Is fruit and vegetable intake associated with asthma or chronic rhino-sinusitis in European adults? Results from the Global Allergy and Asthma Network of Excellence (GA2LEN) Survey

Vanessa Garcia-Larsen, Rhonda Arthur, James F Potts, Peter H Howarth, Matti Ahlström, Tari Haahtela, Carlos Loureiro, Ana Todo Bom, Grzegorz Brożek, Joanna Makowska, Marek L Kowalski, Trine Thilsing, Thomas Keil, Paolo M Matricardi, Kjell Torén, Thibaut van Zele, Claus Bachert, Barbara Rymarczyk, Christer Janson, Bertil Forsberg, Ewa Niżankowska-Mogilnicka, Peter G J Burney, Vanessa Garcia-Larsen, Rhonda Arthur, James F Potts, Peter H Howarth, Matti Ahlström, Tari Haahtela, Carlos Loureiro, Ana Todo Bom, Grzegorz Brożek, Joanna Makowska, Marek L Kowalski, Trine Thilsing, Thomas Keil, Paolo M Matricardi, Kjell Torén, Thibaut van Zele, Claus Bachert, Barbara Rymarczyk, Christer Janson, Bertil Forsberg, Ewa Niżankowska-Mogilnicka, Peter G J Burney

Abstract

Background: Fruits and vegetables are rich in compounds with proposed antioxidant, anti-allergic and anti-inflammatory properties, which could contribute to reduce the prevalence of asthma and allergic diseases.

Objective: We investigated the association between asthma, and chronic rhino-sinusitis (CRS) with intake of fruits and vegetables in European adults.

Methods: A stratified random sample was drawn from the Global Allergy and Asthma Network of Excellence (GA2LEN) screening survey, in which 55,000 adults aged 15-75 answered a questionnaire on respiratory symptoms. Asthma score (derived from self-reported asthma symptoms) and CRS were the outcomes of interest. Dietary intake of 22 subgroups of fruits and vegetables was ascertained using the internationally validated GA2LEN Food Frequency Questionnaire. Adjusted associations were examined with negative binomial and multiple regressions. Simes procedure was used to control for multiple testing.

Results: A total of 3206 individuals had valid data on asthma and dietary exposures of interest. 22.8% reported having at least 1 asthma symptom (asthma score ≥1), whilst 19.5% had CRS. After adjustment for potential confounders, asthma score was negatively associated with intake of dried fruits (β-coefficient -2.34; 95% confidence interval [CI] -4.09, -0.59), whilst CRS was statistically negatively associated with total intake of fruits (OR 0.73; 95% CI 0.55, 0.97). Conversely, a positive association was observed between asthma score and alliums vegetables (adjusted β-coefficient 0.23; 95% CI 0.06, 0.40). None of these associations remained statistically significant after controlling for multiple testing.

Conclusion and clinical relevance: There was no consistent evidence for an association of asthma or CRS with fruit and vegetable intake in this representative sample of European adults.

Keywords: Adults; Asthma; Chronic rhino-sinusitis; Europe; Fruits; GA2LEN; Meta-analysis; Vegetables.

Figures

Fig. 1
Fig. 1
Weighted adjusted negative binomial regressions of asthma score association with total intake of fruits (top) and fruity vegetables (below) (per centre, and meta-analysis of pooled results)
Fig. 2
Fig. 2
Weighted multivariable analyses of association between CRS with total intake of fruits (per centre, and meta-analysis of pooled results)

References

    1. Julia V, Macia L, Dombrowicz D. The impact of diet on asthma and allergic diseases. Nat Rev Immunol. 2015;15:308–322. doi: 10.1038/nri3830.
    1. Seyedrezazadeh E, Moghaddam MP, Ansarin K, Vafa MR, Sharma S, Kolahdooz F. Fruit and vegetable intake and risk of wheezing and asthma: a systematic review and meta-analysis. Nutr Rev. 2014;72:411–428. doi: 10.1111/nure.12121.
    1. Shaheen SO, Sterne JA, Thompson RL, Songhurst CE, Margetts BM, Burney PG. Dietary antioxidants and asthma in adults: population-based case–control study. Am J Respir Crit Care Med. 2001;164:1823–1828. doi: 10.1164/ajrccm.164.10.2104061.
    1. Patel BD, Welch AA, Bingham SA, Luben RN, Day NE, Khaw KT, Lomas DA, Wareham NJ. Dietary antioxidants and asthma in adults. Thorax. 2006;61:388–393. doi: 10.1136/thx.2004.024935.
    1. Romieu I, Varraso R, Avenel V, Leynaert B, Kauffmann F, Clavel-Chapelon F. Fruit and vegetable intakes and asthma in the E3N study. Thorax. 2006;61:209–215. doi: 10.1136/thx.2004.039123.
    1. Barros R, Moreira A, Padrão P, Teixeira VH, Carvalho P, Delgado L, Lopes C, Severo M, Moreira P. Dietary patterns and asthma prevalence, incidence and control. Clin Exp Allergy. 2015;45:1673–1680. doi: 10.1111/cea.12544.
    1. Garcia-Larsen V, Chinn S, Arts IC, Amigo H, Rona RJ. Atopy, wheeze and bronchial responsiveness in young Chilean adults. Do dietary antioxidants matter? Allergy. 2007;62:714–715. doi: 10.1111/j.1398-9995.2007.01357.x.
    1. Liang W, Chikritzhs T, Lee AH. Lifestyle of young Australian adults with asthma. Asia Pac J Public Health. 2015;27:NP248–NP254. doi: 10.1177/1010539512439229.
    1. Lv N, Xiao L, Ma J. Dietary pattern and asthma: a systematic review and meta-analysis. J Asthma Allergy. 2014;7:105–121.
    1. Hooper R, Heinrich J, Omenaas E, Sausenthaler S, Garcia-Larsen V, Bakolis I, Burney P. Dietary patterns and risk of asthma: results from three countries in European Community Respiratory Health Survey-II. Br J Nutr. 2010;103:1354–1365. doi: 10.1017/S0007114509993266.
    1. Garcia-Larsen V, Luczynska M, Kowalski ML, et al. Use of a common food frequency questionnaire (FFQ) to assess dietary patterns and their relation to allergy and asthma in Europe: pilot study of the GA2LEN FFQ. Eur J Clin Nutr. 2011;65:750–756. doi: 10.1038/ejcn.2011.15.
    1. Bousquet J, et al. GA2LEN (Global Allergy and Asthma European Network) addresses the allergy and asthma ‘epidemic’. Allergy. 2009;64:969–977. doi: 10.1111/j.1398-9995.2009.02059.x.
    1. Tomassen P, Newson RB, Hoffmans R, et al. Reliability of EP3OS symptom criteria and nasal endoscopy in the assessment of chronic rhinosinusitis: a GA2LEN study. Allergy. 2011;66:556–561. doi: 10.1111/j.1398-9995.2010.02503.x.
    1. Sunyer J, Pekkanen J, Garcia-Esteban R, Svanes C, Künzli N, Janson C, de Marco R, Antó JM, Burney P. Asthma score: predictive ability and risk factors. Allergy. 2007;62:142–148. doi: 10.1111/j.1398-9995.2006.01184.x.
    1. Palmer SC, Ruospo M, Campbell KL, et al. DIET-HD Study investigators. Nutrition and dietary intake and their association with mortality and hospitalisation in adults with chronic kidney disease treated with haemodialysis: protocol for DIET-HD, a prospective multinational cohort study. BMJ Open. 2015;5:e006897. doi: 10.1136/bmjopen-2014-006897.
    1. Ireland J, van Erp-Baart AM, Charrondière UR, Møller A, Smithers G. Trichopoulou A; EFCOSUM Group. Selection of a food classification system and a food composition database for future food consumption surveys. Eur J Clin Nutr. 2002;56:S33–S45. doi: 10.1038/sj.ejcn.1601427.
    1. FSA (Food Standards Agency) McCance and Widdowson’s the composition of foods. Seventh Summary edn. Royal Society of Chemistry: Cambridge; 2002.
    1. Simes RJ. An improved Bonferroni procedure for multiple tests of significance. Biometrika. 1986;73:751–754. doi: 10.1093/biomet/73.3.751.
    1. Pekkanen J, Sunyer J, Anto JM, Burney P, European Community Respiratory Survey Operational definitions of asthma in studies on its aetiology. Eur Respir J. 2005;26:28–35. doi: 10.1183/09031936.05.00120104.
    1. Kelly Y, Sacker A, Marmot M. Nutrition and respiratory health in adults: findings from the health survey for Scotland. Eur Respir J. 2003;21:664–671. doi: 10.1183/09031936.03.00055702.
    1. Troisi RJ, Willett WC, Weiss ST, et al. A prospective study of diet and adult-onset asthma. Am J Respir Crit Care Med. 1995;151:1401–1408. doi: 10.1164/ajrccm.151.5.7735592.
    1. Soutar A, Seaton A, Brown K. Bronchial reactivity and dietary antioxidants. Thorax. 1997;52:166–170. doi: 10.1136/thx.52.2.166.
    1. Moreno-Macias H, Romieu I. Effects of antioxidant supplements and nutrients on patients with asthma and allergies. J Allergy Clin Immunol. 2014;133:1237–1244. doi: 10.1016/j.jaci.2014.03.020.
    1. Arora P, Ansari SH, Najmi AK, et al. Investigation of anti-asthmatic potential of dried fruits of Vitis vinifera L. in animal model of bronchial asthma. Allergy Asthma Clin Immunol. 2016;12:42. doi: 10.1186/s13223-016-0145-x.
    1. Anhê FF, Varin TV, Le Barz M, et al. Gut microbiota dysbiosis in obesity-linked metabolic diseases and prebiotic potential of polyphenol-rich extracts. Curr Obes Rep. 2015;4:389–400. doi: 10.1007/s13679-015-0172-9.
    1. Bédard A, Garcia-Aymerich J, Sanchez M, et al. Confirmatory factor analysis compared with principal component analysis to derive dietary patterns: a longitudinal study in adult women. J Nutr. 2015;145:1559–1568. doi: 10.3945/jn.114.204479.
    1. Tanaka T, Takahashi R. Flavonoids and asthma. Nutrients. 2013;5:2128–2143. doi: 10.3390/nu5062128.
    1. Garcia V, Arts IC, Sterne JA, et al. Dietary intake of flavonoids and asthma in adults. Eur Respir J. 2005;26:449–452. doi: 10.1183/09031936.05.00142104.
    1. Knekt P, Kumpulainen J, Jarvinen R, et al. Flavonoid intake and risk of chronic diseases. Am J Clin Nutr. 2002;76:560–568.

Source: PubMed

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