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

  • Morales E & al.
  • Thorax
  • 21 Mar 2019

  • International Clinical Digest
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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).
    • Ptrend<.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.