Pediatric asthma: up to 20% of cases are tied to modifiable factors

Takeaway

• Modifiable factors may mitigate risks for asthma and allergic conditions in young children.
• Prospective intervention studies needed.

Why this matters

• Asthma prevalence is rising fastest in countries undergoing “westernization.”
• Few data exist on how multiple lifestyle factors correlate with asthma risk.
• Authors developed Healthy Lifestyle Index (HLI) comprising 5 dichotomized factors: no parental smoking, child’s adherence to Mediterranean diet, child’s healthy BMI, high physical activity, and nonsedentary behavior.

Key results

• Current wheeze, aOR, vs children with 0 or 1 healthy lifestyle factor:
  • 2 factors: 0.93 (95% CI, 0.87-1.01).
  • 3: 0.77 (95% CI, 0.71-0.83).
  • 4 or 5: 0.66 (95% CI, 0.60-0.72).
  • P_trend<.001.
• Significant trends also for asthma ever, current rhinoconjunctivitis symptoms, current eczema symptoms.
• Nonsignificant associations with eczema ever, hay fever ever.
• Risk reductions most prominent in Western Europe, Latin America, and wealthier countries.
• 16%-20% of preventable cases of asthma (ever or current symptoms, respectively) were attributable to adherence to 4-5 lifestyle factors.

Study design

• Multinational cross-sectional questionnaire study of children aged 6-7 years (n=70,795).
• Authors assessed associations between HLI and risks for asthma, rhinoconjunctivitis, eczema.
• Funding: None disclosed.

Limitations

• Causation not established.
• Risks for underreporting, recall, reporting bias.