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Jamalvandi M, Sasanfar B, Nafei Z, Behniafard N, Jafari M, Salehi-Abargouei A. Dairy intake in association with asthma symptoms among a large sample of children and adolescents: a cross-sectional study. Front Nutr 2024; 11:1298704. [PMID: 38577161 PMCID: PMC10991747 DOI: 10.3389/fnut.2024.1298704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/26/2024] [Indexed: 04/06/2024] Open
Abstract
Background and objective Dairy products may be associated with an increased risk of asthma, although there is little scientific evidence to support this association. The goal of this study was to explore the association between dairy consumption and asthma symptoms. Materials and methods This cross-sectional study was conducted on children and adolescents aged 6-8 and 13-14 years living in central Iran. Dietary food consumption was assessed using a multiple-choice questionnaire. Logistic regression was used to obtain odds ratios for the association between milk, other dairy products, and total dairy consumption with the risk of asthma symptoms. Results In total, 7,667 participants (3,414 boys and 4,253 girls) were included in the current study. Milk intake and total dairy consumption were not associated with the likelihood of wheezing, asthma confirmed by a doctor, current asthma, and asthma medication use. In addition, there was no association between other dairy product intake and the odds of wheezing in the past 12 months in the crude model. However, after adjusting for several confounders, those in the top category had lower odds of wheezing in the past 12 months than those in the bottom category (OR: 0.58; 95% CI: 0.40-0.85). Conclusion The consumption of dairy products other than milk, including cheese and yogurt, might reduce the likelihood of wheezing in children and adolescents.
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Affiliation(s)
- Mona Jamalvandi
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Bahareh Sasanfar
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Nafei
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nasrin Behniafard
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Allergy and Clinical Immunology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Marjan Jafari
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amin Salehi-Abargouei
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Yazd Cardiovascular Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Song F, Xie Y, Guo N, Zhao H. Consumption of milk and dairy products and risk of asthma in children: a systematic review and Meta-analysis. Arch Public Health 2023; 81:147. [PMID: 37587503 PMCID: PMC10428541 DOI: 10.1186/s13690-023-01162-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/27/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Some reports demonstrate that asthma benefits from milk and dairy products, however, the findings are controversial. We used meta-analysis as a tool to summarize published data on the association between dairy products consumption and asthma. METHODS A systematic literature search was conducted to identify studies of dairy products and asthma in children in PubMed, ISI (Web of Science), and EMBASE until 21 July 2022. Random-effect meta-analyses with summarized data were performed for total (high/low) milk and dairy intake. Subgroup analysis was used to identify sources of variation in responses. Publication bias and sensitivity analysis were done to examine the stability of results. RESULTS There was no correlation between consumption of dairy products and reduced risk of asthma (OR = 0.82; 95% CI: 0.60-1.05). Our results revealed that elevated consumption of milk and dairy has significant correlation with reduced risk of asthma in Non-Asian population (OR = 0.74; 95% CI = 0.51-0.96) and high quality studies (OR = 0.73; 95% CI = 0.50-0.95). No individual study influence and publication bias was seen in the sensitivity analysis and publication bias assessment. CONCLUSION There was no correlation between consumption of dairy products and reduced risk of asthma. However, we observed that elevated consumption of milk and dairy has significant correlation with reduced risk of asthma in Non-Asian population and high quality studies. More high-quality and population-specific studies should be conducted to determine the risk link between milk consumption and asthma in children.
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Affiliation(s)
- Feng Song
- Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment & Chinese Medicine Development of Henan Province, Henan University of Chinese Medicine, Henan, China
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Henan, China
- Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Henan, China
| | - Yang Xie
- Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment & Chinese Medicine Development of Henan Province, Henan University of Chinese Medicine, Henan, China.
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Henan, China.
- Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Henan, China.
| | - Nannan Guo
- Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment & Chinese Medicine Development of Henan Province, Henan University of Chinese Medicine, Henan, China
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Henan, China
- Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Henan, China
| | - Hulei Zhao
- Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment & Chinese Medicine Development of Henan Province, Henan University of Chinese Medicine, Henan, China
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Henan, China
- Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Henan, China
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Association of milk intake with hay fever, asthma, and lung function: a Mendelian randomization analysis. Eur J Epidemiol 2022; 37:713-722. [PMID: 34978666 PMCID: PMC7614013 DOI: 10.1007/s10654-021-00826-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 12/01/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Previous observational studies have indicated a protective effect of drinking milk on asthma and allergy. In Mendelian Randomization, one or more genetic variants are used as unbiased markers of exposure to examine causal effects. We examined the causal effect of milk intake on hay fever, asthma, forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) by using the lactase rs4988235 genotype associated with milk intake. METHODS We performed a Mendelian Randomization study including 363,961 participants from the UK Biobank. RESULTS Observational analyses showed that self-reported milk-drinkers vs. non-milk drinkers had an increased risk of hay fever: odds ratio (OR) = 1.36 (95% CI 1.32, 1.40, p < 0.001), asthma: OR = 1.33 (95% CI 1.38, 1.29, p < 0.001), yet a higher FEV1: β = 0.022 (SE = 0.004, p < 0.001) and FVC: β = 0.026 (SE = 0.005, p < 0.001). In contrast, genetically determined milk-drinking vs. not drinking milk was associated with a lower risk of hay fever: OR = 0.791 (95% CI 0.636, 0.982, p = 0.033), and asthma: OR = 0.587 (95% CI 0.442, 0.779, p = 0.001), and lower FEV1: β = - 0.154 (standard error, SE = 0.034, p < 0.001) liter, and FVC: β = - 0.223 (SE = 0.034, p < 0.001) liter in univariable MR analyses. These results were supported by multivariable Mendelian randomization analyses although not statistically significant. CONCLUSIONS As opposed to observational results, genetic association findings indicate that drinking milk has a protective effect on hay fever and asthma but may also have a negative effect on lung function. The results should be confirmed in other studies before any recommendations can be made.
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Childhood Overweight/Obesity and Asthma: Is There a Link? A Systematic Review of Recent Epidemiologic Evidence. J Acad Nutr Diet 2013; 113:77-105. [DOI: 10.1016/j.jand.2012.08.025] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Accepted: 08/22/2012] [Indexed: 11/23/2022]
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Lockwood CM, DeFrancesco CA, Elliot DL, Beresford SAA, Toobert DJ. Mediation analyses: applications in nutrition research and reading the literature. ACTA ACUST UNITED AC 2010; 110:753-62. [PMID: 20430137 DOI: 10.1016/j.jada.2010.02.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2009] [Accepted: 09/01/2009] [Indexed: 12/01/2022]
Abstract
Mediation analysis is a newer statistical tool that is becoming more prominent in nutrition research. Its use provides insight into the relationship among variables in a potential causal chain. For intervention studies, it can define the influence of different programmatic components and, in doing so, allows investigators to identify and refine a program's critical aspects. We present an overview of mediation analysis, compare mediators with other variables (confounders, moderators, and covariates), and illustrate how mediation analysis permits interpretation of the change process. A framework is outlined for the critical appraisal of articles purporting to use mediation analysis. The framework's utility is demonstrated by searching the nutrition literature and identifying articles citing mediation cross referenced with the terms "nutrition," "diet," "food," and "obesity." Seventy-two articles were identified that involved human subjects and behavior outcomes, and almost half mentioned mediation without tests to define its presence. Tabulation of the 40 articles appropriately assessing mediation demonstrates an increase in these techniques' appearance and the breadth of nutrition topics addressed. Mediation analysis is an important new statistical tool. Familiarity with its methodology and a framework for assessing articles will allow readers to critically appraise the literature and make informed independent evaluations of works using these techniques.
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Affiliation(s)
- Chondra M Lockwood
- Division of Health Promotion and Sports Medicine, Department of Medicine, Oregon Health and Science University, Portland, OR, USA
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Kozyrskyj AL, HayGlass KT, Sandford AJ, Paré PD, Chan-Yeung M, Becker AB. A novel study design to investigate the early-life origins of asthma in children (SAGE study). Allergy 2009; 64:1185-93. [PMID: 19416140 DOI: 10.1111/j.1398-9995.2009.02033.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This is a description of the Study of Asthma, Genes and the Environment (SAGE), a novel birth cohort created from provincial healthcare administrative records. It is a general population-based cohort, composed of children at high and low risk for asthma, living in urban and rural environments in Manitoba, Canada. The SAGE study captures the complete longitudinal healthcare records of children born in 1995 and contains detailed information on early-life exposures, such as antibiotic utilization and immunization, in relationship to the development of asthma. Nested within the birth cohort is a case-control study, which was created to collect information on home environmental exposures from detailed surveys and home dust sampling, to confirm asthma status in children and use this data to validate healthcare database measures of asthma, to determine differences in immune system responsiveness to innate and adaptive immune stimuli in asthma, to genotype children for genes likely associated with the development of asthma and to study the epigenetic regulation of pre-established protective vs allergic immune responses. The SAGE study is a multidisciplinary collaboration of researchers from pediatric allergy, population health, immunology, and genetic and environmental epidemiology. As such, it serves as a fertile, interdisciplinary training ground for graduate students, and postdoctoral and clinician fellows.
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Affiliation(s)
- A L Kozyrskyj
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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Overweight and changes in weight status during childhood in relation to asthma symptoms at 8 years of age. J Allergy Clin Immunol 2009; 123:1312-8.e2. [DOI: 10.1016/j.jaci.2009.02.029] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2008] [Revised: 02/19/2009] [Accepted: 02/20/2009] [Indexed: 11/19/2022]
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Current World Literature. Curr Opin Allergy Clin Immunol 2009; 9:177-84. [DOI: 10.1097/aci.0b013e328329f9ca] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Current Opinion in Pulmonary Medicine. Current world literature. Curr Opin Pulm Med 2009; 15:79-87. [PMID: 19077710 DOI: 10.1097/mcp.0b013e32831fb1f3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Daley D, Lemire M, Akhabir L, Chan-Yeung M, He JQ, McDonald T, Sandford A, Stefanowicz D, Tripp B, Zamar D, Bosse Y, Ferretti V, Montpetit A, Tessier MC, Becker A, Kozyrskyj AL, Beilby J, McCaskie PA, Musk B, Warrington N, James A, Laprise C, Palmer LJ, Paré PD, Hudson TJ. Analyses of associations with asthma in four asthma population samples from Canada and Australia. Hum Genet 2009; 125:445-59. [PMID: 19247692 DOI: 10.1007/s00439-009-0643-8] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2008] [Accepted: 02/13/2009] [Indexed: 11/28/2022]
Abstract
Asthma, atopy, and related phenotypes are heterogeneous complex traits, with both genetic and environmental risk factors. Extensive research has been conducted and over hundred genes have been associated with asthma and atopy phenotypes, but many of these findings have failed to replicate in subsequent studies. To separate true associations from false positives, candidate genes need to be examined in large well-characterized samples, using standardized designs (genotyping, phenotyping and analysis). In an attempt to replicate previous associations we amalgamated the power and resources of four studies and genotyped 5,565 individuals to conduct a genetic association study of 93 previously associated candidate genes for asthma and related phenotypes using the same set of 861 single-nucleotide polymorphisms (SNPs), a common genotyping platform, and relatively harmonized phenotypes. We tested for association between SNPs and the dichotomous outcomes of asthma, atopy, atopic asthma, and airway hyperresponsiveness using a general allelic likelihood ratio test. No SNP in any gene reached significance levels that survived correction for all tested SNPs, phenotypes, and genes. Even after relaxing the usual stringent multiple testing corrections by performing a gene-based analysis (one gene at a time as if no other genes were typed) and by stratifying SNPs based on their prior evidence of association, no genes gave strong evidence of replication. There was weak evidence to implicate the following: IL13, IFNGR2, EDN1, and VDR in asthma; IL18, TBXA2R, IFNGR2, and VDR in atopy; TLR9, TBXA2R, VDR, NOD2, and STAT6 in airway hyperresponsiveness; TLR10, IFNGR2, STAT6, VDR, and NPSR1 in atopic asthma. Additionally we found an excess of SNPs with small effect sizes (OR < 1.4). The low rate of replication may be due to small effect size, differences in phenotypic definition, differential environmental effects, and/or genetic heterogeneity. To aid in future replication studies of asthma genes a comprehensive database was compiled and is available to the scientific community at http://genapha.icapture.ubc.ca/.
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Affiliation(s)
- Denise Daley
- James Hogg iCAPTURE Center, University of British Columbia (UBC), 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
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Mai XM, Becker AB, Liem JJ, Kozyrskyj AL. Fast food consumption counters the protective effect of breastfeeding on asthma in children? Clin Exp Allergy 2009; 39:556-61. [PMID: 19159404 DOI: 10.1111/j.1365-2222.2008.03169.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fast food consumption and childhood asthma have rapidly increased in recent decades. During the same period there has been an increased rate of prolonged breastfeeding. OBJECTIVE To evaluate if fast food consumption was associated with asthma in children, and if the proposed protective effect of breastfeeding on asthma was altered by fast food consumption. METHODS This case-control study included 246 children with allergist-diagnosed asthma and 477 non-asthmatic controls at age 8-10 years. Information on fast food consumption and exclusive breastfeeding was obtained from questionnaire data. The association between asthma and fast food consumption was evaluated. Asthma in relation to exclusive breastfeeding was also evaluated, taking into account fast food consumption as a modifying factor. RESULTS Children with asthma were more likely to consume fast food than children without asthma [crude odds ratio (OR) 1.70, 95% confidence interval (CI) 1.23-2.34]. In comparison to prolonged exclusive breastfeeding (> or =12 weeks), asthma was positively associated with short-term exclusive breastfeeding (<12 weeks) in children who never or occasionally consumed fast food (crude OR 1.84, 95% CI 1.09-3.11), but not in children who frequently consumed fast food (crude OR 1.07, 95% CI 0.72-1.61). The P-value for this interaction (0.109) was borderline. Children with high fast food consumption who were exclusively breastfed <12 weeks as infants, had greater than a twofold risk of asthma compared with infants who had been exclusively breastfed for a longer time period and who did not become high consumers of fast food in later childhood. These findings were not affected after final adjustment of confounders and covariates. CONCLUSION Fast food consumption is associated with asthma in children and potentially counteracts the protective effect of prolonged breastfeeding on asthma. This may explain the paradoxical phenomenon of parallel increased rates of prolonged breastfeeding and asthma in children. 556-561.
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Affiliation(s)
- X-M Mai
- Department of Pediatrics and Child Health and Manitoba Institute of Child Health, University of Manitoba, Winnipeg, MB, Canada
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