmental Exposure; Epidemic; Epidemiologic Studies; Epidemiology; Evaluation; Fatty Acids; Fatty acid glycerol esters; Female; Fishes; Food; Food Processing; Foundations; Frequencies; Funding; Future; Health; Healthcare; Hospitalization; Hour; Human Characteristics; Immersion Investigative Technique; Individual; Indoor Air Pollution; Intake; Investigation; Link; Longitudinal Studies; Low income; Lung diseases; Macronutrients Nutrition; Manuscripts; Measurement; Measures; Meat; Mediterranean Diet; Mentored Patient-Oriented Research Career Development Award; Minerals; Minority; Morbidity - disease rate; National Research Service Awards; Nutrient; Obesity; Observational Study; Olive oil preparation; Outcome; Parents; Participant; Pattern; Pharmaceutical Preparations; Play; Polyunsaturated Fatty Acids; Population; Preparation; Prevalence; Protocols documentation; Questionnaires; Recruitment Activity; Research; Research Personnel; Respiratory physiology; Risk; Risk Factors; Role; Sampling; Solid; Symptoms; Time; Training; United States; Vitamins; Waist-Hip Ratio; base; clinically significant; cohort; disorder risk; drinking; experience; fast food; fruits and vegetables; good diet; high risk; improved; inner city; interest; modifiable risk; mortality; novel; programs; prospective; public health relevance; respiratory; sugar; trend

DESCRIPTION (provided by applicant): Asthma is a common respiratory disease of increasing prevalence in the Unites States. Morbidity and mortality rates are extreme, and the prevalence of asthma is disproportionately high in poor, minority populations. Rising asthma prevalence overall has trended in parallel to transition to a Western diet pattern, typified by higher intakes of processes foods (e.g. meats and refined grains), n6-polyunsaturated fatty acids (PUFAs), high fat dairy products, and sugary desserts and drinks. Most diet and asthma research to date has focused on individual vitamins, minerals, and fatty acids. Results vary, and supplement trials have demonstrated mixed or negative results. Given the complex nature of human diet with interaction between components, there is increased interest in the concept that nutrients in asthmatics may act synergistically in foods and diet patterns, rather than in isolatio. Emerging evidence suggests that a diet high in fruit, vegetable, whole grain, n3-PUFAs, and antioxidant intake may be a "respiratory healthy" diet but confirmatory studies are needed. A countering question is whether there exists an unfavorable diet that worsens asthma. Proposed hypothesis: A Western dietary pattern, as defined above, will be significantly and independently associated with increased asthma morbidity in US adults. Independent links between asthma and a Western dietary pattern will be evaluated in two distinct cohorts: (1) the Atherosclerosis Risk in Communities (ARIC) a large cohort with participants from four communities across the US, and (2) a primarily poor, African-American, inner city Baltimore City cohort prospectively evaluated as part of the INHALE Study, a cohort of adult asthmatics undergoing comprehensive environmental and demographic characterization. Two novel aims are proposed. (1) To investigate the association between Western dietary pattern and asthma prevalence and morbidity in a large, prospective, US epidemiologic cohort study. A collaborative effort with ARIC investigators who have previously defined "Western" and "prudent" dietary patterns in the cohort will be employed to determine effects of Western diet pattern on asthma prevalence, symptoms, medications use, and hospitalizations in ARIC; questions otherwise unaddressed in this cohort. (2) To investigate the association between Western dietary pattern and asthma morbidity among a cohort of 70 urban, primarily African-American asthmatic adults in the INHALE Study. A Baltimore-specific quantitative food frequency questionnaire, 24-hour dietary recalls, and detailed anthropometric measures (to isolate the effects of diet from those of obesity), will be added to the parent protocol. Individual dietary pattern will be linked to asthma symptoms, hospitalizations, and medication use while controlling for potential covariates. This two-population approach will allow us to identify significant effects of diet, a potentially modifiable risk factor, on asthma prevalence and morbidity in both a large, US cohort and a smaller cohort of high-risk individuals. Study results will inform the need for dietary interventios aimed at improving asthma health outcomes.

描述（由申请人提供）：哮喘是一种常见的呼吸道疾病，在美国的患病率不断增加。发病率和死亡率极高，哮喘的发病率在贫穷的少数民族人口中高得不成比例。哮喘患病率总体上呈上升趋势，与向西方饮食模式的过渡平行，典型的是加工食品（例如肉类和精制谷物）、n6-多不饱和脂肪酸（PUFA）、高脂肪乳制品和含糖甜点和饮料的摄入量较高。迄今为止，大多数饮食和哮喘研究都集中在个别维生素，矿物质和脂肪酸上。结果各不相同，补充试验显示了混合或负面的结果。鉴于人类饮食成分之间相互作用的复杂性，人们对哮喘患者的营养素可能在食物和饮食模式中协同作用而不是孤立作用的概念越来越感兴趣。新出现的证据表明，富含水果、蔬菜、全谷物、n3-PUFAs和抗氧化剂的饮食可能是一种“呼吸健康”的饮食，但需要进行验证性研究。一个相反的问题是，是否存在一种不利于哮喘的饮食。提出的假设：如上所述，西方饮食模式与美国成人哮喘发病率增加显著且独立相关。将在两个不同的队列中评估哮喘与西方饮食模式之间的独立联系：（1）社区动脉粥样硬化风险（ARIC），一个由来自美国四个社区的参与者组成的大型队列，和（2）作为INHALE研究的一部分进行前瞻性评估的主要是贫困的非裔美国人、内城区巴尔的摩城市队列，一组正在进行全面的环境和人口统计学表征的成人哮喘患者。 提出了两个新的目标。(1)在一项大型、前瞻性、美国流行病学队列研究中调查西方饮食模式与哮喘患病率和发病率之间的关系。与ARIC研究者的合作将被用来确定西方饮食模式对ARIC中哮喘患病率、症状、药物使用和住院的影响，这些研究者之前在队列中定义了“西方”和“谨慎”的饮食模式;这些问题在该队列中未得到解决。(2)在INHALE研究中，对70名城市主要是非洲裔美国哮喘成年人队列研究中，探讨西方饮食模式与哮喘发病率之间的关系。巴尔的摩特定的定量食物频率问卷，24小时饮食回忆和详细的人体测量（以隔离饮食的影响从肥胖），将被添加到母方案。个人饮食模式将与哮喘有关 症状、住院和药物使用，同时控制潜在的协变量。这种两人群的方法将使我们能够在一个大型的美国队列和一个较小的高危人群队列中确定饮食（一个潜在的可改变的风险因素）对哮喘患病率和发病率的显著影响。研究结果将告知旨在改善哮喘健康结果的饮食干预的必要性。