Diet quality and asthma in Peruvian children and adolescents

Background: Asthma prevalence is increasing in many countries and diet is one of several factors contributing to this trend. However, this relationship has rarely been investigated in Peruvian children. Objective: Determine the relationship between diet quality and asthma in a population of Peruvian children. Methods: We evaluated 768 children (574 asthmatics-194 controls) in two peri-urban districts in Lima, Peru. Asthma was defined as a history of doctor-diagnosed asthma, report of wheeze or asthma medication use in 12 months. Control subjects had no history of asthma or wheeze and had normal lung function. Diet was assessed using food frequency questionnaires with eleven food groups classified as healthy or unhealthy according to the Alternative Healthy Eating Index. Diet quality score was created by dividing frequencies into quartiles (1-4) for healthy and unhealthy food groups and summing these quartile scores to create a final score; a higher score indicates a healthier diet. Multivariable logistic regression was used to determine the relationship between diet score and asthma status adjusting for confounders including SES, residence site, age, sex and BMI. Results: Mean age of participants was 13.8 years. Mean diet score was 5 (±1.23; range 2-8). Continuous diet score was associated with asthma status with a one-unit increase in diet score associated with a 17% lower odds of asthma (p=0.009). Participants in the highest quartile of diet score had 60% reduced odds of having asthma (p=0.002) when compared to the lowest. Conclusions: Higher diet quality was associated with lower odds of having asthma. Diet modification in this population may be a potential intervention to prevent the increasing prevalence of asthma.